My research would make use of quantitative research design. The experimental study design is the most desired for this study. In this study, a known number of obesity patients would be subject to same exercise and diet therapy for a known period. The effectiveness of incorporating telemonitoring in-home care discharge planning to reduce hospital readmission would be determined.
The classical experimental study design would test the research question with optimal control thus the ability to have the based conclusions from a study that has least bias. Independent variables can also be manipulated to have the best results.
The disadvantage of this approach is that it may not represent an ideal situation since the study is controlled. The results may only be applicable in the experiment and not real life situation. Some variables may not be controlled by the conditions of the home-based care would vary from home to home (Von Elm et al, 2015).
Variables for the study
Independent variables: Incorporation of telemonitoring in home care discharge planning for patients with chronic heart failure.
Dependent variables: Reduction in the number of the hospital readmission in three months.
Confounding variables: The impacts of the environmental conditions at home. Various patients would be exposed to ddifferent environmental conditions depending on their status and use of appropriate diet.
Sampling preferred for the study.
To find the participants, I look at the demographic of the patients with heart failure from the records of clinics and public health centers in every state in the country. The contacts of the patients were taken and letters of participatory request sent to every patient who met the threshold of taking part in the study. The young participants were only accepted after consent from their parents. The request letter indicated that the study would help to find the best therapy for the patients with heart failure in future to achieve the best health care plans. The participants were not to be provided with any compensations. The patients selected were reviewed then interviewed and chosen on the specific criteria. Randomized stratified sampling would be used to select 50 men and 50 women for the study both control and experimental study. Each participant picked a number that determined whether they would act as a control or use the therapy for the study. Stratified random sampling helped to reduce error in this study (Woodward, 2013).
Inclusion and exclusion criteria for the study.
Inclusion criteria includes a man or woman over 30 years old who have heart failure condition and have been put under telemonitoring after discharge from the hospital. The participants must have been discharged before being selected for this study.
Exclusion criteria includes: pregnant females, patients who are frequent drug users or patients who are obese. Patients under hospital care are also excluded. Patients who are below 30 years and those who do not have telemonitoring facility after being discharged from the hospital.
Effects of the sample size on the results and application of the results.
Due to the cost implications of my study, I feel the sample size is enough for providing the data that is significant for the study. The results provided would help health care providers to suggest appropriate ways of taking care of the patients with heart failure condition while at home. Showing the results of the study would help to encourage the heart failure patients to have the best treatment and monitoring plans while at home to avoid readmission. The outcome of the results would be documented and used for future reference in similar studies and treatment of heart patients while at home (Inglis, Conway & Clark, 2015).
Steps of data collection
Review of demographic information of obesity patients in the health centers
Initial survey inviting potential participants to inquire as to their eligibility
Fitness check of all the selected participants for the study before the commencement of the therapy program.
Daily measurement of the various body measures such as weight, waist circumference, height and cholesterol levels.
Monitoring of the blood pressure and the recovery process of the patients while ta home.
Data Analysis for the study
Null hypothesis: Telemonitoring process of the patients would make significant difference in avoiding readmission for the patients who have been discharged.
Alternate Hypothesis: Telemonitoring process of the patients would make significant difference in avoiding readmission for the patients who have been discharged.
To determine the difference in recovery process of the patients with heart failure recorded after weekly observation. The significance of the recovery process would be observed based on the frequency of readmission to the hospital after being discharged for home based care. The significance significance of the rate of readmission would help to determine the usefullness of the telemonitoring proess (Kitsiou, Pare & Jaana, 2015).
For my second dependent variable my hypothesis is as follows:
Null hypothesis: There is no significant reduction in the number of the hospital readmission in three months.
Alternate hypothesis: There is significant reduction in the number of the hospital readmission in three months.
In my second variable, I would observe the number of the cases of readmission in all the patients who are put under home based care. A comparison is made between those with telemonitoring and those without and the number of the cases of readmission help to determine the significance of the use of telemonitoring in this care plan (Hindricks et al, 2014).
Feasibility of the study
I think my research would be a bit costly since it would require fitness trainers, workforce for the interviews, traveling to collect information about the patients and provision of the diet plans for the participants and supply of the telemonitoring devices. The study had various challenges, and several adjustments had to be made to achieve the objectives, for instance, injury to the patients during training.
Lesson learned regarding the research process.
The most significant lesson I gathered is that there are a lot of considerations that need to be made in the process. The choice of the confounding variable is fundamental as it determines a lot about the variables and the guiding rules and the ethical standards should be well explained.
The main difficult was settling for the choice of the confounding variable. The other condition that affect the heart failure had to be understood before settling on the best confounding variable.
Hindricks, G., Taborsky, M., Glikson, M., Heinrich, U., Schumacher, B., Katz, A., ... & Kautzner, J. (2014). Implant-based multiparameter telemonitoring of patients with heart failure (IN-TIME): a randomised controlled trial. The Lancet, 384(9943), 583-590.
Kitsiou, S., Pare, G., & Jaana, M. (2015). Effects of home telemonitoring interventions on patients with chronic heart failure: an overview of systematic reviews. Journal of medical Internet research, 17(3)..
Inglis, S. C., Conway, A., C\leland, J. G., & Clark, R. A. (2015). Is age a factor in the success or failure of remote monitoring in heart failure? Telemonitoring and structured telephone support in elderly heart failure patients. European Journal of Cardiovascular Nursing, 14(3), 248-255.
Woodward, M. (2013). Epidemiology: study design and data analysis. CRC press.
Von Elm, E., Altman, D. G., Egger, M., Pocock, S. J., Gotzsche, P. C., Vandenbroucke, J. P., & Strobe Initiative. (2014). The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. International Journal of Surgery, 12(12), 1495-1499.
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