Research Methods in Health and Social Care Proposal for Literature Review Student ID Number: Does Living a Healthy Life Style Affects The Health Condition Of Individuals With Type 2 Diabetes? : A Proposal for Literature Review Research Proposal Topic What the Effects Of Healthy Life style in people with type 2 diabetes? Table of Contents Abstract 3 Introduction: 3 Methodology 3 Findings and Conclusion: 3 Introduction 4 Aim of Study 4 Objectives 5 Rationale for Choosing This Research Topic 5 Methodology 6 Literature Search 6 Literature Review 7 Keywords 7 Boolean Operators and Truncation 7 Inclusion Criteria 8 Exclusion criteria 8 Data Collection & Search Record 8 Qualitative research 8 Ethical Consideration 9 Critical Appraisal 9 Sampling 9 Data extraction 10 Data Synthesis 10 Chi Square Test 10 Discussion 11 Conclusion 12 References 13 Appendix A 15 Time Frame for the Research Project 15 Appendix B Diabetes Care 16 Appendix C: Data Synthesis 17 Abstract Introduction: Diabetes is a worldwide public health problem with lifelong condition that causes a person's blood sugar level to become too high. In the UK, Type 2 diabetes is far more common than type 1. Over 90% of adults in the UK live with Type 2 diabetes. Research has shown that a healthy life style can be used as an intervention to improve and maintain type 2 diabetes condition. This is a proposal for a review that aims to explore existing literature regarding the impact living a healthy life style can have on the individuals with type 2 diabetes. Also, the preventive effects of living a healthy life style in order to avoid type 2 diabetes will also be analysed. Methodology: In this study, CINAHL. MEDLINE and Pub Med databases will be searched to find current articles and journals using the terms such as diabetes, type 2 diabetes, health education and promotions as well as identification and preventative methods. In order to have to update information on the topic, Boolean operators AND, OR will be combined with the search hypotheses. Sources to be used includes cumulative index of nursing and allied Health Literature (CINAHL), Medical Literature on Line (MEDLINE) and Pub Med. The search terms ‘well-being, health education and diabetes, ‘health education’ and glycaemic control will be used. Together with the Boolean operators ‘AND’,’OR’ to combine the search concepts. Findings and Conclusion: Selected data of studies will be synthesized and analysed in the review to find a correlation between healthy living and any improvement in sufferers of type 2 diabetes. It is noted that an initial search has found a number of themes and hypothesis but an in-depth analysis is needed to support or disagree with the proposal topic. However, the initial search and reviews suggests that there is a considerable evidence that indicates that living a healthy life style improves the condition of some individuals with type2 Diabetes. That said, there are considerable amount of literature and studies that needs to be reviewed and analysed before a final conclusion can be reached. Introduction The purpose of this proposal is to research the impact of healthy lifestyle on the people with suffering from type2 diabetes. Relevant and reputable research evidence will be conducted to find answers to the aims, objectives and the research questions. The primary aim is to be able to answer the question: Does living a healthy life style improves the health condition of people living with Type2 diabetes? According to Creswell (2013), a research proposal is a concise and coherent summary of a proposed research. It sets out the central issues or questions that the researcher intends to address. A literature review will be conducted to finds adequate and sufficient evidence to answers to different component of the research question. A literature review surveys books, scholarly articles, and any other sources relevant to a issue, area of research, or theory, and provides critical evaluation in relation to the research problem being investigated, (Davies et al. 2005). Thus, the communication of research findings provides a valuable opportunity to inform others of a current investigation and it and can lead to development of policies and for further research to be conducted. Diabetes is a serious and chronic disease that occurs either when the pancreas does not produce enough insulin (a hormone that regulates blood sugar, or glucose), or when the body cannot effectively use the insulin it produces. (Global Report on Diabetes). While type 2 diabetes occurs body are unable to produce enough insulin (Parker,2017). Diabetes is a metabolic disorder that affects mainly organs and systems of the body and it can cause serious health complications including heart disease, blindness, kidney failure, and lower-extremity amputations. It a growing concern worldwide and it is fast becoming an epidemic in most countries of in the world with the of people affected expected to double in the next decade due to increase in ageing population, thereby adding to the already existing burden for healthcare providers, especially in poorly developed countries(Parker,2017). Hence, it a global challenge to explore ways to improve the health and social systems to make the most of this demographic shift. Aim of Study The aim of this research is to identify the impact on healthy life style on people with type 2 diabetes using reputable research evidence. Objectives • To identify and promote healthy living among type2 diabetes sufferers. • To