NURS FPX 4025 Assessment 3

Name

Capella university

NURS-FPX4025 Research and Evidence-Based Decision Making

Prof. Name

Date

Assessment 3:

Understanding COPD and Smoking Cessation

Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease that severely affects breathing and quality of life. Smoking is the primary risk factor contributing to COPD, and continued smoking accelerates disease progression. Despite the well-documented benefits of smoking cessation, many individuals struggle to quit due to nicotine addiction, psychological stress, and limited access to support systems. COPD remains a significant public health concern in the United States, impacting approximately 16 million adults (Centers for Disease Control and Prevention [CDC], 2024).

Quitting smoking not only slows disease progression but also improves overall lung function and reduces the risk of hospitalizations. However, due to various barriers, many COPD patients find it challenging to quit smoking successfully. This assessment evaluates the effectiveness of structured smoking cessation programs compared to standard counseling in assisting COPD patients in achieving long-term smoking abstinence and improving their lung health over six months.

Diagnosis and Challenges

COPD manifests through persistent symptoms such as chronic coughing, breathlessness, and frequent respiratory infections. If left unmanaged, it can lead to severe complications, including hospitalizations, cardiovascular diseases, and respiratory failure. Smoking cessation remains the most effective intervention for slowing disease progression, yet many patients face challenges such as nicotine dependence, emotional stress, and lack of healthcare access (American Lung Association [ALA], 2024). Socioeconomic factors also play a crucial role, as individuals from low-income backgrounds or those residing in remote areas may struggle to access smoking cessation resources.

Additionally, limited financial means may prevent some patients from affording essential COPD medications, such as inhalers or nicotine replacement therapies. Healthcare providers, particularly nurses, are instrumental in bridging these gaps by educating patients, providing support, and implementing evidence-based smoking cessation strategies (Wang et al., 2024). By addressing these challenges, structured programs can enhance smoking cessation rates and improve disease management.

Research Question and PICO(T) Framework

Understanding the most effective smoking cessation approach for COPD patients requires a structured research question. The PICO(T) framework is a useful tool for formulating a focused research question:

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)?

A breakdown of the PICO(T) components is provided in the table below:

PICO(T) Criteria	Description
Population (P)	Adult patients diagnosed with COPD, for whom smoking cessation is critical for disease management.
Intervention (I)	A structured smoking cessation program incorporating behavioral counseling and pharmacotherapy (e.g., nicotine replacement therapy [NRT], varenicline, or bupropion), which has shown higher success rates than single interventions (Fu et al., 2022).
Comparison (C)	Standard smoking cessation counseling, typically consisting of brief counseling sessions or educational materials.
Outcome (O)	Sustained smoking cessation and improved pulmonary function over six months.
Time (T)	A six-month period, as research indicates that abstinence beyond this timeframe leads to long-term cessation success (Hu et al., 2021).

This research question aims to identify the most effective smoking cessation strategies for COPD patients, providing insights into best practices for disease management and improved patient outcomes.

Evidence and Literature Review

A comprehensive literature review was conducted to gather evidence on smoking cessation programs for COPD patients. Databases such as PubMed, CINAHL, Cochrane Library, and Google Scholar were searched using keywords including “COPD,” “smoking cessation,” “nicotine replacement therapy,” “behavioral counseling,” and “pharmacotherapy.” Boolean operators were used to refine the search, ensuring a focus on studies specifically addressing smoking cessation in COPD patients. The CRAAP criteria (Currency, Relevance, Authority, Accuracy, and Purpose) were applied to assess the credibility of sources. Peer-reviewed articles, systematic reviews, and meta-analyses from reputable organizations such as the CDC and ALA were prioritized.

Three key studies highlight the effectiveness of smoking cessation interventions. Wang et al. (2024) conducted a meta-analysis showing that quitting smoking significantly improved lung function (FEV1% increase of 6.72), walking ability (6-MWT increased by 64.46), and oxygen levels (1.96 higher). Han et al. (2023) found that structured programs incorporating cognitive-behavioral therapy and pharmacotherapy resulted in higher quit rates than standard counseling. Fu et al. (2022) emphasized the importance of using evidence-based practice models, such as the Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model, to enhance smoking cessation interventions. Collectively, these studies support the effectiveness of structured smoking cessation programs in improving patient outcomes.

NURS FPX 4025 Assessment 3

Study	Findings
Wang et al. (2024)	Smoking cessation led to improved lung function (FEV1% increased by 6.72), increased walking ability (6-MWT by 64.46), and higher oxygen levels (1.96 increase).
Han et al. (2023)	A structured smoking cessation program incorporating cognitive-behavioral therapy and pharmacotherapy led to higher quit rates compared to standard counseling.
Fu et al. (2022)	The use of evidence-based practice models, such as JHNEBP, improves smoking cessation outcomes and slows COPD progression.

Conclusion

Smoking cessation is vital for COPD patients as it significantly improves lung health and overall quality of life. Structured smoking cessation programs that include behavioral counseling and pharmacotherapy have demonstrated greater success rates than standard counseling. These programs provide essential support, helping patients overcome barriers to quitting smoking and reducing COPD-related complications. Nurses and healthcare providers play a crucial role in implementing these programs and guiding patients through the cessation process. By adopting evidence-based smoking cessation interventions, healthcare systems can enhance patient outcomes and contribute to the long-term management of COPD.

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