Cardiovascular Disease Prevention on Patients Case Study

Cardiovascular Disease Prevention on Patients Case Study Cardiovascular Disease Prevention on Patients Case Study I need support with this Health & Medical question so I can learn better. Hide Assignment Information Turnitin® This assignment will be submitted to Turnitin®. Instructions Assessment Task 3 Task description Research Proposal Students are to construct a carefully planned research proposal on their chosen topic in consultation with the Unit Coordinator and supervisor. The research proposal must include the following sections: Background (including relevant literature) Study rationale (Statement of study significance – e.g. gap in the literature being addressed, or particular workplace application) Aim[s] / Objective[s] Research question[s] Methodology/Theoretical perspective (and justification for their appropriateness) Study Design and Method[s] (and justification for their appropriateness) Consider a flow diagram Data collection plan Data analysis plan Ethical considerations Implications: policy and practice Translation and Dissemination Project timeline References Appendices The research proposal is to be presented in Report format: University of Tasmania Cardiovascular Disease Prevention on Patients Case Study Cover page (title, affiliation, name, supervisors’ names and affiliations, course code and course title, hypothetical RQ or plan to carry out research in future, date, student number), Table of Contents and use a standardised referencing format. It is expected that your research proposal will be constructed throughout the unit in collaboration with your allocated supervisor/academic mentor. Assessment criteria See the Assignment 3 rubric Links to unit’s intended learning outcomes 1,2,3,4,5 Task length 2500 words, weighting 35% (Tables, Figures, Appendices & Reference list are not included in word count) NOTE: In text citations are included in the word count. engagement_activity_contract_template.docx literature_review.docx ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS Contract Template Submit a contract to the CAM720 drop box entitled Engagement Activity 2 – Contract using this template. Research question: What do General Practitioners believe hinders patient’s adherence to cardiovascular disease prevention lifestyle counselling in general practice? Proposed methodology: A qualitative interview method will be employed. General practitioners will be recruited through direct invitation by email using publicly accessible GP clinic contact details. Interviews would be conducted over the phone or through video calls to minimise contact due to the ongoing Covid-19 pandemic. Epistemological paradigm: Pragmatism: Lifestyle counselling by GPs is an intervention that focuses on improving diet, physical activity, cessation of smoking and management of stress. This study will explore practitioners lived experience of this intervention in practice. Other important information: Strict code of ethics as outlined by the National Health and Medical Research Council would be adhered to. All data collection would be garnered under informed consent. Date: 05/08/2020 Your name/signature: Sunsuwa Jeremiah Supervisor(s) names and email(s): Prof. Roger Hughes [email protected] Supervisor(s) signatures: What do general practitioners believe hinders patient’s adherence to cardiovascular disease prevention lifestyle counselling in general practice? BACKGROUND Cardiovascular disease is among the leading cause of death worldwide despite many preventable measures that individuals can take to prevent or minimize it. According to (Mucheru et al. 2018) cardiovascular disease is related to heart or blood vessels. Examples of cardiovascular diseases are heart attack, heart failure, hypertension, coronary heart disease, stroke, and arrhythmia (Thomas et al. 2009). ). In 2016, over 150 countries reported the leading cause of death is related to cardiovascular diseases, and the average annual death was over 17 million (Mucheru et al. 2018). What is saddening is that most individuals who have succumbed to cardiovascular diseases could have prevented it by simply improving the quality of their lifestyles. (Rippe 2018) reports that the majority of cardiovascular diseases are linked with the lifestyle of individuals. For example, a person who is fond of eating junk food and not exercising has a high chance of developing cardiovascular disease than a person who does regular exercise and eats low sugar and low-fat foods. Some of the lifestyle activities that can help reduce cardiovascular problems are physical activity, stress management, developing a healthy diet, smoking cessation, and sound nutrition (Francis et al. 2015). Therefore, it is frustrating that despite the knowledge about the impact of specific lifestyles on the health of a person, many people continue to ignore them. According to (Thomas et al. 2009), the process of exercising triggers the heart to pump blood around the body at a high rate, thus helping the heart and other body parties working at an optimal efficiency condition, which in turn helps keep them healthy for a longer time. However, lack of exercise and consumption of a bad diet, especially fast foods, causes the development of the fats in the different organizations as it is not digested, thus causing a lot of strain in the transportation of blood and minerals inside the body (Rippe 2018).University of Tasmania Cardiovascular Disease Prevention on Patients Case Study General practitioners (GPs) have extensively tried to offer