Present the components of the theory and discuss how stakeholders are integrated into the design of the theory or model.Assignmen

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Quantitative/Qualitative Summary

Sandra Jayussi

Chamberlain University Comment by Salena Tully: See APA 7th edition page 61 for how to format a title page. The date and class should both be listed.

Comment by Salena Tully: Thank you for submitting your Evidence Synthesis paper. I know this is not the score you hoped for. Some of the sections require more attention. Primary sources of references are needed to support strong objective statements in your analysis section. The synthesis section was a summary of independent studies instead of collective findings supported by two or three of your studies. When working on the synthesis section, please be sure to identify the themes. Sometimes, all three studies are in support, while other times, it may be two of the three. Think one to two paragraphs. Thank you for providing the summary table as an appendix. Some additional work will be necessary before resubmitting in your week seven papers. Thank you for your attention to scholarly writing and excellent APA format. Well done with both!

Quantitative/Qualitative Summary

Diabetes is a significant ailment that affects many individuals globally. It is a chronic ailment that impairs the body's physiological function by interfering with its ability to produce an essential hormone called insulin. As a result, the body fails to break down and absorb sugar adequately; hence its levels in the bloodstream become high. The disease precipitates significant complications in the body of patients. Loss of eyesight is one of the critical complications caused by the condition in the patient's body. According to Kim et al. (2018), diabetic retinopathy is one of the complications that patients with diabetes present with. Subsequently, Wang and Tao (2019) comment that the condition causes maladaptive changes to the choroid and retina of the eye that aggravate as the disease becomes more severe. Further, Moudgil et al. (2021) posit that failing to treat the condition promptly can lead to blindness which is irreversible damage to the eyes of the patients. Comment by Salena Tully: Each statement must be supported with a reference. Comment by Salena Tully: You are off to a solid start. A general statement regarding the sources of evidence (2 quantitative and 1 qualitative) used for synthesis is required and though not required, a purpose of the paper statement to close the introduction will elevate this section.

Analysis of the Practice Problem Comment by Salena Tully: Level one headings should be centered.

Diabetes is a significant health problem because of its complexities in the human body. Studies show that it affects eyesight, an essential physiological function in humanity (Wang & Tao, 2019). Human vision plays significant roles, including allowing individuals to engage in their day-to-day activities such as working, reading, and playing. It also safeguards humanity by helping them to see and avoid dangerous objects. Therefore, impairment or loss of eyesight is a significant deterrent to functionality because it makes individuals from performing their day-to-day activities (Kim et al., 2018). As a result, they rely on others to perform different functions. Also, the condition escalates the financial implications of treating diabetic patients.

Diabetes retinopathy, a severe eye ailment, causes many diabetic patients to have impaired vision or lose their eyesight entirely. According to Wang and Tao (2019), approximately one in every twenty diabetic adults aged over twenty-nine years has the condition in the U. S. Evidence from government databases shows that currently, over 890,000 diabetic patients grapple with different stages of the infection. Additionally, Moudgil et al. (2021) indicate that white people were the most susceptible to the condition, while African Americans were least vulnerable to it. Further. Kim et al. (2018) posit that women were more predisposed to the disease than men. According to statistical evidence, ten percent more females with diabetes contracted the ailment than men. Comment by Salena Tully: The data presented is relevant; however, use of primary sources of evidence are required. You have included a secondary source as the data came from an author who cited the national agency/data. Comment by Salena Tully: Strong section. I have included a couple of links to CDC where you can find reputable data from a well-known agency versus taking the information from the studies you have selected. https://www.cdc.gov/visionhealth/pdf/factsheet.pdf https://www.cdc.gov/visionhealth/projects/economic_studies.htm

Evidence Synthesis

A review of literature that discusses diabetic retinopathy brings to light crucial evidence that shows that it is a significant health concern in diabetic patients that affects the quality of the life they lead. Kim et al. (2018) examined the relationship between the severity of diabetic retinopathy in diabetic patients and the extent of the damage in vital parts of the eyes such as the choroid and retina. The authors deduced that as the eye ailment becomes more advanced, the corresponding damage to the eyes intensifies (Kim et al., 2018). According to the evidence compiled from the study they undertook, patients with a mild form of the ailment had minor changes in their eye structure. At the same time, those in whom the condition was severe had aggravated damages in the eye structure.