review various factors affecting type2 diabetes control. • To determine the preventive effects of healthy life style for people with type2 diabetes condition. Rationale for Choosing This Research Topic As mentioned earlier, Type 2 diabetes affects over 400 million people worldwide, International Diabetes Foundation suggests that by 2040, there will be more than 640 million people with diabetes worldwide. In addition, James (2016) indicated that the prevalence of Type 2 diabetes is expected to double within the next 20 years, due to the increase of the age, obesity and the number of ethnic groups of high risk in the population. According to the data from Public Health England, over 3.8 million people in England aged over 16 suffers from diabetes, which is estimated to be around 9% of the adult population. It financial burden on the UK economy is estimated to be around 10-22 % of the total health expenditure (D0H, 2017). Therefore, it is imperative to undertake a research and be able to evidence if the majority of type2 diabetes cases can be prevented or arbitrated through diet and lifestyle modification. Methodology Methodology simply refers to the approaches used to collect data. However, it is essential to include a consideration of the concepts and theories which underlie the methods(Creswell,2013). Methodology decisions depend on the nature of the research question. Methodology in research can be considered to be the theory of correct scientific decisions(Creswell,2013). James (2016) describe methodology as coherent group of methods that complement one another and that have the ability to fit to deliver data and findings that will reflect the research question and suit the researcher purpose. The following section will look at the search strategies and selection criterion used for this review and the type of studies used. It will then discuss the methodological foundations of the reviewed research. This includes inclusion and exclusion criteria, data and critical analysis and the literature search strategy deployed Literature Search A literature search is an approach used by researcher to search and evaluation of the available literature in the given subject or chosen topic area. It synthesises the information in that literature into a summary and critically analyses the information gathered by identifying gaps in current knowledge; by showing limitations of theories and points of view; and by formulating areas for further research and reviewing areas of controversy (Dougherty, 2009). A literature search will be performed using CINAHL, MEDLINE and Pub Med. The three databases will be used to search for current journals, literature review relevant to the topic because information from these sources are reputable and reliable for nursing research. Parahoo (2006) indicated the use of MEDLINE and CINHAL to conduct a literature search will provide update and adequate information that will enable researchers to find answers to research questions, aims and objectives. According to Macnee and McCabe (2008), Creating effective search strategy is curial in reducing the large amount of literature into concise and manageable information. The use CINAHL databases enable the researcher to have access to most current literature that is relevant to the research project. In addition, the search strategy is useful because it allows identification; in a structured way, of the most suitable information to the subject area (Cronin et al., 2008). In this study, publication used is limited to last 10 years. It is essential to use and up to date information in order to find answers to the aims and objectives of the proposal topic. MEDLINE database was used in order to have access to the most recent research on Type 2 Diabetes and other related information. The search strategy is geared and targeted towards people with Type 2 diabetes, the reasons is to identify way and preventative measure that can be implemented to limit the risk associated with the disease. Overall, MEDLINE and CINAHL literature journals were used for this research because journals and articles are in English language and it would have been expensive and time consuming to translate it. Literature Review A literature review provides methodical summary and critical analysis of research and non-research literature; the purpose of which to assist the reader in understanding the whole research as well as informing the readers about the strengths, limitations and weaknesses within the described studies (De Los Reyes & Kazdin, 2008). This proposal includes a literature review which will provide a valid platform for thoroughly analysing various component of the research question. According to Rhodes (2011), a literature review is a guiding principle or topical focus, based on an account of what has been published on a specific topic. A literature review includes a well written review of a completed and executed study, which is clearly reported and closely related to research problem. The literature review will aim to explore the relationship between two variables, to measure the impact of health education programmes among patients with type2 diabetes. In addition, relevant research articles from Google scholar database are and evidence based nursing will be retrieved for this study Keywords Timmins and McCabe (2005), recommend the use of appropriate keywords to make the search more effective and concise. Keywords include original concept words with their possible synonyms. In this