Capella FPX 4025 Assessment 3
Student Name
Capella University
NURS-FPX4025 Research and Evidence-Based Decision Making
Prof. Name
Date
Assessment 3
Chronic Obstructive Pulmonary Disease (COPD) is a lung disease that makes breathing hard. Smoking makes it worse, but many patients find it difficult to stop. COPD is one of the top 10 causes of death in the U.S. Around 16 million adults in the U.S. have this disease (Centers for Disease Control and Prevention [CDC], 2024). Stopping smoking can slow the disease and improve health, but some people lack the support to quit. This assessment compares structured smoking cessation programs to standard counseling. It aims to see which method helps COPD patients quit smoking and improve their lung health over six months.
Explaining a Diagnosis
COPD is a lung disease that makes it hard to breathe. It causes coughing, shortness of breath, and lung infections. If not treated well, it can get worse over time. People with COPD may end up in the hospital often. The disease can also lead to heart problems and even breathing failure. The best way to slow down COPD is to stop smoking. But quitting is hard. Many people struggle because they are addicted, stressed, or do not have support (American Lung Association (ALA), 2024). Some people have a tougher time managing COPD. Older adults, low-income people, and those without good healthcare access have more problems dealing with the healthcare issue (Alupo et al., 2024). They usually do not have enough money for medicine or doctor visits.
Without care, their symptoms get worse. They end up in the hospital more often. Some may even die from the disease. For example, if someone lives far from a doctor, they may not get the right treatment. Some people cannot afford inhalers or oxygen. Others do not get enough information about their disease. These problems make lung infections and poor health more likely. Good care can help. Helping people quit smoking and making sure they see a doctor can lower these risks (Wang et al., 2024). Nurses play a big role. They teach patients and help them get the care they need to stay healthy.
Describing a Research Question
People with COPD need to stop smoking to help slow down their disease and feel better. However, quitting smoking is very hard for many people. A clear research question helps find the best ways to solve this problem (Gosak et al., 2024). Using the PICO(T) method, the research question is: In adult patients diagnosed with COPD (P), how does a structured smoking cessation program incorporating behavioral counseling and pharmacotherapy (I) compared to standard smoking cessation counseling (C) affect the smoking cessation rates and pulmonary function (O) within six months (T)?
Breakdown of the PICO(T) Criteria
- Population (P): Adult patients diagnosed with COPD. This population is chosen because COPD is strongly linked to smoking, and cessation is a primary goal in disease management.
- Intervention (I): A structured smoking cessation program incorporating behavioral counseling and pharmacotherapy (e.g., nicotine replacement therapy NRT, varenicline, or bupropion). This intervention aligns with Fu et al., (2022) suggesting that multi-component cessation programs improve quit rates compared to single interventions.
- Comparison (C): Standard smoking cessation counseling may include brief counseling or educational materials provided by healthcare professionals.
- Outcome (O): Sustained smoking cessation rates and improved pulmonary function. Measuring cessation success and lung function over time allows assessment of the intervention’s effectiveness.
- Time (T): The six-month timeframe is selected based on existing research indicating that sustained cessation beyond six months is predictive of a long-term smoking abstinence rate of 27.6% (Hu et al., 2021).
This research question revolves around sticking to quitting smoking COPD care. Some people have a harder time quitting, like those with less money or limited healthcare. This study compares planned programs with regular advice to see which works best for quitting long-term. The results can help nurses use better ways to support quitting, leading to better health and fewer COPD problems.
Literature Search
A thorough search was done to find evidence on ways to help COPD patients stop smoking. The search used multiple academic databases, including PubMed, CINAHL, Cochrane Library, and Google Scholar, to ensure a broad range of high-quality sources. The initial search strategy included keywords such as “COPD,” “smoking cessation,” “nicotine replacement therapy,” “behavioral counseling,” “pharmacotherapy,” and “pulmonary rehabilitation.” Boolean operators (AND, OR) were used to refine the search, ensuring that studies addressed smoking cessation interventions specific to COPD rather than general tobacco cessation programs.
Studies were assessed using the CRAAP criteria (Currency, Relevance, Authority, Accuracy, and Purpose) to determine credibility. Priority was given to peer-reviewed journal articles, systematic reviews, and meta-analyses published within the last five years. Sources from reputable organizations, such as the CDC and the American Lung Association (ALA), were also considered to ensure clinical relevance. The search process was refined by applying filters for full-text availability, English-language publications, and studies focusing on adult patients. Initially, a large volume of general smoking cessation literature was retrieved. Still, by adding specific terms like “COPD patient adherence” and “effectiveness of structured cessation programs,” the results were narrowed to studies directly relevant to the research question. This approach ensured that only the most credible and applicable evidence was selected to inform evidence-based practice in COPD smoking cessation interventions.
Relevant Articles
Three key sources provide strong evidence on smoking cessation interventions for patients with COPD and their impact on disease management. The first source, Wang et al., (2024), presents a meta-analysis on the link between smoking and COPD progression. They looked at 11 studies from 13,460 papers. People who quit smoking had better lung function (FEV1% improved by 6.72, FEV1/FVC by 6.82). They could walk farther (6-MWT increased by 64.46) and had better oxygen levels (1.96 higher). Quitting smoking lowered the risk of death (RR = 0.75). This article is highly credible as it synthesizes data from multiple high-quality studies, reducing bias and increasing generalizability. It is also relevant because it highlights the risk of continued smoking in COPD patients, reinforcing the importance of structured cessation programs.
