Nursing problem in the clinical area

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.


Research Question
The role played by dietary carbohydrate in maintaining a healthy weight (BMI <25) in
subjects who have a genetic history or predisposition to obesity (BMI >30)?

PICOT Study 2
P-Population: The research will include adults age 30 to 50 years with a family history of
obesity. Additionally, the population will consist of both males and females diagnosed as being
obese and those with a healthy weight, with both groups consuming carbohydrates regularly.
Patients with no family history of obesity will be excluded.
I-Intervention: Patients randomized as having BMI above 30 with normal or significantly high
consumption levels of carbohydrates will, with a family history of obesity, will be put on diets
made up of low carbs, high in proteins, healthy fats vegetables and fruits for 6 to 12 weeks. Also,
their weights will be monitored regularly to determine any weight changes.
C-Comparison: patients struggling with obesity but have no family history obesity will be used
as the active control. They will also be subjected to similar dietary changes as the selected group;
this enables to evaluate the primary effects of minimized/low intake of carbohydrates.
O-Outcome: continuous recording (charts, graphs) of weight and calculating BMI changes.
T- time: the weight changes will measure weekly then cumulatively interpreted every 12 weeks.
Literature search
The rising numbers of overweight cases and obesity incidences hold a significant
problem to chronic illnesses prevention and management globally (WHO. 2015). Driven by
financial development, industrialization, automation, urbanization, physical inactivity, and an
overall drastic change in nutritional standards influenced by fast-foods, which are high in
unhealthy fats and carbohydrates, has led to a myriad of nations and populations to be
particularly vulnerable to obesity with those that have a family history of obesity is at higher risk

PICOT Study 3
(Fleming. 2014). Understanding the link between genetic and dietary predisposition is still a
multiplex, multifactorial, and partly a preventable condition through lifestyle adjustments (Li.
2015). If current lifestyle patterns stand, it is estimated that 38% of global adult numbers will be
overweight; subsequently, 20% will be diagnosed with obesity (Hu. 2016). Presently America’s
scientific projections based on current trends, the majority of adults above age 40 years could go
up to 85% (Wang. 2018). Also, those with a family history of obesity and of low-socioeconomic
status will be at a higher risk of obesity (Stevens . 2015).


Hu, F. (2016). Obesity epidemiology. Oxford University Press.

PICOT Study 4
Li, S., Zhao, J. H., Jian’an Luan, U. E., Luben, R. N., Khaw, K. T., Wareham, N. J., &
Loos, R. J. (2015). Physical activity attenuates the genetic predisposition to obesity in 20,000
men and women from EPIC-Norfolk prospective population study. PLoS medicine, 7(8).
Ng, M., Fleming, T., Robinson, M., Thomson, B., Graetz, N., Margono, C., & Abraham,
J. P. (2014). Global, regional, and national prevalence of overweight and obesity in children and
adults during 1980–2013: a systematic analysis for the Global Burden of Disease Study 2013.
The Lancet, 384(9945), 766-781.
Stevens, G. A., Singh, G. M., Lu, Y., Danaei, G., Lin, J. K., Finucane, M. M., &
Paciorek, C. J. (2014). National, regional, and global trends in adult overweight and obesity
prevalences. Population health metrics, 10(1), 22.
Wang, Y., Beydoun, M. A., Liang, L., Caballero, B., & Kumanyika, S. K. (2018). Will all
Americans become overweight or obese? Estimating the progression and cost of the US obesity
epidemic. Obesity, 16(10), 2323-2330.
World Health Organization. (2015). Obesity: preventing and managing the global
epidemic (No. 894). World Health Organization.