Discussion: discuss how and what type of Qualitative Data you would collect related to your POI

Qualitative Paper
Heart disease is one of the chronic health problems with considerable prevalence in not only the USA but other global states. Heart disease affects the health, wellbeing, and quality of life of the patients and their families. Nurses and other healthcare providers play crucial roles in implementing evidence-based interventions that enhance outcomes such as safety, efficiency, and quality in heart disease management. They obtain the evidence-based data from sources such as practice guideline recommendations and high-quality studies. The purpose of this paper is to analyze qualitative studies on the use nurse-led health education program on prevention and self-management among patients diagnosed with heart disease.

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Describing Qualitative Studies
Qualitative research is a type of study that mainly focuses on the acquisition of non-numerical data. The aim of obtaining descriptive data is to understand the reality, attitudes, motivation, and beliefs of the study participants. The researcher adopts methods such as in-depth interviews, observations, and focus groups to obtain the data needed for the investigations(Harvey & Land, 2021). The importance of qualitative research is that it generates theories and provides insights into complex phenomena in nursing practice and healthcare.
Data collection for the proposed project will be collected using focused interviews. Focused interviews will be collected from heart disease patients and nurses involved in the delivery of the nurse-led interventions. The data will be audio recorded for it to be transcribed verbatim. The qualitative data obtained will focus on the participants’ attitudes and experiences with the nurse-led interventions. It will also explore the challenges experienced by the patients and nurses in the use of the project interventions. The approach to analyzing the data will entail reading the transcripts, re-reading again to understand what the participants meant in their descriptions, developing nodes, and grouping similar nodes into themes. The themes will be used to describe their data and understand their views and experiences with the intervention.
Appraisal Tools, Studies, and Matrix
The appraisal tools, studies, and matrix have been attached.
Evidence Matrix
The evidence matrix has been attached.
Article Discussion
McParland et al. (2022) is a mixed methods systematic review that investigated the types and outcomes associated with the different types of nurse-led interventions for multimorbidity. The systematic review followed the Joanna Briggs Institute methods for convergent-integrated reviews. The articles used in the research were obtained from databases that included CINAHL, EMBASE, Cochrane CENTRAL, and MEDLINE. Grey literature sources utilized included the Journal of Multimorbidity and Comorbidity and reference mining. The studies were included if they used English language to report nurse-led interventions for people with multimorbidity. Two reviewers assessed the quality of the studies using the JBI tools. The data in the selected articles were extracted and synthesized using core outcome sets and a pre-existing taxonomy of interventions.
The data collection using the JBI tools focused on details that include participant information, methodology, intervention, setting, authors’ conclusions, and outcomes. Qualitative data was extracted at the level of themes, distinct concepts, or subthemes. Data synthesis was done using the convergent-integrated approach. The quality score of the included studies was 77.5%. The common theme identified from the analysis is that involvement of advanced practice nurses in nurse-led interventions improves care outcomes. The intervention types were mostly case-management interventions followed by transitional care interventions, self-management, nurse-led interdisciplinary team, and ICT interventions. The use of these interventions improved healthcare and patient outcomes. The implications of this study are that nurses should be proactively involved in implementing nurse-led interventions to address the care needs of patients with multimorbid conditions such as heart disease. They should also implement evidence-based interventions to determine the safety, efficacy, and quality of nurse-led interventions in other chronic conditions. The study provided level I evidence. The study provides high quality evidence. The implication is that nurses and other healthcare providers can use the results and interventions with confidence because of the quality of the methods utilized in the research (Domin, 2022).
The results in the study by McParland et al. (2022) are credible. The researchers adopted scientific methods of investigation in selecting data sources with high quality evidence. The methods utilized were consistent across the different studies, hence, their credibility. The results are also trustworthy. The research process involved several researchers with extensive experience in nursing and healthcare. They also utilized evidence-based tools to eliminate data sources with weak validity, reliability, and relevance to the topic focus. As a result, nurses and other healthcare providers can depend on the reported findings when making their clinical decisions. The study also has high confirmability level since the methods utilized in the investigation can be tested elsewhere to determine their effectiveness. The focus on mixed interventions lowered the transferability of the study.
