Nursing critique
Introduction
Hypertension is a lifestyle condition that affects approximately 25% of the adult population. Of these population, 80% of them live in middle or low income developing countries. The prevalence continues to grow as the community does grow. With the growing population, it has become increasingly care for patients with hypertension. In patients with more than one lifestyle condition, the effect is even worse. The treatment of hypertension is a modification of lifestyle condition which requires the help of an attending nurse with a proper care plan. Adherence to the change of lifestyle for patients can be quite hectic. Most of them cannot manage on their own and therefore require nurses’ intervention. Lack of adherence to the nursing care plan has remained a challenge to the full recovery of hypertension patients. Long term treatment of the patient has always remained a challenge for nurses. To deal with the lack of treatment adherence of many patients, Sandra, Dort, and Lyda have conducted research that should help the patients adhere to regimen treatment with minimal help from the nurse. The nursing study focused on the patient with hypertension and those with type-2 diabetes. The study was meant to test adherence to a therapeutic regimen using individual teaching to each of the hypertensive or therapeutic patients. The focus of this paper is to critically analyze the elements of the study protocol mentioned above. The critical analysis focuses on every aspect of the study. The report begins from unearthing the background of the study to the limitations, all with the objective to find how the research is practical.
The study is focused on comparing patient teaching individuals as a nursing intervention method compared to regular caring plan as a way of ensuring that the patients of hypertension and diabetes undergo their long term treatment without missing the care plan schedule. To analyze this situation correctly, the study has to be conducted with two groups that can be compared. Objectively, the treatment is supposed to help patients adhere to the therapeutic regimen in those infected with hypertension and diabetes type 2. The impact of these nursing intervention options, as explained in the text, is based on the analysis of glycosylated hemoglobin and systolic blood pressure levels.
Title of the study
The title of the study is well structured. It contains all the elements of a good title. The words that have been used are more than eight, 22 words precisely. Twenty-two words are enough to make a title suitable for use. Concerning the content of the research, the title is congruent with the study as it captures what discussion to expect in the body of the study. From the title, it is easy to identify the key variables. Group compliance and the teaching intervention method are the key variables as deduced from the title. Additionally, the abstract provides the perfect type of summary. The abstract analyzes, in summary, the aim of the study, the background that necessitated the study, the methodology used in the nursing study, and a few recommendations on what to expect after the study. Using the abstract, it is clear to identify the background of the research as one that is complete and accommodative. Through the background of the study, it stands out that those who need the hypertensive care and diabetic care are often looked out by their doctors and less likely their nurses.
Purpose of the study
Based on a systematic care review, the authors of the study detected that most nurses are unable to provide care to hypertensive and diabetic patients, and therefore, paves the way for doctors to be involved, which is quite hectic. The reason for the limitation of the nurses is that patients are unable to adhere to long term adherence. In terms of percentage, the non-adhering patient was identified. Due to this gap, the authors of the study decided to come up with a nursing intervention plan that would enhance the adherence of drugs on hypertensive and diabetic patients. The purpose of this study, therefore, has been clearly stipulated. The aim of the study is to help the Colombian nursing population increase adherence to the therapeutic regimen. The therapeutic regimen is a common treatment for both diabetes and hypertension. The study seeks to introducing, “teaching individual,” as the perfect solution towards lack of adherence displayed by a higher percentage of Columbian patients. Especially, patients who are affected and do not want to adhere to long term treatment. The purpose, as it is clearly stated in the study, is to compare ‘teaching individual’ as nursing intervention efficiency over individual long term care plan. The hypothesis of the study explains its purpose even better. The hypothesis is that, ‘the nursing intervention of, ‘teaching individual’, is more effective to increase adherence of hypertensive and diabetic patients to therapeutic regimen than usual the usual care. Apart from the mentioned purpose, the study acknowledges that incase the nursing intervention works, it would automatically mean that the intervention is better at decreasing levels of glycosylated hemoglobin and systolic blood pressure. The way the hypothesis is specific and exceptionally designed is proof on the importance and the defined purpose of the study.
Conceptual framework
The framework of this intervention is based on the nursing intervention as defined by (NIC). Nursing Intervention Classification is any treatment based on clinical knowledge and judgment conducted by a nursing staff aimed at favoring the expected result of any lifestyles of the patient. Based on the concept of nursing intervention, the study has followed the concept in trying to come up with an intervention that solves the problem for most of the Colombian diabetic and hypertensive patients. Since the authors have a history of nursing, they fit within the conceptual framework of coming up with a nursing intervention.
