Use of Psychological Interventions by Nurses in Improving Quality Health Care - Essay Example

Use of Psychological Interventions by Nurses in Improving Quality Health Care Sharon Edwards Tennessee Tech Chronic diseases commonly involve various aspects of health care to ensure their effective management. Different interventions are normally utilized because of the complex circumstances surrounding the occurrences of the conditions and the capacity of individuals to live with these conditions. Patients suffering from chronic diseases like cardiac illnesses, gastrointestinal diseases and malignancies among others suffer from various psychological issues like stress, anxiety and depression. These problems significantly interfere with their swift recovery and health outcomes. This research has selected two most common diseases; coronary heart disease and cancer, to study how psychological interventions performed by nurses can impact on the health outcomes of patients with the diseases. The study looks at various studies conducted to evaluate the effects and impact of psychological intervention on patients suffering from these conditions. In addition, the study has been conducted through meta-analysis and systemic review of original research conducted on the subject and their theoretical relevance to current practice. Results from randomized controlled trials show that if nurses incorporate psychological interventions in treating patients with coronary heart diseases and cancer, significant improvement in the quality of health care can be attained. However, these interventions do not considerably decrease the overall mortality rate, but significantly improve the life span and quality of health of patients suffering from chronic diseases. Introduction There are numerous interventions that nurses use to provide healthcare services to patients, and that enhance quick recovery. Recuperation of a patient is the fundamental purpose for the application of different interventions to treat an existing condition. While medical interventions might be assumed to have significant a effect on the recovery of patients, others are also utilized to quicken the recovery process. The presence of a psychological condition affecting a patient with a chronic disease affects his or her response to the medication provided to treat the condition. Patients suffering from chronic diseases are commonly affected by the other related factors or conditions such as depression, which cannot be effectively managed through medical interventions (Hoffman et al., 2007). Studies have revealed that by not putting in place psychological interventions, nurses delay the recovery of patients with chronic diseases (Stanton, Revenson, & Tennen, 2007). This study is designed to analyze different controlled trials performed to evaluate the relationship between psychological treatments and the health improvement of patients. The various psychological issues faced by patients hinder their recovery and often worsens their disease condition. The research will be helpful in identifying the main psychological treatments and solutions that have been proven to improve patient care. Variables Independent Variables: Controlled trials conducted on psychological interventions relating to patient health. Dependent Variables: Health outcomes and recovery patterns of patients. Summary Research revealed psychological interventions performed by nurses can significantly improve patient health status (Claar & Blumenthal, 2003). Patients suffering from chronic diseases like Cardiac diseases, gastrointestinal diseases, Malignancies, etc. suffer from various psychological issues such as stress, anxiety, and depression. These problems interfere in patient recovery and health outcomes. This research selected two prevalent diseases, coronary heart diseases and cancer, to study how psychological interventions performed by nurses can impact health outcomes of such patients. This study has been conducted by meta-analysis and systemic review of original research conducted on the subject and their theoretical relevance. The results from randomized controlled trials show if nurses incorporate psychological interventions in treating patients with coronary heart diseases and cancer significant improvement in quality of health care can be obtained (Osborn, Demoncada, & Feuerstein, 2006). However, it is found that these interventions do not considerably decrease the overall mortality rate, but significantly improve the life span and quality of health of patients suffering from chronic diseases. This paper focuses on the relationship between nursing and psychology by examining the application and use of psychological interventions in improving patient health outcomes and quality of care. The study has mainly selected two chronic diseases: coronary heart diseases and cancer in order to evaluate the impact of different psychology models on the health improvement of patients suffering from them (Claar & Blumenthal, 2003). Literature Review Cognitive behavior of individuals commonly has a fundamental effect on how the body functions in response to other external factors (Stanton et al., 2007). Medical interventions are the basic interventions applied to the different individuals hospitalized with different chronic conditions. Observation of these patients, however, necessitates the inclusion of different interventions to enhance the recovery. There as some commonly reported psychological problems associated with the presence of chronic diseases among patients (Osborn et al., 2006). Depression and anxiety are some of the basic psychological problems associated with chronic diseases and that require psychological interventions. These problems have detrimental effects upon the patient’s cognitive skills. Assessment conducted on different psychological interventions presented positive findings indicating the efficacy of the psychological interventions (Hoffman et al., 2007). Some of the common psychological effects of chronic diseases include emotional functioning of the patient becoming impaired. Psychological interventions range from examinations to visits by a medical professional. The impact of such social gestures has been established as an element which has the potent of improving a patient’s well-being, consequently enhancing recovery. The effects of the diseases are commonly displayed upon the behaviors of the affected individuals. Chronic diseases present various social implications upon the individuals suffering from the condition and immediate family members as well. Heart diseases and cancer account for almost half of all deaths associated with various chronic illnesses affecting human beings(American Psychology Association, 2014). The management of these chronic conditions comes with a burdening financial implications for affected people and their family members. Other than these financial implications associated with the conditions, the