Coronary Heart Disease - Research Proposal Example

I. This study explores how an educational, disease management outpatient program may improve health conditions for CAD patients by understanding demographic, biological and behavioral risk factors in the delivery of service. The study implements a quantitative methodology in investigating patients’ recovery levels. The researcher selects the participants for this study using the non-probability technique of purposive sampling. There are three main quantitative practices used in this process: questionnaires, interviews, and data analysis. There is a psychosexual questionnaire that determines CAD patients’ mental states; there is also a risk-behavior questionnaire that determines their propensity for behavior detrimental to the recovery process. The results from these questionnaires are used to design the Coaching Patients On Achieving Cardiovascular Health (COACH) program that is central to the research. Structured interviews are conducted with health care professionals at pre-determined intervals to determine patients’ progress in the program. In addition, monthly interviews are conducted by the researcher with the patients concerning their progress in the COACH program. Finally, data analysis is used in two distinct ways. The first is through documentary analysis which compares the results of the experiment with data from past experiments. The second means of data analysis is conducted through a triangulation method that factors: (1) the interviews that are conducted by the researcher with the healthcare professionals; (2) the analysis of the patients’ medical records; and lastly, (3) the observations that are made by the researcher during his monthly on site visits. The quantitative, non-experimental, correlational design of this study has been proven effective by other researchers who have investigated similar research issues. II. Introduction Coronary heart disease is controllable and most importantly preventable. Over 60 million Americans suffer from some form of cardiovascular disease, and a substantial portion of them, 12.6 million, become victims. Alternative disease management programs are presented as effectual methods of helping decrease these numbers. Extant studies which demonstrate “psychoeducational interventions” appear to have a convincing, positive impact on mediating disease effects. Specifically, McGillion et al. (2004) reported that these “educational treatment programs featuring multi-modal self-help treatment packages; employing both information-based material and cognitive-behavioral strategies” have been shown to produce “chronic disease-related learning effecting changes in the knowledge and behavior for disease self-management” (p. 175). By reducing hospital visits and readmissions, outpatient symptom management programs offer significant health care system savings (Palmer, Appleton, & Rodriques, 2003). One study reported such programming reduced inpatient CHF costs by 45.5% (Riegel et al., 2002, p. 708). Problem Statement The purpose of this study was to explore how an educational, disease management outpatient program may improve health conditions for CAD patients by understanding demographic, biological and behavioral risk factors in the delivery of service. Over the course of a 12 month period the researcher will develop, implement and evaluate a disease management program for CAD patients in Georgia, the study investigates two sub problems as follow: Subproblem Statements 1.  Does the gender of the patient play a role in adhering to the strategy of a health coach? 2. Does age play a role in readmission for patients with coronary artery disease? Importance of Research This research is important as it investigates the occurrence of nonfatal myocardial infarction or death from coronary artery disease (CAD). Other principal end points are the occurrence of death from coronary artery disease and nonfatal myocardial infarction. In addition to the main end points, the effect of having a health coach and whether gender plays a role in the treatment of the disease as it relates to frequency of readmissions to a hospital and or death of the patient is analyzed. Ultimately, the objective of the Coaching patients On Achieving Cardiovascular Health (COACH) study was to determine whether dietitians or nurses who did not prescribe medications could coach patients with coronary artery disease to work with their physicians to achieve the target levels for their total cholesterol (TC) and other risk factors, thus reducing and improving readmission criteria. Best Practices For a convenience sample, the research draws upon forty participants who have been recently discharged from the hospital to serve as participants for this study. Three best practices were implemented to examine the impact psychoeducational practices had on improved health conditions for CAD patients. These include a questionnaire in developing a psychoeducational COACH program, administering the COACH program, and a quantitative methodology for assessment. The questionnaire is administered at the beginning of the study to gain a thorough understanding of the CAD patients’ current state of affairs. Ethical considerations are considered and the patients are informed of the nature of the research. There is a psychosexual questionnaire that determines CAD patients’ mental states and a risk-behavior questionnaire that determines their propensity for behavior detrimental to the recovery process. The results from these questionnaires are used to design the Coaching Patients On Achieving Cardiovascular Health (COACH) program that is central to the research. Specific considerations are made for the following conditions: (1) unhealthy blood cholesterol levels; (2) high blood pressure; (3) smoking; (4) insulin resistance; (5) diabetes; (6) overweight or obesity; (7) metabolic syndrome; (8) lack of physical activity; and lastly, (9) family history of early heart disease. Interviews are conducted with the health care professionals administering and monitoring the COACH patients to gain research data. Respondents are also subject to one-on-one interviews with the researcher during a monthly visit. Documentary analysis is carried out in this study through the examination of the patients’ records as well as the analysis of other literature with regard to the explanation of the effectiveness of outpatient programs in reducing the readmission rates of patients with CAD or CHD. The data analysis of these best practices makes use of multiple regression. Causal analysis regards independent variables as the principal causes of the dependent ones. A number of subproblems are investigated within the study’s overriding framework. The subproblems investigate the interrelationship of gender and age on the patients’ success in implementing the psychoeducational COACH program in reducing the risk of CAD. As a result, this is a correlative study looks into the effects of the independent variable on the dependent. Read More