Research Critique

Criteria

Article 1

Article 2

Article 3

APA-Formatted Article Citation with Permalink

Bobo, D. L. (2015). Improving the Education Gap for Patients with Chronic Kidney Disease.

Hagren, B., Pettersen, I. M., Severinsson, E., Lützén, K., & Clyne, N. (2005). Maintenance haemodialysis: patients’ experiences of their life situation. Journal of clinical nursing, 14(3), 294-300.

Plantinga, L. C., Pham, H. H., Fink, N. E., Rubin, H. R., Jaar, B. G., & Powe, N. R. (2005). Use of dialysis educators beyond nurses and physicians and outcomes in patients with kidney failure. Advances in chronic kidney disease, 12(4), 424-432.

How Does the Article Relate to the PICOT Question?

It explains the importance of having good training programs for the patients who have chronic kidney disease as a way to extend their life spans with minimal complications or negative outcomes.

This article champions for the better community level education mechanisms that play role in the prevention of CKD as well as the management among the patients who already got the CKD.

It highlights why a deep focus should be put on the CKD trainers different from the frontline staff in the healthcare system like nurses and the critical role they play towards concerted efforts in the fight against kidney failure.

Quantitative, Qualitative (How do you know?)

Quantitative.

In the methodology section, the researcher say that a quantitative, pre and post survey, quasi-experimental design study was implemented from March, 2015 to July, 2015 within the offices of the nephrology clinic.

Quantitative

It involved structured interviews with a selected sample of the population.

Qualitative.

It uses non structured interviews where the respondents answered on their satisfaction with non-medical education offered in the clinics.

Purpose Statement

The intention of this project was to study the effects of a well-developed training program, in the adults found with CKD with the sole purpose of reducing the gaps that exist in education for an improved understanding and management.

The aim of this study was to examine how patients suffering from CKD on maintenance hemodialysis experience their life situation.

The basis was that this knowledge is useful to offer professional assistance that considers a person's whole life situation

This study was commissioned to establish if education offered to CKD patients had any relationship to the patient outcomes in a cohort of incident dialysis patients

Research Question

What is the key purpose and role of structured education program, among the adults who have been diagnosed with chronic kidney disease?

What role does CKD patient education play in the alleviation of ‘pain’ during the period of fighting the disease?

Does patient education by nonmedical personnel affect the outcomes in the CKD patients

Outcome

The impact of a structured education program called Kidney Smart Class℠ was established on the levels of information and knowledge of the adult patients who have been diagnosed with chronic kidney disease.

The patients in this study indirectly expressed an existential struggle, indicating lack of adequate support during their hard struggles with CKD.

Patients who were treated at clinics with nonmedical educators reported more satisfaction on the information offered as compared to those treated at clinics without nonmedical educators

Setting

(Where did the study take place?)

The setting of this study took place within a large nephrology clinic located in the northeast corridor of the United States with four offices throughout the surrounding area.

CKD clinics that perform maintenance hemodialysis.

The study took place in 79 United States clinics that were involved in care and treatment of CKD

Sample

50 participants took place in the study and were divided into control group (25) and the experimental group (25).

41 patients between the ages of 29 and 86 years

The sample was a cohort of 1,005 incident dialysis patients

Method

A quantitative, pre and post survey, quasi-experimental design study method was used in this article.

Use of structured interviews

Logistic and Poisson regression and Cox proportional hazards models were used 

Key Findings of the Study

Results of the study carried out indicated that Kidney Smart Class℠ had a statistically significant outcome on the perceived knowledge among adult CKD patients and this is shown by the rise in the post survey scores recorded.

The research found that caregivers and educators were not always aware of some modules and therefore could not be solely depended to offer full support, care and management to the CKD patients

The overall satisfaction level, patient self-management and care were not statistically significantly to the use of nonmedical educators and that the use of nonmedical staff for patient education at dialysis clinics had a limited effect on the level of patient satisfaction.

