Reply to the discussions. One page each with at least 2 sources from journal paper only

Post 1

PICOT Question:

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In patients with hypertension (P), does practicing stress management techniques (I) compared to no management of stress (C) decrease blood pressures (O) over a 6-month period (T)?

Team Members:

Team members will include the voluntarily participating subjects, five registered nurses, and the medical director,

Step One: Stakeholder

The primary stakeholders of this study are the participants with hypertension experiencing stress. Additional stakeholders include myself, nurses, and medical director involved in the research study.

Step Two: Potential Barriers

One potential barrier to this study is that the subjects in the control group may be reluctant or noncompliant with the provided stress management techniques as well as the willingness to decrease or fully discontinue previously prescribed medications. Another potential barrier is that some subjects may not accurately monitor their blood pressures with the correct techniques and equipment.

Step Three: Tools and Instruments for Measuring Changes:

Each subject will be provided with the same blood pressure monitors and instructed on specific times of the day to monitor their blood pressures (Unyte, 2017). Each participate will be provided with a heart rate variability (HRV) monitor by Unyte to monitor the health of their physiological state such as heart rate, skin temperature, blood pressure, muscular tension, and brain waves. The HRV monitor will be used to test the adaptability between each subject’s sympathetic and parasympathetic nervous system during times of heightened stress and states of rest and digest (Unyte, 2017). Additionally, each participant will be asked to complete the Perceived Stress Scale (PSS) prior to the start of the study, midway through the study, and upon completion of the study. The PSS is a questionnaire used to measure each individual self-reported stress level through assessment of their feelings and thoughts over the past month (Manzar et al., 2019).

Post 2

PICOT Question: In patients with postpartum depression (P), does a community based screening and support system strategy (I) compared to individual’s personal strategies (C) reduce the severity of the effects of postpartum depression (O) in six months (T)?

Step One: Identifying Stakeholder

The primary stakeholders who will be involved will be pregnant women experiencing postpartum depression. Health care providers to be involved will include nurses, doctors, and pharmacists. Psychologists will play a key role in the diagnosis of postpartum depression and provision of psychological assistance to the pregnant women. Additionally, the spouses to the pregnant women, family members, and community members will be involved. The health care professionals will be crucial in the formulation of intervention strategies.

Step Two: Identifying Potential Barriers

A major barrier to the project will be adherence to the interventions implemented. Depression causes a state of inactivity in some cases making it hard to get through to a patient (Masmoudi, 2017,). In addition to this, mood swings and other psychological effects could reduce the effectiveness of the intervention since some participants may withdraw or choose not to participate on some days. This could potentially affect the results of the study. Another barrier may be time constraints because the support system need to commit a certain amount of time to care for the pregnant women.

Step Three: Identifying Tools to Measure Change

The tool used in assessing postpartum depression is the Edinburg Postnatal Depression Scale (EPDS). The tool is easy to use since it is a 10 question screening tool (Field, 2017). The questions are specific to pregnant women and thoroughly assess the potentiality of postpartum depression in pregnant women. Psychologists will be consulted during filling of the questionnaire and their professional opinion of the individual participants will be sought.

First Month

Research question formulation and analysis of available data

Identifying and recruiting stakeholders

Assessment of participants and signing of consent forms

Second Month

Collection of baseline and demographic data

Involvement of spouses and support group

Commencement of intervention

Third Month

Assessment of adherence levels

Collection of preliminary data

Documentation of progress

Fourth Month

Addressing challenges

Therapy sessions ongoing

Medical checkup of fetus

Fifth Month

Assessment of barriers

Individualized meetings with participants

Medical checkup of mother

Sixth Month

Data collection and analysis

Documentation of data

Report writing and dissemination of findings.

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