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Topic of Interest
Cardiovascular (CVD) disease is one of the leading causes of mortality and morbidity in the United States as well as worldwide (Dickson et al., 2013). Minimizing the risks of CVD in the affected populations could significantly improve their quality of life and public health in general. The topic of interest discussed and explored in this paper is the efficiency of nurse-led self-care programs in minimizing the rates and severity of cardiovascular disease in patients over 40 years old who already have the condition or are likely to develop it in the near future.
PICOT Method and Question
In order to demonstrate the application of the PICOT method to the topic of interest, it will be broken down into separate components and then formulated into a question.
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Population people over the age of 40 affected by CVD or likely to develop the condition in the near future.
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Intervention nurse-led telephone and email-based program directed at self-care improvement by means of influencing lifestyles and choices of the patients
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Comparison compared to no intervention
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Outcome minimization of CVD rates in the target population
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Time six months
PICOT Question: In the population over 40 years of age diagnosed with CVD (or under risk of developing it within the next year), how do the participation in a nurse-led telephone and email-based self-care program affect the rates of CVD within 6 months compared to the population provided only with usual CVD treatment?
Examination of Current Literature
There are several recent evidence-based nursing studies that researched nurse-led self-care for CVD. The study by Zhu, Wong, and Wu (2014) conducted in a form of randomized control trial involved 73 hypertensive patients divided into two groups (nurse-led intervention and doctor-led treatment) within 8 weeks. The study found no significant difference in BP readings, but the nurse-led participants demonstrated higher health literacy, self-management, and satisfaction rates.
The study by Cicolini et al. (2014) showed that in both control (CVD treatment) group and intervention (nurse-led email reminder program plus treatment) group the BP readings and quality of life improved. Also, the intervention group showed a significant decrease in factors leading to CVD aggravation (fat and sugar consumption, passive lifestyle, obesity). The research by Chang, Fitchi, and Kim (2012) evaluated the impact of nurse-led empowerment sessions (8 weeks) on the experimental group of 30 people and the control group of 22 (receiving standard treatment for hypertension) all the participants were diagnosed with metabolic syndrome.
The researchers found that the intervention improved lifestyle, satisfaction rates, symptoms prevalence, and self-management rates in the group that received the empowerment. Carrington and Stweart (2014) studied the effects of nurse-led programs on CVD patients observing the clients of a nurse-led clinic; the researchers identified significant positive long-term outcomes and symptoms prevalence changes in terms of BP rates, blood glucose, and lifestyles.
Wijngaart, Sieben, Vlugt, Leeuw, and Bredie (2014) researched the effects of multidisciplinary follow-up care led by nurses and involving 176 patients and lasted for a year. The intervention showed a reduction in risk factors and symptom prevalence.
Implications for Nursing Practice
The reduction of CVD rates in the affected populations and those in the risk of developing such conditions could produce a massive positive impact on the aforementioned patients improving their self-management skills and lifestyle choices. Also, nurse-led programs do not require much time and can be conducted remotely via phone call and email reminders, which signifies the efficiency of such interventions.
References
Carrington, M. & Stewart, S. (2014). Cardiovascular disease prevention via a nurse-facilitated intervention clinic in a regional setting: The Protecting Healthy Hearts Program. European Journal of Cardiovascular Nursing, 14(4), 352-361.
Chang, A., Fritschi, C., & Kim, M. (2012). Nurse-Led Empowerment Strategies for Hypertensive Patients with Metabolic Syndrome. Contemporary Nurse, 3008-3032.
Cicolini, G., Simonetti, V., Comparcini, D., Celiberti, I., Di Nicola, M., & Capasso, L., & Manzoli, L. (2014). Efficacy of a nurse-led email reminder program for cardiovascular prevention risk reduction in hypertensive patients: A randomized controlled trial. International Journal of Nursing Studies, 51(6), 833-843.
Dickson, V., Nocella, J., Yoon, H., Hammer, M., Melkus, G., & Chyun, D. (2013). Cardiovascular Disease Self-Care Interventions. Nursing Research and Practice, 2013, 1-16.
Wijngaart, L., Sieben, A., Vlugt, M., Leeuw, F., & Bredie, S. (2014). A Nurse-Led Multidisciplinary Intervention to Improve Cardiovascular Disease Profile of Patients. Western Journal of Nursing Research, 37(6), 705-723.
Zhu, X., Wong, F. K. Y., & Wu, L. H. (2014). Development and evaluation of a nurse-led hypertension management model in a community: a pilot randomized controlled trial. International Journal of Clinical and Experimental Medicine, 7(11), 43694377.
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