Another significant theme that was noted by Wang and Tao (2019) was that maladaptive changes in the eye structure in patients who were yet to be diagnosed with diabetic retinopathy, such as changes in the density of the capillaries in the choroid, was an indication that the affected patients could have condition hence they should be tested. The authors examined the eyes of a group of diabetic patients ranging from those who had not been diagnosed with the disorder to those who had complicated forms of the ailment (Wang & Tao, 2019). The factual data compiled from the patients showed that the condition of the choroid worsened as the infection became more severe. Subsequently, screening undiagnosed patients with mild changes in the choroidal structure showed that they had diabetes.

Wang and Tao (2019) also compiled evidence that proved that diabetic retinopathy caused aggravated damage to the eyes as it became more severe. The study highlighted the significance of physicians examining the eyes of diabetic patients. The information compiled from the survey showed that the examination of the eyes of diabetic patients helped the professionals to determine whether the patients had diabetic retinopathy. As a result, they sent the patient for ophthalmic screening for confirmatory diagnosis (Wang & Tao, 2019). Further, the study showed that healthcare professionals confirmed that the macrovascular changes in patients with severe cases of the condition were more extensive than in those in whom the disease was in a mild stage.

The evidence compiled from the literary analysis highlighted that the changes in ocular structure in diabetes patients with diabetic retinopathy corresponded with the severity of the condition. It showed that patients' eyesight became more damaged when they stayed with the disease for prolonged periods (Moudgil et al., 2021). Therefore, it unearthed the essentiality of early diagnosis of the condition and initiating treatment to prevent the infection of the eyes from deteriorating, hence increasing the risk of the patient becoming blind. This shows that monitoring patients' eyes is an effective practice when caring for patients with diabetes (Moudgi et al., 2021). It helps in the early detection of diabetic retinopathy and initiation of treatment, a process that helps in reducing the chances of the patients' eyesight being impaired or losing their vision. Comment by Salena Tully: This section includes a summary of independent studies or an annotated bibliography. A true synthesis will address the themes common to all included studies, intertwining the collective findings. In most cases, two or more studies will be referenced to support each of the main themes. Synthesis is a challenging skill but with continued practice, it will become second nature. For the week seven paper, I recommend going back into Module 5 and reviewing the “Explore” section. The course navigator does an excellent job showcasing two syntheses and describing the components that make the pieces a synthesis.

Appraisal of the Evidence

The article named Quantitative analysis of retinol and choroidal microvascular changes in patients with diabetes is a quantitative study that addressed explores a medical challenge faced by diabetic patients. It utilizes single research to compile good quality, level II evidence. The quality of the evidence is classified as good because it uses effective procedures for undertaking a research study, such as manipulating an independent variable, including a control group to prove the validity of the compiled evidence, and using effective methods of selecting participants (Kin et al., 2018). Subsequently, it clearly explains the processes used while carrying out the study, such as the method used during the process, the strategies used to compile data, and how it was analyzed to make conclusive assertions about the research question. However, its main shortcoming is that it does not explain the limitations experienced during the study. Nevertheless, the evidence compiled from the study is reliable and can be applied in the clinical setting to provide evidence-based care. Comment by Salena Tully: Please avoid including study titles in the main paper. It’s best to include the author(s) for reference. For example: Using a quantitative methodology, Crabtree et al. (2016) ….” Please apply this guidance to all portions of the main paper that include study titles.

The article named Choroidal structural changes correlate with severity of diabetic retinopathy in diabetes Mellitus is also a quantitative study that provides good quality level III evidence. The single research investigative study analyzed the choroidal changes in a group of selected participants to determine the changes that occurred in the structure of their eyes as the condition became more severe. The evidence compiled from the study was of good quality because effective strategies were used in the study, such as providing clear explanations of the objectives that the study aimed to fulfill and incorporating an adequate number of participants (Wang & Tao, 2019). The strategies used to collect and analyze data are also explained well. Therefore, it is possible to replicate the experiment to determine whether the evidence compiled from the study is accurate. Further, it also explains the limitations encountered during the research and the steps taken to overcome them. Therefore, the evidence gathered from the study is reliable and applicable in providing quality care to diabetic patients.

The article named Quantitative analysis of retinol and choroidal microvascular

Changes in patients with diabetes is a qualitative study that provides adequate evidence that answers the research question. It contains good quality, level II evidence applicable in the clinical setting. The evidence compiled from the study can be classified as good evidence because it clearly states what the investigative study aimed to achieve and the process it used to achieve it (Moudgil et al., 2021). Subsequently, it explains why it chooses the approaches to accomplish its purpose, outlines the outcomes unearthed from the study, and discusses their implications in the clinical settings. Further, the study is undertaken by experts in the medical field. However, the study's primary shortcoming is that it does not document quotes from the respondents in the study to support its claims. Still, it contains significant evidence that can be applied in the clinical setting to provide quality, evidence-based care to the patients. Comment by Salena Tully: One qualitative study was required. I am only seeing that quantitative methods were used. You will need to replace one of the studies included with a qualitative source. You did a great job appraising however.

