The research in question was conducted for the purpose of finding out whether cognitive dysfunctions create poor participation in heart failure treatment. Thus, researchers have analyzed data by selecting people with chronic heart failure. The difference that was being examined was between patients with low Mini-Mental State Examination (MMSE) scores vs. regular ones. Based on the findings, researchers came to the conclusion that cognitive functions are linked to participation in heart failure treatment. Thus, individuals with low MMSE are less likely to follow up with the outpatient recommendations, while those with high MMSE are more likely to follow the plan recommended by the healthcare provider.
The research question is whether cognitive dysfunctions are associated with lower participation in outpatient treatment in patients with heart failure. The researchers have determined a hypothesis. Based on the statement, which has been the initial assumption, impaired cognitive functions correlate with a lack of participation in the treatment of heart failure. The frame in which the structural concepts of the research were placed fits the study itself. Specifically, the authors have looked at data from patients with heart failure based on medical reports. Then, these individuals were assessed based on MMSE guidelines and placed in two categories. The contrast between the two allowed researchers to come to comprehensive conclusions.
The study itself relies on quantitative data without the inclusion of prior research in the form of a literature review. It was omitted due to a certain gap in information when it comes to this particular research question. While the authors provide several references, there is not enough data on cognitive functions as a direct correlation to non-participation or participation in heart failure treatment. Thus, there is a need for this study due to the importance of covering topics that are rarely discussed in scientific articles.
All the gathered data and examined patients were from the Sahlgrenska University Hospital. Those over the age of 65 with a diagnosed heart failure were selected for the research. There were more than 1050 screenings, and 157 of the assessed individuals participated in the actual study (Ekman et al., 2001). Researchers have excluded patients primarily due to communication issues as a result of severe dementia. As mentioned prior, the initial sampling objective was looking for individuals with heart failure. The next step was to determine the cognitive abilities. Thus, MMSE was administered, and patients who scored 27 and lower were identified as having cognitive dysfunctions. The outpatient treatment was nurse-directed, which allowed for effective monitoring and accurate findings. Researchers have analyzed the data using a Mann-Whitney U-test and Fisher’s exact test.
The authors of the study have found that patients with higher MMSE scores were more likely to follow the nurse-directed outpatient program. On the other hand, people with low cognitive functions were prone to skipping medications, diet recommendations, and other vital concepts in heart failure treatment. The authors have illustrated the findings in a cohesive way, portraying all the patterns, similarities, and factors that became clear during the research. Moreover, the researchers have managed to proficiently present the information in regards to the link between cognitive limitations and non-participation in treatment by approaching the subject from different viewpoints.
In terms of practical implications, the study encourages healthcare providers to consider cognitive abilities as another measure for ensuring patients follow treatment guidelines. Thus, nurses can apply the study’s findings in practice when determining individuals who need extra assistance in following the instructions that align with heart failure treatment measures. The practical appliance can be generalized as considering a patient’s cognitive state as a factor that may compromise outpatient participation in mitigating health risks.
The researchers have discussed the limitation that may have influenced the results of the study. The first limitation is the narrow sample size consisting of only 157 participants (Ekman et al., 2001). Another limitation illustrated by the authors is the use of MMSE. It is considered a relatively simple and quick screening tool. Thus, there is a chance that some errors have occurred, and the results are not entirely accurate. Moreover, it has been stated that the regular screening measurements have been changed for the study. Usually, MMSE guidelines suggest that the score of 24 and under-represents evidence of cognitive issues. However, for this research, the number used for comparison was 28. Thus, patients with a lower score were compared with those with a score equal to or higher than 28. It is certain that the researchers have addressed the limitations properly and have referred to the possible errors that might have compromised the conclusion.
The change that would have added more validity to the test is using a larger sample size for examination. The authors of the study have mentioned that the screening process led to the exclusion of a large number of potential participants. However, the research question is crucial and can provide insight into a possible cause of non-participation in heart failure treatment. Thus, assessing more people and data is essential for having evidence-based information for healthcare providers to apply in their medical settings.
References
Ekman, I., Fagerberg, B., & Skoog, I. (2001). The clinical implications of cognitive impairment in elderly patients with chronic heart failure. The Journal of Cardiovascular Nursing, 16(1), 47–55. Web.