study, the search term like diabtetes, health promotions and education, heathy lifestyle and glycaemic control will be used to conduct searchers on different databases Boolean Operators and Truncation Boolean operators are valuable to increasing and limiting a search, thus, it will be effective to use multiple search terms for a research topic. Draganov (2014) implies that approach communicate with the database that ALL search terms are present in the resulting records. Boolean operators AND, OR and NOT will be used to combine keywords in searching the databases for appropriate literature. “AND” combines keywords for more focused results, “OR” explores the database for any of the keywords used with it and “NOT” limits results by excluding all articles having the specific keyword (Cronin et al., 2008). Inclusion Criteria Inclusion criteria are the characteristics of the prospective subjects or in the case of this review, characteristics of the studies that they must have to be included in the review. For the purpose of this review, the inclusion criteria will apply to locate more feasible articles. Inclusion criteria will include using articles published within 10 years more from different part of the world but only articles published and written in English. Exclusion criteria Articles that are not published in English and over 10 years’ period will not be used for this study. The use Boolean Operators to down the search criteria crucial in identifying the most current research. Data Collection & Search Record In this study, research questions will be broken down in order to identify the researchable keywords. This method will help the researcher to identify and locate relevant articles. On the other hand, PICO framework narrow their searches. PICO framework was used to formulate the research questions in this study, whereby, P symbolises patient or population, I epitomise intervention, C comparison and O outcome of the intervention. Qualitative research Qualitative research is an exploratory research that is employed by researchers to gain an understanding of underlying reasons, opinions, and motivations (Creswell, 2013). In this study, it will help to provide and insights into the problem statement and develop ideas for the hypotheses. The reason the researcher embraced qualitative research approach is become more experienced with the phenomenon under investigation. With qualitative research method, research problems become research questions based on prior research experience and data collection usually involves interview, observation, questionnaires etc. According to Katsirikou and Skiadas (2010), qualitative researcher is essential in health and social care settings because of their emphasis on people lived experience. In this research project, the use of qualitative approach will help to develop hypotheses for further testing and for qualitative questionnaire development. Ethical Consideration Ethical considerations in research are critical. Ethical principles include encouraging Voluntary participation, maintaining confidentiality and anonymity of the participants as well as ensuing that the information collected from individual will not cause them any risks or harm. All research requires ethical approval either from the participants or committee board. The objective is to protect participants from physical or psychological risks (Windle, 2002). However, this study does not require an ethical approval as the research will only use secondary data. Although, the researcher will consider and review the ethical approval in terms of the informed consents provided for participants in the any secondary data used. It will also look into the right of individual to withdraw at any time without any repercussion. Critical Appraisal Critical appraisal is a methodological process of identifying the strengths and weaknesses of a research article in order to assess the usefulness and validity of research findings. It is a vital element of evidence-based medicine (LoBiondo-Wood and Haber, 2014). According to Creswell (2013), the essential components of a critical appraisal are an evaluation of the suitability of the study design for the research question and a careful assessment of the key methodological features of this design. The researcher employed the Use PICO for effective design of research question and Boolean operators to narrow and searches that will be relevant to the study. Critical Appraisal Skills Programme (CASP) will be used to develop an evidence-based approach in this study, it will help researcher to identity the strengths and limitation of the study (Hong and Plugge, 2017). In this study, CASP will help to establish the risk of bias and evaluate the validity and reliability of the study findings. Generally, CASP tools will be used to appraise and summarize the evidence of the impact of healthy life style on Type 2 diabetes patients. Sampling Sampling is a process used in statistical analysis in which a predetermined number of observations are taken from a larger population. The methodology used to sample from a larger population depends on the type of analysis being performed, but may include simple random sampling or systematic sampling. It is mostly used in quantitative research for the purpose of generalisation (Creswell, 2013). For this study, the sampling technique will be to determine the statistical power of the data to confirm its reliability. Data extraction The data collection process follows an accurate