lifestyle coaching to minimize cardiovascular cases with no progress (McKinn et al. 2016). There is a need to investigate why, despite knowing the consequences of adopting a specific lifestyle, increases the risk of developing cardiovascular diseases among individuals in society. Exploring the lived experience of general practitioners in Tasmania will help get a perspective on how patients receive the well-known lifestyle factors which aim to reduce cardiovascular risk in patients such as improving diet, physical activity, stress management and smoking cessation and why they are not adhered to and also why the G.P.s find it difficult to incentivize patients to adhere to these methods. METHODOLOGY The research adopted the research question based on the planning guide for Participatory Action Research (Koshy, Koshy & Waterman 2010). The research question is, what do general practitioners believe hinders patient’s adherence to cardiovascular disease prevention lifestyle counselling in general practice in Tasmania? The key terms derived from the title to help gather relevant journal articles were “general practitioners,” “cardiovascular diseases,” “preventive measures,” “lifestyle counselling,” and “general practice.” Also, the database utilized to ensure the articles were peer-reviewed and valid were PubMed, Web of Science, and Scopus. The inclusion and exclusion criteria of determining effective and most relevant articles for the research were the date/time factor, geographic location of study, participants, exposure of interest, peer review, type of publication, setting, and reported outcomes. The date was a crucial factor in choosing the relevant articles. The date range of the article selection was from 2010 to 2020. For geographic locations, the study tried to limit the study in the most affected countries and regions. Priority was given for articles that covered Australia, especially in Tasmania, Australia, because they have adopted the Australian healthcare system. Also, for participants of the study, the most relevant article will have participants who have full competency of the lifestyle factors linked with cardiovascular issues provided by general practitioners. Based on the exposure of interest, articles that consider participants who have previous education or training in lifestyle choices by general practitioners were considered for including articles in the research. Also, only articles that utilized peer-reviewed sources in their studies were considered to ensure that information provided was accurate and valid. Apart from peer-review consideration, another factor was the type of publication as it is supposed to be related to health, medics, or social services. Based on the result, a qualitative interview method will be employed. General practitioners will be recruited through a direct invitation by email using publicly accessible G.P. contact details. Interviews will be conducted over the phone or through video calls to minimize contact due to the ongoing Covid19 pandemic. The strict code of ethics, as outlined by the National Health and Medical Research Council, would be adhered to. All data collection would be garnered under informed consent. RESULT A total of 158 was identified through the search in the three websites, PubMed (72), Web of Science (46), and Scopus (40). The total documents found based on the keywords identified were 158 and an additional 14 sources from other sources like CINAHL and EMBASE. After screening them using the inclusion and exclusion criteria, I removed another 92 articles leaving only 14 articles for checking their eligibility. University of Tasmania Cardiovascular Disease Prevention on Patients Case Study Finally, I removed another six articles because of four main reasons. Firstly, an article lacks sufficient information that can provide insights into the research question. Secondly, the critical limitations of some articles that had a possible significant impact on the creditability and accuracy of their final results and findings. Thirdly, lack of alternative research studies that can back up the conclusions of the study. Fourthly and finally, setting issues based on the availability of the full text because some publications required a person to purchase the articles to have full access. The information about the process of identifying the qualitative synthesis articles is shown in the PRISMA diagram below. The PRISMA Flow Diagram Diagram 1. Shows an in-depth analysis of the process of identification of the qualitative articles to help answer the study research question. Based on the research, there was no single article that was identified based on the search for the terms “cardiovascular diseases” and “lifestyle counselling.” Six of the articles (Booth & Nowson 2010);(Fanaian et al. 2010); (Beattie et al. 2017); (James et al. 2020); (Jansen et al. 2017); and (Ju et al. 2018) examined the relationship between G.P.s, lifestyle education, and cardiovascular risks. The remaining two (Jayasinghe et al. 2016) and (González-Chica et al. 2016) examined the effect of health literacy on health outcomes in patients with CVD risk. The characteristics of the final eight articles are presented in the table below. Article Information Study Design Participants Purpose Findings Limitations Booth, A.O. and Nowson, C.A., 2010 Crosssectional studies using the Health Omnibus Survey (HOS) n=386 C.D.s were selected to participate in the survey from country areas in South Australia To determine whether patients received lifestyle advice from their G.P. for weight loss or