Introduction to Nursing Research

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Introduction to Nursing Research: Two Qualitative Research Articles

Papaspurou, M., Laschou, V. C., Partsiopoulou, P., Fradelos, E. C., Kleisiaris, C. F., Kalota, M. A., … & Papathanasiou, I. V. (2015). Fears and Health Needs of Patients with Diabetes: A Qualitative Research in Rural Population. Medical Archives, 69(3), 190. doi: 10.5455/medarh.2015.69.190-195

Background of Study

Patients who depend on insulin are those with chronic illness and have adapted well to dealing and living with any fears and any health needs that arise. A vital element in the adaptation process to chronic disease is availing nursing care at the onset of the disease, as this leads to acceptance, as well as, the early management of possible complications.

The authors established the significance of the study by recognizing how diabetic patients, especially those that depend on insulin face fears during the initial stages of the disease. A reader should care about this study as it educates on the acceptance of the ailment as well as the familiarization with treatment to avoid the fears.

The purpose of the study by Papaspurou et al. (2015) was to study the self-management issues persons with diabetes deal with, particularly those requiring to inject insulin. In addition, the study investigated the fears that patients diagnosed with diabetes face during the early stages, subsequent development stages.

The research questions were:

What are the problems faced by diabetic patients?
What are the fears and needs expressed by insulin-dependent patients?
What psychological help can nurse offer to these patients?

The purpose of the study and the research question were related to the problem which explained the fears that patients who depend on insulin face in their day-to-day lives.

Methods of Study

The authors used an interpretive phenomological approach in their qualitative study. The sample size had 15 respondents/patients with Type II diabetes (six men and nine women) who were all insulin-dependent. The patients recounted their needs and fears through semi-structured interviews. The study was carried out in Greece.

Semi-structured interviews as the method of research was appropriate in answering the research question as patients were able to describe their needs and fears.

The authors cited several previous qualitative and quantitative studies by different authors that were relevant to the study and linked to the purpose and that aided in getting further information regarding the problem under investigation. Other types of literature included were from health organizations like the Centers for Disease Control and Prevention and the U.S. Department of Health and Human Services. The references were between 2004 to 2014 meaning that Papaspurou and his colleagues used current studies. The literature review contained adequate information about the topic of study; however, the authors failed to point out the weaknesses of the conducted studies. In addition, there was no developed framework from the findings of the study.

Results of Study

From the interview results of the study sample, the authors indicated that nursing care was important in early and late stages of the diabetes. Patients have a sense of safety and relief when nurses guide them through the treatment process. Nurses should ensure that they are beside the patients to counter the fear. It was found that patients had the fear of stigmatization, deprivations, fear for family, fear for work, fear for complication, and fears for life itself. Their needs include; need for psychological support, need for training on treatment and adaptation, need for exercise and diet, hypoglycemia knowledge needs, and need for recognition and addressing complications among other needs. The nursing practitioners should be aware of this in order to manage the disease and treat diabetic patients with care.

Ethical Considerations

The study was approved by an Institutional review board. Before the interviews, patients were consulted on whether they willing to participate. There were ethical consideration regarding the treatment administered by nurses as well as the lack of treatment.

Conclusion

The results showed that diabetic patients were exposed to many needs and fears linked to the various processes that include treatment, diagnosis, expected results, and management of diabetes. Such fears were related to the effects and the complication that chronic disease might have in their lives. Self-management and care are important goals that nurses should set. Family support, psychological support, and training on the disease are also important in managing the condition and overcoming the associated fear.

Wong, E. L., Yam, C. H., Cheung, A. W., Leung, M. C., Chan, F. W., Wong, F. Y., & Yeoh, E. K. (2011). Barriers to effective discharge planning: a qualitative study investigating the perspectives of frontline healthcare professionals. BMC Health Services Research, 11(1), 242. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-11-242

Background of Study

Previous studies have revealed that an effective discharge plan is among the important factors linked to the quality care of inpatients as well as unnecessary readmissions to hospitals (Nosbusch, Weiss, & Bobay, 2011). Understanding how diabetes patients perceive the treatment process by health practitioners is key in developing an effective discharge plan. The clinical problem that led to Wong et al (2011) study is the barriers that hinder proper discharge planning in hospitals. The authors indicate that hospital discharge is a process that poses challenges to healthcare givers, patients, and professionals. What was not known is that a well thought discharge plan can significantly boost the overall healing process of patients and reduce their readmission.

