Achieving Health Potential - Essay Example

Running Head: ACHIEVING HEALTH POTENTIAL Achieving Health Potential of the of the Achieving Health Potential Introduction This study substantiates the effectiveness of acupressure in preventing post-operative nausea and vomiting, limitations are recognized, because of restrictions on availability of time, personnel and budget. As the subjects were sampled from patients who received general anaesthesia, the generalizations made in this study are limited to this group of patients. These initial results should be exploited by additional research with larger sized samples under multivariate statistical analysis. However, it is felt that the results of this study may promise a broader application besides postoperative patients. Post-operative pain is also known to be associated with poor post-operative recovery. It is also thought that tachycardia and hypertension are linked to pain and that vulnerable patients with a history of heart disease may suffer myocardial ischemia and infarction as a consequence of pain. The RCS&CA (1990) conclude that to ignore pain is neither humane nor cost-effective. Limited resources proscribed the employment of a secretary to record these interviews. Literature Review Recent research on post-operative pain following day case and short-stay general surgery tends to be found in the literature on clinical audits and patient satisfaction surveys, and is considered to be an important patient outcome indicator in quality assurance programmes. However, although many of the audits consist of telephone interviews the data presented are largely quantitative. Of those studies (Hawkshaw 1994, Otte 1996) which publish some qualitative findings the sections on pain are small and without much detail. The incidence of post-operative pain is considered to be high in particular groups of ophthalmic patients. Van den Berg et al. (1999) and Waterman et al. (1997) both report that extraocular surgical patients appeared to experience more pain than intraocular patients. The reason for this is not fully understood but may be connected to the extended manipulation and surgical trauma of extraocular muscles. As detailed above, hydroxyapatite implantation involves a great deal of extraocular muscle manipulation. No studies have explored pain in hydroxyapatite orbital patients, whether from a qualitative or quantitative approach. There is no clear statement about the limitations of the research. Most patients found that pain would subside, to varying degrees, when eye movement was reduced. The patients, who experienced a great deal of pain, reported that they would lie still in order to prevent eye movement. As discussed prior, they were placing themselves at possible risk from serious complications related to immobility. The prescription of appropriate analgesia would have enabled these patients to mobilize more freely, thus reducing the risk of post-operative complications. Participants Fifty-five participants enduring general anaesthetic short stay ophthalmic surgical procedure consented to within the average age of 39 years are using for this study report. Study working within the specific duration of 8 days post-surgery. This study based on telephonic interviewed responses of only fifty patients. Remaining five were not interviewed cause of telephone contact could not be made. Missing data can be recover if we avoid telephonic interviews, in place of this we can use face to face interviews. This face to face interviews method is more feasible than telephone because our sample size is not too large. Methodology This methodology section is completely based on the qualitative interviews from the employed to achieve the study objectives. Main purpose of this qualitative interview is just to grasp more sensitive and personal aspects of postoperative pain, nausea and vomiting. Investigators investigate on this approach, to exploring how patients make sense of their illness or condition. The results of such a study can present approaching into patients' predicaments and give indications of how to recover service stipulation. Studies on nausea and vomiting do not report on patients' journeys home, but from the data of this study it seems that for a small number it can be very unpleasant. Control of pain and an appropriate time of discharge may serve to reduce nausea and vomiting on the journey home, but it may also be of value to prescribe a dose of antiemetic immediately prior to departure for those patients who have had nausea and vomiting and who have histories of travel sickness. This aspect of nursing care requires further research. This is the clear statement about participated in this research where the fifty participants taking part of this research study. Research Instrument And Data Collection This study is divided in one larger qualitative study, the rest half which is quantitative. The other half of the study consists of the measurement of post-operative pain, nausea and vomiting in hospital and at home over 1 week. Overall, a great deal of data was yielded and in order to publish most of the findings it was decided that the results of the study would be split. The quantitative data, however, have been used to inform the discussion of the qualitative findings and vice versa. Telephone interviews were undertaken at whatever time possible because they were found to be efficient in time and conducive to free flowing conversation. So this will be the sufficiently works