hypertension Less than 1/3 of overweight/obese patients reported that they had received lifestyle advice to assist with weight loss from their G.P. The difficulty for individuals to reduce dietary salt intake and a reduction in the salt content of manufactured foods is needed Fanaian, M. et al., 2010 Health Improvement and Prevention Study (HIPS) n= 30 general practices in NSW, Australia Evaluate the capacity of general practice to identify patients at high risk for developing vascular disease – Beattie, J et al., 2017 Crosssectional study using the Bettering the Evaluation and Care of Health (BEACH) program n= 100 patients across different regions in Australia Examining prevalence rates of lifestyle risk factors in the Western Victorian Primary Health Network (WV PHN) The results of this study will help inform improvements to the implementation of primary prevention of vascular disease and inform the implementation of other preventive health initiatives There were significantly lower frequencies of clinical advice and counseling relating to diet and exercise provided to patients Measures such as weight, height, smoking status, and alcohol consumption were all selfreported González-Chica, D.A. et al., 2016 CrossSectional Studies n= 587 patients selected from 24 practices were sequentially recruited between 2007 and 2008 Assessing the relationship between health literacy and healthrelated quality of life (HRQoL) in patients with ischaemic heart disease (IHD), and to investigate the role of sociodemographic and clinical variables as possible confounders. Exploring general practice nurses’ perceptions of interactional factors supporting communication with patients about lifestyle risk. The positive effect of health literacy on health outcomes has been widely discussed but not how they influence HRQoL in patients Patients in the lowest quintile of socioeconomic position were not included James, S. et al., 2020 Qualitative descriptive study embedded in a concurrent mixed methods design n= 15 Baccalaureate prepared in Australia. Lack of awareness of the nurses’ role was perceived to have an impact on the initiation of lifestyle risk conversations. n= 25 G.P.s participated in semistructured interviews in New South Wales, Australia Identification of how C.D.s make decisions about the management of CVD risk Older patients receive different care depending on their G.P.’s perceptions of aging and CVD prevention, and their knowledge of available evidence Nurses who were unwilling to be videoed, therefore, did not have the opportunity to present their perspectives through the interviews. University of Tasmania Cardiovascular Disease Prevention on Patients Case Study The sampling strategy aimed to maximize the range of experiences and views rather than be representative of the general GP population Jansen, J. et al., 2017 Framework Analysis method Jayasinghe, U.W. et al., 2016 A crosssectional study of baseline data from a clusterrandomized trial 739 patients from 30 general practices across four Australian states conducted in 2012 and 2013 Investigating the impact of health literacy on HRQoL in a large sample of patients without known vascular disease or diabetes Health literacy accounted for 45, and 70 % of the total between patient variance explained in PCS12 and MCS-12, respectively Patients with low health literacy may not have understood why it was important to be involved or what might have been required. Additionally, there was a possibility of selection bias based on high literacy individuals Ju, I., et al., 2018 A systematic review and thematic synthesis of qualitative studies using the Enhancing Transparency of Reporting the Synthesis of Qualitative research (ENTREQ) framework n= 34 studies involving 1223 participants across nine countries. Describing the perspectives of general practitioners (G.P.s) on the prevention of CVD across different contexts. Complexities of considering the patient’s cognitive capacities, practical circumstances, and health status prevented primary care healthcare providers from offering lifestyle education Inability to differentiate whether G.P.s were using an absolute risk assessment or an individual risk factor approach and whether perspectives were different in primary and secondary prevention LITERATURE ANALYSIS The literature review of the research question provides insightful information about some of the factors that may contribute to why despite knowing the adverse impact of some lifestyle choices like smoking tobacco and lack of physical exercise, can increase risks of cardiovascular diseases. One of the major trends on the researches is that majority of general practitioners are aware of the lack of response and a poor record of education of the lifestyle practices that can help reduce on the lifestyle choices but lack of sufficient skills or strategies of how they can help them provide the lifestyle education Beattie et al., (2017). For instance, Ju et al. (2018) report that the factors that explain the low record of the G.P.s to deliver lifestyle choice education are the complexity of considering patient’s cognitive capacities, practical circumstances, and health status. Jansen et al. (2017) reveal another complexity that hinders G.P.s from offering lifestyle coaching based on how they perceive older adults. Apart from that, there is limited knowledge of general practitioners, especially nurses who have regular interaction with patients, on their roles of providing lifestyle choices education (James et al., 2020; Booth, A.O. and Nowson, C.A., 2010; and Fanaian, M. et al., 