psychological effects of these conditions present a bigger challenge in the management of the conditions (Stanton, 2006). Many individuals are faced with the inability to take care of themselves, and this creates a difficulty in the management of the conditions. It necessitates specialized care as the affected individuals become dependent on assistance from family members following cognitive impairment. Treatment of cognitive problems associated with chronic diseases become essential in the provision of holistic healthcare for the affected individuals. Depression remains the most common psychological problem associated with infection by chronic diseases. Nearly one-third of all people suffering from chronic diseases develop symptoms of depression as the disease advances (American Psychology Association, 2014). This only becomes an element that worsens their condition, and inadvertently causes the recovery process to become slowed as well. The pervasive condition of the chronic illnesses makes the affected individuals to require help in order to cope with the emotional distress; change behaviors in seeking to maximize the effect of the interventions; and manage the various disruptions which the illness might have on their routine activities. Chronic diseases present a crucial challenge in the psychological and social burdens by the conditions upon the patients and immediate family members as well. To improve the management of these conditions, patients require a significant level of psychological adjustments to enhance the daily functioning of the body systems (Stanton et al., 2007). The experience of many chronic conditions necessitates adoption of different ways of livelihood that could affect the patient’s cognitive capabilities. Since many of these conditions have limited medical interventions, the control factors of the conditions involve psychological and even social interventions. The modification to an altered way of life by the affected individuals presents a challenge, necessitating the application of psychological interventions. While medical interventions are utilized in the treatment of the physical components of the condition, the cognitive elements of the disease become subject to psychological intervention. These interventions enable patients and family members to optimize the medical care using medication through effective management of psycho-social and behavioral aspects of the diseases affecting the individuals (Stanton et al., 2007). The utilization of psychological interventions remains focused on providing two basic approaches towards comprehensive healthcare provision. First, these responses provide healthcare to the cognitive problems which emanate from chronic illnesses. This serves are a treatment for the mental conditions occurring as a result of a chronic disease. Secondly, they are a source of education and training to the sick and their family members regarding psychosocial effects of chronic conditions. This education becomes essential in aiding patients to develop better understanding; consequently resulting in improved care and management of the chronic conditions. Purpose To summarize the publications existing on the implications of psychological interventions in nursing profession with patient care, and focusing of patients with coronary conditions and cancer. Methodology The research being conducted will be increasingly focused on providing information regarding the nursing interventions which are used in enhancing recovery for the cognitive problems occurring as a result. The research focuses of reviewing materials that are available from different sources as a way of gaining insightful information on the subject under investigation. A combination of both qualitative and quantitative elements of research structures will be utilized within the context of this research (Cooper, Hedges, & Valentine, 2009). This will mainly be as a result of the various controlled trials that have been reviewed in establishing the results presented here. The findings of the study will include both qualitative and quantitative data because of the various elements which have been studied by individual researchers from the past. The utilization of this approach will enhance the gathering of information from different sources and publications as a way of gaining insightful knowledge of the interventions utilised by nurses. The theoretical approach could identify existing discrepancies in the available literature as ways of building on aspects that future researcher could engage in. While much research has been conducted on this subject, this research methodology will enable the comparison of the findings established by various researchers. Such comparisons have a significant role in strengthening the evidence and identifying weaknesses that might have occurred. Within the field of medical research, knowledge gained from these researches becomes essential to future researchers, who can utilize this information in the identification of possible research topics. Study Design The study will involve collection of data from secondary sources, which are mainly previous research studies published in different academic and professional journals. The study will utilize a meta-analysis approach to analyze findings from various studies included within the context of this research. The fundamental advantage presented by this design, within the context of the topic being investigated remains access to different research materials, which are based on factual research (Denzin & Lincoln, 2011). The utilization of this research design enables the study to include an increased sample size, which will enhance the capability of the researcher to study the effects of interest. This design involves reviewing different researches in seeking to develop a single conclusion from various researches conducted in a similar field of study. This results in increased sample size, and greater diversity, consequently making the conclusions drawn from this research to have greater statistical power, than any of the studies included. Meta-analysis research provides a researcher with the capacity to overcome the underlying problem of relatively small sample sizes, prevalent among many random controlled trials. This research design also allows the researcher to make comparisons of findings developed by different researchers in seeking to increase the precision of conclusions established from them. Through the utilization of this research existing discrepancies in the conclusions drawn from different researches become clearly identified, and possible causes of these differences outlined. The effects of these causes upon the findings can be explored in order to estimate their magnitude while seeking to eliminate the occurrence of similar errors in future studies. The combination of various random controlled trials results in the highest possible level of evidence being presented within