Introduction
Empirical evidence indicates that Chronic Obstructive Pulmonary Disease (COPD) and diabetes are connected because they are both associated with inflammation. Also, the hyperglycemia that is related to diabetes may be worsened by medications indicated for COPD (Gooneratne, Patel, & Corcoran, 2010). Therefore, the nursing interventions that are applied in the management of COPD and diabetes comorbidity among older adults should be guided by evidence-based practices to prevent undesired patient outcomes (Wakabayashi, Motegi, Yamada, Ishii, Gemma, & Kida, 2011).
This paper presents a review of the article “Obstructive Pulmonary Disease and Their Families: Influences On Health-Related Quality Of Life and Hospital Admissions” (Ingadottir & Jonsdottir, 2010) with a view of determining the indicators of high-quality nursing care in the management of older patients with COPD and diabetes. The goal of the paper is to apply the findings within the selected research article about their implications on the treatment of older patients with COPD and diabetes comorbidity that are using Prednisone.
Research Question
The research article addresses the research question on the role of partnerships between providers and family members in promoting the health outcomes of patients with COPD. In addressing this research question, the researchers evaluated the health outcomes of adult patients with COPD whose health care interventions involved collaboration between health care providers and members of the family. The researchers aimed at determining the importance of high-quality nursing practices in overcoming the complex problems that are associated with COPD among adult patients.
Research Design
The researchers applied the prospective and retrospective pretest-posttest design in conducting their study. They applied this design to evaluate the nursing interventions or practices that are applied in the care of adults with COPD and addressing the needs of their families. The prospective and retrospective pretest-posttest design allowed the researchers to apply multiple data points to measure the behavior of nurses in the care of patients with COPD and the level at which they collaborate with family members in the health care process. The study design also enabled the researchers to measure health care behaviors and interventions for COPD with accuracy.
Sampling
The researchers applied a convenience sampling technique to select the participants in the study. This type of sampling allowed the researchers to measure the major health outcome variables of the study with efficiency. A sample of 39 women and 11 men of the average age of 66 years were selected and involved in the study process. The majority of the participants (n = 36) had severe COPD. However, the sample size in this study is relatively small, which would have limited the findings and conclusions that were drawn from the study. The small sample size also limited the ability of the researchers to involve a control group in their study (Ingadottir & Jonsdottir, 2010).
Data Collection Methods
Data were collected within three periods. The first period in data collection was 6 months before the actual research. The second period was during the entry of the sampled participants into the care practice and the third period was 6 to 12 months after the implementation of health care interventions for COPD. Hospital admissions data was collected during the three data collection periods.
Psychometric data and clinical data sets were collected during the entry of the selected patients into health care practice. Clinical data were collected from the documentation of nurses on the smoking status of patients, their demographic data, BMI, stage of COPD, and several family members. Electronic patient record systems were used to generate data on patient admissions within the three data collection periods. Two psychometric instruments were used in the collection of psychometric data. These are HRQL and SGRG. The two instruments are designed to measure the health status of individuals with breathing problems (Ingadottir & Jonsdottir, 2010).
The collection of psychometric data involved self-completed reports from patients. Nurses assisted the patients in reporting their psychometric information and responding to the psychometric data collection instruments.
Limitations of the Study
The retrospective pretest model that was applied in the study limited the accuracy of the study findings because it relies on the recall of participants on their health conditions and symptoms. To overcome this limitation, future studies should minimize the effect of memory-related problems among participants. The self-reported psychometric data also limited the study because this data collection method is associated with bias (Bordens & Abbott, 2002).
To overcome this limitation, researchers should compare the self-reported psychometric data with patient records. The small sample size limited the ability of the researchers to include a control group in the study. Therefore, the researchers were not able to isolate or eliminate bias and confounding variables during the study.
Findings and Significance to Nursing
The researchers report that the day’s patients with COPD spend in hospital and the rate of hospital admissions are significantly reduced when health care providers collaborate with family members in the implementation of health care interventions. The quality of life among patients with COPD is also improved through provider-family partnerships in the health care process. Furthermore, the researchers found out that adherence to inhaler medications among patients with COPD improve significantly when health care providers involve family members in the care process.
The findings that are reported in the article are relevant to nursing practices involving the care of older patients with COPD and diabetes comorbidity because they provide guidelines for the inclusion of family members in the process of administration of Prednisone to these patients. The involvement of family members in the care of these patients specifically improves their health care outcomes since it prevents the worsening of diabetes due to the use of COPD medications.
Collaboration between providers and family members promotes communication on health care guidelines and the administration of medications for COPD to enable family members to assist in minimizing undesired health effects on patients with COPD and diabetes comorbidity. Therefore the research findings within the article are applicable in overcoming the complex problems that older patients with COPD comorbidities face within outpatient health care settings.
Summary
The research in the selected article was aimed at determining how the complex problems that patients with COPD face can be overcome through effective health care interventions, including a partnership between providers and family members. Though prospective and retrospective pretest-posttest design, the researchers evaluated health care practices for COPD and the associated health care outcomes with a view of assessing the role including family members in enhancing the quality of care and achieving the desired patient outcomes. The research findings within the article are applicable in informing nursing practice in the care of older patients with COPD and the complex problems that they face as a result of comorbidities of this disorder with other health conditions, such as diabetes.
References
Bordens, K. S., & Abbott, B. B. (2002). Research design and methods: A process approach . McGraw-Hill.
Gooneratne, N. S., Patel, N. P., & Corcoran, A. (2010). Chronic Obstructive Pulmonary Disease Diagnosis and Management in Older Adults. Journal of the American Geriatrics Society, 58(6), 1153-1162. Web.
Ingadottir, T. S., & Jonsdottir, H. (2010). Partnership-based nursing practice for people with chronic obstructive pulmonary disease and their families: influences on health-related quality of life and hospital admissions. Journal of Clinical Nursing, 19(19/20), 2795-2805. Web.
Wakabayashi, R., Motegi, T., Yamada, K., Ishii, T., Gemma, A., & Kida, K. (2011). Presence of In-Home Caregiver and Health Outcomes of Older Adults with Chronic Obstructive Pulmonary Disease. Journal of the American Geriatrics Society, 59(1), 44-49. Web.