Summary of Area of Interest
The past decade has witnessed an upsurge in the number of older adults in the USA as it is the case in many western economies. The escalation in the number of adults necessitates knowledge about these individuals’ life situation including the general quality of life. Increase in age is associated with increased risk of various chronic diseases including rheumatoid arthritis (RA) and osteoarthritis (OA) both of which are associated with proliferation in pain and a general decrease in quality of life. RA and OA often start at 40 years and by age 75 more than 86 percent of the total population have either clinical or radiographic evidence of OA (Munyanga et al., 2014). OA and RA may appear separately or together and often affect connective tissues and joints, therefore, limiting physical function and mobility. Since the symptoms in both diseases are similar and the only difference is appearance and intensity, studying both illnesses in regards to pain is not only realistic but more effective. Undeniably, the physical changes associated with RA and OA, the concept of pain, the decrease in quality of life and statistical evidence of the ever-increasing number of older adults in the USA warranty research in RA and OA and techniques of reducing pain and increasing quality of life.
Since both OA and RA have no cure, treatment interventions are focused on symptom management that includes standard medical therapy such as non-steroidal anti-inflammatory drugs and acetaminophen in some cases. However, the drugs are associated with common side effects such as stomach upsets (Zou, 2017). Studies report that acupuncture is useful in the treatment and management of pain in various conditions including chronic lower back pain and fibromyalgia (Ringdahl & Pandit, 2011). Its popularity is due to its analgesic effects, lower costs and the belief that it is a safe non-pharmacological intervention. However, despite the worldwide application of acupuncture, inferences from previous research on the ability of acupuncture to reduce and relieve pain in OA and RA patients remains uncertain mainly due to various limitations in the past surveys. Since nurses have a solemn duty to facilitate comfort and ensure the most effective care for all the patients, research on the effectiveness of acupuncture in pain reduction collaborates their sworn oath as medical professionals.
The paper intends to develop a PICOT question that relates to the application of acupuncture in pain management among older adults with rheumatoid arthritis and osteoarthritis in addition to describing every PICOT element in the research question. Moreover, the article identifies the key words and provide rationale for the words selected.
Five Questions
- What are the most effective pain management techniques in older adults with osteoarthritis and rheumatoid arthritis during flare-ups?
- What are some of the standard measurements of quality of life and pain among older adults with rheumatoid arthritis and osteoarthritis?
- Is standard medical therapy useful in the management of pain in adults with rheumatoid arthritis and osteoarthritis during flare-ups?
- Does treatment with acupuncture decrease the amount of pain in adult patients with rheumatoid arthritis and osteoarthritis as compared to standard medical therapy?
- Does treatment with acupuncture decrease the amount of pain in adult patients with rheumatoid arthritis and osteoarthritis during flare-ups as compared to standard medical therapy?
Each of the above questions focuses on pain management and the quality of life among older adults with rheumatoid arthritis and osteoarthritis. However, the attention to detail differs in each case; for instance, the first question has several answers from medical therapy to physical therapy to acupuncture all of which can be used in pain management. The last question illustrates the researchers’ intention to compare acupuncture and medical treatment in pain management, particularly during flare-ups. A well-formulated research question often requires specificity and preciseness in the identification of the different variables and population of interest to the research in efforts of effectively using available resources (Aslam & Emmanuel, 2010). Therefore, the fifth question was selected because it is more specific, it is less costly in terms of research resources such as research staff as compared to the other four questions. However, the researcher intends to either consider including or excluding the phrase “during flare-ups” depending on the data collected from the field during the pilot study. The term has worked to reduce the study area, but it might have narrowed the research to the point of over-specification. Therefore, it is pending clarification.
PICOT Question
Does treatment with acupuncture decrease the amount of pain in older adults with rheumatoid arthritis and/or osteoarthritis during flare-ups as compared to standard medical therapy?
Population or Patient (P)
Focuses on addressing a specific population, the important attributes of the population including the demographics and the issue that affects this particular population (Aslam & Emmanuel, 2010). For instance in the above PICOT question “P” is “In older adults with rheumatoid arthritis and/or osteoarthritis.
Intervention (I)
The intervention can be a treatment of interest or a procedure or prognostic factors associated with the issue under investigation. For instance, in the above research question “I” is “does treatment with acupuncture.”
Comparison (C)
It involves comparing two treatment options or procedures. In the above case “c” is “as compared to standard medical therapy.”
Outcome (O)
Describes the effect of the intervention. For instance in the above research question “o” is “decrease the amount of pain.”
Timeframe (T)
It describes the timeframe associated with the described intervention and is usually linked to the outcome. In the above research question “T” is “during flare-ups.”
Therefore, does treatment with acupuncture (I) decrease the amount of pain (O) in older adults with rheumatoid arthritis and/or osteoarthritis (P) during flare-ups (T) as compared to standard medical therapy (C)?
Key Words
Acupuncture, rheumatoid arthritis, osteoarthritis, standard medical therapy, pain, quality of life, flare-ups in arthritis, older adults, functional mobility, arthritis.
Each of the above words is vital in the literature search on the effectiveness of acupuncture on the two types of arthritis compared to the standard medical procedure. The above words illustrate that the research is grounded in healthcare and nursing particularly, they showcase the study is under functional mobility associated with arthritis. They also indicate the research issue which is, the management of pain and improvement of the quality of life in older adults (Cannon & Boswell, 2010). Each word is vital in the development of the theoretical and conceptual framework of the research in addition to contributing to the conclusion of the study through data from empirical literature.
References
Aslam, S., & Emmanuel, P. (2010). Formulating a researchable question: A critical step for facilitating good clinical research. Indian Journal of Sexually Transmitted Diseases and AIDS, 31(1), 47-50.
Cannon, S., & Boswell, C. (2010). Connection between research and evidence-based practice. Jones and Bartlett Publishers.
Munyanga, T., Froese, M., Zarychanski, R., Abou-Setta, A., Friesen, C., Tennenhouse, M., & Shay, B. L. (2014). Pain management with osteoarthritis: A systematic review and meta-analysis. BMC Complementary and Alternative Medicine.
Ringdahl, E., & Pandit, S. (2011). Treatment of knee osteoarthritis. American Family Physician, 1287-1292.
Zou, S. (2017). Five balances in the management of rheumatoid arthritis. Journal of Biosciences and Medicine, 5, 10-21.
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