systematic gathering of information relevant to a research question or hypothesis of a study (LoBiondo-Wood and Haber, 2014). This is vital in the research process as it allows researchers to identify potential problems and explore possible solutions (Macnee and McCabe, 2008). The instruments that will be used for the data collection is a key aspect in determining the reliability validity of the study results. The instruments used will be scrutinised to determine whether this was the most suitable and reliable source for the study. Data Synthesis Data synthesis begins with descriptive comparisons of the study question, methods and results. It is essential to include summary tables that will present key information relating to population, country, perspective, comparison of intervention or measure of benefits. In this study, the analytical approaches would be compared with robustness discussed, for instance, whether the studies used the same type of modelling technique and the same model structure (Macnee and McCabe, 2008). Chi Square Test It is a statistical method assessing the goodness of fit between a set of observed values and those expected theoretically. In the case of this study, the impact of healthy lifestyle on individual with type2 diabetes will be examined by looking at other factors like culture, social economic factors, gender and genetics (Qian, 2009). Discussion The expected outcome at this stage is to choose a research topic, conduct an effective literature search and an oral presentation plan. It is not expected at this stage to confirm or disapprove the research question or hypothesis. The main focus is to select relevant articles, identify the purpose or rationale for the research and the methodology used in the research study and include references (Cronin et al 2008). Several randomized clinical trials have demonstrated that diabetes is preventable. One of the first diabetes prevention trials was conducted in Daqing, China. Pan et al, (1997) found that after 6 years of active intervention, risk of type 2 diabetes was reduced by 31, 46, and 42% in the diet-only, exercise-only, and diet-plus-exercise groups, respectively, compared with the control group. In a subsequent 14-year follow-up study, the intervention groups were combined and compared with control subjects to assess how long the benefits of lifestyle change can extend beyond the period of active intervention. Many epidemiological studies and randomized clinical trials have suggested that lifestyle interventions, such as diet and exercise, have beneficial effects, especially in high-risk patients with impaired glucose tolerance. (Yang et al, 2010), (Ramachandran et al, 2008). Chu-Chih Chen et all (2017) in their study, investigated the cross-sectional and longitudinal associations between healthy lifestyle (HLF) and DM among middle-aged and elderly participants in the Healthy Aging Longitudinal Study in Taiwan (HALST). Psychosocial health, physical activity, diet, smoking, alcohol consumption, and waist circumference (WC) were considered to be lifestyle factors. Siegel et al (2008) undertook a community based study and found that a lifestyle intervention reduced weight and improved diet and physical activity at 12 months among 50- to 65-year-old participants at high risk of developing type 2 diabetes. Research has shown that diabetes can be prevented by maintaining a healthy body weight, quality diets such as whole grain, fruits and nuts. By avoiding excessive weight gain, engaging in physical activities and avoidance of regular consumption of red and processed meat and refined grains, individual can lower the risk of type2 diabetes. The Department of Health through Public Health England have promoted health education and awareness for people with diabetes. For instance, the NHS Diabetes Prevention Programme offers behavioural interventions to people at high risk of developing Type 2 diabetes (determined via blood glucose levels) largely in the form of group sessions of around 1-2 hours, delivered face-to-face for a minimum of nine months (Fenton, 2017). The objective is to identify those at high risk and refer them into evidence-based behavioural interventions to help them reduce that risk through achieving or maintaining a healthy weight through recommendation of some levels of activity and a healthy, balanced diet Conclusion Type2 diabetes is a global crisis that threatens the health and economy of all nations. It has been suggested that changes in lifestyle are very important in the treatment of diabetes. This research proposal highlighted the prevalence of diabetes and its impact on UK economy health expenditure. It also stresses the importance of living a healthy life style such as engaging physical activities, eating quality and health diet, avoid bad habits such as smoking and drinking, and monitoring the intake of sugary items in managing and treating type 2 diabetes. The proposal also emphasised on the approaches that will be implemented for final literature review. Although, the proposal cannot serve as an answer to the research question. It is essential that further research is conducted in the future that help guide clinical practice in the future. Notwithstanding, the proposal is useful in developing the knowledge of the research process as well as paving the way for further exploration on the subject References Creswell, J. (2013). Research Design. 