Evidence-Based Project Proposal

Narrative of the Literature Search

A literature search is an integral part of any research because it allows evaluating previous findings and coordinating the direction of new research. When it comes to nursing, a literature search is usually a complicated process due to the existence of many databases and the complexity of problems under investigation. For the current research, the major health care databases such as ProQuest Nursing & Allied Health Source, NCBI, PubMed, Medline, BioMed Central were used. The search period was limited to five years. The articles also were to be peer-reviewed.

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The PICOT format was used to formulate initial search terms. Thus, the research questions used in the search were as follows: elderly patients with chronic diseases; patient education intervention; medication treatment; increase in health knowledge, and improvement in health status; over six months. Many of the research results apart from patient health education were dedicated to cardiac patients. It can be explained by the widespread of cardiovascular diseases among elderly patients (Aranha, Patel, Panaich, & Cardozo, 2015).

Aranha et al. (2015) also claim that health literacy decreases cardiovascular disease risk factors among elderly patients. A study by Bibas, Levi, Bendayan, Muille, Forman, & Afilalo (2014) deals with therapeutic interventions for frail elderly patients. Another research dedicated to patient education investigates the influence of patient education on the increase in knowledge and promotion of changes in health behavior (Melo Ghisi, Abdallah, Grace, Thomas, & Oh, 2014).

The following Evaluation Table provides a detailed analysis of two articles dedicated to educational interventions among elderly patients.

Evaluation Table

First Author Conceptual Framework Design/Method Sample & Setting Major Variables Measurement Data Analysis Findings Appraisal
Bibas et al. (2014) Therapeutic interventions for elderly patients can be considered a conceptual framework of the research. The study is aimed to discover the peculiarities of frail elderly patients, particularly those with cardiovascular disease because they prove to be frailer than other older adults. The research is a qualitative study which uses the method of literature review on the issue of frailty as a prognostic marker. Inclusion and exclusion criteria were used to select the materials for research. PubMed was used as a resource for the study. Out of 666 search results that came after the application of search string, 38 were selected according to inclusion and exclusion criteria. The searched materials included the following types of intervention: exercise training, nutritional supplementation, exercise plus nutrition, pharmaceutical agents, and multi-dimensional programs and home-based services. The major variable of the study was the prevalence of frailty in the conditions of cardiovascular disease. The impact of frailty on mortality and morbidity was also one of the focuses of the investigation. Then search results were studied by two independent observers to check data eligibility. They also selected the necessary information according to a form provided by the researchers. These data included the name of the study, author, type of design, sample size, baseline characteristics, frailty assessment tool used, intervention details, control group, primary and secondary outcome measures, and results (Bibas, 2014). The interventions and outcomes of the studies appeared to be diverse. Thus, providing statistical pooling and meta-analysis was not suitable. Randomized clinical trials do not provide enough data to empower frailty treatment. Exercise training interventions have a favorable impact on the results of the physical performance test. Home-based exercises are also efficient and provide good results. The study is an attempt to compare the efficiency of interventions presented in clinical trials. It is useful for clinical practice since the problem of frailty among elderly people is a burning one, particularly for patients with cardiovascular disease.
Melo Ghisi et al. (2014). The conceptual framework of the research aimed to discover the role of patient education among cardiac patients in the increase of knowledge level and positive changes in health behavior. The study uses a literature search in various electronic databases. The selected articles were dedicated to the problems of cardiovascular patients and included the experience of patient education by healthcare providers. Inclusion and exclusion criteria were applied. This systematic review included 42 articles that were selected out of 343 eligible ones. The selection consisted of peer-reviewed researches dedicated to cardiac patients. Moreover, every article had to have some educational interventions concerning patients with cardiovascular disease. Finally, the results of these studies had to include some outcomes of the mentioned education interventions. The independent variable of the studies was educational intervention applied for patients with cardiovascular disease. Consequently, the dependent variable included the outcomes of these interventions. They could comprise any influence on knowledge, behavior, or psychological interventions. For example, the behaviors influenced were physical activity, diet, bad habits such as smoking, etc. The research measured the characteristics of the included investigations. Next, it analyzed the nature of education interventions according to WINDER description elements. Also, the tools used to assess the knowledge in the studies were compared. The analysis of the data collected revealed that none of the reviewed educational interventions had necessary intervention elements. As for the knowledge, the tools to assess it were analyzed. Finally, the analysis showed that all researches used self-reports to evaluate the psychological condition of patients and their behavior change. The systematic review proved that educational interventions have a positive impact on the increase in patients’ knowledge and their behavior change. Educational interventions also conditioned growth in physical activity, attention to healthy diets, and a decrease in the number of smokers among patients. The investigation revealed mostly positive results of educational interventions among cardiac patients. It appeared that nurses usually are health educators and lectures of group discussions are usual forms of patient education. The study can be helpful for healthcare providers who want to introduce patient education since it summarizes the useful experience of other institutions.

Search Tracker

Search # Initial search terms Database And/Or? Added search terms Title (Ti)
Anywhere, etc.
# of articles found
1 Elderly patients with chronic diseases ProQuest Nursing & Allied Health Source, NCBI, PubMed, Medline, BioMed Central. Or
And
Within 5 years Anywhere 12(6)
2 Patient education intervention ProQuest Nursing & Allied Health Source, NCBI, PubMed, Medline, BioMed Central. And Within 5 years Anywhere 7(3)
3 Medication treatment ProQuest Nursing & Allied Health Source, NCBI, PubMed, Medline, BioMed Central. And Within 5 years Anywhere 9(5)
4 Increase in health knowledge and improvement in health status ProQuest Nursing & Allied Health Source, NCBI, PubMed, Medline, BioMed Central. And Within 5 years Anywhere 11(7)
5 Over a period of six months ProQuest Nursing & Allied Health Source, NCBI, PubMed, Medline, BioMed Central. Or
And
Within 5 years Anywhere 6(3)

Table 2. Details on Search Tracker.

References

Aranha, A., Patel, P., Panaich, S., & Cardozo, L. (2015). Health literacy and cardiovascular disease risk factors among the elderly: A study from a patient-centered medical home. The American Journal of Managed Care, 21(2), 140-145.

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Bibas, L., Levi, M., Bendayan, M., Muille, L., Forman, D,E., & Afilalo, J. (2014). Therapeutic interventions for frail elderly patients: Part I. Published randomized trials. Progress in Cardiovascular Diseases, 57(2), 134-143.

Melo Ghisi, G.L., Abdallah, F., Grace, S.L., Thomas, S., & Oh, P. (2014). A systematic review of patient education in cardiac patients: Do they increase knowledge and promote health behavior change? Patient Education and Counseling, 95(2), 160-174.doi:10.1016/j.pec.2014.01.012.

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