A reader would care about this study as it emphasizes on the significant of effective discharge planning practices in hospitals to help reduce cases of patient readmission. The authors also elucidate on the barriers that stress discharge planning and suggest ways on how hospitals can develop an operational discharge planning system.

The aim of the study by Wong et al (2011) was to study the supposed quality of the existing hospital discharge from the viewpoint of health professionals and to recognize the challenges affecting effective patient discharge planning in Hong Kong.

The research questions for this study are:

What barriers hinder proper discharge planning in hospitals?
What are the current discharge planning practices considered by health practitioners in acute and rehabilitation centers?
What important components help in developing an operative patient discharge preparation structure?

The purpose of the study and the research question are related to the problem mentioned in the study.

Method of Study

Qualitative methods were appropriate in answering the research questions. The authors used focus group interviews among different medics who were responsible for organizing the discharge planning processed in public healthcare centers and had a working experience of at least 10 years. Wong and his colleagues used content analysis to analyze data as it emphasized to the conceptual significance and the experiences shared by participants. The interviews covered three major points which were the identified perspectives from which the research was developed. The areas were; barriers to efficient discharge, current practices adopted by hospitals on discharge services, and the suggested processes and structures for an operational discharge planning system.

The authors used different quantitative and qualitative studies that were linked to the purpose of the study. Journal articles were used for the study and cited in the literature review to support the research. The references were old as they were published from 1990 to 2011. They were however relevant to the study. The authors did not indicate the weaknesses of the valuable research studies. The literature review was informative as it provided sufficient background information on the research problem.

Results of the Study

The research participants stated that there was the lack of systematic discharge planning in the hospitals. There was also a lack of a policy-driven method in public health sector. Participants thought of the current discharge programs as disjointed approaches as there were no protocols followed in discharging patients. They agreed on the importance of facilitating the process in order to minimize needless hospital readmission. The study found out that the U.S, Australia, and UK began adopting policy driven guidelines for health professionals to execute and this includes systematic discharge programs. 20 percent of patients require complex discharge, while the rest are simply discharged. The complex ones should have a system designed to guide the discharge process. Generally, the participants acknowledged the importance of policy-guided discharge programs in establishing effective and comprehensive discharge planning.

The findings of the study help in providing crucial insights into the advancement of efficient discharge planning in order to improve in-patient care quality

The findings contribute to nursing knowledge as they enable medical professional to identify the barriers that hinder the effective application systematic discharge programs. Such barriers include poor manpower management, poor communication, and low staff numbers. Hospitals should examine discharge planning processes and staffing patterns to resolve such barriers.

Ethical Considerations

The authors obtained ethical consent from the Clinical Research Ethics Committee of the Hospital Authority for their study. They also obtained a written informed consent from each respondent before the interview and the discussion. No sex or age restriction was considered during the research. They explained the purpose of their study to the healthcare professionals as well as their right to not participate. All research discussions were documented as anonymous and reserved as confidential.

Conclusion

The authors concluded that effective discharge planning calls for agreement from healthcare stakeholders or providers, capacity planning, hospital discharge procedures, and performance appraisals. Healthcare providers agree on the importance of a policy-driven protocol and a standardized system for operational discharge planning. The study offers an important message on how communication between social care and health professionals, patients and their health providers, and among the providers themselves should be improved of effective discharge planning policies are to be adopted.

References

Nosbusch, J. M., Weiss, M. E., & Bobay, K. L. (2011). An integrated review of the literature on challenges confronting the acute care staff nurse in discharge planning. Journal of Clinical Nursing, 20(5‐6), 754-774. https://doi.org/10.1111/j.1365-2702.2010.03257.x

Wong, E. L., Yam, C. H., Cheung, A. W., Leung, M. C., Chan, F. W., Wong, F. Y., & Yeoh, E. K. (2011). Barriers to effective discharge planning: a qualitative study investigating the perspectives of frontline healthcare professionals. BMC Health Services Research, 11(1), 242. Retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/1472-6963-11-242

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