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Prompt: IRB is an important step in the research process. State the required components one should look for in a project to determine if IRB submission is needed. Discuss an example of a research study in one of your literature review articles that needed IRB approval, and describe why IRB approval was needed in this instance. Previous assignment that needs to be referenced for this discussion is attached.Use at least 2 scholarly resources. Cite in APA 7. No plagarism, No AI.
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Intervention for Proposed Clinical Change
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Intervention for Proposed Clinical Change
The Issue Under Study
In this research project paper, Tai Chi is presented as an alternative pain-relieving
physical activity among older adults suffering from chronic Rheumatoid Arthritis (RA). In order
to address the shortcomings in conventional pharmaceutical interventions, which are
accompanied by adverse effects and skyrocketing costs, this project will adopt nonpharmacological methods like Tai Chi. Such may make the general health provision cheaper and
the grounds on which patients may be well taken care of (Sánchez-Flórez et al., 2022). The study
provides evidence that, just as with elderly patients, physical exercises meet the requirements
and limitations inherent to the general approach to RA treatment. Acts of such kind may decrease
discomfort and increase the level of mental comfort one enjoys in life. The effect of tai chi
exercise on pain and physical function in patients with rheumatoid arthritis is supported by
evidence. According to Smolen et al. (2020), a more extensive treatment plan should be
organized for geriatric patients with RA in addition to conventional therapy.
The paper has numerous major purposes, such as investigating the adequacy of Tai Chi
for pain management and good health. The paper highlights the value of a qualitative data
collection method, such as thorough in-depth interviews and focus groups for understanding
pain, pain experience, and functional limitations associated with this technique. This paper
studies the community benefits of adopting a cheap, available pain relief system and
modification in medical problems addressing unbearable lifestyles under general pain
management (Mudano et al. 2019). Additionally, to establish the requirement of budgeting and
financial analysis for any program of such nature, one should understand it to consider economic
necessities like training expenses and equipment purchases. This project, therefore, offers a basis
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for the inclusion of alternative interventions in the usual care of RA, recognizing its limitations
and noting that quality studies are necessary in order to ensure better pain relief among elderly
patients with RA.
Solutions Or Interventions
This literature review suggests that several solutions and interventions can be
recommended to incorporate alternate physical activities, especially Tai Chi, into the pain control
management of aged RA patients. Such interventions aim to improve patient’s health, decrease
reliance on drugs, and foster a better livelihood. One possible solution is to create specialized Tai
Chi programs for elderly persons with RA, considering their physical limitations and unique
requirements. Therefore, Tai Chi and rheumatology specialists should design these programs to
avoid exposing senior patients to any risks with uncontrolled or unmonitored practices. The
exercises should include non-strenuous activities to enhance flexibility, balance, and muscle
tone.
The second approach involves the training of instructors. Such training should comprise
the knowledge of the disease, limitations in these patients, and possibilities to adjust Tai Chi
exercises. As such, it is a high-quality training that must be under healthcare professionals.
Thirdly, the collaboration with healthcare providers. It will involve partnering with
rheumatologists, physiotherapists, and other healthcare providers to determine the inclusion of
Tai Chi in the general RA patients’ management scheme. This will ease full patient management,
which includes medical therapy and physical exercise.
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The fourth solution is to run awareness programs on Tai Chi therapy for patients and
health practitioners. Such campaigns could involve organizing workshops, developing
informational brochures, and presenting in healthcare contexts to increase awareness of the use
and benefits of Tai Chi. Another potential solution is to undertake research to determine whether
Tai Chi can be prescribed as a substitute for pain treatment initiated by RA among the elderly.
The impact of qualitative quality tools on chronic pain intensity, physical functionality,
psychosocial issues, and quality of life should be assessed through a quantitative approach to
evaluate the studies.
Other Views on The Problem and Solutions
This paper suggests a non-pharmacological intervention of Tai Chi to control RA pain in
elderly patients. However, the literature offers differing opinions on the issue of RA pain
management and strategies for solving it. Although Tai Chi is emphasized for its low-impact,
gentle movements that favor RA patients, certain studies also recommend yoga, Pilates, and aqua
therapy. For example, Tai Chi and similar alternatives may enhance flexibility, strength, and
general mental health, among other benefits that may be preferred over traditional forms
(Mudano et al., 2019). For example, yoga focuses on breath control and meditation, which can
contribute to stress reduction even more.
