Quantitative Research Critique and Ethical Consideration Essay

Quantitative Research Critique and Ethical Consideration Essay

Proper management of blood pressure is a key consideration for every healthcare provider to reduce disability, mortality, and cardiovascular-related deaths resulting from hypertension. It is possible to manage hypertension through lifestyle modification, antihypertensives, or both (Mills et al., 2020). In addition, both patients and healthcare providers must play an active role in the process to influence outcomes. Patients ought to adhere to interventions proposed by healthcare providers. On the other hand, healthcare providers monitor, treat and advise patients accordingly. Nonetheless, care is long-term and involves some adjustments along the way.

Consequently, it is imperative to use either telemonitoring or usual outpatient care in follow-up. Telemonitoring is a new concept in managing chronic conditions with promising results of enhancing long-term follow-up and management of chronic conditions such as hypertension (Morawski et al., 2018). Arguably, much quantitative research has been done to evaluate its impact on blood pressure control to ascertain the effectiveness of telemonitoring. Quantitative research helps in attaining greater knowledge and understanding subject matter. The purpose of this paper is to present a critical appraisal of two quantitative studies addressing the impact of telemonitoring in the management of blood pressure.

PICOT statement: Among adult patients with hypertension (P), does care using telemedicine (I) compared to standard regular visits (C) reduce blood pressure in 6 months (T)?

Background of Studies

            The need to improve health outcomes in patients with hypertension has led several researchers to come up with evidence-based methods of management. Several researchers about telemonitoring have also added to the knowledge of management and long-term follow-up of patients with hypertension. A study by Hoppe et al. (2020) evaluated the effectiveness of home telehealth compared to outpatient visits in reducing readmission rates in patients with postpartum hypertension. This study improves nursing practice by improving the care for mothers with postpartum hypertension. Effective management of postpartum hypertension reduces maternal mortality and other complications in the postpartum period. Compared to this study, a study Morawski et al. (2018) evaluated the effectiveness of using a smartphone application in improving adherence to treatment and control of blood pressure. The broad objective was the main research question for the study. This study integrates the use of the mobile application as a component of telemedicine to improve blood pressure control.

How Articles Support Nursing Practice Problems

The two studies by Hoppe et al. (2020) and Morawski et al. (2018) are relevant to the nursing problem and the PICOT question. My proposed nursing project compares the effectiveness of telemonitoring to usual outpatient care visits in the control of blood pressure. Management of blood pressure is complex and requires collaboration between healthcare providers and patients. Healthcare providers have the skills and knowledge in the management of blood pressure and pass the same information to patients. On the other hand, patients have to adhere to instructions and work closely with healthcare providers. Either telemonitoring or outpatient visits offer an opportunity for interaction and help in long-term care.

As a result, the study by Hoppe et al. (2020) which compares the effectiveness of telemonitoring to outpatient visits enlightens healthcare providers about the effectiveness of either in treatment. The best option that improves healthcare outcomes should be adopted. In addition, Morawski et al. (2018) also enlighten healthcare on the importance of smartphone apps in improving adherence to care in hypertension. According to Poulter et al. (2020), suboptimal medication adherence is the reason for poor blood pressure control in most patients. Therefore, enhancing adherence is key to improving patient outcomes and reducing long-term complications.

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Methods of Study

            Both studies were quantitative with different designs. The study by Hoppe et al. (2020) was a non-randomized control trial involving 428 women divided into either control or intervention groups. The intervention group used a tablet and Bluetooth BP monitoring for daily transmission of vitals while the control benefit from routine care from outpatient visits. Both groups were on different antihypertensives for BP control. Using non-randomized control makes it easier to create groups by matching characteristics and ensuring participants are not assigned depending on the chance. However, the assignment of groups may be influenced by the investigators making the groups incomparable, thus limiting its use.

Comparably, Morawski et al. (2018) did a randomized control trial study involving 412 participants divided into either group. The intervention group used a Bluetooth app to transmit daily BP recordings. The Medisafe app tracked adherence, reminded patients to take medications, and assisted in dosage calculation. The use of randomized control trials is advantageous as it helps in reducing selection biases by investigators and allows equal opportunity for everyone to be selected. However, randomization may not be possible due to ethical reasons. It is against ethics to deprive a patient of a certain treatment that is believed to improve their condition.

