Project Part B

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timer Asked: Dec 11th, 2018
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Question description

Instructions for Project Part B:

Writing Your Letter to the Author of the Research Study Refer to document titled How to Write an APA-Style Letter for formatting of your letter.

1. APA formatting (2 points)

2. Focus on one major point. Give your letter more force by focusing on one issue and providing evidence for that issue. (1 point)

3. State the article you're responding to. Orient the researchers as quickly as possibly by stating the name and date of the article and the specific issue in the study that you are responding to. You can do this in just one or two sentences. (1 point)
4. State your position. After you have stated the argument you are responding to, you should clearly state the position you are taking on the issue and why. Take this time to show why the issue is relevant and important but remember to be brief. (2 points)

5. Provide evidence. Now that you have stated your groups’s position on an issue, you need to back it up with facts. You need to show that your group has put thought into formulating your letter. Though your letter is short, providing a few key facts can make a big difference. Here are some ways to provide evidence: (2 points)

6• Use recent anecdotal evidence from your workplace. • Use statistics, data, or survey results.

7. Say what should be done. Once you have provided evidence for your group’s point of view, end the letter by saying what can be done to address the issue. Perhaps just raising awareness of the issue is enough, but there may be other things that the researchers can do to address the issue in the future (ex., recognizing and integrating your suggestions for future research). (2 points)

8. Have a simple closing. End with one sentence that summarizes your group’s point of view on the issue so the researchers have a clear reminder of your main message. (1 point)

9. Include a closing phrase and your name(s). At the very end of your letter, include a simple “Sincerely,” or “Best regards,” to finish your letter. Indicate your MSN student status since it is relevant to the issue addressed in your letter. (1 point)

Editing Your Letter:

1. Trim down your letter to avoid wordiness. Your letter should be short and concise: between 150 and 300 words long. (2 points) • Cut out extraneous phrases or flowery language. Be straight and to the point. This will help you cut down on your word count. • Eliminate phrases like “We think” and “We believe”. It’s apparent that the content of your letter is what you think and believe, so you don’t need to waste the words.

2. Be respectful and professional in tone. Even if you disagree with an issue, maintain a respectful tone instead of being angry or accusatory. Keep your tone formal and avoid slang or casual phrasing. Do not insult the researchers. Keep an even, unbiased attitude when writing your letter. (1 points