However, this paper highlights non-pharmacological approaches in opposition to some
researchers and physicians who have emphasized traditional medical interventions as the key
role in the management of RA. They include disease-modifying antirheumatic drugs (DMARDs),
biologics, and corticosteroids (Hanly & Lethbridge, 2021). Proponents of this perception think
that while alternative treatments can be supplemental, they should not substitute medical
interventions known to inhibit disease progression and protect the joints. As the literature
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indicates, a broader concept calls for a combination of pharmacological and nonpharmacological treatments. The model argues for an individualized treatment strategy
comprising medication, physical activity, and lifestyle changes, a patient-centered approach
where the patients have some input in planning for their treatment.
Other studies favor digital solutions and telemedicine as pain management technologies
in the advanced technological arena. These include wearables for monitoring physical activity,
telerehabilitation, and self-management mobile applications for exercise adherence. The
supporters of this notion suggest that technology can enhance patients’ involvement, immediate
feedback, and greater accessibility, especially to people with mobility issues. Other researchers
highlight mind-body techniques such as mindfulness, meditation, cognitive-behavioral therapy
(CBT), and formal practices. According to Sánchez-Flórez et al. (2022), these efforts address the
psychological components of chronic pain and RA life, such as stress, anxiety, and depression
related to the condition.
In addition, numerous pieces of literature emphasize the significance of patient education
and self-management in relieving pain for RA. In this regard, patients are taught about their
disorder, treatment choices, and how to deal with different symptoms. As such, the literature
offers various viewpoints, from traditional medicine perspective to whole-person care practices.
These consist of technological interventions, mind-body therapies, and patient education that will
help in the management of RA pain in geriatric patients. Such diversity of perceptions highlights
the heterogeneity of pain-management programs and advocates for an individualized patientcentered strategy that considers every patient’s specific needs, preferences, and circumstances.
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The APRN’s Role in The Intervention
Advanced practice registered nurses have diverse and integral roles in the provision of
interventions such as Tai Chi for the management of RA pain in their elderly population. These
interventions can only be led by APRNs because they possess the skills of a great clinician,
operate in holistic caring modes, and can function independently. The latter regards their role and
has many clinical consequences. The first role is assessing and developing a person-centered
pain care plan. According to Urbanowicz (2019), APRNs are mainly responsible for checking a
patient’s physical capabilities, level of pain, and general health. Such assessment allows them to
adapt to specific patient requirements, making these interventions secure and advantageous, like
Tai Chi. When planning care, APRNs can make care plans unique to each patient, ready to
combine alternative therapies with traditional RA treatments by incorporating comorbidities,
physical limitations, and patient preferences.
The second responsibility is that of educating and counseling. Education is also the
cornerstone of APRN practice. APRNs should offer education on the utility, health, and care to
be taken when undergoing Tai Chi for RA, including Tai Chi in the self-management of patients
with the disease. They can also aid APRNs in providing teaching regarding lifestyle
modifications, pain relief mechanisms, and self-care maneuvers so that patients are educated and
can participate in the management of the disorder (Urbanowicz, 2019). Thirdly, APRNs
encourage the connection and continuum of care. APRNs are usually the primary care providers
in the healthcare sector. In this role, they collaborate with other health care practitioners such as
rheumatologists, physiotherapists, and Tai Chi trainers to offer an integrated interdisciplinary
approach to taking care of patients. It would not be possible to include non-pharmacological
interventions in the patient’s treatment plan without this collaboration.
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The fourth role entails monitoring and follow-up. Evaluating the effectiveness of Tai Chi
for pain is an ongoing monitoring and follow-up. The treatment plan should be adjusted in these
cases, and APRNs should periodically assess the dynamics of pain, physical functioning, and
quality of life. Continuous appraisal enables the early identification of issues or difficulties
concerning patient safety and treatment outcomes. The fifth role is as a researcher and evidencebased practitioner. They take part in the studies to develop their research and keep up-to-date
with the latest evidence when implementing Tai Chi interventions. This input makes the care
provided more meaningful and furthers the body of knowledge regarding RA management.
In addition, APRNs do act as advocates and policy developers. It is, therefore, their role
to act as advocates for patients and change policies regarding care. They could enhance the
availability of alternative therapies such as Tai Chi during RA management, ensure insurance
coverage, and develop integrative pain management guidelines and policies.
Implications for Clinical Practice
Some of the implications of integrating Tai Chi and other such interventions in the
control of RA pain led by APRNs were identified in clinical practice. It enhances patient
outcomes. The involvement of APRNs in holistic, patient-centered care may alleviate physical
and psychological outcomes for elderly RA patients. It also increases accessibility. Especially in
community settings or via telehealth services, APRNs can enhance alternative therapy
accessibility. Tai Chi will advance holistic care. Their participation encourages an integrative
perspective to healthcare, incorporating conventional medicine with alternative treatments.
