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Research critiques provide nursing students and nurse professionals with a framework to synthesize evidence based practice (EBP) from research studies and provide feedback for improvement (Bosewell & Cannon, 2012). Furthermore, research critiques provide nurses with the opportunity to contribute to the body of nursing knowledge (Coughlan, Cronin, & Ryan, 2007), as will be evidenced in this paper which aims to undertake a comprehensive critique of a quantitative research article by Stravrianopoulos (2017) titled Impact of a Nurse-Led Telephone Intervention Program on the Quality of Life in Patients with Heart Failure in a District Hospital of Greece. The present paper is focused on generating evidence of how nurses could use simple interventions to improve the quality of life of patients with heart conditions.
Research Question/Hypothesis
The researcher did not make use of a research question; however, he hypothesized that regular nurses-led telephone intervention in patients with heart failure may indeed enhance the quality of their lives. This hypothesis, in my view, was clearly stated and reflected the information presented in the literature review by the researcher.
As suggested by Coughlan et al. (2007), the hypothesis was effective in forming a link between the initially stated research problem (the complex problems experienced by patients with heart failure, leading to low quality of life indicators) and the methods used to undertake the study. The events that could have affected this hypothesis include the research design and data collection strategies, the research scope, and practical aspects such as available resources and skills (Bosewell & Cannon, 2012).
Research Design
Stravrianopoulos (2017) used a quantitative research approach and an experimental research design to undertake the study, based on the fact that the sampled participants were assigned to intervention and control groups. Some of the strengths of an experimental research design include the capacity to ascertain the objectivity of the intervention and draw conclusions regarding the intervention or treatment, the capacity to check and verify results due to its element of repeatability, and the orientation to achieve better results due to the controlled environment of experimental research (Creswell, 2014). However, experimental research designs not only create artificial scenarios that fail to represent real-life situations, but are also associated with the challenge of inability to control all extraneous variables. It is clear that Stravrianopoulos (2017) used this research design due to its capacity to ascertain the effect of the telephone intervention by comparing the experimental group with the control group upon exposure to the intervention.
Sample
The sample of the study comprised 50 male and female patients with heart failure, who were selected to participate in the study without giving due consideration to their origin and marital or socioeconomic status. The sample size is not adequate as the number of people with heart failure and other cardiovascular conditions in Greece (the population) is much higher compared to other countries in Europe (Tsgari, 2014). As mentioned, 50 participants took part in the study. This number can be described as adequate to identify intervention-oriented effects and also based on the fact that the study context was limited to a district in Greece.
Data Collection
Data for the study were collected by the patients themselves via a questionnaire, meaning that the instrument was self-administered. However, Stravrianopoulos (2017) failed to describe how the Minnesota Living with Heart Failure Questionnaire (MLHFQ) contained in the actual data collection instrument evaluated the quality of life indicators of patients pre- and post-intervention. Moreover, the researcher did not indicate how he addressed ethical considerations involving patients, including how he guaranteed their confidentiality and autonomy.
Study Limitations
The limitations of the study included the use of a relatively small sample and participant bias due to the pre-test/post-test method used in the study. The limitation of a small sample size can be overcome by ensuring the recruitment of adequate participants depending on the population size, while that of participant bias can be addressed by making sure that participants are not made aware of whether they belong to the intervention group or the control group (Creswell, 2014). Limitations are important to list and discuss in a study since they alert readers on potential problem areas that could limit the generalizability and validity of research findings.
Findings
The study found that the quality of life indicators of patients with cardiovascular conditions improved upon exposure to the 16-week telephone intervention program offered by four qualified nurse professionals; however, Stravrianopoulos (2017) was unable to find further statistical correlations in other test areas such as the relationship between the regularity of hospital visits by patients with heart conditions and exposure to the telephone intervention. Drawing from these findings, it is clear that the researcher was able to prove the initial hypothesis. These results, in my view, are less credible or convincing because they cannot be generalized to the larger population of people with heart failure and other cardiovascular conditions in Greece due to the small sample size used in the study.
Summary
It is clear from the study findings that simple strategies such as nurses telephone interventions could be used to improve the quality of life of patients with heart failure and other cardiovascular conditions. Although the findings are not strong enough due to credibility and generalizability issues, nurse practitioners could still use the telephone intervention to pass on important information to heart failure patients, including how to prevent the risk factors associated with the disease and how to adopt healthy lifestyles and behavior. Furthermore, the intervention is quite cheap to implement in practice settings. Overall, researchers need to conduct a large-scale study with the view to confirming the findings of this study.
References
Bosewell, C., & Cannon, S. (2012). Introduction to nursing research: Incorporating evidence based practice. Burlington, MA: Jones & Bartlett Learning.
Coughlan, M., Cronin, P., & Ryan, F. (2007). Step-by-step guide to critiquing research. Part 1: Quantitative research. British Journal of Nursing, 16(11), 658-663.
Creswell, J.W. (2014). Research design: Qualitative, quantitative, and mixed methods approaches (4th ed.). Thousand Oaks, CA: Sage Publications, Inc.
Stravrianopoulos, T. (2016). Impact of a nurse-led telephone intervention program on the quality of life in patients with heart failure in a district hospital of Greece. Health Science Journal, 10(4/5), 1-8.
Tsagari, D. (2014). Greece tops list of heart disease and strokes in Europe.
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