The Effect of a Tailored Message Intervention by Sethares and Elliott - Essay Example

Critique of Article The study by Sethares and Elliott (2004) sought to determine the impact of a tailored messages intervention on quality of life, heart failure readmission rates, and health beliefs among individuals diagnosed with heart failure. The study utilized randomized control trial, which availed tailored message intervention at the time of hospitalization, as well as 1 week and 1 month consequent to the discharge. The study relied on health belief model to inform theoretical framework. The study population of the study included 70 individuals who manifest a primary diagnosis of chronic heart failure. The study findings detailed that heart failure readmissions rates and quality of life did not considerably vary between control groups and treatment. The study also revealed that, health beliefs, apart from benefits of medication, considerably shifted from baseline within the treatment group in directions hypothesized by the Health Belief Model. Introduction In the article, Sethares and Elliott (2004) conclude that a tailored message intervention altered the beliefs of the individuals with heart failure in terms of the gains and barriers of taking medications, self-monitoring for indications of fluid overload, and committing to a sodium-restricted diet. Sethares and Elliott (2004) maintains that future research may be required to further examine the influence of health belief changes on real self-care behaviors, especially on the impact of tailored interventions on real changes within self-care behaviors and the dose of intervention required to influence the changes. The title of the article is concise in implying the key variables of the study and the study population. The title of the article highlights the focus of the article and variables that will be utilized in the study. The abstract of the article concisely summarizes the key features of the study including objective, design, subjects, theoretical framework, results, and conclusions. The statement of the problem is clear-cut and easy to identify; furthermore, the problem statement forms the foundations of a coherent persuasive argument on the efficacy of a tailored message intervention provided during hospital admission. Evidently, the problem presented in the study has a significant bearing on nursing. There is a good alignment between the research problem and the quantitative methods and paradigms utilized in the study. The randomized control trial was utilized to appraise the impact of a tailored message intervention on heart failure readmission rates and quality of life among the elderly subjects (Sethares & Elliott, 2004). The study of guided by three research questions and the three hypotheses, which are clearly stated and suitably worded with a mention of the key variables and study population. The authors hypothesize that individuals who received the intervention would manifest lower heart failure readmission rates and improved quality of life. The research questions and hypotheses of the study align with the conceptual framework and literature review. The literature review of the study is dominated by primary sources that are up-to-date accompanied by extensive synthesis of evidence on the problem under study (Sethares & Elliott, 2004). Evidently, the literature review avail a fertile ground for a new study examining the influence of health belief changes on real self-care behaviors. Although, the conceptual framework endeavors to conceptually define key concepts, it can be faulted on the grounds that it is insufficient in elucidating on perceived susceptibility and severity and how they relate to Health Belief Model. The methodology of the study guarantees protection of human rights by instituting suitable procedures to safeguard the rights of the participants. The authors ensured that individuals with heart failure consented to involve in the control or treatment group, which indicates that the study was designed to reduce risks and increase benefits to the participants. The study satisfies requirements for informed consent and goes at long lengths in ensuring that the study is ethical. The intervention aligns with the results, which means that the conclusion is not erroneous. The study utilized a randomized control trial, which cannot be regarded to be the most thoroughly possible design when judged on the basis of aim of the study. Although, the numbers of data collection points were adequate and appropriate in improving the interpretability of the findings, the research design does little to reduce threats and biases to the external validity of the study (Sethares & Elliott, 2004). Randomized controlled trials (intervention studies) are often perceived as the gold model research design for highlighting cause-effect linkages between the outcome and intervention. Although, the methodology choice is excellent; the study does not have a very specific exclusion criteria for the sample. The population size and random sample of the study is adequately described and the study institutes necessary measures to increase representativeness and minimize bias. The sample of the study (n=70) is adequate and is drawn from population of adult diagnosed with chronic heart failure and admitted to a community hospital located in the Northeast between October 1999 and December 2000. The authors also go at great lengths to ensure that the operational and conceptual definitions of the study are coherent and congruent. The article also avails evidence highlighting that the randomized control trial yielded valid and reliable data (Polit & Beck, 2012). The data collection was meticulous and structured in a manner that reduced bias; indeed, the baccalaureate-prepared research who conducted the data (interviewing 88 subjected hospitalized for heart failure) was adequately trained for the task. The study also featured an intervention detailing tailored message intervention during hospitalization is sufficiently thoroughly developed and executed. The data analysis was undertaken through the use of SPSS and descriptive statistics were computed on each study variable and investigated for the presence of systematic or random missing data, outliers, and significant distortion. The data analysis minimized Type I and Type II errors and demonstrated a strong alignment to the research question and hypothesis. Type I and Type II errors usually result from forcing the outcomes of quantitative analysis into the mold of a decision regarding whether to reject or not reject the null hypothesis. Information regarding statistical significance is adequately presented and fits with the confidence intervals presented. The findings are also sufficiently summarized with effective utilization of figures in a manner that fosters metasynthesis of qualitative studies. Largely, the interpretation of the findings aligns with prior research, as well as the study’s conceptual framework. The interpretations of the study are justified, sound, and consistent with the limitations of the study. The authors outline reasonable and comprehensive implications of their study in light of clinical practice and calls for further research into the subject. However the impact on mortality and quality of life can be regarded as inconclusive based on the presented body of evidence; nevertheless, the study has unequivocally demonstrated improvements in health behavior. It is pertinent that future research highlight probe the components of intervention and self-management that are pertinent to enhancing health outcomes. The changes reported in the study, especially the impact of changes on perceptions and self-care practice is a critical consideration owing to self-care behavior change that carries positive outcomes. The authors are keen to acknowledge the influence of other factors such as nurses or physicians availing education to the participants, which could have impacted on the study findings and that should be put into consideration in future research. There is no doubt that heart failure is a prominent disease and a leading cause of hospitalization and death. Chronic heart failure can be regarded as a costly condition, which places significant demands on health resources owing to frequent hospitalizations. As such, any study on the condition is welcome and adds knowledge wealth on the condition. The treatment and management of heart failure is highly intricate, which is worsened by the fact that those who suffer from heart failure also manifest other multiple co-morbidities that render disease management intricate. The results of the study highlights the significance of tailored message intervention, which has been proved to alter the beliefs of the individuals with heart failure in aspects such as advantages and barriers of taking medications, self-monitoring for indications of fluid overload, and committing to a sodium-restricted diet. Conclusion Overall, the study can be regarded as well-authored, structured, and adequately detailed for critical analysis. Although, the intervention studies not feature a CONSORT flow chart to highlight the flow of participants within the study, the study is well authored to ensure that the findings are accessible to practicing nurses. The credibility of the authors cannot be put into doubt given that they possess adequate clinical, methodologic, or substantive qualifications and experiences to improve confidence within the interpretation and findings of the study. Based on the analysis, I consider the study findings valid and reliable. I have confidence in the results and I consider the research to have significantly contributed meaningful evidence, which can be employed in the nursing discipline. References Polit, D. F., & Beck, C.T. (2012). Nursing research: Generating and assessing evidence for nursing practice, (9 th ed). Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins. Sethares, K. A. & Elliott, K. (2004). The effect of a tailored message intervention on heart failure readmission rates, quality of life, and benefit and barrier beliefs in persons with heart failure. Heart & Lung, 33 (4): 249-260. Read More