Jiang et al. (2021) is a qualitative study that examined patients’ preferences of a nurse-led, home-based heart failure self-management program. The researchers enrolled 11 English/Chinese participants from an intervention arm involving the use of the interventions. One-to-one semi structured interviews were conducted to explore the participant experiences with the program. Purposive sampling was adopted to recruit the participants. The inclusion criteria included those who were willing to participate in the research, aged at least 21 years, diagnosed with heart failure, could read and understand English/Chinese, and owned a smartphone.
Descriptive data analysis was used in this study for the sociodemographic characteristics of the study participant. Thematic analysis was used to identify, analyze, and report the themes within the data. Trustworthiness of the study was achieved by ensuring adequacy and feasibility of the semi structured interview guide. The themes that were identified from the study included areas of improvement, manageability of the intervention, personal accountability in self-care, increased self-efficacy in cardiac care, and empowered with knowledge and skills in self-care. The results of this study showed that the nurse-led program was easy to manage, reduced the need for travel, increased understanding of their health needs and skills for self-care, and ultimate empowerment to embrace healthy lifestyles and decisions for optimum outcomes. The implications of these findings are that nurses can influence the lifestyles, behaviors, and decisions of their patients. Nurse-led interventions can empower patients to be responsible for their health and health outcomes. Therefore, they should explore additional innovative strategies to improve outcomes among patients suffering from heart disease.
The study by Jiang et al. (2021) is credible and trustworthy. The researchers ensured credibility by adopting scientific approaches to qualitative study, including data analysis and collection. The results are trustworthy since the authors achieved adequacy and feasibility in the semi structured interview guide that was used. The results are dependable since the authors ensured accuracy by audiotaping and transcribing the data. The results are also confirmable since the developed themes reflect the experiences and perceptions of the participants. The results are also transferable based on the detailed contextualization of the study, which enables readers to draw conclusions from the investigation. The study provided level III evidence, since it is a qualitative study. The meaning of this level of evidence is that nurses may rely on its use when making clinical decisions(Domin, 2022). However, they should incorporate other sources of evidence-based data since the study has low quality evidence.
Applicability to Practice and Future Research
As noted above, McParland et al. (2022) found that nurse-led interventions, including those focusing on self-management improved outcomes such as health-related quality of life and patient-centered outcomes. The study demonstrated mixed effects of the interventions on costs, mortality, healthcare utilization, and other outcomes. The study results are applicable to nursing practice. First, nurses can implement any of the nurse-led interventions such as case management and those targeting self-care management to improve outcomes in patients suffering from chronic illnesses. Secondly, nurses can also utilize the interventions to determine their sustainability in improving the patient and health organizations outcomes. According to McParland et al. (2022), future studies should aim at evaluating the components of the nurse-led interventions that improve patient and healthcare outcomes. Randomized controlled trials should also be conducted using the nurse-led interventions to inform their validity and reliability in nursing practice. lastly, future studies should examine the effect of the nurse-led interventions on treatment burden among patients with chronic illnesses.
The findings by Jiang et al. (2021) are applicable to nursing practice and healthcare. For example, nurses adopt care interventions such as health education on disease self-management to increase patients’ self-efficacy in managing their conditions. Similarly, the adoption of interventions such as follow-up care and incorporation of technology into heart disease management improves outcomes. According to Jiang et al. (2021), future studies should aim at building on the best practices identified from nurse-led interventions to adapt to different contexts and improve care outcomes for the diverse population.
The EBP model that demonstrates best fir for the project is Lewin’s model of change. Lewin’s model is appropriate for the project since it provides systematic approaches that can be adopted to foster sustainable change. The stepwise implementation of the EBP will ensure the minimization of potential challenges that may threaten the realization of the desired outcomes(Alolabi et al., 2021). One of the things that need to be done before changes can be made is training nurses about the implementation of the intervention. It is also important to raise stakeholder awareness through consultative discussion. The organization is also yet to provide the required support for the project. The project still requires approval from the organization’s department involved in quality improvement initiatives.
Conclusion
Heart disease has considerable disease burden to the affected populations. Nurse-led interventions improve heart disease treatment outcomes. The reviewed studies support the use of nurse-led interventions to improve patient and care outcomes. The intervention is feasible due to the ease associated with its implementation. Therefore, strategies to ensure its successful implementation will be explored continually.