The second source, Han et al. (2023), examines the effectiveness of structured smoking cessation programs that combine behavioral counseling, pharmacotherapy, and pulmonary rehabilitation. The study found that combining NRT with cognitive-behavioral interventions led to higher quit rates than providing counseling alone. Han et al. (2023) used a randomized controlled trial (RCT), a gold-standard research method that ensures high credibility and reliability. The third source, Fu et al. (2022), discusses implementing evidence-based practice (EBP) models to support smoking cessation in COPD patients.
It highlights how the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model can help integrate structured interventions into clinical settings. The study claims that implementing evidence-based smoking cessation interventions using the JHNEBP model can improve pulmonary function in COPD patients by reducing disease progression and enhancing respiratory health. This study is credible due to its systematic approach and is highly relevant as it directly applies to nursing practice and patient-centered care. The study by Hu et al. (2021) found a 27.6% of abstinence rate in patients who attempted to quit smoking after six months. These sources collectively provide strong evidence-based guidance for improving smoking cessation strategies in COPD patients, enhancing disease management and patient outcomes.
Analyzing Evidence
The evidence strongly supports structured smoking cessation programs with behavioral counseling and pharmacotherapy as more effective than standard smoking cessation advice for COPD patients. Wang et al. (2024) highlight the benefits of quitting smoking, showing significant improvements in lung function (FEV1% and FEV1/FVC), walking distance (6-MWT), and oxygen levels. Additionally, quitting smoking reduces the risk of death, reinforcing the importance of structured interventions. Han et al. (2023) demonstrate that structured programs using nicotine replacement therapy (NRT) and cognitive-behavioral interventions lead to higher quit rates than standard advice alone. Their randomized controlled trial (RCT) findings confirm that structured programs are more effective than minimal guidance in achieving sustained smoking cessation.
Fu et al. (2022) emphasize the role of EBP models, such as the JHNEBP model, in integrating structured smoking cessation interventions into clinical settings. Their study shows that such programs improve pulmonary function and slow disease progression in COPD patients. Together, these studies prove that structured smoking cessation programs result in higher quit rates, improved lung function, and better overall health outcomes within six months. Thus, structured interventions are superior to standard smoking cessation counseling in managing COPD effectively. The findings are relevant to COPD management, providing actionable strategies to improve cessation success rates.
Conclusion
Quitting smoking is very important for people with COPD. A step-by-step program with support and medicine works better than just talking to patients. People who quit have healthier lungs and feel stronger. Nurses and doctors can use these programs to help more patients stop smoking. This can mean fewer hospital visits and a better life for COPD patients.
References
Alupo, P., Baluku, J., Bongomin, F., Siddharthan, T., Katagira, W., Ddungu, A., Hurst, J. R., Boven, van, Worodria, W., & Kirenga, B. J. (2024). Overcoming challenges of managing chronic obstructive pulmonary disease in low- and middle-income countries. Expert Review of Respiratory Medicine. https://doi.org/10.1080/17476348.2024.2398639
American Lung Association (ALA). (2024). Learn about COPD | American Lung Association. Lung.org; American Lung Association. https://www.lung.org/lung-health-diseases/lung-disease-lookup/copd/learn-about-copd
Centers for Disease Control and Prevention (CDC). (2024, June 12). COPD. Chronic Disease Indicators. https://www.cdc.gov/cdi/indicator-definitions/chronic-obstructive-pulmonary-disease.html
Fu, Y., Chapman, E. J., Boland, A. C., & Bennett, M. I. (2022). Evidence-based management approaches for patients with severe chronic obstructive pulmonary disease (COPD): A practice review. Palliative Medicine, 36(5), 770–782. https://doi.org/10.1177/02692163221079697
Capella FPX 4025 Assessment 3
Gosak, L., Štiglic, G., Pruinelli, L., & Vrbnjak, D. (2024). PICOT questions and search strategies formulation: A novel approach using artificial intelligence automation. Journal of Nursing Scholarship. https://doi.org/10.1111/jnu.13036
Han, M. K., Fu, Y., Ji, Q., Duan, X., & Fang, X. (2023). The effectiveness of theory-based smoking cessation interventions in patients with chronic obstructive pulmonary disease: A meta-analysis. BMC Public Health, 23(1). https://doi.org/10.1186/s12889-023-16441-w
Hu, Y., Xie, J., Chang, X., Chen, J., Wang, W., Zhang, L., Zhong, R., Chen, O., Yu, X., & Zou, Y. (2021). Characteristics and predictors of abstinence among smokers of a smoking cessation clinic in Hunan China. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.615817
Wang, Z., Qiu, Y., Ji, X., & Dong, L. (2024). Effects of smoking cessation on individuals with COPD: A systematic review and meta-analysis. Frontiers in Public Health, 12. https://doi.org/10.3389/fpubh.2024.1433269