Introduction
Improved patients’ outcomes, the quality of life, and reduced readmissions is a goal that any health care system would strive to achieve. Stavrianopoulos (2016) emphasizes the need for a proper disease management program to patients with heart failure (HF) using nurse-led telephone intervention programs. Through an empirical study, the article demonstrates that phone interventions significantly improve patients’ quality of life and reduce readmission. This paper is purposed to review Stavrianopoulos (2016) paying attention to research question/design, adopted sample and its adequacy, data collection method, limitations, findings, and most importantly, the implications of the study on nursing, especially on follow-up and self-care programs for HF patients.
The Research Question
Stavrianopoulos (2016) answers the implicit question of whether adopting nurses-led telephone intervention programs would augment the quality of life and reduce readmission among heart failure patients. It is observed that the research question is vital in care provision for patients with HF, especially in the transitional stage. The appropriateness and effectiveness of a program is a crucial element that should be considered when giving care to HF patients.
The research question could be linked to several issues and trends in the treatment and management of HF. First, there are concerns regarding the high morbidity and mortality rates irrespective of the considerable progress in research and treatment of HF. Second, the poor HF patients’ quality of life and readmissions are associated with increased severe financial implications to health care systems and, therefore, the need for effective intervention programs, which include nurse-led telephone intervention as suggested by various literature (Stavrianopoulos, 2016).
The Research Design
Stavrianopoulos (2016) used a quantitative correlation case-control study design where 50 participants (diagnosed with HF) were randomly put into two groups, A and B, with 25 subjects in each case. Members of group A received the nurses-led telephone interventions while group B was the control group. A study questionnaire was used on both groups before and after the interventions. Once a week for 16 weeks, the program was used in the intervention group.
The used study design has significant strength in the ability to compare and establish a correlation among variables. The use of a control group gives significant observations that highly influence the inferences. Moreover, the study design is relatively cheap and requires few staff.
A key disadvantage of the design pertains to the reliability of the information provided by members of either the intervention group or the control group. The author noted that participants from the intervention group might deliberately change their responses and, therefore, heighten bias. Nevertheless, it is postulated that Stavrianopoulos (2016) adopted the design due to its appropriateness in comparisons and establishing correlations among variables and low cost compared with other designs that require more resources and more personnel.
The Sample
Stavrianopoulos (2016) used a sample of 50 participants who had HF as per the NYHA II and III classification. The selection procedure paid no consideration to the origin, marital, or socioeconomic status of the subjects. Nevertheless, underage (18 years) and those without phones were excluded. Although the sample size was adequate for the study design, a bigger sample would have provided better insights and the aptitude to generalize findings.
The study sample had 34 male and 16 female participants. Regarding educational, there were 6, 24, and 20 participants with high school/below high school, high school graduates, and university/college qualifications respectively. On marital status, 7, 27, and 15 participants were single/never married, married, and divorced/separated respectively. Regarding age, 11 were aged 50-60 and 39 were aged above sixty years. The numerical representation of different demographical elements was adequate, especially due to the need to address issues regarding age, stress, and education and how they affect the quality of life among HF patients.
Nevertheless, the small number of participants significantly add to the limitations of the study.
The Data Collection Method
A questionnaire was used to collect data from the respondents. The patients were required to fill in the information regarding the quality of life before and after interventions. Also, the questionnaire requirements pertained to demographic and social data using the “Minnesota Living with Heart Failure Questionnaire” (MLHFQ), scale (Stavrianopoulos, 2016). It took 20 minutes to complete the questionnaire. The author and the team contributed significantly to data collection.
Apart from excluding minors from participating in the study, the author did not highlight any ethical issues. Also, the author did not mention anything about the participants’ consents.
Limitations
The study faced several limitations. Most outstandingly, the sample used in the study was relatively small. As such, the generalization of the findings faces difficulties. Moreover, the study faced limitations regarding internal validity that emanated from the possibilities of respondents changing their answers and, therefore, enhance bias.
This study could form a basis for future studies on the topic and, therefore, it is vital to address the limitations. First, future studies should include more participants/or bigger sample size to facilitate generalization. Second, there will be a necessity to enhance accuracy in responses from both the intervention and control groups. This could be achieved by educating the respondents on the importance of such studies.
Listing and discussing the limitations of a study within the study is vital. The author allows the reader to comprehend some of the elements that would influence the implications and the contributions of the study to the affected field. Moreover, limitations in a study make critical bases for future research.
Findings
The study revealed considerable differences in outcomes between subjects from the intervention group (A) and those from the control group (B). Although reductions in frequencies of hospital visits were observed in both groups, a significant decrease (from 50.88 to 31.53) in the MLHF scale was observed in the intervention group, which implied the improved quality of life. The control group score had changed from 52.40 to 53.80.
The differences observed between the two groups is linked to the interventions. Therefore, the results of the study provide an affirmative response to the implicit research question.
The author noted that internal validity could be affected by the likelihood of respondents changing their answers. Nevertheless, the credibility of the findings is relatively high, especially due to the lack of widespread effect on internal validity. Moreover, other researchers as mentioned in the study have comparable results.
Summary
This paper is a critique of Stavrianopoulos (2016), which propagates the adoption of nurses-led telephone intervention programs to the management of heart failure (HF). The paper provides descriptions and discussions of key elements of the article, including, research question, research design, the sample, data collection method, limitations, and findings.
The author of the article endeavored to answer whether nurse-led interventions could augment outcomes and improve the quality of life in HF patients. The results revealed that the provision of the interventions had significant positive effects.
The findings provide imperative insights and, therefore, have a relatively high probability of being implemented in the practice. The findings could significantly add value to the progressive research on the treatment of HF.
It could be concluded that nurse-led telephone intervention programs are essential and should be adopted to reduce the high mortality and morbidity rates among HF patients.
References
Stavrianopoulos, T. (2016). Impact of a nurses-led telephone intervention program on the quality of life in patients with heart failure in a district hospital of Greece. Health Science Journal, 10(4:5), 1-9.