Conclusion

Diabetes is a significant health issue that is prevalent in contemporary society. It is a chronic ailment that causes patients to develop a wide range of complications that lower their quality of life. Diabetic retinopathy is one of the typical complexities in diabetic patients. Diabetic retinopathy is an eye ailment that causes maladaptive changes in the retina and choroid of patients. Evidence compiled from the literature shows that the structural changes in the eyes of the patients intensified as the ailment became more severe. Therefore, it highlights the need for early detection of the condition to avoid impairment of the sight diabetic patients. Additionally, it provides evidence that helps healthcare professionals conceptualize the approach they can use to detect the ailment promptly. It also brings to light the need for regular screening of patients for early detection of the condition and prompt initialization of the treatment process. Comment by Salena Tully: Concise close. In addition, I recommend addressing the overall appraisal of the collective findings given it was a required section expanded upon in the paper.

References

Kim, M., Choi, S. Y., & Park, Y. H. (2018). Quantitative analysis of retinal and choroidal microvascular changes in patients with diabetes. Scientific Reports, 8(1), 1-8.

Moudgil, T., Bains, B. K., Bandhu, S., & Kanda, N. (2021). Preferred practice pattern of physicians regarding diabetic retinopathy in diabetes mellitus patients. Indian journal of ophthalmology, 69(11), 3139.

Wang, H., & Tao, Y. (2019). Choroidal structural changes correlate with severity of diabetic retinopathy in diabetes mellitus. BMC ophthalmology, 19(1), 1-9. Comment by Salena Tully: Excellent APA!

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Appendix A

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2

Project Change in Healthcare

Name

Institutional Affiliation

Professor

Date

The stakeholders in a health care setting include patients, policymakers, patient providers, and pharmacists' ancillary service providers and medicine. The team of interprofessional primary stakeholders that must be anticipated during a project change must include the team of professionals in any health care setting to ensure that quality is offered to patients and that institutions get profit to enable them to expand their service provision. Therefore, patients are the major key stakeholders that must be incorporated whenever a change is anticipated in a healthcare setting. The role of patients is to help in regard of learning the healthcare system and such that donors of personal clinical data among other beneficiaries acknowledge the importance of patience since they are the key responsibility of any health care unit (Wu et al,2019) The other stakeholder in a healthcare set up is of patient providers who play a major role in the direction of healthcare towards support in funding activities and offering of solutions in cases where projects emerge and others have to be changed to meet the current role of healthcare and ensure the quality of care.

The other stakeholders in a healthcare setting who can easily be associated with project change plans are physicians, employers, insurance companies, and the rest of pharmaceutical firms. Therefore, while implementing future change in projects, then these stakeholders act as professional teams who will ensure that expectations are met in a timely and concise manner while ensuring quality is topnotch in the event of meeting patient needs and boosting the reputation of the organization. However, challenges exist in the execution of a project change while interacting with the primary stakeholders. This is because steps must be followed in anticipating project change such as impacting healthcare providers to use newer and better forms of care based on recent extensive research in that the entire organization must be prepared for change, a vision, and a plan must be crafted to reflect the change, changes then executed while embedding the culture of the health care setting.

The common challenges faced in a healthcare setting include the type of systems to be used, complex science base, technological advancements, and workforce shortages. Therefore, in the vent of meeting quality standards and preparing the nursing team for changes such as that of new drugs introduced by the U.S Food and Administration which has recently approved the use of Farxiga for heart disease to treat adults and a reduced ejection to mitigate cardiovascular deaths and hospitalizations among adults (Taylor et al,2019). Therefore, the common barriers that can be experienced among stakeholders in healthcare such as dealing with patients and informing them on the new methods of treatment they should opt for are tasking. This is because patients might be rigid in decisions that concern their health; therefore, much effort is needed to convince them otherwise which limits the project change and scope within the organization.

Additionally, the other issue that might arise from pharmacists' ancillary service providers is the changes that might come with different changes in medication. This might result in different delivery of medications, counseling, and offer to patients such that ineffective communication between hospitals and their service providers might impact in failure in project change towards incorporating better health services and care. Policymakers can still make the process of project change in healthcare difficult by complicating the processes and documents is needed to acquire certification to offer certain health services (Mazlan et al,2020). Typically, evidence has shown the lack of healthcare professionals in familiarizing with the latest research evidence, however, incentives might help in motivating them towards en

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