Week 5 discussion comment.

 

Make a comment using your own words in each discussion but please provide at least one reference for each comment.

Do a half page for discussion #1 and another half page for discussion #2 for a total of one page.

Provide the comment for each discussion separate.

Discussion #1

Why was the study done?

            The study explained that there is a rising number of children with obesity, which is leading to an increase in disease, increased medical cost, and lifelong illnesses.  The study was developed to evaluate the compliance of providers to clinical guidelines for childhood obesity and interventions to improve compliance.  The practice interventions to improve compliance were provider awareness, provider involvement, and collaborative support by the researcher.   This study will assist in my research of practice inventions for childhood obesity and the effectiveness of provider education in lowering childhood obesity.  

What is the sample size?

            For this study, the individuals randomly selected 70 charts from a pediatric office of 3 providers.  The study includes children from ages 6-12 years old and approximately 75% of the patients were Hispanic.  The study included two groups, interventional and non-interventional.  While the study included the evaluation of 70 patients, the study lacked diversity and was limited to 3 providers.  I believe it would be more beneficial to evaluate the interventions in this study if the researchers included more providers and a more diverse group of patients,       

Are instruments of the variables in the study clearly defined and reliable?

Yes, the instruments of the variables in this study were clearly defined.  The variables in this study were provider awareness, provider involvement, and provider support.  The study closely evaluated the adherence of the interventional tool, including diagnosis adherence, laboratory adherence, and laboratory adherence.

How was the data analyzed?

            To analyze the data, there were 70 well-visit charts pulled from the entire pediatric practice, which included 3 providers that were involved in the study and 3 providers were not involved and did not received any education or support.  The charts were evaluated based on the pre- and post-provider interventions to assess for overall practice improvement in managing childhood obesity.

Were there any unusual events during the study?

The only unusual finding in this study was that group 1 had a higher rate of overweight or obese patients than group 2.  All other categories were very similar among the two groups.

How do the results fit in with previous research in this area?

            While most studies directly focus on patient interventions for treating and preventing childhood obesity, this study focused on provider education and adherence to clinical guidelines.  Development of patient interventions and clinical guidelines are only beneficial if they are applied consistently in practice.  Evaluating the knowledge and adherence to clinical guidelines can improved compliance and identify barriers related to provider education and implementation.

What are the implications of the research for clinical practice?

            The study showed that focusing on and improving provider awareness, provider involvement, and provider support for childhood obesity can improve diagnosis and treatment.  In this study the diagnosis of childhood obesity increased from 19.6% to 60.9%.  In addition, the laboratory adherence improved from pre intervention rate of 6.7% to 45.8% post intervention.  The laboratory adherence and diagnosis adherence were statically significant P<0.05%, whereas the counseling adherence improved, but was not statically significant.

Discussion #2

The PICOT question guiding this study is:

In people aged at least 18 years old with schizophrenia (P) how effective is tele-nursing services (I) compared with usual care (C) in increasing adherence to medication (O) within a period of three months (T)? Consequently, the keeper study selected for this assignment is:

Baker, R. A. (2020). Effects of Tele-Nursing Intervention among Patients with Schizophrenia: An Evidence-Based Approach. International Journal of Medical and Biomedical Studies, 4 (2), 1-16.

· Why was the study done? 

This investigative study was carried out in order to evaluate and determine whether tele-nursing may be used as an effective strategy in enhancing the level of adherence to medication among patients diagnosed with schizophrenia. According to Baker (2020) tele-nursing in this case occurred through the use of telephone calls and short text messages. Adherence to medication in this research was expected to result in positive outcomes such as increased quality of life, improvement of schizophrenic symptoms and reduction in rates of hospitalization (Baker, 2020).

· What is the sample size? 

The sample size that was included in this study was 18 articles. According to Melnyk and Fineout-Overholt (2015) this may be considered a small sample size. In order to come up with this sample size the researcher conducted a search in databases with articles published in the period 2010-2015. According to Baker (2020) the databases examined included CINAHL, Wiley, Pubmed, PsycINFO, OVID and Science Direct. It is after searching these databases that the researcher settled on the 18 articles.

· Are instruments of the variables in the study clearly defined and reliable?

The instruments of variables in the current study by Baker (2020) were clearly defined and reliable. The dependent variable in this study was adherence to medication. The researcher was interested in examining and evaluating changes to this variable. The independent variable, on the other hand, was the use of tele-nursing intervention. Since the researcher believed that tele-nursing influences adherence to medication by schizophrenic patients, they manipulated it in order to determine the changes that it brings about.

· How was the data analyzed?

The collected data was analyzed by examining each of the sample articles in order to determine their purpose, objectives, study design, findings and conclusion (Baker, 2020). All the participants included in the research had to be adults diagnosed with schizophrenia, prescribed with anti-psychotic medication after discharge, and recipients of tele-nursing intervention

· Were there any unusual events during the study? 

There were no strange or unusual events which were noted during this study in regards to elements such as sample size, variables, data analysis, findings or conclusions.

· How do the results fit in with previous research in this area? 

The results from this research fit in with other researches of a similar nature. In his conclusion, for example, Baker (2020) asserts that the application of tele-nursing intervention is effective enhancing adherence to prescribed medications among schizophrenic patients. This conclusion is in tandem with those made by researchers such as Uslu and Buldukoglu (2015) and Beebe, Smith and Philips (2017). These researchers argue that tele-nursing influence adherence to medication by schizophrenic patients positively.

· What are the implications of the research for clinical practice? 

This study addresses a relevant and important clinical issue because medical adherence is a significant issue in the successful management of chronic illnesses such as schizophrenia. The implication of this is that health care professionals, particularly nurses, must consider the use of telephone calls and short text messages to encourage increased adherence to medication by schizophrenic patients.