This paper critiques two published nursing research studies focused on Heart Failure (HF) patients and their caregivers. The first study employs a qualitative design using open-ended interviews to explore how caregivers make decisions about HF treatment. The second study uses a quantitative design to evaluate the effectiveness of post-discharge telemonitoring by an Advanced Practice Nurse (APN) in reducing hospital readmissions and associated costs. The paper examines each study's purpose, research question, methodology, peer-review status, and potential for researcher bias or conflict of interest, providing a comparative overview of how different research designs are applied in clinical nursing contexts.
Studies are conducted under a number of different auspices and with a variety of purposes. This particular study described its secondary purpose as a method for describing decision-making and the decision-making process undertaken by patients with Heart Failure (HF). Even more importantly, the study's primary purpose was to determine and describe the process exhibited by the HF patients' caregivers.
The specific question the study sought to answer was: "How do caregivers of family members with HF make decisions?" (p. 56).
The study was conducted using a qualitative design (p. 58). A qualitative design is normally employed to gather data on perceptions, thoughts, and beliefs concerning any number of subjects. This study was set up to determine the process by which caregivers make decisions regarding HF patients, and to explore why they made the decisions they did. Since perceptions, beliefs, and thoughts all play a significant role in medical treatment, the design was intended to determine how influential the caregivers' thoughts and beliefs were when making treatment decisions.
Other qualitative methodologies and characteristics involved in the study included the gathering of data through open-ended, unstructured interviews. Interviewing study participants allows for the collection of data through discussion, questions, and answers. Broad statements began the interview process, and questions specifically related to decision-making were then asked (p. 59). Additional characteristics included memos kept by the interviewers and evaluation notes made by the researchers.
The study appears to present perspective through data analysis conducted after the data were gathered. Since thoughts and beliefs are constantly changing, the study provides a snapshot of how certain caregivers react to situations. This snapshot offers a perspective that can be beneficial to other caregivers facing similar circumstances.
The study was published through a university study program by a major international journal for nursing practice. Indicators that it was peer reviewed include the fact that correspondence regarding the article was directed to the DNS at the university. Another method for identifying peer-reviewed articles is that they are published in journals — publications typically designated by that title because they undergo peer review. Since a peer-reviewed article implies that it was evaluated by a committee or experts in the field, its publication through a major university also lends credence to the conclusion that the study was peer reviewed. The journal's website did not explicitly state whether an editorial board was employed.
There was no immediate indication that the researchers introduced any bias into the study's design; in fact, the methodology used appeared entirely appropriate for this type of study. There also seemed to be little concern for financial gain from the results. Because the study sought qualitative data from individual caregivers, there was little, if any, financial benefit to be gained by anyone associated with the study.
The purpose of the second study was to "examine effectiveness of post-discharge telemonitoring by an APN on reducing subsequent hospital readmissions, emergency department visits, and costs and increasing the time between discharge and readmission among older adults with Heart Failure (HF)" (p. 21). Secondary study considerations included the examination of depressive symptomatology, quality of life, caregiver mastery, and social support for HF patients.
The implicit research question was whether an alternative strategy — specifically, the use of an electronic home monitoring intervention — would be cost-effective and efficient in the medical treatment of HF patients.
"Quantitative measures, baseline comparisons, and outcome data"
"Peer review confirmation and manufacturer conflict of interest"
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