Guideline on lifestyle management to reduce cardiovascular risk.

Mercedes Yumar

Nursing Research

            My research proposal relates to guideline on lifestyle management to reduce cardiovascular risk.  According to the Centers for Disease Control and Prevention (CDC), overweight and obesity are complex health problems that affect more than two-thirds of adults residing in the United States (U.S.).  There are many health conditions associated with overweight and obesity including hypertension, coronary heart disease, and high cholesterol. The challenge for many practitioners is choosing an appropriate weight management therapy that will simultaneously address these multiple health conditions. 

            A qualitative approach will help me understand the feelings, values, and perceptions that underlie and influence behavior that put people at risk for cardiovascular diseases.  I will also be able to identify the patients’ needs and better understand the context/meaning of the data.

            The complexity of using mixed methods requires that researchers carefully consider the planning of such studies.  One major consideration is the timing of the quantitative and qualitative components.  Depending on the goals of each component, the phases of data collection can be either sequential or concurrent.  When sequential, the first phase of data collection can help to inform the second phase, or the second phase can be used to aid in the interpretation of data collected in the first phase.

References

National Clinical Guidelines Centre. Lipid modification: cardiovascular risk assessment and the modification of blood lipids for the primary and secondary prevention of cardiovascular disease. London (UK): National Institute for Health and Care Excellence (NICE) p.50 (Clinical guideline: no. 181). Retrieved from http:// www.guideline.gov

Tappen, R. M. (2016).  Advanced nursing research: from theory to practice. Burlington, MA: Jones & Bartlett Learning.

Discussion 5: Manuel M Cabrera

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Why is the bloodstream infection higher in hemodialysis patients as compared to the general population?

During an investigation, a researcher can choose numerous data collection methods and techniques, but it is important to keep the mind open and engaged between what we know and what we are testing or observing. Data can be collected from all relevant sources to find answers to the research problems. Secondary data is a type of data already published and primary data is the collection based in our calculations and observations.

During the initial planning for data collection a researcher must select measures and procedures for specific data collection modes. An approach, not properly planned, can lead to wasted time and discarded data. Physical assessment measures, biological tests, and observations are among the most used methods for testing.

Another potential method for data collection is the use of interviews. The power of the interview lies in the opportunity for the participant to contribute to the direction that the study will take (Tappen, 2016). Structured and Semi-structured interviews are often based on questions created by the investigator. During a Structured interview, the examiner clearly defines the topic of interest and can even put boundaries on the responses. The interviewer takes a neutral stance following the script. Semi-structured interviewing allows the interviewer more opportunity to explore answers for clarifications or ask for a more in-depth response (Tappen, 2016). The responses are usually briefing, and the interviewer can reward the questions.

Ending an interview effectively is important to remember. Reviewing important points, allowing clarification, expressing appreciation among others are important factors to be considered during the debriefing phase.

In conclusion, testing, observation, and interviewing are qualitative methods that will have a great and a positive impact in the interpretation of my research.

Yindra Isaac

Nursing Research

            My research question relates to hypertension and modifiable risk factors.  My proposal will determine the modifiable risk factors associated with hypertension while assessing and evaluating non-adherence to medication to determine if a lack of understanding and education exists with medication use.  Current hypertension management guidelines acknowledge the value of proper patient education and nursing input is a vital part of adherence to medication and health plan (Kear, 2015). 

            I will be using a qualitative approach using content analysis method because the aim of this study is to explore patients’ experiences with their illnesses and the reasons which influenced them in not following hypertensive care recommendations.

            Mixed methods research includes collecting, analyzing and interpreting data using both quantitative and qualitative methods in a single study or series of studies in order to investigate a phenomenon or attempt to answer a research question (Tappen, 2016).  In successful mixed methods research, the methodologies chosen will have complementary strengths and non-overlapping weaknesses.  This will result in a comprehensive look at the research problem from many perspectives and will offer a more complete picture when analyzing results.

References

Tappen, R. M. (2016).  Advanced nursing research: from theory to practice. Burlington, MA:      Jones & Bartlett Learning.

Kearney, P. M., M. Whelton, K. Reynolds, P. Muntner, P. K. Whelton, and J. He. 2005. Global burden of hypertension: Analysis of worldwide data. Lancet 365(9455): 217-223.

Katherine Panesso-

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        A topic that I would like to research and take a closer look at would be the shortage of nurses in the United States and its magnitude along with the effects that we should anticipate. A question in particular that I would propose is what affects from this supposed shortage are we already identifying and how is it affecting the care being provided? The qualitative method I would select to assist in obtaining answers to this question would be likely be unstructured interviews with a group of nursing leaders, executives and nurses to obtain answers and feedback from their perspective and experiences. Like any method there are positives and negatives to this method. One of the good things about an unstructured interview would be that it allows the person being interviewed to provide any and all feedback they feel is relevant to the topic which in turn fosters the opportunity to obtain more qualitative data. The down side to this method can be that much of the qualitative data being collected is essentially subjective and may not necessarily dictate the majority take on the topic.

       Using both qualitative and quantitative data to obtain more information in the relationship between decreases of nurse availability to patient satisfaction would be a chance to assess how one affects the other.  By obtaining both subjective and objective data, it offers an opportunity to decipher and relate the trends in the data that is being collected versus the qualitative data being collected verbally.

