Dietary Approaches to Stop Hypertension
Dietary Approaches to Stop Hypertension
PICOT Question and Literature Research
This assignment needs 3 QUANTITATIVE and 3 QUALITATIVE sources
The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.
For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.
Use the “Literature Evaluation Table” to complete this assignment.
- Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
- Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
- The PICOT question will provide a framework for your capstone project.
- Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.
Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles. Therefore, they should not be included in this assignment.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are not required to submit this assignment to LopesWrite.
Dietary Approaches to Stop Hypertension
PICOT Question and Literature Research
Summary of Clinical Issue (200-250 words):
Hypertension is one of the highest health problems globally because it contributes to increased rates of mortality and morbidity. It is estimated that approximately 56% of coronary artery diseases and 48% of stroke incidences result from hypertension (Chiu et al. 2014). In the US, hypertension affects 29% of the population leading to risks of cardiovascular diseases and stroke. Factors such as poor dietary practices, sedentary lifestyles, and physical inactivity are the primary contributors to hypertension. According to Osté (2010), physical inactivity augments the risk of hypertension 8-9 times. Lifestyle modifications, including exercise and diet changes are the central management and preventive measures against cardiovascular diseases and hypertension (Apovian et al. 2014). Besides, lifestyle modifications increase the efficacy of antihypertensive drug and control of blood pressure. Therefore it is critical to maintaining levels of blood pressure through exercises and dietary changes to prevent damage of vital body organs.
The PICOT question aims to determine whether the DASH and WTW improve blood pressure control among urban African Americans within five months of initiation of the intervention. According to Apovian et al. (2018), enhancing adherence to exercises and the DASH diet is essential to reducing an individual’s blood pressure. However, WTW is an intervention looking to reduce physical inactivity among individuals to help manage cardiovascular diseases and stroke. EBP intervention can be implemented and applied to determine whether they enhance or impede high-quality nursing care. This help to evaluate the outcome of the WTW and DASH on improving the level of patient’s high blood pressure.
PICOT Question:
Does the DASH (Dietary Approaches to Stop Hypertension) and “Worth the Walk” (WTW) improve blood pressure control among urban African Americans within five months of initiation of the intervention?
| Criteria | Article 1 | Article 2 | Article 3 |
| APA-Formatted Article Citation with Permalink | Akita, S., Sacks, F. M., Svetkey, L. P., Conlin, P. R., & Kimura, G. (2003). Effects of the Dietary Approaches to Stop Hypertension (DASH) diet on the pressure-natriuresis relationship. Hypertension, 42(1), 8-13. https://www.ncbi.nlm.nih.gov/pubmed/12756219 | Chiu, S., Bergeron, N., Williams, P. T., Bray, G. A., Sutherland, B., & Krauss, R. M. (2015). Comparison of the DASH (Dietary Approaches to Stop Hypertension) diet and a higher-fat DASH diet on blood pressure and lipids and lipoproteins: A randomized controlled trial–3. The American journal of clinical nutrition, 103(2), 341-347. | Kwon, I., Choi, S., Mittman, B., Bharmal, N., Liu, H., Vickrey, B., Song, S., Araiza, D., McCreath, H., Seeman, T., Oh, S. M., Trejo, L., … Sarkisian, C. (2015). Study protocol of “Worth the Walk”: A randomized controlled trial of a stroke risk reduction walking intervention among racial/ethnic minority older adults with hypertension in senior community centers. BMC Neurology, 15, 91.
https://bmcneurol.biomedcentral.com/articles/10.1186/s12883-015-0346-9 |
| How does the Article Relate to the PICOT Question? |
The article proves whether the (DASH) the diet has a significant blood pressure (BP)-lowering action |
The article analyzes whether the DASH Dietary Approaches to Stop Hypertension is a critical dietary modification for reducing cardiovascular disease and blood pressure (BP) risk. |
The article reflects how physical activity through the Worth the Walk” (WTW) can help prevent stroke by reducing blood pressure. |
| Quantitative, Qualitative(How do you know?) | The article is quantitative because it is based on the collection and analysis of numerical data. | The article is quantitative because it is based on the collection and analysis of numerical data. | The article is quantitative because it is based on the collection and analysis of numerical data. |
| Purpose Statement | The effect of the DASH diet on the pressure-natriuresis relationship to find out the mechanisms of its BP-lowering action. | The effects of substituting full-fat for low-fat dairy foods in the DASH diet, with a corresponding increase in fat and a reduction in sugar intake, on blood pressure and plasma lipids and lipoproteins | The relationship between the Worth the Walk” (WTW) intervention and biological markers of health including blood pressure, non-HDL cholesterol, and body-mass index, |
| Research Question | Does Dietary Approaches to Stop Hypertension (DASH) diet, rich in fruits, vegetables, and low-fat dairy foods, have substantial blood pressure (BP)-lowering action? | Does substituting full-fat for low-fat dairy foods in the DASH diet, with a corresponding increase in fat and a reduction in sugar intake affects blood pressure and plasma lipids and lipoproteins | Does the WTW increase physical activity and improve self-efficacy for being physically active and reducing the risk of stroke. |
| Outcome | The study outcome is to find out whether the DASH diet can lower high blood pressure among patients with hypertension. | The DASH significantly reduces blood pressure, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol in the body. | The WTW intervention will increase physical activity and reduce the risk of stroke |
| Setting
(Where did the study take place?) |
The study was carried out in a hospital setting that is not mentioned n the study.
|
The study was carried out at a clinical research center in Berkeley, California. | The study was carried out at four ethnic-specific clusters at senior centers in Los Angeles. |
| Sample | The study sample 412 participants were expected, but a sample size of n=375 was used in the study. | The study sample involves thirty-six participants who finished all the experimental diets and took part in the study. | The study sample involves a total of 240 participants (60 participants from each of the four targeted ethnic groups). |
| Method | The study employed a parallel-group design. | The study employed a 3-period randomized crossover trial design. | The study employed a single-blind randomized wait-list controlled trial design. |
| Key Findings of the Study | The study showed that the DASH diet reduced BP effectively in groups with high sodium sensitivity. Besides, the DASH diet did not imply blood pressure at low intakes of sodium. | The HF-DASH diet significantly reduced lipoprotein (VLDL) and triglycerides concentrations and significantly increased LDL compared with the DASH diet.