on time consuming factor. Some patients were unobtainable when telephone contact was attempted, and four patients did not have a telephone and rather than lose them from the study, they were interviewed at their first post-operative visit 8 days after surgery, in the out-patient department. An interview schedule was devised after reading the literature and interviewing a nurse who had herself had a hydroxyapatite implant. The plan consisted of open-ended questions which asked patients to involve on their experiences of pain, nausea and vomiting whilst in hospital, on discharge and at home. Patients were probed on their ability to manage and relieve pain and PONV. Questions also give the idea about their perceptions and their methods of coping with side effects of medication. Patients were also invited to comment on how the service might be improved and to suggest any additional information that they thought future patients might need. This research method is identified to be less reliable and thus, at the time of the interview and with the patient, it was felt cautious to check the notes frequently for simplicity and understanding. Data Collection & Analysis Yes, there is a clear description given in this article that this data was collected by means of questionnaire technique. It only collected from patients who received general anaesthesia; the generalizations made in this study are limited to this group of patients. Qualitative study indicates that a grounded theory approach will provide methodological cohesiveness for this research concern. By way of comparison between a phenomenological and a grounded theory approach to the research concern, I will illustrate the superior fit of grounded theory to the research query. Categories for this study were developed by following detailed analysis of interview transcripts. The categories developed out of the questions which had been asked at interview. Analysis of this qualitative interview analyzed during the period of data collection to seek out issues of importance to patients. Qualitative Research Qualitative research by means of interviews encourages patients to confer problems of concern to them and even if points made by patients were carried forward to the subsequently interview, not each and every patient was asked the similar questions. It has been determined therefore not to point to the exact number of patients raising exacting items in the text. Patient responses gather about the qualitative variables like Patients' methods of managing pain in hospital and at home, close eyes, avoid eye movement, move head not eyes when looking round, Keep head still, lie still, sleep, avoid bright light, call nurse, take analgesia and can take analgesia regularly. Also gather the qualitative information about taking anti-emetic, keep still, call nurse, control pain and avoid food in this situation of preventing post-operative nausea and vomiting. This approach of finding qualitative results can easily be interprets and clear for data analysis discussion. The qualitative data provide vivid evidence of the impact of inappropriate analgesia and discharge arrangements for those patients who were in severe pain. Quantitative Research If quantitative data had been collected without the qualitative data, it is probable that these practices may have persisted unamended. Numerical data, though useful in identifying related variables, do not always communicate clearly the personal and sensitive aspects of care. The results of this study highlight the post-operative experiences of patients undergoing general anaesthesia for short-stay surgery. Although the findings are specific to the sample of patients who participated, many of the issues that are raised will be of relevance to nurses who care for surgical patients in other specialities, particularly the shortage of beds and the timing of discharge of postoperative patients and the consequent effect on patients' pain and nausea. The importance of patient education is well known; however, the detail and manner of information giving needs further exploration. The study indicates that qualitative research offers additional perspectives on the appropriateness of services provided and how they might be improved. Fifty- five patients were engaged to this study. In which fifty patients, in total, were interviewed. It means our sample size would be n = 50 (large sample size allowed for a range of patient opinions). Five patients were not interviewed because telephone contact could not be made. Significance level of .05 means that there is a 5% chance that one would find a sample difference of means this large or larger when the unknown real difference is zero. At the customary 0.05 significance level cutoff customarily used by researchers, this is too much chance. That is, the researcher would not reject the null hypothesis that the group means do not differ on the dependent variable being measured. The most frequently used relational (linear) statistic is Pearson correlation and interpretation of a correlation coefficient does not even allow the slightest hint of causality. The most a researcher can say is that the variables share something in common; that is, are related in some way. The more two things have something in common, the more strongly they are related. There can also be negative relations, but the important quality of correlation coefficients is not their sign, excluding their absolute value. But here correlation coefficients not