Evidence-Based Practice and Applied Nursing Research

Evidence-Based Practice and Applied Nursing Research

Quantitative Research

“Are Patients Satisfied with Telehealth in Homecare? A Quantitative Research Study in Congestive Heart Patients” is a quantitative researched article based on telehealth and homecare. The study is intended to determine whether patients are satisfied with the use of telehealth in healthcare. Patients suffering from congestive heart diseases are in constant need of care, and telehealth is one of the tools used to ease the burden. With the aid of telehealth, visiting nurses and caregivers can provide quality care and education to patients. Therefore, the study is meant to understand the perception of patients towards the use of telehealth and to facilitate changes to improve telehealth facilities. The results of the study are intended to promote changes in health behaviors towards the management of chronic diseases.

The research uses several previous studies to support the purpose of the study. The research by DelliFraine and Dansky had been used to support the investigation. The two researchers conducted a study from 2001-2007 and concluded that telehealth positively affected clinical outcomes. Since the previous research proves that telehealth improves healthcare, this research seeks to see the perception of patients and improve in services offered by telehealth.

The results were examined using the Analysis of Covariance (ANCOVA). The data collected was analyzed to find out whether patients preferred telehealth home health services or usual home care. All questionnaires had similar questions, and they were administered to patients with heart failure.

The research used a descriptive, quasi-experimental research design to collect data. Data used for the study was collected using questionnaires. The participants were patients with congestive heart conditions who were between the ages of 55-99, and they voluntarily filled research questionnaires. The data collected was used to compare between telehealth home health services and usual home health care.

The evidence presented in the introductory part of the journal article supports the outcome of the study and the implication of future research. The report begins by introducing a previous survey which was conducted to establish the effectiveness of telehealth. After it was confirmed that telehealth improved the quality of healthcare services, this study was conducted to determine the perception of patients towards telehealth. From the data analysis, it is evident that many patients are satisfied with telehealth because it is reliable as well as cost-efficient. The study leaves a knowledge gap where further research can be conducted to determine the perception of caregivers towards telehealth.

The journal article protects human subjects during data collection and analysis. The participants consented to participate in the study by sending a consent letter. Furthermore, all the information was given by patients as confidential and used strictly for the survey. The study, however, did not have cultural considerations. The self-report demographic questions only covered age, gender, prior home health services, and living alone. The questionnaire was meant for any home patient suffering from congestive heart disorder, regardless of their cultural background.

The strength of the study was the ability to cover patients diagnosed with heart failure. Ideally, patients with heart failure require close supervision by healthcare providers. The congestive heart condition is associated with a high rate of re-hospitalization, which translates to high-cost care. Therefore, a study to determine the perception of patients towards telehealth will influence patients and caregivers to utilize telehealth services. Through telehealth, patients adapt self-care and management practices, which reduce the cost of re-hospitalization. The study can also be applied in other chronic conditions where patients can utilize telehealth and improve their health.

The limitation of the study was that the descriptive quasi-experimental design inhibited the ability to generalize the findings to a larger population. The sampling did not also consider children suffering from heart conditions. Pediatric caregivers, therefore, cannot apply this study because of the age difference. Also, the experimental design did not support a cause-effect relationship for the findings. Telehealth would be improved significantly if there was a causal-effect relationship in the study.

The evidence in the introductory part of the article serves to inform current nursing practices. Nurses are primary caregivers, and many patients rely on nurses to hasten the recovery process. One of the major problems facing the nursing profession today is the shortage of nursing staff, which results in understaffing. Heart conditions are associated with a high rate of re-admission, which increases the workload for nurses. As more patients with heart conditions get re-hospitalized, nurses have to work extra shifts to attend to the needs of all patients. Telehealth reduces the rate of re-hospitalization because healthcare providers use technology to monitor the progress of home patients. Also, patients can learn self-care and self-management, which reduces the rate of re-hospitalization. Implementing telehealth minimizes the workload for many patients. Therefore, nurses will be motivated to work in environments where they are not forced to work longer shifts than their regular working hours.