Results of Study

            Results from both studies contribute to the PICOT and nursing practice. Telemonitoring contributed positively to blood pressure control and general health outcomes of hypertensive patients. For instance, in the study by Hoppe et al. (2020), patients who used telehealth compared to standardized care registered reduced instances of readmission. In addition, Morawski et al. (2018) found increased adherence to medication among the intervention group compared to the control group. Blood pressure control also improved among patients who used smartphone apps. Findings from these studies improve nursing practice in terms of improving adherence and reducing readmissions. Therefore, nurses can apply telemonitoring in their respective areas to improve medication adherence and improve general outcomes of patients.

Ethical Considerations

            Ethical principles guide every research involving human subjects. Likewise, researchers in these studies were conversant with ethical principles and applied them in their respective consideration. Informed consent is one of the ethical principles considered in this research. Ethics requires that every participant is informed about the risks and benefits of research and be allowed to take part in research voluntarily (Mardani et al., 2019). Participants in these studies were contacted and informed about the benefits and risks of research before signing the consent form to participate in research studies.

Another ethical consideration is the confidentiality of the participant`s information. Confidentiality is a vital ethical principle that requires keeping the information of all participants anonymous and private throughout the study. The use of unique identifiers, proper keeping of files, and encryption of data are some of the ways of maintaining confidentiality in research (Mardani et al., 2019). The researchers in both studies upheld the principle of confidentiality since no third party had access to participants’ information. Participants’ identities remained anonymous and no researcher collected personal information from the participants.

Conclusion

            Management of hypertension is a collective engagement of both patients and healthcare providers. Implementing proper blood pressure measurement as well as enhanced communication and adherence to treatment, is key to blood control. Research findings from the two quantitative pieces of research support the effectiveness of telemonitoring in the management of hypertension. Nurses and other healthcare workers should assess the feasibility of an intervention to manage their patients and improve their health outcomes.

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References

Hoppe, K. K., Thomas, N., Zernick, M., Zella, J. B., Havighurst, T., Kim, K., Williams, M., Niu, B., Lohr, A., & Johnson, H. M. (2020). Telehealth with remote blood pressure monitoring compared with standard care for postpartum hypertension. American Journal of Obstetrics and Gynecology, 223(4), 585–588. https://doi.org/10.1016/j.ajog.2020.05.027

Mardani, A., Nakhoda, M., Noruzi, A., & Shamsi Gooshki, E. (2019). Ethical considerations in the biomedical research: analysis of national biomedical research ethics guidelines in Iran. Journal of Medical Ethics and History of Medicine, 12, 4. https://doi.org/10.18502/jmehm.v12i4.767

Mills, K. T., Stefanescu, A., & He, J. (2020). The global epidemiology of hypertension. Nature Reviews. Nephrology, 16(4), 223–237. https://doi.org/10.1038/s41581-019-0244-2

Morawski, K., Ghazinouri, R., Krumme, A., Lauffenburger, J. C., Lu, Z., Durfee, E., Oley, L., Lee, J., Mohta, N., Haff, N., Juusola, J. L., & Choudhry, N. K. (2018). Association of a smartphone application with medication adherence and blood pressure control: The MedISAFE-BP randomized clinical trial. JAMA Internal Medicine, 178(6), 802. https://doi.org/10.1001/jamainternmed.2018.0447

Poulter, N. R., Borghi, C., Parati, G., Pathak, A., Toli, D., Williams, B., & Schmieder, R. E. (2020). Medication adherence in hypertension. Journal of Hypertension, 38(4), 579–587. https://doi.org/10.1097/HJH.0000000000002294

 

In this assignment, you will write a critical appraisal that demonstrates comprehension of two quantitative research studies.

Use the practice problem and two quantitative, peer-reviewed research articles you identified in the Topic 1 assignment (or two new articles based on instructor feedback in Topic 1) to complete this assignment.

In a 1,000–1,250-word essay, summarize two quantitative studies.

Use the “Research Critique Guidelines – Part II” document to organize your essay.

You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.

Attachments

NRS-433V-RS-T3-ResearchCritiqueGuidelinesPart II.docx