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Nurses-Led Telephone Intervention in Heart Failure
The article under analysis is entitled Impact of a nurses-led telephone Intervention program on the quality of life in patients with heart failure in a district hospital of Greece. It was written by Theodosios Stavrianopoulos in 2016. The purpose of the article is to determine if telephone intervention in patients suffering from chronic heart failure (HF) regularly led by nurses may improve their quality of life. In his article, the author claims that in most developed countries, many programs focus on the early detection of symptoms of this disease and patients education.
Most of these programs include telephone intervention, which has shown improvement in the life quality in HF patients, a period of hospitalization, overall cost, and a decrease in hospital admissions. In general, other studies on telephone intervention showed improvement in the emotional aspect of patients health, which is essential, as heart failure is aggravated by anxiety, fear, and stress. Moreover, support via telephone is easy, cheap, and capable of supporting all patients with HF, especially those recently discharged from a hospital (Stavrianopoulos, 2016).
Research Question
At the beginning of the article, the author provides a detailed description of the problem under consideration. He claims that although much progress in treating the HF has been recently made, the morbidity and mortality rates are still high. Besides, dealing with this issue also requires many resources, thereby creating financial problems. The author provides a statistics stating that nearly 10% of HF patients return to the hospital with the same problem after their discharge in a week, nearly 25% return in a month, and 40% return within a year. Thus, life expectancy and the quality of life of patients can be considerably reduced due to frequent hospitalizations and unpleasant symptoms.
They impact the emotional, social, and physical aspects of their lives. However, up to 50% of hospital admissions of patients with HF can be avoided if provided with better nutrition, appropriate medication, and a good specialist to control all their symptoms. In my opinion, this articles research question is very important in nursing practice, as it provides methods of reducing morbidity and mortality of HF patients. However, the research is not new, as many other studies have been made concerning this issue. Additionally, one thing that could have affected the research question is the innovations in medicine that could have considerably reduced morbidity and mortality of patients with HF (Stavrianopoulos, 2016).
Research Design
As far as the research design is concerned, telephone intervention was carried out in both men and women whose plasma levels of natriuretic peptide BNP were elevated and whose heart ultrasound confirmed HFs diagnosis. Patients were divided into two groups. The first was the intervention group, and the second was the control group. Before and after the intervention, all patients had to complete a questionnaire. According to NYHA II and III classifications, all patients had HF. Telephone intervention continued for sixteen weeks and was carried out once a week. The duration of each phone intervention was approximately twenty minutes (Stavrianopoulos, 2016).
Since the research under analysis is a quantitative study, it is the most appropriate type of research design. The main strength of this kind of design is that it allows receiving results quickly, and it is cheap. The main weakness of questionnaires is that patients can be deliberately dishonest or lie unintentionally when they interpret questions differently. Thus, this can affect the accuracy of the study. In my opinion, the author chose this type of design because it is simple and gives quick results, which is enough for this kind of study (Debois, 2016).
Sample
The study population consisted of fifty patients of both sexes with HF. The selection of the sample did not depend on the socioeconomic or marital status of patients. Two groups of patients, namely the intervention and control group, were created. Each group included 25 patients. Considering the intent of the study and the research question, the sample size was rather small. These numbers cannot be considered completely adequate, as they do not allow generalizing the findings (Stavrianopoulos, 2016).
Data Collection Methods
The data collection method used in this research was a questionnaire filled in by patients before and after the intervention and consisted of social data, demographic, and the scale called Minnesota Living with Heart Failure Questionnaire (MLHFQ), that evaluated the difference between the patients life quality before and after telephone intervention led by nurses. The time required for the questionnaire completion was twenty minutes. Nurses collected the data after the intervention had been completed. The research was conducted in Greece in the district of Ilia. The research duration was sixteen weeks from November 2010 till February 2011 (Stavrianopoulos, 2016).
Regarding the ethical aspect, all patients were eighteen years old or older and those who could also be reached by telephone. Additionally, the questionnaire was anonymous, and all patients gave their consent to participate in the study (Bowrey & Thompson, 2014).
Limitations
The principal limitation of the given research is a rather small sample. Therefore, it is difficult to make the results more generalized. Another significant limitation of the study is that the chosen method of pre- and post-testing may have provided some participants with an opportunity to write wrong answers intentionally. Particularly, this concerns those who knew that they were part of the intervention group, as they might have wanted to influence the research results to justify the time and effort of nurses who conducted telephone intervention. Nevertheless, the provided limitations did not affect the results that showed the efficaciousness of the intervention (Stavrianopoulos, 2016).
Thus, in future studies, the first limitation can be overcome by using a much larger sample. The second limitation can be overcome by telling patients that the study is important, and that must not lie, as the results can be distorted. In my opinion, it is important to mention the limitations in all studies. They show all its weaknesses and inform the reader what aspects of the research can have slightly inaccurate results (Debois, 2016).
Findings
Overall, the research demonstrated that the method of telephone intervention led by nurses had a positive influence on the HF patients quality of life, as seen by the overall score between the two groups in the MLHF scale. Additionally, the telephone intervention program reduced the risk factors and positively affected self-care. Moreover, adding education on self-care considerably improved the patients quality of life. Thus, the findings of the study answered its research question. Despite the discussed limitations, the results of the study can be considered credible (Stavrianopoulos, 2016).
Conclusion
Despite the considerable progress in HF therapy, the prognosis and quality of patients lives are still poor. This research showed that the life quality of patients having types of NYHA II and NYHA III significantly improved after the program of telephone intervention led by nurses. However, apart from that, as it was shown in the MLHFQ scale, no additional considerable statistical correlations were detected. Additionally, the findings correspond to the research question and hypothesis of the study. According to the findings, there is enough evidence that suggests that all national health systems should implement such programs as they decrease morbidity and mortality of patients with HF (Stavrianopoulos, 2016).
References
Bowrey S., & Thompson J. P. (2014). Nursing research: Ethics, consent and good practice. Nursing Times, 110(1-3), 20-23.
Debois, S. (2016). 9 Advantages and Disadvantages of Questionnaires.
Stavrianopoulos, T. (2016). Impact of a nurses-led telephone Intervention program on the quality of life in patients with heart failure in a district hospital of Greece. Health Science Journal, 10(4), 1-9.
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