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Self-Management Potential in Chronic Care
Introduction
Research articles help the nurses to investigate the topic they are interested in and obtain information for further research and implementation of evidence-based practice. Thus, it is crucial to select appropriate articles and analyze them according to the set criteria. The purpose of this paper is to provide a critique of the article titled Potential for self-management in chronic care: Nurses assessments of patients. This qualitative research is based on the interviews of the nurses who work with the patients suffering from chronic diseases.
Critique of the Research Article
The article deals with self-management practices used for patients with chronic diseases. It is stated that most data provided at the beginning of a content analysis of the articles do not answer research questions as it is not intended to be read by analysts (Dumay & Cai, 2015). Still, it is crucial for understanding the main purpose of the study. The problem in the article concerns the increase of patients with chronic illnesses, which is a burden for a medical system. It is important because chronic diseases cause higher costs and more efforts to provide health care. The purpose of the study is to evaluate the methods of assessing chronic patients and provide clinical reasoning for utilizing self-management support. The hypothesis is that variations in experience, work setting, and age of nurses can provide a good initial sampling. The key terms that are defined in the article are self-management, decision-making, patient assessment, and nursing care.
The objective of this study is to identify the opinion of nurses on self-management and evaluate the factors that influence the success of this approach. The variables used for this study are patients with chronic diseases as a dependent variable and nurses as an independent variable. The literature review touches on the main aspects of care for patients with chronic diseases. It is noted that self-management support success varies depending on the patients. The care for chronic patients is reported to be shifted from physicians to nurses in some countries.
The researchers argue that little is known about how and to what extent tailored self-management is provided in daily practice and whether and how patients are assessed regarding their eligibility for self-management support (Bos-Touwen et al., 2015, p. 283). The nurses are believed to be capable of evaluating the ability of a patient to apply a self-management approach. Fitting self-management to the needs of a patient is stated to increase the level of successful interventions. The review seems to be rather broad and utilizes the references to sources published during the past few decades. It does not contain any evidence of bias.
The design of the study is qualitative research that uses grounded theory. It is emphasized that qualitative analysis is usually performed in natural settings and uses such data as a text or words (LoBiondo-Wood & Haber, 2017). Thus, the research is appropriate to qualitative methods as it uses interviews with nurses who work with chronically ill patients as the main data for analysis. It is also stated that qualitative research contributes significantly, if not more so than quantitative research, to the field of primary care at various levels (Leung, 2015, p. 324). It means that the method to research self-management support was appropriate to the studied problem as it concerns primary care. As a result of the study, a theoretical model is built to represent the strategies of nurses in self-management support and assessment of chronically ill patients. For conducting qualitative analysis, the Qualitative Analysis Guide of Leuven (QUAGOL) is utilized. The study is original and applies alternate data collection and analysis.
Initially, sampling included five nurses with different characteristics of the age, experience, and working environment. Three of them were primary care nurses who worked with various chronically ill patients. Two nurses worked in secondary care and were specializing in one chronic illness. The data was collected by conducting face-to-face interviews. The questions were based on expert knowledge and literature review. All the interviews were recorded and data collection was continued until enough information was received. The ethical considerations included voluntary participation and an informed consent form. Therefore, the strategies for manipulation of the independent variable such as nurses were chosen correctly, and the participants were protected from harm. The interviews were anonymous and the researchers did not use the personal information of the participants.
The study addressed such criteria as a definition of self-management, its potential, factors that lead to its success, typology of patients, and approaches to individualized self-management. The validity of these elements is based on the professional experience of the nurses who participated in the study. After analysis of qualitative data with the help of QUAGOL, it is possible to say that nurses divide patients into three categories when assessing their capability of self-management. Thus, their professional experience plays a significant role in the success of self-management support as they can identify who can utilize this approach effectively. These results are supported by other studies in the given field. Some researchers also confirm that active monitoring can be utilized to engage patients in individualized care and give health care providers adequate assessments of their activities (Chiauzzi, Rodarte, & DasMahapatra, 2015).
Conclusion
The limitations of this research are that it uses interviews with nurses who can describe only their practice and experience. Thus, further research should be observational and explore the methods to reach patients and the impact of assessment on decision-making. This research can be applied to improve patient assessment by the nurses. I would use this information in my practice to improve my skills of patient assessment to provide them better advice in self-management.
References
Bos-Touwen, I., Dijkkamp, E., Kars, M., Trappenburg, J., De Wit, N., & Schuurmans, M. (2015). Potential for self-management in chronic care: Nurses assessments of patients. Nursing Research, 64(4), 282-290.
Chiauzzi, E., Rodarte, C., & DasMahapatra, P. (2015). Patient-centered activity monitoring in the self-management of chronic health conditions. BMC Medicine, 13(1), 77.
Dumay, J., & Cai, L. (2015). Using content analysis as a research methodology for investigating intellectual capital disclosure: A critique. Journal of Intellectual Capital, 16(1), 121-155.
Leung, L. (2015). Validity, reliability, and generalizability in qualitative research. Journal of Family Medicine and Primary Care, 4(3), 324.
LoBiondo-Wood, G., & Haber, J. (2017). Nursing research-e-book: Methods and critical appraisal for evidence-based practice (9th ed.). St. Luis, MI: Elsevier Health Sciences.
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