ResearchPrinciple for Nursing Project
a)Focus of the study
Heartfailure is an abnormality of cardiac structure that leads to lack ofproper oxygen delivery by the heart and also, the heart is unable topump blood as expected. A heart failure progresses with time as aresult of the heart`s pumping action growing weaker. Heart failurecan affect one side of the heart or both, but mostly it affects both. Left-side heart failure ensues when the heart fails to pump adequateblood rich in oxygen to all body parts. Right-side heart failurefollows if the heart is unable to pump sufficient blood to the lungsto get oxygen. It can be difficult to determine the diagnosis ofheart failure since its symptoms are non-discriminating. Heartfailure condition occurs to both children and adults. The symptoms ofheart failure differ, some people may experience breathlessness andfatigue while others have fluids building up in their legs, abdomen,and ankles. Individuals who suffer from heart failure experiencebreathlessness and limited physical activity. Additionally, there isno known cure for heart failure. Nevertheless, treatments such aslifestyle changes and medicines can assist in prolonging the lifespan of people with the heart condition (Taylor, Sagar, Davies, Dala,Lough & Rees, 2014).
b)Significance of the study
Thestudy carried out was to determine whether there was a differencebetween heart failure patients who followed a self-management manualon their own and those who got assistance from a nurse specialist.Since most patients know little about their condition and itsmanagement, heart failure nurses have found it important to enlightenpatients about the importance of keeping fit, consuming a healthydiet and understanding symptoms so that they can seek medicalattention. Moreover, the goal of treating heart failure patients isto improve their survival, to relieve symptoms and to preventhospital admission. In the past, the concentration was on patients`mortality, but currently, the concentration is on preventinghospitalization since it is relevant to both healthcare systems andpatients. This change is due to the increase in patients with chronicdiseases who have to face tremendous financial and clinical impact.The Heart Failure Association published some recommendationspatients should engage in aerobic exercise as it improves functionalcapacity. Further, it encourages patients to enroll in aself-management program to decrease the risk of hospitalization.Also, the Institute of Medicine named self-management as the priorityfor healthcare in the United States (Coulter, Ryan, Shepperd &Perera, 2015).
a)Aim of the research
Theresearched aimed at finding out if there was any difference betweenheart failure patients who followed a self-management plan on theirown and those who got assistance from a nurse specialist.
Theexperimental design was the type of research design used. It is theexperimental design because the objective was determined and theprocess of the study was selected. In the research, there were someindependent factors such as different operators or machines. Forinstance, there were patients with nurse specialists, and there werepatients without them. Additionally, an experimental design must havecontrol this means there must be a control group. In the research,the control group consisted of people above 18 years and sufferingfrom LVSD heart failure, people who could read English and who coulddecide about their care.
c)Was the research design appropriate?
Thoseeligible for participation got randomized by a computer those whowould follow the self-management plan with the help of a nurse andthose who would follow it without a nurse. The experimental designwas appropriate since it would give factual findings it leaves noroom for biasedness` (Cockayne, Pattenden, Worthy, Richardson &Lewin, 2014).
Thestudy participants were people over the age of 18, individuals whowere able to read English and who were suffering from LVSD heartfailure and who had been randomized by computer.
b)Inclusion and exclusion criteria
Anyonefound to have a record of cognitive deficits in that they could notgive their consent about participating in the research, they couldnot read English, they lived in a nursing home, and had alife-threatening condition, was exempted from the study. A writtendocument was given to potential participants, for them to go throughit and if they decided to participate in the study, they would givetheir consent in writing (Cockayne etal.,2014).
c)Importance of identifying criteria before recruitment
Itis an essential requirement to have criteria in place for choosingthe participants because it ensures there are equality and nosystematic differences among the parties. Needless to say, itguarantees that only individuals with the required characteristicsparticipate in attaining factual findings.
Afterthe potential participants had come up, random sampling took placeit happened by choosing the participants randomly by the help of acomputer. Random sampling works well in large sample populations, andsince this research needed many participants, it was the bestsampling method to use.
e)Was the sampling technique appropriate?
Randomsampling avoids bias, and in such studies, non-biased findings areessential. It is important to note that, experimental research designaims at delivering accurate results. Accuracy got achieved throughthe use of random sampling since it is not biased. Therefore, it wasappropriate to use random sampling in the experimental researchdesign both are known to be accurate (Taylor etal., 2014).
f)Intervention and control group
Thestudy got carried out between two parties one party comprised ofpatients who undertook the self-management plan with the help of anurse this is the group referred to as the intervention group. Then,the other party comprised of patients who undertook theself-management plan on their own this group was known as thecontrol group.
g)Allocation into the groups
Patientsgot placed randomly into each cluster through the use of a computerthrough a safe telephone randomization service.
h)Was the allocation appropriate?