Third, APRNs educate patients, including self-management support, and this empowers the
patients and enhances patient engagement and self-efficacy. This comprises several important
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implications; as it is, the change project concerns the inclusion of Tai Chi as an alternative
physical activity for elderly persons to control rheumatoid arthritis pain.
The Implications of the Change Project
It is reported that there is a global prevalence of about 18 million people living with
rheumatoid arthritis (Karp et al., 2023). This is an autoimmune disease, accompanied by constant
inflammation and destruction of headlands, more spread among women and increasing with the
age. Offering Tai Chi as a simultaneous rehabilitation program for older people having RA may
lead to significant betterment of the status of one’s health. Such non-pharmacological
interventions might reduce pain intensity, increase mobility, and bring back joint function. In
addition, such patients benefit from positive effects on mental health by lowering stress and
improving mood, which eventually increases their quality of life. As the project mitigates
dependence on costly pharmaceutical-based interventions with health implications, this may
ultimately lower the overall healthcare costs.
This project is a step towards comprehensive treatment of chronic diseases, for instance,
RA. This supports introducing wellness treatment in physical, mental, and emotional health
regimens, moving away from medicine only. Through this project, patients become active
participants in managing their conditions. If a user appreciates Tai Chi, it gives them a sense of
control over their health, enabling them to develop self-efficacy that is essential in the control of
chronic diseases. To make this project operational, a lot has to be done by way of educating the
patients, healthcare personnel, and even the community to fill in knowledge gaps. This type of
education will ease the adoption of Tai Chi and knowledge regarding other alternative methods
in Pain impairment that could affect their attitude toward controlling chronic diseases. This
project presents new directions for exploring how different therapies, such as Tai Chi, can treat
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chronic conditions. Evidence-building is also necessary to validate and improve these
interventions, thus contributing to evidence-based practice in health care.
Conclusion
The integration of Tai Chi with elderly rheumatoid arthritis pain management as a
proposed clinical change is an improvement on the inadequacies of traditional avenues and
embraces holistic non-pharmacological intervention. This initiative is a demand for patientcentered care that can reduce the costs of medical treatment and contribute to physical and
psychological health. In this intervention, Advanced Practice Registered Nurses (APRNs) have
significant roles in patient assessment, education, monitoring, and collaboration. This concept,
therefore, advances the idea of holistic RA management that demonstrates alternative therapies
in improving the quality of life in elderly patients.
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References
Hanks, R. G., Eloi, H., & Stafford, L. (2019). Understanding how advanced practice registered
nurses function as patient advocates. In Nursing Forum (Vol. 54, No. 2, pp. 213-219).
https://doi.org/10.1111/nuf.12319.
Hanly, J. G., & Lethbridge, L. (2021). Use of disease-modifying antirheumatic drugs, biologics,
and corticosteroids in older patients with rheumatoid arthritis over 20 years. The Journal
of Rheumatology, 48(7), 977-984. https://doi.org/10.3899/jrheum.200310.
Karp, N., Yazdany, J., & Schmajuk, G. (2023). Peer Support in Rheumatic Diseases: A
Narrative Literature Review. Patient Preference and Adherence, 2433-2449.
https://doi.org/10.2147/PPA.S391396.
Mudano, A. S., Tugwell, P., Wells, G. A., & Singh, J. A. (2019). Tai Chi for rheumatoid
arthritis. The Cochrane Library. https://doi.org/10.1002/14651858.cd004849.pub2.
Sánchez-Flórez, J. C., Seija-Butnaru, D., Valero, E. G., Acosta, C. D. P. A., & Amaya, S. (2022).
Pain Management Strategies in Rheumatoid Arthritis: A Narrative Review. Journal of
Pain & Palliative Care Pharmacotherapy, 35(4), 291-299.
https://doi.org/10.1080/15360288.2021.1973647.
Smolen, J. S., Landewé, R. B., Bijlsma, J. W., Burmester, G. R., Dougados, M., Kerschbaumer,
A., & Van Der Heijde, D. (2020). EULAR Recommendations for Managing Rheumatoid
Arthritis with Synthetic and Biological Disease-Modifying Antirheumatic Drugs: 2019
Update. Annals of the Rheumatic Diseases, 79(6), 685-699.
https://doi.org/10.1136/annrheumdis-2019-216655.
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Urbanowicz, J. (2019). APRN transition to practice: Program development tips. The Nurse
Practitioner, 44(12), 50-55. https://doi.org/10.1097/01.NPR.0000605520.88939.d1.
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