References
Alolabi, Y. A., Ayupp, K., &Dwaikat, M. A. (2021). Issues and Implications of Readiness to Change. Administrative Sciences, 11(4), Article 4. https://doi.org/10.3390/admsci11040140
Domin, K. (2022). Evidence-Based: Practice in Nursing & Healthcare 2022-2023. Amazon Digital Services LLC – Kdp.
Harvey, M., & Land, L. (2021). Research Methods for Nurses and Midwives: Theory and Practice. SAGE Publications.
Jiang, Y., Koh, K. W. L., Ramachandran, H. J., Tay, Y. K., Wu, V. X., Shorey, S., & Wang, W. (2021). Patients’ Experiences of a Nurse-Led, Home-Based Heart Failure Self-management Program: Findings From a Qualitative Process Evaluation. Journal of Medical Internet Research, 23(4), e28216. https://doi.org/10.2196/28216
McParland, C., Johnston, B., & Cooper, M. (2022). A mixed-methods systematic review of nurse-led interventions for people with multimorbidity. Journal of Advanced Nursing, 78(12), 3930–3951. https://doi.org/10.1111/jan.15427

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POI:

Heart disease is considered to be one of the leading causes of mortality on earth. However, preventative measures can be taken to decrease the risk of developing this chronic disease. As a FNP, the role of education and prevention of the disease could greatly affect patients. This includes education about the disease and how diet, exercise, and smoking impact heart disease.

Guideline/Position Statement: The cost of coronary heart disease and the promise of prevention.

Qualitative Paper Directions for Assignment

Please read through these step by step directions for a better understanding of the assignment. At the end you will see a video presentation going over the rubric and how to submit.

Approximate lengths of each section outlined below.

Step 1: Introduction

Write an introduction to the topic and end the paragraph with a thesis statement. The introduction should include 2-3 attention grabbing statements and end with 1 concise thesis statement that describes the overall purpose of your paper.

Step 2: Describing Qualitative Research

Describe what qualitative research is in your own words. Then discuss how and what type of Qualitative Data you would collect related to your POI. For example, if I was interested in knowing what it is like to be a parent in the hospital, then I might decide to interview (how) mothers and fathers of Neonatal Intensive Care Unit patients. I would look for themes (based on data saturation collected in interviews) in their answers until I collected enough information to find trends in the data. I might use that data to then develop new teaching methods to better prepare parents for caring for the baby based on the themes uncovered. Be sure to clearly identify that the information you are gathering is qualitative in nature. Sometimes, you might describe a process that could be used qualitatively or quantitatively, like a questionnaire, so it is important to provide enough information to ensure you are demonstrating a thorough understanding of qualitative literature collection. (2-3 paragraphs)

Step 3: Appraisal Tools, Studies and Matrix

Locate your 2 qualitative studies so you can appraise each separately with the tool below. Your studies should be highly similar to the original POI/Clinical question, but some variability is typically permissible. Faculty realize searching for qualitative studies can be more difficult, so some variation may be necessary. However, topics should be highly related/similar to the originally approved POI. For example, if my original topic was looking at Nutrition Management for Type II Diabetes in Adults, I might now look at the stigma associated with Diabetes in the patient and or family member or I might look for self-care measures associated with Diabetes in adults. While neither is the same as the original topic, they are still highly similar because they both discuss Diabetes and management/living with the disease.

One of your studies must be considered a Meta-synthesis or fit into the category outlined in the table below, while the other study must be a qualitative single study;-see table below. Once you have found 2 different qualitative study designs as specified, complete an appraisal tool for each study using the following link. Only complete the section of the tool related to the qualitative appraisal.

Keep in mind that you may need to vary your search strategy to find your qualitative literature. For example, if I am looking at pain tools in children, I may not be able to find any qualitative literature on this specific search, so I will look for a similar topic that impacts the patient such as: anxiety, depression, ICU pscyhosis, sleep disturbances. All of these subtopics may also be impacted by pain in children. Talk to your instructor for guidance if needed.

Qualitative Study Selection Options
You must choose one (1) QUALTITATIVE study from this category (column): You must choose one (1) QUALTITATIVE, Single study from this category (column): DO NOT USE any from this column:
Meta-ethnography Ethnography Any study that is Quantitative only
Meta-synthesis Phenomenology Quality Improvement study/project
Systematic Review – analyzes data qualitatively Grounded theory Literature reviews
Combination of above Case Study Scoping Reviews
Mixed methods Systematic Review, but must analyze data qualitatively Narrative Analysis Integrative Reviews
Historical Studies Implementation Strategies
Action Research Animal studies
Participatory Action Research

Use this tool to complete the appraisals for both qualitative studies separately. Attach the completed tool to your paper or with your assignment. Use the link below to complete. You can save the document as a pdf, use the edit function to fill in or handwrite and scan back into the assignment area.

Appraisal Tool pdf or Download Appraisal Tool pdf or

Microsoft word version Download Microsoft word version Microsoft word version Download Microsoft word version

Follow all steps carefully as the tool will guide you which steps to move to in each section of the tool.

