NURS FPX 4025 Assessment 3

Name

Capella university

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Assessment 3

Chronic Obstructive Pulmonary Disease (COPD) is a debilitating lung disease that impairs breathing and is worsened by smoking. Although smoking exacerbates the condition, quitting is a challenging process for many patients. COPD remains one of the leading causes of death in the United States, with approximately 16 million adults affected (Centers for Disease Control and Prevention [CDC], 2024). While stopping smoking can slow disease progression and improve overall health, many individuals face significant barriers, such as addiction, stress, or lack of support, that make quitting difficult. This assessment compares the effectiveness of structured smoking cessation programs versus standard counseling for COPD patients. The objective is to evaluate which method more effectively supports smoking cessation and improves lung health over a six-month period.

Explaining a Diagnosis

COPD is a progressive lung disease characterized by symptoms such as chronic coughing, shortness of breath, and frequent lung infections. If not properly managed, the disease can worsen over time, leading to frequent hospitalizations, heart problems, and respiratory failure. The primary strategy to slow COPD progression is smoking cessation, but quitting is often a difficult challenge. Many individuals struggle due to nicotine addiction, stress, or lack of support (American Lung Association [ALA], 2024). Furthermore, certain populations, such as older adults, low-income individuals, and those without sufficient access to healthcare, may experience more significant difficulties in managing COPD (Alupo et al., 2024). These groups often lack financial resources for medications and doctor visits, which contributes to worsening symptoms and higher hospitalization rates. For instance, individuals living in remote areas may lack access to healthcare, resulting in inadequate treatment. Additionally, the inability to afford medications like inhalers or oxygen, or lack of proper education about their condition, increases the risk of complications. Addressing these barriers through smoking cessation programs and regular healthcare visits can significantly reduce these risks (Wang et al., 2024). Nurses play an essential role in educating patients and ensuring they receive the necessary care for better health outcomes.

Describing a Research Question

The need for smoking cessation in COPD patients is critical for slowing disease progression and improving quality of life. However, many individuals face significant challenges in quitting smoking. Developing a focused research question is essential to identify the most effective approaches to overcome these challenges (Gosak et al., 2024). Using the PICO(T) framework, 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), impact smoking cessation rates and pulmonary function (O) within six months (T)?

Breakdown of the PICO(T) Criteria

PICO(T) Criteria	Description
Population (P)	Adult patients diagnosed with COPD. This group is targeted because smoking is a primary cause of COPD, and cessation is a key intervention for managing the disease.
Intervention (I)	A structured smoking cessation program, which includes behavioral counseling and pharmacotherapy (e.g., nicotine replacement therapy (NRT), varenicline, or bupropion). This multi-component intervention is supported by evidence showing higher success rates compared to single interventions (Fu et al., 2022).
Comparison (C)	Standard smoking cessation counseling, typically consisting of brief counseling sessions or educational materials provided by healthcare professionals.
Outcome (O)	The key outcomes are sustained smoking cessation and improved pulmonary function, which will be assessed over a six-month period.
Time (T)	The six-month timeframe is selected based on research showing that sustained cessation beyond this period correlates with long-term smoking abstinence (Hu et al., 2021).

This research question aims to explore the effectiveness of structured cessation programs in aiding COPD patients to quit smoking and improve lung health. The study will assess the relative impact of these programs compared to standard counseling, offering insights into best practices for COPD care and improving patient outcomes.

Literature Search

A comprehensive literature search was conducted to identify evidence on smoking cessation interventions for COPD patients. Various academic databases, such as PubMed, CINAHL, Cochrane Library, and Google Scholar, were used to ensure a wide range of high-quality sources. The search focused on keywords like “COPD,” “smoking cessation,” “nicotine replacement therapy,” “behavioral counseling,” “pharmacotherapy,” and “pulmonary rehabilitation.” Boolean operators (AND, OR) helped narrow the search to studies specifically addressing smoking cessation in COPD rather than general tobacco cessation.

The search results were filtered using the CRAAP criteria (Currency, Relevance, Authority, Accuracy, and Purpose) to assess the credibility of the sources. Peer-reviewed articles, systematic reviews, and meta-analyses from reputable organizations such as the CDC and the ALA were prioritized. The search strategy was refined by including specific terms like “COPD patient adherence” and “effectiveness of structured cessation programs,” which resulted in studies directly relevant to the research question. This systematic approach ensured that only the most reliable and applicable evidence was included for informing evidence-based practice in COPD smoking cessation.

Relevant Articles

Three key sources provide strong evidence regarding smoking cessation interventions for COPD patients. Wang et al. (2024) conducted a meta-analysis on the relationship between smoking and COPD progression. Their findings indicated that individuals who quit smoking showed significant improvements in lung function (FEV1% improved by 6.72), walking ability (6-MWT increased by 64.46), and oxygen levels (1.96 higher). Moreover, quitting smoking reduced the risk of death (RR = 0.75), reinforcing the importance of structured cessation programs.

Han et al. (2023) examined the effectiveness of structured smoking cessation programs that integrate behavioral counseling, pharmacotherapy, and pulmonary rehabilitation. Their randomized controlled trial (RCT) revealed that combining NRT with cognitive-behavioral interventions led to higher quit rates compared to standard counseling. Lastly, Fu et al. (2022) discussed how evidence-based practice models, such as the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, can support the implementation of structured smoking cessation interventions in clinical settings. Their study found that these interventions improved pulmonary function and slowed COPD progression. These sources collectively provide compelling evidence supporting the effectiveness of structured smoking cessation programs for COPD patients.

Analyzing Evidence

The evidence strongly supports the use of structured smoking cessation programs involving behavioral counseling and pharmacotherapy, as opposed to standard smoking cessation counseling. Wang et al. (2024) found that smoking cessation led to substantial improvements in lung function, walking distance, and oxygen levels. Additionally, quitting smoking reduced the risk of mortality, underscoring the critical role of structured interventions in COPD management. Han et al. (2023) showed that combining NRT and cognitive-behavioral interventions resulted in higher quit rates than standard advice alone. Fu et al. (2022) emphasized the importance of integrating evidence-based practices in clinical settings to improve smoking cessation outcomes. The collective findings confirm that structured programs lead to higher cessation rates, improved pulmonary function, and better health outcomes, making them superior to standard counseling in managing COPD.

Conclusion

Quitting smoking is essential for individuals with COPD, as it helps slow disease progression and improves lung health. Structured smoking cessation programs, which offer both support and pharmacotherapy, have proven to be more effective than standard counseling. These programs lead to better long-term health outcomes, including improved lung function and reduced hospitalizations. Nurses and healthcare providers can use these programs to help patients quit smoking, improving their quality of life and reducing the burden of COPD.

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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

NURS FPX 4025 Assessment 3

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

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