a research. Population and Sample The population of the research to be included within the context of the research include random controlled trials which have been undertaken in the field. The inclusion will remains limited to controlled random trails which focus in patients suffering from heart disease and cancer. Research studies that have been conducted focusing on different chronic conditions like diabetes will not be included within the population. Establishment of these inclusion specifications will be essential in seeking to eliminate selection bias from the researcher, who might consider other influential factors in selecting the studies (Ferguson & Brannick, 2012). The studies that will be included within the context of the research must be ones which are utilizing psychological interventions in the management of chronic conditions, among the individuals who were being researched. The sampling process will be conducted in a random manner, and the search will begin with the keywords defined by the researcher. These keywords will present the guideline upon which the elements of the studies included in the research will be based. The studies included within this research have been selected through a random approach from a large database of studies to analyze the effects of psychological interventions on patients suffering from coronary heart diseases and cancer, including both men and women. Random selections were employed in order to eliminate the assumption of the true effect of the independent variable on all the included studies (Cooper et al., 2009). This will be conducted in seeking to ensure that only researches that utilize psychological interventions have been included within the study. Though random sampling will be utilized in selecting the relevant research articles, other factors like the relevance of research findings must be considered during the sampling process. This will be essential in ensuring the conclusions presented are in line with the elements being research for generalization of the results. Investigative Techniques The techniques utilized within the study will include analysis of various publications presenting information on the topic being studied. Different literature sources will be analyzed in order to assign weights to studies that can be included or excluded from the research. The investigation will be conducted in order to establish the following critical elements of meta-analysis research 1. Effect size This will be utilized to quantify the existing difference between different treatment effects. The effect size is important in measuring the strength of the phenomenon under investigation. The various effect sizes of different research will be established in order to the standard error of the effect size. This will be essential in the facilitation of the substantive significance of the research result. 2. Publication bias The publication bias is essential in seeking to establish the validity of meta-analysis findings presented in the research. The funnel plot is utilized in estimating the existence of publication bias. The approach is based on the presumption that sample effect increase results in a similar effect upon the precision of the findings (Peters, et al., 2008). The funnel plot is constructed from results of effect size against the sample size of the study. 3. Heterogeneity Existence of significant heterogeneity among the studies remains essential to the research being conducted. The method of Q statistics will be utilized in determining this essential aspect of meta-analysis research. Establishment of heterogeneity becomes critical in determining the researches to be included within the study. This statistical approach does not identify the cause of the heterogeneity Instrumentation A meta-analysis including randomized controlled trials, intervention studies, and telephone monitoring. The combination of these instrumentation approaches will be essential in validating the findings presented within the research. The validity of research findings remains fundamental towards ensuring that the results are reliable and can be generalized within different settings. Replication of the findings in other related researches will also be based on the understanding of these elements. Data Collection The data involved within the research is entirely secondary data from research previously published from multiple sources regarding the topic being researched. The researcher will utilize internet sources, libraries, and other databases which will be searched by using keywords for data collection. The data will be collected for the following sources 1. Libraries Many libraries contain large volumes of publications that might have critical information regarding various researches that have been undertaken in the topic under investigation. The library search will remains limited to published materials presented in reliable sources, which are available within the libraries. The utilization of libraries will ensure that the research can find the articles with relative ease. This is mainly because the publications are commonly placed within the same segment of the library, and the researcher can seek assistance from librarians. 2. Internet sources Internet sources will be utilized after establishing the keywords which the researcher will utilize to establish from the library based research. The internet sources might present information that might not be available in libraries as there are some online journals which might contain useful articles for inclusion within this research. Online libraries will also be visited to provide further academic materials to aid in the presentation of relevant studies to be included within the research. 3. Other databases Other than the libraries and online sources there are other relevant databases which could present highly credible sources for information. The utilization of these databases might be able to present some relevant researches that have not been published, yet could be relevant to the topic. This could be essential in overcoming publication bias. These might include Resource centers – these are databases of various relevant organizations like institutions of higher learning and medical facilities. These organizations might have conducted researches that were never published and are contained within their resource centers. Researchers – the researchers who have been involved in some of the researches might be contacted to provide information that might pertain to their experiences during the research. They might also be able to provide information regarding current research activities which might be continuing within the field. Data Analysis Plan Qualitative Comparison Analysis is performed by comparing and contrasting information (Onwuegbuzie, Leech, & Collins, 2012). A unique case orientation approach will be utilized in making the first levels of data analysis in order to eliminate the bias that might occur at later stages of the research. This will be critical in enhancing the analysis of the findings in order to draw valid conclusions based on the researches include within the research (Simmons, Nelson, & Simonsohn, 2011). Different data analysis approaches will be utilized in seeking to conduct the analysis of the data gathered. The data analysis plan will combine several statistical models for establishing the existing effect of the variables being investigated, within the various studies included in the study. The following models will be considered within the context of conducting the study. 