For help on how to complete the tool, watch this video: “How to Complete the Appraisal”Links to an external site.

Creating an Evidence Matrix

The matrix is a continuation of the matrix you originally submitted in Module 3. Therefore, you will now have 4 studies included on the matrix. Highlight or Bold the NEW studies for the qualitative paper appraisal. You need to correct any mistakes or issues that you may have had with the matrix submitted with the quantitative paper or you will be counted off again on this paper. This document will be used again in 611 if you are in the DNP track, so be sure to put it in a safe place that you will be able to easily find again. The matrix should be included as an appendix OR you may upload as a separate attachment if needed. Use either link below to complete, one is a pdf, the other is a word document. You will need to complete the matrix for this assignment If for some reason you can not get the document below to adjust to your margins, you may re-create a document in word using a table format with all the same headings. Be sure you are include all 4 studies on the matrix.

Matrix PDF VersionDownload Matrix PDF Version

or Microsoft version Download or Microsoft version

SUBMISSION:

You will need to submit your 2 studies, completed appraisal tools and completed matrix (with each qualitative study added on it for a total of 4) along with your assignment. The documents should be submitted separately with the paper.

Step 4: Article Discussion

Use the information from your appraisal tool to discuss in detail the following information for each study: (2-3 pages)

Purpose or phenomenon, research design and Methodology (steps, procedures and strategies for gathering and analyzing data) used in each study

Data Collection: the discussion must include phenomenon or themes discovered, sample of participants or studies included, how selected, if data saturation was used, etc.

Credibility and Trustworthiness: Discuss concepts of credibility and trustworthiness which include dependability, confirmability and transferability. Each of these terms should be fully discussed to demonstrate understanding. Support the concepts with evidence from each study.

To understand trustworthiness and credibility, check out these links:

Trustworthiness and Credibility VideoLinks to an external site.

Results and Clinical Implications should be discussed.

Level of evidence and quality of evidence ratings (according to tool). Discuss what the level and quality ratings mean in relation to strength of the evidence and decision to sue (or not use) this information to guide practice. You need to fully support this section from evidence in the study and other resources. Understanding the levels of evidence tells you about the type of study performed, design, methods, etc. and if those findings should be applied to your own practice area. Grade of Recommendation is important because it helps you make a judgement about the quality of evidence; together they impact the decision about implementation into practice.

The following tool can be used to help you determine strength and quality, but this information is also listed directly on the tool.

Johns Hopkins Evidence Rating ScaleDownload Johns Hopkins Evidence Rating Scale

Other helpful links to understanding this information can be found in the required and recommended resources.

Be sure that you attach your 2 studies to the paper/assignment.

Step 5: Applicability to Practice and Future Research

Discuss the findings from each study in practice and how you will use them to make a change. Review your model selected from the Forum Discussion and determine where you are in the next step of the process of implementation. The discussion should include the EBP or QI model that demonstrates best fit for your POI. Be sure to include why it is a better fit than the other. Next consider what is still needed before changes can be made. Careful consideration of who, what, and how you would implement changes is needed and should detail: stakeholder involvement, financial, structural or process changes needed (at least one of these concepts must be discussed), technology support, ethical considerations such as HIPAA or Institutional Review Board approvals. Support with peer reviewed references. (2-3 paragraphs)

Step 6: Conclusion

Provide a conclusion paragraph to the paper summarizing all main points. A conclusion should NOT state any new information that was not previously addressed in the paper. While it can re-state the purpose of your writing, it should not repeat the thesis verbatim. Additionally, it should summarize the main points of each section.

Step 8: Turnitin

Be sure to submit your paper to turnitin. You do not have to submit your matrix or the appraisal tools to turnitin as they will skew your similarity report findings. Faculty will view your similarity report upon submission. You are expected to view the report for similarity and make any necessary changes, then re-submit prior to the due date.

See Rubric for specific Scholarship deductions.

Page limit: 6 pages, excluding title page, references, appendices and/or attachments.

Submission Info.: Title page, paper, references. The matrix, appraised studies, and appraisal tools should be submitted along with your paper as separate, individual attachments. All documents (paper and other required documents) must be uploaded to the assignment area as a Microsoft Word OR Adobe PDF. The paper (and including additional required documents) should be submitted to the assignment area as a Microsoft word or Adobe PDF Document.

References: you must include at least 2 additional peer reviewed references. All References should be current, no older than 5 years.

To see the rubric, go the next section of the Module and click on the rubric link.