Methodology
According to methodology, the study has adhered to every method protocol required to meet nursing interventions standards. To begin with, from the clinical trial protocol the study has received an approval from clinical trials by the government. The methodology was approved and reported according the nursing SPIRIT guidelines and methodology.
The design of the study is consistent with an experiment of the nature. The experiment is a comparative study that requires two groups, an experimental group and a control group. The design of the study is in compliance of the study, a randomized control group with usual care and another experimental group which consists of patient with teaching individual intervention added to their regular care plan. The design is supposed to take up to twelve months which is justifiable owing to the fact that the change on the patients has to take quite a longer duration.
There could never be a better setting than the one chosen by the author and the ones carrying out the study. There is no place to target patients than a public health whose intention is to better the health safety of patients and provide comfort for their operating nurses. The fact that the public health care institution provides care is justification enough to validate the setting of the study.
The study includes patient above the age of 18. Such an inclusion criteria is justifiable owing to the fact that this age group represents a huge percentage of the patient who suffers from hypertension and diabetes. More critically, it is this age group that finds it more difficult to adhere to therapeutic regimen treatment and care plan. Another critical analysis that justifies the inclusion criteria in the methodology is the fact that patients who are able to carry out their daily duties are the most defiant. It is even easier to observe patients of the said age group than it is to observe old age patients or young aged patients.
It is through methodology, that a study is considered either valid or reliable. The validity of the research is proven through the way the process of how randomization was conducted. The process of randomization was conducted by the nurses. Delivering intervention to the nurses by only one researcher as noted in the study, helps in ensuring that the result is consistent. Consistency in any study is proof of research validity. Reliability of the study has been captured by the study involving different nurses in each step of the methodology. The nurses, who performed the teaching intervention, are not the same ones who took measurements. The same ones who took measurements are blinded from observing the control group. The study as per this analysis stood the test of validity and reliability. Using the questionnaires, made the patients even more anonymous contributing to further validity.
The study is consistent with ethical considerations standards required for a research study. Prior ethical issues were reported to the professional body. Through the timely intervention, the ethics committee as stated in the study was able to conduct follow up audits. Even after the follow up audits, the partial and the finals results showed that the study had met the required ethical standard criteria. Such a commitment validates the study.
Result analysis
The result analysis of the study has been done in two separate topics in relation to the two hypotheses. The primary outcome, which is the first sub topic under result analysis mainly, focuses on results from the questionnaire. These results proved adequate performance of teaching validation. It is through the primary outcome that it was possible to publish the study.
On the secondary outcome topic the results focused on the effect of the method on glycosylated hemoglobin. The analyses of blood were conducted on laboratories which might have affected the course of the study. However the results remained as consistent as expected.
In relation to limitation the study failed to highlight the limitations that the experiment might have caused. It is possibly the only aspect that the study failed to implement. In their defense, they focused on reasoning that since the experiment was not going to be published, it would be better not to focus on the limitations of the study. However, one of the limitations we can deduce from the study is that the two lifestyle conditions are the ones that have been focused upon. It becomes rather difficult to make an assumption regarding if the, teaching individual nursing intervention might work as an intervention for other life style conditions.
Discussion
At the discussion part, the study mentioned a few literatures on how they got the idea of using educational style as an intervention method for care challenge. It is through the multi-component interventions that the idea of using teaching individuals to improve on adherence to therapeutic regimen emerged. The discussion of the experimental study is outstanding since it goes further to recommend the research to nursing fraternities. The discussion recommends that in any cases that the nurses are having problems with patients in regard to adherence to long term treatment, should consider using teaching individual as a nursing intervention. Apart from teaching individual nursing intervention, the study goes further to recommend that any health authorities and health policy makers who recommend treatment care plan through therapeutic regimen should think about using more than one nursing intervention especially on the line of nursing care treatment.
In conclusion the analyzed nursing study adheres to the essentials of a nursing intervention study. In the same manner, the nursing strategy is exceptional as it proposes one of the most essential styles of dealing with hypertension and diabetes. Most importantly, the study suggests a nursing intervention that even works for those at low income areas which is what a country like Columbia needs.