2010). Another set of the conclusion that one can draw from the literature is that life choice competency can significantly affect the rates of cardiovascular treatment but do not focus on how they affect health-related quality of life (HRQoL) (Jayasinghe et al., 2016; González-Chica, D.A. et al., 2016). The outcome might explain the reason why some individuals are aware of lifestyle choice impact on health wellbeing but still choose to abandon them. The whole literature review shows the significant gaps that cause high rates of cardiovascular diseases in general practices preventable by altering life choice activities. CONCLUSION The literature review’s main objective is to provide an understanding of what the general practitioners believe impact the attitude of patients on following the lifestyle education that can help reduce cardiovascular risks in general practices. According to the reports, one learns that the low cases of lifestyle choices education to patients by G.P.s reduces the probability of individuals following them. Additionally, one learns that lack of competency by G.P.s on the need to provide the lifestyle education that would help motivate or encourage patients to use them in general practice and the complexity of an individual’s characteristics is the reason why G.P.s do not provide it. Finally, the study reveals that the reason why G.P.s might lack the awareness of the need to provide cardiovascular lifestyle education is that even though they understand its importance, they fail to understand how it may affect HRQoL. Therefore, there is a need for future research to examine the effective strategies that can help understand individual’s demographics so that they can evaluate the most efficient strategies of delivering cardiovascular risk education based on lifestyle choices. The key to understanding this is through determining how health competency affect HRQoL. University of Tasmania Cardiovascular Disease Prevention on Patients Case Study Apart from that, there is a need to conduct further studies examining the competency of cardiovascular lifestyle education by G.P.s in general practice to determine if they will offer the correct and effective education to impact individuals positively. REFERENCES Beattie, J., Binder, M., Harrison, C., Miller, G. & Pedler, D. 2017, ‘Lifestyle risk factors and corresponding levels of clinical advice and counselling in general practice’, Australian Family Physician, vol. 46, pp. 751-5. Booth, A.O. & Nowson, C.A. 2010, ‘Patient recall of receiving lifestyle advice for overweight and hypertension from their General Practitioner’, BMC Family Practice, vol. 11, no. 1, p. 8. Fanaian, M., Laws, R.A., Passey, M., McKenzie, S., Wan, Q., Davies, G.P., Lyle, D. & Harris, M.F. 2010, ‘Health improvement and prevention study (HIPS) – evaluation of an intervention to prevent vascular disease in general practice’, BMC family practice, vol. 11, pp. 57-. Francis, D.K., Bennett, N.R., Ferguson, T.S., Hennis, A.J.M., Wilks, R.J., Harris, E.N., MacLeish, M.M.Y., Sullivan, L.W. & On behalf of the, U.S.C.A.f.H.D.R.G. 2015, ‘Disparities in cardiovascular disease among Caribbean populations: a systematic literature review’, BMC Public Health, vol. 15, no. 1, p. 828. González-Chica, D.A., Mnisi, Z., Avery, J., Duszynski, K., Doust, J., Tideman, P., Murphy, A., Burgess, J., Beilby, J. & Stocks, N. 2016, ‘Effect of Health Literacy on Quality of Life amongst Patients with Ischaemic Heart Disease in Australian General Practice’, PLoS One, vol. 11, no. 3, p. e0151079. James, S., McInnes, S., Halcomb, E. & Desborough, J. 2020, ‘Lifestyle risk factor communication by nurses in general practice: Understanding the interactional elements’, J Adv Nurs, vol. 76, no. 1, pp. 234-42. Jansen, J., McKinn, S., Bonner, C., Irwig, L., Doust, J., Glasziou, P., Bell, K., Naganathan, V. & McCaffery, K. 2017, ‘General Practitioners’ Decision Making about Primary Prevention of Cardiovascular Disease in Older Adults: A Qualitative Study’, PloS one, vol. 12, no. 1, pp. e0170228-e. Jayasinghe, U.W., Harris, M.F., Parker, S.M., Litt, J., van Driel, M., Mazza, D., Del Mar, C., Lloyd, J., Smith, J., Zwar, N. & Taylor, R. 2016, ‘The impact of health literacy and life style risk factors on health-related quality of life of Australian patients’, Health Qual Life Outcomes, vol. 14, p. 68. Ju, I., Banks, E., Calabria, B., Ju, A., Agostino, J., Korda, R.J., Usherwood, T., Manera, K., Hanson, C.S., Craig, J.C. & Tong, A. 2018, ‘General practitioners’ perspectives on the prevention of cardiovascular disease: systematic review and thematic synthesis of qualitative studies’, BMJ open, vol. 8, no. 11, p. e021137, viewed 2018/11//, . Koshy, E., Koshy, V. & Waterman, H. 2010, ‘ Action Research in Healthcare, SAGE Publications, London, UNITED KINGDOM.’. McKinn, S., Bonner, C., Jansen, J., Teixeira-Pinto, A., So, M., Irwig, L., Doust, J., Glasziou, P. & McCaffery, K. 2016, ‘Factors influencing general practitioners’ decisions about cardiovascular disease risk reassessment: findings from experimental and interview studies’, BMC Family Practice, vol. 17, no. 1, p. 107. Mucheru, D., Hanlon, M.-C., Campbell, L.E., McEvoy, M. & MacDonald-Wicks, L. 2018, ‘Cardiovascular disease lifestyle risk factors in people with psychosis: a cross … Purchase answer to see full attachment Student has agreed that all tutoring, explanations, and answers provided by the tutor will be used to help in the learning process and in accordance with Studypool’s honor code & terms of service . Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10