Recommendations of the Researcher

The researcher recommends that some more research is needed whereby the sample size is large in order to be able to validate the results obtained and come up with some good conclusions and expound on the differences in the statistical significance that early education provision among the people with CKD

Qualified nurses and doctors need to create routines to attend to the CKD patients and offer some guidance and education without leaving them to non-medical staff and caregivers

Recommends that more research is needed to understand what levels of education of the non-medical educators is optimal for better outcomes

Criteria

Article 4

Article 5

Article 6

APA-Formatted Article Citation with Permalink

Davis, J. S., & Zuber, K. (2013). Implementing patient education in the CKD clinic. Advances in chronic kidney disease, 20(4), 320-325.

Thomas, N., Bryar, R., & Makanjuola, D. (2008). Development of a self‐management package for people with diabetes at risk of chronic kidney disease (CKD). Journal of Renal Care, 34(3), 151-158.

Dixon, J., Borden, P., Kaneko, T. M., & Schoolwerth, A. C. (2011). Multidisciplinary CKD care enhances outcomes at dialysis initiation. Nephrology Nursing Journal, 38(2).

How Does the Article Relate to the PICOT Question?

It relates to the picot question since it explains why implementing education in the clinic where we have CKD patients is key to fighting it.(CKD)

The article describes why self-management knowledge among the CKD plays big role in decreasing the advancement of the disease to risky levels.

This article outlines how different approaches towards CKD knowledge helps to improve positive outcomes in a dialysis

Quantitative, Qualitative (How do you know?)

Qualitative

It used informal groups that randomly answer questions passed to them.

Quantitative

The research used structured interviews.

Qualitative method.

The study involved evaluation of experiences of the CKD patients with the multidisciplinary care.

Purpose Statement

Establish if having structured programs of education play any role in the management of CKD patients and if non-medical educators or professional; staff matter more

The purpose of this study was to identify what role education and self-management tools among the CKD patients played to the management of CKD.

The study wanted to establish the role of education in CKD patients more critically the multidisciplinary case and the traditional nephrology care.

Research Question

What role the well-structured education programs plays towards management of CKD patients and prevention of negative progressions.

Whether self-care management tools and education had impact on the extent of management of CKD patients.

The research question was what methods worked better for the CKD patients between the multidisciplinary care approach and the traditional nephrology care method

Outcome

Education plays a very important role in the CKD patients’ disease management and it’s effective on the disease progression.

23% study population (n = 1946) was identified to be at the risk of kidney damage.

Patients who reported to have received multidisciplinary care were 42% less likely to be admitted to the hospital for dialysis initiation, and had significantly lesser days hospitalized (p = 0.001), fewer admissions (p = 0.005), and reduced charges for a 90-day period (p = 0.003) after dialysis initiation.

Setting

(Where did the study take place?)

Clinics concerned with CKD care, treatment and management- The University of Alabama at Birmingham (UAB) CKD clinic

South‐west London, UK

Nephrology Section at Dartmouth-Hitchcock Medical Center

Sample

1844 patients

1946 persons at risk of kidney damage

The sample sized involved was those patients who received CKD care using a multidisciplinary care model (n = 89) with those who received traditional nephrology care (n = 82)

Method

Group interviews

A multi‐method study used interviews with 15 patients at high‐risk of progressive kidney disease.

The study involved the outcome comparison of patients who received CKD care by use of multidisciplinary care and those who used traditional nephrology care.

Key Findings of the Study

A key finding is that provision of education to CKD patients is a very integral part of kidney diseases management and decreasing the rate of moving to worst cases scenarios.

The interviews found that although most of the people some understanding on the risks of kidney disease, they had little or no idea of how to control the condition themselves. Therefore, this study highlights the role of incorporating self‐management tools in the care and management of patients with CKD.

The key findings in this study supported usage of multidisciplinary clinic as a method for improving care of the patient with CKD initiating dialysis, and reducing hospital admissions and costs.

Recommendations of the Researcher

The use advanced medical practitioners in offering education to CKD is highly recommended as compared to no medical staff like the dieticians

That more research is needed to establish the relationship between self‐management tools in the care and management of patients with CKD and progression of it to adverse stages.

The study recommends that more integrated research is needed to evaluate the role of the quality of education offered to CKD patients and determinants in adverse progression.