Nursing research: methods, applications, and evidence-based practice

¶ … Sanford, J., Townsend-Rocchicciolli, J.,Horigan, A., & Hall, P. (2011). A process of decision making by caregivers of family members with heart failure. Research & Theory for Nursing Practice, 25(1), 55-70.

Describe the population for this study.

participants were recruited from cardiology offices, inpatient hospital units, or adult day care facilities. The participant had to be related to the patient with heart failure (HF), provide one activity of daily living, and/or assist the care recipient with two activities of daily living and do this voluntarily.

How was the sample selected? What are the strengths and weaknesses of this sampling strategy?

This was a convenience sample. The participants were recruited from cardiology offices, inpatient hospital units, or adult day care facilities and had to meet certain conditions. The strengths are that the researchers know and get precisely what they are looking for (in terms of qualifications of participants). The weaknesses are that outcome of study may be simply due to characteristics of these participants and selection of the participants may also reflect bias on the researchers' part... A randomized population would not only avert possible bias of the researchers, but may also have a greater chance of telling whether or not outcome was due to chance.

3) Were the subjects in this study vulnerable? Were there any risks for them as the result of participation in the research study?

There are no risks as far as I can see. The study was a direct-face interview on the decision-making and caring styles of the caregiver.

4) Are there any HIPAA concerns that are evident in this study?

Any possible HIPAA concerns may include caregivers divulging private / confidential information about the attitudes / disease and similar variables of the care recipient. Similarly, the information that the caregivers divulge about their own attitude is also confidential in that care recipients may become offended by this information were it divulged to them and the job of the caregivers may be jeopardized.

5) What methods were put in place to ensure that the subjects were giving true informed consent?

Methods are not given. We are simply told that "informed consent was obtained" (p.59)

6) what was the setting for the study?

Open-ended interviews occurred in private mutually agreed on locations: the caregivers' homes, places of employment, or the library.

7) Was the sample adequate for the research design that was selected?

No. We are dealing with a general, large, and homogeneous population: caregivers of people with HF. To adequately survey the way that they feel and make decisions, we need a correspondingly far larger and more diverse sample.

The following questions pertain to: Schwarz, K., Mion, P., Hudock, D., & Litman, G. (2008). Telemonitoring of heart failure patients and their caregivers: A pilot randomized controlled study. Progress in Cardiovascular Nursing, 23(1), 18-26.

8) Describe the population for this study.

Inclusion requirements were patients with HF aged 65 years or older, who had a diagnosis of New York Heart Association (NYHA) classification II, III, or IV HF25 and were functionally impaired in at least 1 activity of daily living (ADL) or one instrumental activity of daily living (IADL), which meant that they required a caregiver.

Other conditions were that they received home care from a home care agency if it was ordered by their physician, received Medicare, had access to telephone, and were able to speak English. They also had to show classic symptoms of HF.

The inclusion criteria for caregivers included their being cognitively intact, having a familial relationship to the patient, and providing assistance with at least 1 ADL or 1 IADL.

Exclusion conditions included planned discharge to a nursing home, inability to be interviewed because of physical illness, current use of a telemonitoring scale, inability to be contacted post discharge, receiving regular infusions or dialysis, NYHA class I, independence in performing ADLs, no caregiver, use of hospice care, client of nonparticipating home health care agency, participation in another study, dementia, planned surgery, inability to speak English, planned hospitalization, and inability to stand on a scale.

9) How was the sample selected? What are the strengths and weaknesses of this sampling strategy?

This too was a convenience study with sample selected from a 537-bed tertiary teaching hospital in Northeastern Ohio. It has the same strengths and weaknesses as previous study only less bias is likely since recruiting conditions are stronger

10) Were the subjects in this study vulnerable? Were there any risks for them as the result of participation in the research study?

There were no risks only possible advantages as outcome of study. Participants were telemonitored to ensure that their HF was kept under control.