The DASH diet significantly reduced BP, LDL cholesterol, and HDL cholesterol. |
The results showed that the physical activity was improved through the WTW intervention and this, in turn, reduces the risks of stroke. Therefore, WTW intervention reduces hypertension and stroke. |
| Recommendations of the Researcher | It is recommended that the DASH diet is a critical non-pharmacological measure for controlling BP. | It is recommended that the modified HF-DASH diet can be used as an effective alternative to the DASH diet. | It is recommended that the Worth the Walk should function as the primary stroke prevention model stroke patients. |
| Criteria | Article 4 | Article 5 | Article 6 |
| APA-Formatted Article Citation with Permalink |
Apovian, C. M., Murphy, M. C., Cullum-Dugan, D., Lin, P. H., Gilbert, K. M., Coffman, G., … & Moore, T. J. (2010). Validation of a web-based dietary questionnaire designed for the DASH (dietary approaches to stop hypertension) diet: the DASH online questionnaire. Public health nutrition, 13(5), 615-622. |
Osté, M. C., Gomes‐Neto, A. W., Corpeleijn, E., Gans, R. O., de Borst, M. H., van den Berg, E., … & Bakker, S. J. (2018). Dietary Approach to Stop Hypertension (DASH) diet and the risk of renal function decline and all‐cause mortality in renal transplant recipients. American journal of transplantation, 18(10), 2523-2533. |
Staffiliano, A. B., Tangney, C, C., Fogg, L. (2018). Favorable Outcomes Using an eHealth Approach to Promote Physical Activity and Nutrition Among Young African American Women. The Journal of Cardiovascular Nursing. 33, 62–71.
https://www.ncbi.nlm.nih.gov/pubmed/28481823
|
| How Does the Article Relate to the PICOT Question? |
The article looks at the DASH diet its correlation to lowering blood pressure and reduces the risk of heart disease, stroke, and osteoporosis. |
The article addresses the Dietary Approach to Stop Hypertension (DASH) diet.
|
The article analyzes improving healthy nutrition behaviors by including a DASH diet can reduce the risk of hypertension. |
| Quantitative, Qualitative(How do you know?) | The study is qualitative research because it marked by use of online questionnaires, to collect verbal information, perceptions, and understandings of the topic. | The study is qualitative research because it marked by use of online questionnaires, to collect verbal information, perceptions, and understandings of the topic. | The study is qualitative research because it marked by use of Web-based questions that are accessible via the Internet and mobile devices, to collect verbal information, perceptions, and understandings of the topic. |
| Purpose Statement | Assess the validity of a new, short, online dietary questionnaire created to capture DASH food intake. | Dietary Approach to Stop Hypertension (DASH) diet and the risk of renal function decline and all‐cause mortality in renal transplant recipients. | Favorable Outcomes Using an eHealth Approach to encourage Physical Activity and Nutrition Among Young African American Women |
| Research Question | Does the validity of a new, short, online dietary questionnaire capture DASH food intake. | Does the DASH diet lead to a lower risk of renal function? | Does eHealth approach promote physical activity and nutrition among young African American women? |
| Outcome | The DASH OLQ is a critical assessment tool for measuring DASH diet adherence. |
The Dietary Approach to Stop Hypertension (DASH) diet reduces the risk of renal transplant among patients. |
To improve healthy nutrition behaviors to decrease health risk behaviors, and decrease the risk of hypertension based on the DASH diet. |
| Setting
(Where did the study take place?) |
The study was carried out at Boston University Medical Center, Boston, Massachusetts. | The study was carried out in a large single‐center prospective cohort of RTR at the University Medical Center Groningen. | The study was carried out at the University Medical Center |
| Sample | The study sample includes faculty and staff aged 20–70 years at Boston University Medical Center | The study sample includes the 817 invited patients; however, 632 participants were eligible for analyses. | The study sample of 142 participants was expected, but a sample size of 124 was used in the study. |
| Method | The study employed a cross-sectional validation of the DASH OLQ method. | The study employed the observational prospective cohort study, and data were collected through a validated 177‐item food frequency questionnaire. | A randomized, pre-post design Web-based design was used in the study. |
| Key Findings of the Study | The DASH OLQ is a critical assessment tool for measuring DASH diet adherence. The DASH diet lowers blood pressure, cholesterol and the risk of stroke, osteoporosis, and heart disease.
|
The study showed that adherence to a DASH‐style diet is linked with a lower risk of renal function. | The DASH participants showed that eHealth approach could be used for changing health behaviors patients with hypertension. |
| Recommendations of the Researcher | It is recommended that the DASH OLQ is important in assessing the DASH diet adherence in clinical practice. | It is recommended that a randomized clinical trial should be carried out to show whether adherence to the DASH diet risk of renal function. | It is recommended that the eHealth approach is a critical program that can be used for changing health behaviors for other populations at risk. |
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