Research Article Critique
Problem statement and or hypothesis
The purpose of the study was to describe the naturalistic outcomes and dimensions of health experienced by women with Interstitial Cystitis (IC) and to identify relationships between these dimensions and women’s current self-care practices for managing their illness. The latter question asks: What is the relationship between women’s subjective evaluations of self-care effectiveness and other measures of health?
Literature review
IC is a chronic disorder characterized by periods of symptom exacerbations and remissions. Histologically, the bladder wall shows a unifocal or multifocal inflammatory infiltration with mucosal ulceration and scarring which ultimately results in contraction of the smooth muscle, diminished urinary capacity, and symptoms of frequent, painful urination and hematuria. Nurses are instrumental in helping IC patients cope through symptom management, emotional support, and patient education. By increasing their awareness of this disorder and the challenging nature of its diagnosis, nurses can help identify patients with IC (1997).
Every clinician should know that psychiatric problems require a huge amount of health care dollars. If patients are untreated, overall medical costs rise exponentially (1999). The need to take a holistic view of clients and to plan interventions that are both acceptable to clients and are likely to be effective has always been emphasized by psychiatric-mental health nurses.
IC is one example of a poorly understood chronic illness that can produce hopelessness and suicidal ideation. Self-care, as a theoretical base of practice in caring for patients with IC, has been suggested as a model of holistic health. Those living with IC look to the nurse/health care practitioner for intervention and care (2004).
Treatment options include diet, symptom, medical, and surgical options. The IC patient’s quality of life is enhanced by the physical care and empathic understanding displayed by nurses as key members of the health care team. The nursing self-care component is crucial to creating harmony for the client to move forward with this chronic condition (1997).
Theoretical and conceptual framework
While the existing literature points to the deep impact that IC can have on women’s lives, there is nonetheless a scarcity of research on the particular issues of self-care and the outcomes in women with this disorder. For this reason the medical and mental health communities are unaware of the best way to assist IC patients in their recovery. To address this gap in the literature, this particular study was conducted which specifically explored the naturalistic outcomes and dimensions of health experienced by women IC and to identify relationships between these dimensions and women’s current self-care practices for managing their illness.
Research Design
For this proposal, the authors employed a combination of qualitative methods. This study examined naturalistic self-care activities and concurrent health dimensions rather than experimental manipulation of these variables. Nonprobability sampling is employed. The participants represented three different patient groups: (1) support group leaders for the Interstitial Cystitis Association (ICA) from the United States and Canada, (2) ICA conference attendees and (3) requested subjects in the ICA newsletter Healthline.
A 52-page survey was used, which included a combination of self-report Likert scales, categorical description, and open-ended questions, to gather data about the multidimensional experience of having and managing IC.
The limitations of the study include the inability to identify temporal precedence between reported effectiveness of self-care and the measures of health dimensions and outcomes.
Data collection procedures
Before the study was conducted, an approval to perform the study was obtained. The participants were selected representing three patient groups. They were informed that the purpose of the study was to learn more about the use and effectiveness of self-care strategies for managing IC.
The IC-SCR, adapted from the Self-Care Responses Tool, was used for the present study. It assessed the cognitive and behavioral strategies used by women in response to a variety of potential and actual threats to women’s sexuality. The IC-SCR was designed to obtain information about self-care to meet universal, developmental, and health deviation needs. Nearly 300 items on the IC-SCR are related to hygiene, diet, cognitive reframing, social support and stress reduction among others. The respondents are asked to indicate how often they have used each strategy during the past year as well as its perceived effectiveness.
Data Quality
The data is of high quality since it can be used for decision-making and planning, which can ultimately improve the self-care effectiveness and health outcomes in women with IC.
Qualitative analysis
The number of self-care and outcome items and the ratio of items to subjects precluded most types of multivariate analyses. Initial correlations between self-care effectiveness factors and outcome measures revealed few significant relationships, partially attributed to data lost due to fluctuations in the numbers of subjects who reported actually using each self-care activity.
Interpretation of results
There is no significant correlation between self-care effectiveness and vocational adjustment. Vocational categories could include work, school, work in the home, or some combination of these. There are no significant correlations between self-care effectiveness items and either extended family relationships or domestic relationships. The only self-care effectiveness item that was significantly correlated with one’s relationship to the health care system and providers was the practice of meditation during an acute attack state. The findings of the study point to the importance of identifying the multiple dimensions of health that are affected by having a chronic illness.
Ethical aspects
In all countries, research works that involve human subjects and animals should be carried out in accordance with high ethical standards set by various ethics committee. The privacy and dignity of every individual involved in the research was protected. The respondents were assured confidentiality and anonymity through identification coding and reports of aggregate data. The participants involved were notified of the aims, methods, expected outcome, benefits and potential hazards of the study conducted. An approval for the study was obtained from the Institutional Review Board of the University of Colorado Health Sciences Center.
Credit:ivythesis.typepad.com
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