What was the article about and what purpose did it have?
The article written by Fleehart and her colleagues is focused on the suicide ideation. This work was published in a peer-reviewed medical journal and is said to be original research, which proves that the information mentioned in it is authoritative, and all claims are well-grounded.
The purpose of this study is to: assess the point prevalence of SI with the PHQ-9 in a cohort of patients with moderate to very severe COPD enrolled in the CASCADE study (COPD Activity: Serotonin transporter, Cytokines, and Depression)…. to explore the narrative context of SI using qualitative data collected as part of the study protocol (COPD) (Fleehart et al. 1322).
In particular, the number of people with depressive symptoms, PHQ-9 and SI was identified along with those who had dyspnea, depression, and anxiety. Thus, the research was aimed to answer the question of how pervasive and correlative suicide ideation is among such population.
What research design was chosen? What were its benefits? Was this research design appropriate?
In order to receive required information, the scientists used mixed methods analysis. In other words, their study includes both qualitative and quantitative research designs. Such approach provided an opportunity to receive the most extended data and investigate the issues from different perspectives so that nothing is omitted or ignored. Qualitative research occurs to be seen as depression interviews. The usage of such method is justified, as it gives an opportunity to find out what people think about their condition and how they feel. It is critical that the interviews were conducted by the study psychiatrist, as one could assess patient’s condition and find out the information that was needed for this particular research.
If the professional was just hired to interact with the sample, one might gather more information that is not crucial, which would make the process of interpretation and assessment more complicated and time-consuming. The information received with the help of qualitative design was used to conduct quantitative research and answer the main question of this longitudinal observational study. Thus, it was done to define the number of patients who had symptoms and health problems related to the suicidal ideation and make a general conclusion on this basis. Considering the purposes of the research designs, it can be concluded that the qualitative study is like a collateral one, as it is used to receive information required to do the main quantitative research.
Who were the participants of this research? How where they selected?
The sample consisted of 202 English speakers. The assessment was seen as a range of interviews and questionnaires conducted both in person and by telephone. In this way, professionals received an opportunity to reach a diverse population aged 40+ years. The inclusion criteria were the age and diagnosis of COPD. The exclusion criteria included a range of different conditions not related with the investigated one, such as other chronic obstructive lung diseases, uncompensated congestive heart failure, and psychotic disorders, etc. As the sample was not very limited, it can be used as a representative of the whole population that has the same conditions. In other words, the results of this research can be used when speaking about all individuals who refer to this type.
How was the study conducted? What variables were chosen and how were they controlled?
The researchers utilized mock interviews that were held by the study psychiatrist in order to control the quality of the paper. Case-control studies based on the results gained after working with English and US patients were also used for such purpose. The study was conducted using a range of different variables. They were identified by the scientists and listed.
However, it cannot be said that they all were clearly presented and identified as dependent, independent and control ones. The participants’ condition was considered with the focus on the presence of depression. The main difference was in the presence/absence of suicide ideation. The variables mentioned by the researchers were grouped into blocks so that the data becomes more structured and its assessment can be simplified. In this way, one can observe variables that refer to sociodemographics, pulmonary disease, psychiatric history/status, psychological well-being, and engagement in self-care. Trying to control the data, the scientists used average numbers, approximate results (±) and percentage. Such generalization also provided an opportunity to avoid biases and possible mistakes.
What methods were used by the researchers to collect the information?
Demographic data was gained directly without additional measurements.
Still, it cannot be said about the rest of the data as: severity of chronic disease included spirometry, performed to American Thoracic Society standards; use of supplemental oxygen; 6-minute walk distance; number of COPD hospitalizations in the previous year; self-reported chronic conditions (Charlson comorbidity index); physical functioning (Medical Outcomes Study-Short Form 36); and dyspnea and fatigue measured with the Chronic Respiratory Questionnaire (CRQ) (Fleehart et al. 1323).
Such methods were previously used in other studies with similar populations, which proves their validity. The researchers explain the way they measured the data but tend to avoid extended explanations and focus more on the results of the research. The data was mainly categorical as the authors divided it into several groups. It can be concluded that the statistical tests were used appropriately, as they provided an opportunity to work with such kind of data without any issues.
What were the findings of the study? Were they useful?
It was found out that: 121 (60%) had depressive symptoms (PHQ ≥6); 51 (25%) had a PHQ-9 ≥10, indicating a high likelihood of current major depression; and 22 (11%) reported SI. Compared to the 99 depressed participants without SI, those with SI were more likely to be female (59% vs 27%, P=0.004); had worse dyspnea (P=0.009), depression (P,0.001), and anxiety (P=0.003); and were also more likely to have received treatment for depression and/or anxiety (82% vs 40%, P,0.001) and more hospitalizations for COPD exacerbations (P=0.03) but had similar levels of airflow obstruction and functioning than participants without SI (Fleehart et al. 1321).
Such findings meet the purpose of the paper and give a full answer to the research question. They show that suicidal ideation is rather common among this population. Moreover, it is tightly connected with other symptoms and diseases. This information is critical for healthcare professionals, as it emphasized that patients with COPD require special treatment approach that should be implemented in all facilities.
Did the research have any limitations?
Even though the researchers received such detailed information, the study can be improved in future, as currently it had some limitations. This research included self-reported information, the diagnosis was not confirmed by special tests, and the environment was not investigated. Except for that, such large number of variables may be rather confusing and is difficult to consider.
Still, the research conducted by Fleehart and colleagues is very useful for students and healthcare professionals as it gives an opportunity to get to know more about patients with COPD. It also provides suggestions for practice that are likely to improve healthcare services and enhance consumers’ satisfaction.
Work Cited
Fleehart, Sara, Vincent Fan, Huong Nguyen, Jungeun Lee, Ruth Kohen, Jerald Herting, Gustavo Matute-Bello, Sandra Adams, Genevieve Pagalilauan and Soo Borson. “Prevalence and Correlates of Suicide Ideation in Patients with COPD: A Mixed Methods Study.” International Journal of COPD 9.1 (2014): 1321–1329. Print.