1. Fixed effect model This approach will be utilized in seeking to establish the weighted average for the estimates presented in the research. The application of this approach will seek to ensure that there is a balance between the studies included within the study based on the weighted average. The focus of the researchers will be on studies that have similarities in the effects and are not much skewed from the average. 2. Random effects model This method will be utilized in synthesizing the heterogeneous research which might be revealed during the planning phase of the study. This analysis is aimed at establishing the effect size of the various identified researches which have been included within the study. The variability of the effect size will be established through random effects models, which define the heterogeneity of the studies. Since the heterogeneity depends on the effect size and precision, it becomes essential to undertake this analysis of establishing the validity of the studies in relation to the current study. 3. Quality effects model This approach will be utilized in establishing the variability of the studies through incorporating the element of quality which is relevant to the study. This approach presents the research with the capacity to utilize methodological evidence from the studies rather than the subjectivity of random probability. The introduction of quality measure eliminates the untenable interpretations which commonly occur during the literature review process. Ethical Considerations The study has evaluated secondary and primary data sources from original research. Therefore, it cannot be counted as original research. The researches that will be included within the context of this study must be analyzed for ethical consideration by the researchers. This will seek to ensure that the conclusions that are drawn in the study present a conclusive evidence that does not have any ethical issues associated to the primary data collection approaches utilized. Bias While the researcher has conducted various activities seeking to eliminate bias within the research, there are various factors that could result in the development of bias. Identification of this bias becomes essential in trying to ensure the research validity is assured through elimination of bias(Felson, 1992). The most common causes of bias in meta-analysis research include the following. 1. Publication bias This refers to the kind of bias that occurs as a result of researches being repetitively published within various journals. It becomes increasingly difficult for researchers to overcome this bias as they cannot tell the number of researches that have not been published. The utilization of a symmetrical funnel plot can be utilized to establish the publication bias in the topic (Peters et al., 2008). The fundamental purpose for the application of approaches for estimating this bias is the adoption of an approach for eliminating the effect of publication bias upon the research findings. There is always a possibility of smaller studies becoming focused in a single direction because of the sample size, thereby minimizing their possibility of being published. 2. Agenda driven bias This is bias that results from the possibility of the researcher conducting the research because of certain personal agendas related to the issues being studied(Felson, 1992). These commonly occur where there is an interest in political or social elements regarding the topic and researchers might only focus of presenting favorable results. This research will be conducted purely for academic purposes, and the researcher does not have any vested personal interest in the subject matter. The plausibility of meta-analysis research increases the possibility of agenda-driven bias having significant impact on the findings of the research. Assumptions The basic assumptions made within this research are: The information presented in the literature is well researched and based on original research. The integrity and ethical issues were adequately addressed within the research conducted earlier The large sample of studies can be applied with generalization to the population based on the validity of the findings Limitations Within the context of conducting a meta-analysis research there are various limitations that the researcher experiences. These limitations present a significant challenge during the process of conducting the research and include the following elements 1. Time consumption One of the fundamental challenge faced by researchers conducting these types of research remains the time consumption when searching for relevant studies. While many researches might be available from different sources, their relevance to the topic under investigation must be analyzed for them to be included within the study. This is a time-consuming factor since the information cannot be gained from abstracts and summaries of the documents. 2. Difficulty drawing conclusions Since the researches included were conducted in different regions and for different purposes, the gathered information remains highly heterogeneous. Drawing conclusion from such a wide database becomes relatively difficult and sometimes the researcher might be forced to make generalized conclusions. The study populations are also heterogeneous and the generalization of the results could result in wrong conclusions if applied within a single platform of meta-analysis research. 3. Justification of results While the results contained in different research studies could be easily justified through exploring the methodology utilized, combination of such researches makes it difficult to justify the conclusions present within this study. There is a significant discrepancy in the findings that makes it relatively difficult to establish the justifiable evidence. References American Psychology Assosiation. (2014). Psychologists’ Role in Treating Persons with a Chronical Illness. Retrieved from http://www.apa.org/about/gr/issues/health-care/chronic.aspx Claar, R. L., & Blumenthal, J. A. (2003). The value of stress-management interventions in life-threatening medical conditions. Current Directions in Psychological Science, 12(4), 133–137. Cooper, H., Hedges, L. V., & Valentine, J. C. (2009). 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