Research Critical Analysis

Research Critical Analysis

Articles Reviewed

1. Taylor, F et al., “Improving clinical skills to support the emotional and psychological well-being of patients with end-stage renal disease: a qualitative evaluation of two interventions. Clinical Kidney Journal, 9(3), 516-524. (2016)
2. 2. Lai, B et al.“). Neurological, psychological, and cognitive disorders in patients with chronic kidney disease on conservative and replacement therapy. ” 95(48). (2016).
3. Cukor, D et al., “Psychosocial intervention improves depression, quality of life, and fluid adherence in hemodialysis. Journal of the American Society of Nephrology”, 25(1), 196-206. (2014)
4. Ibrahim, I et al., “The role of personality and social support in health-related quality of life in chronic kidney disease patients. PloS One”, 10(7). 32-47. (2015).

Background of the Studies

I reviewed a total of four articles, that is, two qualitative and two quantitative. The extensive studies outlined in all the reports have a broader goal of pinpointing that all illnesses often influence both the patient and family in a variety of ways. For the patients, it has been proved that they mostly tend to succumb to mental problems and psychosocial issues. These researches formulate measures useful in eradicating the negative impacts of the disease.

Taylor et al. start by talking about the effects of kidney failure. The major problem identified by this study is that the medical condition is associated with emotional and mental instability in the patients. For this reason, the study, therefore, aims at determining the usefulness of the measures already set in place to address the emotional and mental instabilities in patients. The researchers decided to collect data from the primary source via direct interviews. This methodology employed is beneficial as it offers the interviewer a chance to get a clear understanding of the interviewee’s emotions and experiences. There is also a guarantee in the reliability of the information since it is first-hand.

Lai et al. also addresses the same subject matter of kidney failure. However, this article narrows down to asses the specific disorders associated with kidney failure that remain present even during the treatment plan. The findings from this study made it possible for the researchers to ascertain the effectiveness of a treatment plan.

Cukor et al., the article is a quantitative study to evaluate the effectiveness of CBT in minimizing depression. The target group is the patients presenting with the end-stage renal disease since this group has been confirmed to suffer from severe depression. The research question, therefore, was whether psychological measures reduce depression, thereby enhancing the patients’ quality of life.

Ibrahim et al. realized that the critical problem in end-stage renal illness was advanced mental distress. Therefore, the researchers wanted to investigate how social assistance would influence the overall quality of life. Such kind of social support included affection and love from family members, friends, and society.

Relationship of the PICOT question, Research Articles, and Nursing Practice

PICOT Statement

Population(P): Both children and adults with end-stage kidney disease who equally present with obesity.

Intervention (I): Emotional and disease management support.

Comparison (C): Procedures employed in different patients (inpatient and outpatient).

Outcome (O): To identify if any support will help the patient and improve the care outcomes.

Time (T): Couple of months.

PICOT question:

In obese patients who diagnosed with end-stage kidney disease, how does patient support and intervention measures in the disease management improve outcomes improve patient anxiety, depression, and poor outcome?

With the drastic increase in the prevalence of obesity among children and adults, the prevalence of diseases such as cardiovascular diseases and chronic kidney disease are on the rise. Statistics show that the prevalence of overweight adults grows by 35 percent among men and 40.4 percent for women. Among the children, it is estimated to be 17 percent and 5.8 percent among youths. This, therefore, makes it an issue of concern. Obese individuals often have elevated metabolic needs due to their increases in body weight. Thus, compensatory hyperfiltration usually occurs in these individuals in response to the increased metabolic demands, and this affects the kidneys. Furthermore, the high body mass index caused a lot of pressure exertion on the organs, which can potentially harm them and predispose the obese person to chronic kidney disease (CKD).

The development of CKD and kidney failure has been proved to deteriorate the patients’ mental well-being significantly. The four articles mentioned above are all aimed at addressing the challenges arising from kidney diseases that deny the patients a quality life. This is because these psychological disorders perpetuate negative responses meaning the patients’ conditions progress towards the worst direction. For instance, the patient may continue with harmful eating habits as a way of releasing depression. In such a state, obesity will get worse, which in turn will worsen kidney disease.

Outcomes of Study

The qualitative articles by Taylor et al. and Lai et al. discovered that the old treatment plans for patients with kidney failure were not adequate. These traditional treatment models are characterized by their sole physical focus. Both of the articles agree that kidney disease is much more related to emotional issues, social issues, and psychological disorders. For this reason, the condition requires an alternative treatment plan. All the authors from the two articles recommend the implementation of interventions that focus on all aspects of health, including mental, physical, social, and spiritual. With such plans, evidence indicates that there are significant improvements in health and quality of life. The treatments are also trustworthy and highly relevant in the clinical field.

Results from the articles support the implementation of interventions such as monitoring of psychological disorders, provision of patient sheets that are meant for follow up, and evaluating progress. Apart from that, the enhancement of a personal relationship with the patients is also essential. It provides room for patients to open up and share their concerns with health professionals.

On the other hand, the quantitative articles by Cukor et al. and Ibrahim et al. had similar outcomes supporting disease management plans that incorporated emotional and social support. They both claim that this management plan will alleviate fear and stress among patients with end-stage renal disease (ESRD). By solving depression, which is the core issue in CKD, the researchers believe that the patients will exhibit improvements in their ways of living. Cukor et al. confirmed that CBT works well in reducing depression symptoms among patients with end-stage renal diseases. Overall, they also found out that CBT led to an improvement in the quality of living.

Discussion and Conclusion

All the articles reviewed in this paper are relevant in the clinical practice, particularly when it comes to the management of chronic kidney disease. However, the information is not entirely restricted in kidney cases only, but rather, the same concept can still be applied in other areas. The core duty of a nurse is to deliver care to the patients. The health care described in this definition covers a broad scope. It proceeds beyond medical care to emotional care and social support, as denoted in the health-illness continuum. Therefore, the emotional well being of a patient should equally be prioritized.

The reviewed articles have provided some implications and recommendations. First, Cukor et al., strongly advises that medical personnel should adopt CBT for the management of emotions and alienation of stressful symptoms. They are also encouraged to consider including social support and emotional support as they also play a significant role in the improvement of the health of the patients.

In conclusion, research provides a lot of evidence that is necessary for providing answers to the questions not yet answered in clinical practice. Similarly, they help in determining areas that have the potential for improvement in the health sector with over the aim of improving health care to patients. The articles reviewed above provide a lot of insight regarding the problems faced by patients with end-stage renal disease and provide measures that can be taken to provide a solution. It is also important to note that they are all in line with the PICOT question. Some of the offer the content to be used as answers while the others act as pieces of evidence to the Picot.