1st ed. Thousand Oaks: SAGE Publications. Dougherty, M. (2009). Peer Review and the Nursing Literature. Nursing Research, 58(2), p.73. Emdin, C, Khera, A, Natarajan, P, Klarin, D, Zekavat, S, Hsiao, A, & Kathiresan, S 2017, 'Genetic Association of Waist-to-Hip Ratio With Cardiometabolic Traits, Type 2 Diabetes, and Coronary Heart Disease', JAMA: Journal Of The American Medical Association, 317, 6, pp. 626-634, CINAHL. Fenton, K. (2017). A new approach to tackling Type 2 diabetes is a step forward for prevention | Public health matters. [online] Publichealthmatters.blog.gov.uk. Available at: https://publichealthmatters.blog.gov.uk/2016/03/22/a-new-approach-to-tackling-type-2-diabetes-is-a-step-forward-for-prevention/ [Accessed 2 Apr. 2017]. Goedecke, J, Mtintsilana, A, Dlamini, S, & Kengne, A 2017, 'Type 2 diabetes mellitus in African women', Diabetes Research & Clinical Practice, 123, pp. 87-96, CINAHL. Hanefeld, M, Raccah, D, & Monnier, L 2017, 'Individualized, patient-centered use of lixisenatide for the treatment of type 2 diabetes mellitus', Expert Opinion On Drug Metabolism & Toxicology, 13, 3, pp. 311-321, MEDLINE. Hong, B. and Plugge, E. (2017). Critical appraisal skills teaching in UK dental schools. BDJ, 222(3), pp.209-213. Huang, J, Wang, X, & Zhang, Y 2017, 'Specific types of alcoholic beverage consumption and risk of type 2 diabetes: A systematic review and meta-analysis', Journal Of Diabetes Investigation, 8, 1, pp. 56-68, MEDLINE. James, N. (2016). Nursing Research Using Historical Methods: Qualitative Designs and Methods in NursingMary de Chesnay Nursing Research Using Historical Methods: Qualitative Designs and Methods in Nursing 236pp £65.95 Springer 9780826126177 0826126170. Nurse Researcher, 24(2), pp.8-8. Katsirikou, A. and Skiadas, C. (2010). Qualitative and quantitative methods in libraries. 1st ed. Singapore: World Scientific. Li, X, Shen, J, Lu, Z, Chen, M, Fang, X, & Wang, G 2017, 'High neutrophil-to-lymphocyte ratio is associated with increased carotid artery intima-media thickness in type 2 diabetes', Journal Of Diabetes Investigation, 8, 1, pp. 101-107, MEDLINE LoBiondo-Wood, G. and Haber, J. (2014). Nursing Research: Methods and Critical Appraisal for Evidence-Based Practice. Journal of Nursing Regulation, 5(1), p.60. Macnee, C. and McCabe, S. (2008). Understanding nursing research. 1st ed. Philadelphia, PA: Wolters Kluwer Health/Lippincott Williams & Wilkins. Parker, J 2017, 'Approaches to the prevention of type 2 diabetes in Gibraltar', British Journal Of Nursing, 26, 3, pp. 131-137, CINAHL. Rodríguez, J, & Campbell, K 2017, 'Racial and Ethnic Disparities in Prevalence and Care of Patients With Type 2 Diabetes', Clinical Diabetes, 35, 1, pp. 66-70, CINAHL. Schwartz, S, & Zangeneh, F 2016, 'Evidence-based practice use of quick-release bromocriptine across the natural history of type 2 diabetes mellitus', Postgraduate Medicine, 128, 8, pp. 828-838, CINAHL. Singh, J. (2013). Critical appraisal skills programme. Journal of Pharmacology and Pharmacotherapeutics, 4(1), p.76. Stevens, L., Ricketts, E. and Bruneau, J. (2014). Critical Appraisal through a New Lens. Canadian Journal of Nursing Leadership, 27(2), pp.10-13. Theodorou, N. (2013). Qualitative Research in the Health Sciences – Methodologies, Methods and Processes Qualitative Research in the Health Sciences – Methodologies, Methods and Processes. Nursing Standard, 28(3), pp.28-28. Thiel, D, Al Sayah, F, Vallance, J, Johnson, S, & Johnson, J 2017, 'Association between Physical Activity and Health-Related Quality of Life in Adults with Type 2 Diabetes', Canadian Journal Of Diabetes, 41, 1, pp. 58-63, MEDLINE.. Wang, W, He, M, & Huang, W 2016, 'Association of monocyte chemoattractant protein-1 gene 2518A/G polymorphism with diabetic retinopathy in type 2 diabetes mellitus: A meta-analysis', Diabetes Research & Clinical Practice, 120, pp. 40-46, CINAHL. Windle, P. (2002). Ethical considerations in nursing research. Journal of PeriAnesthesia Nursing, 17(1), pp.49-52. Appendix A Time Frame for the Research Project Specification Actual Time Frame Expected Literature search 1 weeks 1 weeks Data selection and Collection 2 weeks 3 weeks Data Analysis 2 weeks 3 weeks Critical Appraisal 2 weeks 2weeks Conclusion and Recommendations 1 week 1 week Appendix B Diabetes Care Source: Mckinson, 2017 Appendix C: Data Synthesis Table Author Theme Population Country Perspective James, N. (2016). Nursing Research Using Historical Methods: Research into Nursing and health and social care United State Provided the importance of qualitative approach LoBiondo-Wood, G. and Haber, J. 2014 Critical Appraisal for Evidence-Based Practice Critical Appraisal using evidence based approach United Kingdom Provided an insight into the critical appraisal in health and social care Theodorou, N. 2013. Qualitative Research in the Health Sciences Qualitative methods and theories Netherlands Theories of qualitative research Parker, J 2017, 'Approaches to the prevention of type 2 diabetes in Gibraltar', British Journal Of Nursing, 26, 3, pp. 131-137, CINAHL. Identification and preventative measures United Kingdom Highlighted the approaches to preventing type 2 diabetes Hanefeld, M, Raccah, D, & Monnier, L 2017, 'Individualized, patient-centred use of lixisenatide for the treatment of type 2 diabetes mellitus', Expert Opinion On Drug Metabolism & Toxicology, 13, 3, pp. 311-321, MEDLINE. Patient Centred Approaches for the treatment of type 2 diabetes United Kingdom Provided an insight on how Patient Centred approach can be employed to treat type 2 patients’ sufferers