calculated, because we don't have specific data regarding this particular testing. If we assumes a normal distribution where the variance can be estimated from the standard deviation, the uncertainty of using s instead of is tabulated as a t distribution; it gives the probability that the calculated average will fall outside of the distribution. It can be demonstrate that the sample data follows a normal distribution. For this purpose t- values contains predetermined values for both one-sided and two-sided testing. These values are related to the normal distribution. It also affects the appropriateness of the descriptive statistics (if given). Ethics These participants may be given prophylactic anti-emetics, with dexamethasone intraoperatively. An interview starts from ethical information, and patients were informed that they had the right to refuse to take part at whatever the stage of the research, without effecting their treatment or care. This research design is not clearly describe here, because the demographic records are not gathered. Results & Findings Findings and results of this study highlight the post-operative experiences of patients undergoing general anaesthesia for short-stay surgery. Although the findings are specific to the sample of patients who participated, many of the issues that are raised will be of relevance to nurses who care for surgical patients in other specialties, particularly the shortage of beds and the timing of discharge of postoperative patients and the consequent effect on patients' pain and nausea. This particular study attracts patients from all over the United Kingdom (UK), some of the sample came from as far as Hampshire, Isle of Man, Hull and Wales. The journey home was also enquired about at interview. Hospital attracts many patients used the time in the car or on the train as an opportunity to rest and sleep, and experienced relatively few problems. For other patients the journey home was at least uncomfortable and for a few it was dreadful. Three patients were sick at least once on the way home; one patient reported vomiting three times. The importance of patient education is well known; however, the detail and manner of information giving needs further exploration. The study indicates that qualitative research offers additional perspectives on the appropriateness of services provided and how they might be improved. It was considered that the immediate care of patients over-rode the need to control the study, and that the discharge plan and 'take home' drugs should be altered and the effect of doing this should be monitored. Qualitative research methods are sufficiently flexible to allow the study of any changes since their purpose is to attempt to understand and communicate life experiences rather than to predict relationships between variables. Also interviewees were enquiring about their experiences of pain, nausea and vomiting at home. Generally patients indicated that their eye hurt on movement; however, a small number of patients found their pain to be so bad that they questioned whether they should have had the surgery, although this vision changed once the pain had subsided. From tables 1 and 2, we gather that patients' views were also sought on how they managed their pain, nausea and vomiting at home. They learnt a variety of methods to control their pain, nausea and vomiting. There is one more indication from qualitative research that side-effects of medication were also gleaned. Very few patients recognized that the cause of their nausea and vomiting was due to the take-home medication. But from these tables we cannot gather the clear picture of the sample data and appropriate results. As a qualitative analysis these table can easily be handled but in case of quantitative results we cannot interpreted it rightly, because it's not the enough information for this study. Conclusion These qualitative and quantitative results emphasize on the post-operative experiences of patients undergoing general anaesthesia for short-stay surgery. But these findings are specific to the sample of patients who participated; many of the topics that are raised will be of relevance to nurses who care for surgical patients in other specialities, particularly the shortage of beds and the timing of discharge of postoperative patients and the consequent effect on patients' pain and nausea. During the time between the 2nd and 24th hours after the operation, the subjects had to self-record subjective information related to nausea and vomiting; it was likely that some of them neglected to record an occurrence of nausea or vomiting, thus resulting in a reported lower incidence of nausea or vomiting. Moreover, this study was an evaluator blind study. At the beginning, when group selection was random, both the subjects and data collectors were ignorant of the group to which they would be assigned, but when the subjects were wearing a wrist-band or subjected to finger-pressing, they recognized which group they belonged to. The above shortcoming greatly affected the objective of a double blind study. The significant consequence of patient education is well known; however, the detail and manner of information giving needs further exploration. This study indicates that qualitative research offers additional perspectives on the appropriateness of services provided and how they might be improved. So there will be the more recommendations required in the sense of further research identification. Read More