Theallocation was appropriate since no one chose the group in which tobe assigned. For instance, if the patients were asked to choose whichteam they want to fall under, they would have wasted much time, andone group may have had fewer participants resulting in substandardfindings. The allocation was fair, and it would help in providingreliable results (Cockayne etal.,2014).
a)Independent and dependent variables
Inan experiment, there are two types of variables they are thedependent and independent variable. In the research, people want toknow if the patients undergoing a self-management plan with the helpof a nurse and those undergoing the same plan without a nurse haveany difference in that if one is likely to get admitted or not. Theindependent variable here is the type of self-management programwith the nurse or without. The outcome, being the patients` responseto the self-management types is the dependent variable (Coulter etal.,2015).
b)Data collection method
Thedata collection method used is known as the focus group. The datacollection involved analyzing the outcome of patients in their groupof allocation. For instance, the number of the sick admitted from thegroup of self-management with the help of a nurse would be noteddown, alongside the number of patients coming to the hospital fromthe group of self-management without a nurse. This side to sidecomparison made it possible to note any difference in the outcome.Additionally, a logistic regression method was also applied.
c)Appropriateness of data collection method
Thedata collection process is likely to have given reliable results. Theside to side comparison leaves little room for inaccuracy (Cockayneetal.,2014).
d)Reliability and validity
Reliabilityrefers to the production of stable and consistent results by anassessment tool. Validity relates to the authenticity of theresearch.
e)Demonstration of reliability and validity
Inthe study conducted, the results may be valid and reliable becausethe methods used in the research are effective and the outcomes areafter thorough research meaning they are reliable (Coulter etal.,2015).
Thedata analysis put into use is quantitative analysis. Data analyseswere carried out using two-sided significance tests having a fivepercent significance level. The primary analysis of whether anyparticipant was admitted or re-admitted within the stated period of12 months got compared between the two treatment groups. Insituations where patients did not complete the 12 months, yet theywere recorded in the assessment, they got listed under the admissioncategory. On the other hand, patients with no hospital admissiondetails from the nurse were said to have had no admission. Further,two analyses got carried out the first put in comparison the twotreatment groups by use of analysis of covariance for each time pointand adjusting the significant baseline value.
b)Appropriateness of data analysis
Themethod of analysis used was appropriate since it comprised severalvariances such as age, NYHA class and there were random interceptsthat had to undergo consideration.
c)Differences between the intervention and the control groups
Afterthe analysis, there were notable differences in levels of depressionbetween the intervention group and control group, with theintervention group showing higher levels. Also, patients who had thehelp of the nurse recorded a slight reduction in hospital readmissioncompared to the patients without a nurse.
d)Significance of the results
Nevertheless,the difference between the intervention group and control group wasso small in that it held no statistical significance.
e)Did other settings affect the results?
Thestudy had initially been intended to be among patients with theself-management plan manual and those without the manual however,the manual was made available to all before undertaking the trial.The study design was amended to assess the clinical efficiency of theself-management plan between the one with the nurse and the onewithout (Cockayne etal.,2014).
Iwould recommend that the findings from the study to be implemented inclinical practice. The reason being, the study found no evidence of areduction in re-admission to hospitals among the patients whofollowed the self-management plan with the help of the nurse. Sincethere is no difference, I would recommend that patients carry out theplan on their own as this would also contribute to reducing theirfinancial cost (Taylor etal.,2014).
Cockayne,S., Pattenden, J., Worthy, G., Richardson, G., Lewin, R. (2014).Nursing Facilitated Selt-management support for People with HeartFailure and their Family Cares (SEMAPHFOR): a randomized controlledtrial. International Journal of Nursing Studies.
Coulter,A., Entwistle, V.A., Ryan, S., Shepperd, S., Perera, R. (2015).Personalized Care Planning for Adults With Chronic or Long-termHealth Conditions. Cochrane Database Syst Rev. 2015 Mar 3( 3):CD010523. Epub 2015 Mar 3.
Taylor,R.S., Sagar, V.A., Davies, E.J., Briscoe, S., Dala, H., Lough, F.,Rees, K., Singh, S. (2014). Exercise-based Rehabilitation for Heartfailure. Cochrane Database Syst Rev. 2014 Apr 27 ( 4): CD003331.Epub 2014 Apr 27.