RESPONSE- BLOG: PEER FEEDBACK: PRACTICE QUESTIONS AND SEARCH STRATEGIES

SG

Sergio Garcia

Jan 20 9:57pm

Reply from Sergio Garcia

Individualized Psychiatric Care at Humboldt Park

In my work near Humboldt Park, I see how differently patients respond depending on whether care is individualized or delivered as a one-size-fits-all routine. When treatment reflects a patient’s real life culture, stressors, supports, and readiness I notice they are more likely to stay engaged in therapy and follow treatment plans. Symptoms often improve when patients feel the care is truly  theirs.

On the other hand, when every patient receives the same medication plan or rigid protocol simply because it meets a standard, progress can stall. Standardization brings structure, but in psychiatric care it can also create distance. Outcomes shift depending on whether patients feel seen as individuals or processed as diagnoses. These observations led me to focus my literature review on individualized versus homogeneous psychiatric care.

Proposed Practice Question

In adult psychiatric patients receiving care in a community mental health setting such as Humboldt Park, how does  individualized, patient-centered psychiatric care compared to homogeneous, standardized treatment approaches affect treatment adherence, patient engagement, symptom management, and overall clinical outcomes?

Proposed Search Strategies

Databases searched: CINAHL, PubMed/MEDLINE, PsycINFO, Cochrane Library

Search terms: Individualized care, patient-centered psychiatric care, standardized treatment, community mental health, treatment adherence, patient engagement, clinical outcomes. Searches were refined using Boolean operators and word boundaries to narrow results to relevant psychiatric and community-based studies.

Inclusion Criteria

· Peer-reviewed articles published within the last 5–7 years

· Adults aged 18 years and older with mental health conditions

· Community or outpatient psychiatric settings

· Outcomes including adherence, engagement, symptom improvement, or patient satisfaction

· Quantitative, qualitative, or mixed-method studies

Exclusion Criteria

· Pediatric-only studies

· Inpatient-only psychiatric units

· Opinion articles without supporting evidence

· Studies focused only on workflow or organizational efficiency

· Articles without full-text availability

Types of Evidence

Pre-appraised evidence: Systematic reviews and meta-analyses examining patient-centered or individualized psychiatric care and related outcomes.

Single studies: Randomized controlled trials and observational studies comparing personalized psychiatric interventions with standard treatment approaches in real-world settings.

Anecdotal evidence: Patient stories, case examples, and my own clinical experience at Humboldt Park, where one-size-fits-all psychiatric care often overlooks cultural and social context that strongly influences engagement and adherence.

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KM

Kasirim Masi

Jan 20 6:26pm

Reply from Kasirim Masi

Population, Intervention, Comparison, Outcome, and Time (PICOT) Question

In adult, incarcerated individuals with chronic medical conditions housed in a county jail (P), how does the implementation of a structured chronic disease management and discharge planning program that includes early medication reconciliation, patient education, insurance navigation, and linkage to low-cost community clinics (I), compared to usual correctional healthcare practices (C), affect continuity of care and chronic disease management outcomes during incarceration and within 30 days post-release (O, T)?

This practice question addresses a well-documented gap in correctional healthcare: insufficient chronic disease identification, treatment continuity, and care transitions for incarcerated individuals with conditions such as hypertension, diabetes, asthma, and serious mental illness accompanied by comorbid medical conditions.

Proposed Search Strategies

Databases

The primary search approach relied on the Walden University Library's multi-database search, which includes CINAHL, MEDLINE/PubMed, PsycINFO, and Academic Search Complete. These databases were chosen to capture interdisciplinary research in nursing, medicine, public health, and correctional health.

Key Search Terms

Search terms combined using Boolean operators and adjusted as needed:

· Chronic disease management

· Correctional health OR jail OR prison

· Medication reconciliation

· Care transitions OR reentry

· Social determinants of health

· Justice-involved/Incarcerated population

These terms were chosen to reflect both clinical processes (chronic disease management, medication reconciliation) and contextual factors (correctional settings, Social Determinants of Health (SDOH), reentry).

Inclusion Criteria

· Peer-reviewed scholarly articles

· Published within the last 5 years

· Adult correctional or justice-involved populations

· Focus on chronic disease management, medication continuity, or care transitions

· U.S.-based studies preferred but international studies considered if findings are transferable

· Quantitative, qualitative, or mixed-methods designs

· Studies addressing SDOH, insurance continuity, or health equity

Exclusion Criteria

· Editorials, opinion pieces, or commentaries without data

· Pediatric-only correctional populations

· Studies focused exclusively on acute care or infectious disease without relevance to chronic disease management

· Non–English language articles

· Articles lacking relevance to incarceration or reentry contexts

Evidence Types Reviewed Pre-Appraised Evidence

· Systematic reviews or evidence syntheses on correctional health transitions, chronic disease management, or justice-involved populations.

· Clinical recommendations or consensus statements about the continuity of care during incarceration and reentry

These sources will provide high-level evidence to support best practices, in line with the John Hopkins Evidence-Based Practice (JHEBP), Evidence Phase (Bissett et al., 2025). Single-Study Evidence

· Observational studies, cohort studies, or quasi-experimental designs to evaluate chronic disease outcomes, medication reconciliation, insurance continuity, or reentry treatments in jails or prisons

Anecdotal Evidence

· Reports from correctional healthcare organizations, program evaluations, or descriptive reports of reintegration interventions are examples of anecdotal evidence.

Although anecdotal evidence ranks lower on the evidentiary hierarchy, it can yield valuable contextual insights into implementation challenges and practical feasibility when rigorously assessed (Bissett et al., 2025). Rationale

This search technique purposely incorporates clinical evidence and public health views, understanding that chronic illness management in correctional facilities is inextricably linked to social determinants of health, such as poverty, insurance interruption, health literacy, and cognitive impairment. The literature review seeks to find translatable, system-level treatments that improve continuity of care during incarceration and reintegration, hence promoting positive social change and health equity (White et al., 2024).

References

Bissett, K., Ascenzi, J., & Whalen, M. (2025).  Johns Hopkins evidence-based practice for nurses and healthcare professionals: Model and guidelines (5th ed.). Sigma Theta Tau International.

White, K. M., Dudley-Brown, S., & Terhaar, M. F. (Eds.). (2024).  Translation of evidence into nursing and healthcare (4th ed.). Springer.

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