         In my opinion, having a mixed method approach can be very beneficial to the results since it is really all encompassing and comprehensive. Challenges that one could face with using a mixed method approach are that it could extend the amount of time it takes to collect data. It may also increase vulnerability to complications since it is a more robust approach with multiple variables and procedures needed which in turn may also lead to a need of greater resources.

References:

Doorenbos AZ. Mixed Methods in Nursing Research : An Overview and Practical Examples. Kango Kenkyu. 2014;47(3):207–217.

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Muller Sanon

            There are multiple research methods that an individual can use to undergo research and answer possible research questions. One type of research method is those based in a qualitative standing. Qualitative-based research helps manage the humanistic side of data by supplying things like interviews and personal situations. A grounded theoretical study is centered around the possibility of using both items like interviews and specific, qualitative field data to answer research questions. This form of qualitative method will be essential in answer the research question “How does lack of proper sterile conditions affect the rate of hospital-acquired diseases?” Furthermore, this qualitative background will also yield success in the ability to transfer to more quantitative research methods, such as hypotheses testing and data gathering. The method is not without downfall, however, since of the large amount of qualitative research methods, the grounded theoretical study is the one which requires the highest number of participants to produce results.

            As previously mentioned, a methodical approach using both quantitative research and qualitative research is extremely useful for tackling the research question “How does lack of proper sterile conditions affect the rate of hospital acquired diseases?” Furthermore, usage of a mixed methods approach entails the ability to both access data from a purely empirical, mathematical, and scientific standpoint and the ability to complement the aforementioned viewpoints with case-by-case basis situations, whether it be narratives, anecdotes, or prior data. This may prove difficult at times, however, since the presence of “multiple” methods entails a higher volume of research and data-collection from both methods to take place (Tariq, Shema, et al., 2013). This approach does give access to a higher presence of reliability for each research question approached with this method.

References

Tariq, Shema, and Jenny Woodman (2013). Using mixed methods in health research

             Advances in Pediatrics., U.S. National Library of Medicine.

Dailyn Gonzalez 

Week 9: Dailyn Gonzalez

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Hello Professor and Classmates,

            The current health care industry is faced with several challenges that affect the quality and safety of care practices as well as negatively impacting patient outcomes during their hospital stay and after they are discharged from the hospital. One of the challenges is hospital-acquired conditions. Research indicates that apart from facing life-threatening conditions, patients in the clinical setting are at a high risk of developing hospital-acquired infections. An example of a highly prevalent HAI is ventilator-associated pneumonia. The condition is a form of pneumonia that develops in patients within the first seventy-two hours after there are mechanically ventilated. The condition is associated with the emergence, or progressive infiltrate signs of a systematic infection including changes in the sputum characteristics, changes in the count of white blood cells, fever, and the presence of a causative agent. The condition is also attributed to adverse patient and treatment outcomes such as prolonged intensive care unit stay, longer hospital stays, increased cost of health care, and the development of temporary or permanent disabilities or in some situations death.

            Given the prevalence and severity of ventilator-associated pneumonia, it is critical to developing research projects that seek to understand the causes of the condition and evaluating the efficacy of available measures to prevent and treat ventilator-associated pneumonia at its early stages. The research exercises can either follow the quantitative or qualitative approaches. Further, the task can take the mixed method approach where the researcher combines both quantitative and qualitative methods to evaluate evidence and facts associated with the condition. With regards to qualitative methods, Hammarberg, Kirkman, and Lacey (2016) position that the approaches are useful when the research seeks to answer queries about the meaning, experience, and perspectives most often from the participants’ point of view.

Qualitative research approaches can include semi-structured interviews to evaluate perspectives on a focused issues, in-depth interviews to understand the experience, a condition or events from an individual perspective, small-group discussions to investigate beliefs, and analysis of documents and texts such as media articles, government reports, diaries and websites to gain knowledge on private or distributed knowledge (Hammarberg, Kirkman & Lacey, 2016). For the current exercise, the research will significantly benefit from using in-depth interviews given that they allow the researcher to ask detailed questions, they are associated with high response rate and produce detailed information about personal experiences, feelings, and perspectives of the issues being studied. On the downside, the approach can be time-consuming, costly, and is associated with differences in the interpretation of data among interviewers (Hammarberg, Kirkman & Lacey, 2016).

            Various research methodologies have been applied extensively in nursing research that include qualitative, quantitative, and mixed methods approach. Mixed methods involve the combination of both qualitative and quantitative methods in research. According to Tariq and Woodman (2014), quantitative methods such as observational studies, and clinical trials produce numerical data with a focus on statistics or prevalent rates while qualitative approaches produce non-numerical data that focuses on personal opinions and perspectives about the issue. Practice issues that can benefit from the approach include topics that require both statistical and individual aspects. For example, while studying the challenge of ventilator-associated pneumonia, quantitative methods will provide statistical data about the prevalence and the effectiveness of intervention measure. On the other hand, qualitative methods will provide an in-depth analysis of care providers’ perspective on the issue. However, combining the sets of data can be challenging, given that the two approaches originate from separate and incompatible paradigms.

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