Qualitative Research

“Procedural pain in children: a qualitative study of caregiver experiences and information needs” is a qualitative research article based on pain management in children. The study intended to gather information on how caregivers of children in emergency departments managed pain and distress in children. Management of pediatric pain in children is a priority in the health sector because children experience many painful procedures when in hospital care. Also, some younger children do not understand how to communicate effectively, which gives caregivers a hard time in managing pain. Simple processes like intravenous infusion procedures can get prolonged and complicated when pediatric pain is not appropriately handled. Some caregivers become anxious when administering procedures such as IV to children, which in turn increases the child’s perceived pain. Thus, the article is centered on determining how caregivers managed pediatric pain in the emergency department and develop a novel that would serve as a caregiver focused knowledge translation tool.

The research uses several previous studies about pediatric pain to support the purpose of the study by finding a knowledge gap. One of the literature used is by Kennedy, Luhmann, and Zemspky on the implications of unmanaged needle-insertion pain and distress in children. Needle insertion is an inevitable medical procedure, especially in the emergency department. Therefore, the study by Kennedy et al. shows the importance of managing pain in children during medical procedures. Another article referred to in the research is by Smith et al. The article is about caregivers’ responses to pain in their children in the emergency department. The reaction of a caregiver to pain can impact on a child’s perception of pain. Therefore, there is a need to understand how caregivers manage pain in children and help other caregivers implement effective pain management methods.

Data collected in the study was analyzed using a thematic analysis. Thematic analysis is mostly applied to qualitative data where researchers generate themes from interview data. As mentioned earlier, data collected in the study would be used to create a caregiver-focused translation tool. Therefore, the data gathered needed to be analyzed thematically to produce a useful translation tool.

The study adopted a qualitative descriptive design. Data used in the study was collected using direct interviews. Caregivers of children who had performed intravenous (IV) insertion or venipuncture in the pediatric emergency department at an urban tertiary care center were the ones interviewed. The data collected was later analyzed using a thematic analysis.

The evidence presented in the introductory part of the journal article supports the outcome of the study and the implication of future research. The report begins by mentioning the importance of pediatric pain management. When caregivers cannot understand how to manage pain in a child, the recovery process takes longer. Some caregivers have perfected their knowledge of pain management in children, whereas other caregivers struggle to understand children. Therefore, there is a need to share knowledge and ensure all caregivers can effectively manage pain in children and hasten the recovery process. The study gives room for future research where research can be conducted to determine the effectiveness of a caregiver-focused translation tool.

The journal article protects human subjects during data collection and analysis. All the caregivers who participated in the study were volunteers who were approached by a physician or a nurse. The caregivers were approached by physicians or nurses to ensure they felt comfortable. Also, the caregivers who participated in the study were offered a ten dollar gift as a sign of gratitude. Therefore, the study ensured all people who participated felt comfortable and appreciated.

The strength of the study was relying on the Translating Emergency Knowledge for Kids (TREKK)  Parent Advisory Group to guide the study. In relying on TREKK, the study was able to determine the efficiency of the TREKK tool. The limitation of the study was the limitation of experienced caregivers. Thus, it is unclear whether new caregivers can apply the knowledge translation tool when managing pain in children.

The article informs current nursing practices by evaluating how caregivers manage pain in children. Caregivers are in the best position to share knowledge on how to manage pain in children since they interact with children longer than physicians. Furthermore, effective pain management ensures a speedy recovery. The article ensures that caregivers share knowledge on pain management and improve the existing interventions.

References

Metzger LM. (2017). Are Patients Satisfied with Telehealth in Home Health Care? A Quantitative Research Study in Congestive Heart Failure Patients. SM Gerontol Geriatr Res. 1(2): 1009.

Shave, K., Ali, S., Scott, S. D., & Hartling, L. (2018). Procedural pain in children: a qualitative study of caregiver experiences and information needs. BMC pediatrics, 18(1), 324.