DOI Number: 10.5958/j.0974-9357.5.1.005 International Journal of Nursing Education. January-June., 2013, Vol.5, No. 1 15 Effect of Planned Nursing Interventions on Compliance among Persons Undergoing Maintenance Hemodialysis 1 Asha P Nair1, J Silvia Edison2 Lecturer, Al Shifa College of Nursing, Angadipuram PO Malappuram, Kerala, 2Principal Al Shifa College of Nursing, Angadipuram Post, Malappuram, Dt. Kerala ABSTRACT A quasi experimental study was conducted to assess the effect of planned nursing interventions on compliance among persons undergoing maintenance Hemodialysis from a selected hospital in Malappuram, Kerala. It was an evaluative approach and non equivalent pretest post test control group design. 60 patients diagnosed with ESRD undergoing maintenance Hemodialysis in the age group of 18-60 years were selected. After the pretest among experimental and control group, information booklet with adequate explanation was given to experimental group followed by a post test, one month later, for both groups using the same tool in the same setting. Out of 60 patients, (56.6%) were in the age group of 31-50 years and (80%) were males, (71.7%) were married and (33.3 %) belonged to very low income group. After the implementation of planned nursing interventions among experimental group there was significant increase in knowledge, and psychological integrity. The mean pretest and post test knowledge score among the experimental group was 15.13 and 19.13 respectively. The mean pretest and post test psychological distress score among the experimental group was18.97 and 16.47 respectively. The findings were statistically significant, 'p' value <0.05 for knowledge and psychological distress at level of significance 0.05. Keywords: -End Stage Renal Disease CAT- Compliances assessment tool INTRODUCTION Hemodialysis is a life supportive measure for those patients. But it requires a constant motivation from healthcare team members for the enhancement of compliance towards the treatment regimen and thereby improving the quality of life. Most of the reported deaths were due to the lack of awareness and compliance to the therapeutic regimens. The National Kidney Disease Education Program (NKDEP), an initiative of the National Institute of Diabetes and Digestive and Kidney Diseases, works to reduce the morbidity and mortality caused by chronic kidney disease (CKD) and its complications. A report in the NKDEP, Chronic Renal Failure is considered as ‘a worldwide public health problem’. NKDEP suggests plans to place a greater emphasis on patient education1. Chronic kidney disease is a worldwide public health problem. According to the World Health Report and Global Burden of Disease project, diseases of the kidney and urinary tract contribute to the global burden of diseases, with approximately 850,000 deaths every year and 15,010,167 disability-adjusted life years. 4. Asha Nair-15-19.pmd 15 Kidney diseases are the 12th cause of death and the 17th cause of disability respectively. The presence of chronic kidney disease increases the risk of death of cardiovascular disease in patients with diabetes2. Hemodialysis requires patients to commit considerable time to their treatment, to comply with strict dietary and fluid restrictions, and to take medication on a regular basis. Noncompliance among dialysis patients is a major problem, even though it has been shown to be inversely related to survival. Rates of noncompliance depend upon how it is Noncompliance with prescribed therapy defined3. significantly impacts dialysis patient care and outcome. At least one-half of Hemodialysis patients are likely to be noncompliant with some part of their treatment regimen 4.Patient compliance is paramount in the effectiveness of therapeutic regimens. Without compliance therapeutic goals cannot be achieved, resulting in poorer patient outcomes5. Depression is a prevalent and costly burden to dialysis patients impacting on a psychological and somatic level6. Depressive symptoms and depression 3/21/2013, 2:31 AM 16 International Journal of Nursing Education. January-June., 2013, Vol.5, No. 1 are the most frequent psychological problems reported by Hemodialysis patients7. Another study about the feasibility of stage-specific educational interventions for patients with end-stage renal disease with psychological and psychiatric considerations and recommended that increased information about this disease and the treatment options available can be instrumental in improving patient’s quality of life8. mean pre test and post test compliance score among samples in experimental and control group undergoing maintenance Hemodialysis. H2: There will be a significant difference between mean pre test and post test compliance score among samples in experimental group undergoing maintenance Hemodialysis. METHOD MATERIAL & METHOD Objectives of The Study • To assess the pretest and post test Hemodialysis compliance among persons in both experimental and control group undergoing Hemodialysis. • To find out the effect of planned nursing interventions on Hemodialysis compliance among persons in experimental group undergoing Hemodialysis. The research design adopted for the study was a quasi- experimental non equivalent pretest post test control group research design. It was a two group pre test and post test method. The compliance of 60 patients undergoing maintenance Hemodialysis was assessed in the pretest followed by a post test to all subjects using the same tool in the same setting after 30 days. The design used is depicted below. X E2 C2 E1 C1 HYPOTHESIS H1. There will be a significant difference between Selected Group Pre Test Intervention Day One Patients who are on maintenance Hemodialysis E1 Experimental Group In the present study, semi structured interview schedule was used by the investigator regarding demographic data to assess the compliance of clients undergoing maintenance Hemodialysis. Compliance assessment tool for data regarding knowledge, serum and biophysiological values and psychological integrity was developed. • Section A deal with demographic profile of the patient. • Section B is Compliance Assessment Tool (CAT). It has three parts; Section A consisted of demographic variables such as age, sex, marital status, educational qualification, occupation, family income, religion, domicile, type of family, and frequency of Hemodialysis in a week, presence of major illness / illnesses and period under treatment. Section B: Compliance Assessment Tool ,has three parts; Part A deals with knowledge, is a semi structured interview schedule which has 25 items. It covered the 4. Asha Nair-15-19.pmd 16 After Pre Test Day One C1 Control Group Tool and Intervention Post Test Planned Nursing Intervention Day 30th E2 Experimental Group C2 Control Group following aspects such as general information, Hemodialysis procedure, dietary modifications, care of vascular site and prevention of complications. The researcher read out the statements and the responses. The study subjects were expected to respond with a response which they feel is correct, and the investigator put a check mark against it to complete the interview. One mark has given for each correct answer. After finding out the mean knowledge score of all the respondents, three grades; adequate, moderate and inadequate were given for the respondents. Grading of knowledge of clients undergoing Hemodialysis. Based on knowledge level, clients with ESRD undergoing maintenance Hemodialysis are classified as below, • Adequate Knowledge Score above 15 (>80%) • Moderate Knowledge Score between 10-15 (60-80%) • Inadequate Knowledge Score below 10 (<60%) Part B is a record review containing 10 items for obtaining serum chemistry& bio physiologic measurements. It include measurements of serum 3/21/2013, 2:31 AM International Journal of Nursing Education. January-June., 2013, Vol.5, No. 1 17 Creatinine, Urea, Potassium, Albumin, Fasting Blood sugar, Hemoglobin, Calcium, Phosphorous and biophysiological measurements such as Inter dialytic weight gain and Blood pressure. If the values were within the limit it is considered as desirable range and if the values were too high or too low, is considered as undesirable range. Part C is a rating scale taken from Psychosocial Assessment Tool (PAT-5).It is a standardized tool for measuring psychosocial problems in Hemodialysis patients. It consists of 7 items and responses will be collected and interpreted against criteria. The overall scoring below 15 is mild, between 15-20 is moderate and above 21 is considered as severe psychological distress. Table 1 depicts the Significance of difference in the mean pretest knowledge and Psychological Distress score among patients undergoing Hemodialysis. From the above table it is revealed that there is no statistically significant difference in the mean pretest knowledge scores of experimental and control group, (t (58) = -.573, p > 0.05). Table also revealed that the mean pretest psychological distress score of experimental and control group in the pretest is also not statistically significant (t (58) = 1.657, p > 0.05) .This shows that the samples selected are homogenous with respect to knowledge and psychological distress. Table 2. Significance of difference in the mean post test knowledge and psychological distress score of experimental and control group n=60 INFORMATION BOOKLET Information booklet was developed based on the topic of the study, review of the related research publications and non–research literature. A blue print of content pertaining to the information regarding renal function, renal failure, Hemodialysis, dietary management, medications and stress reduction strategies was prepared for the construction of Information booklet. DATA COLLECTION PROCESS After obtaining the verbal and written consent of the patients to participate in the study, they were interviewed using the semi- structured interview schedule. Planned nursing intervention was conducted for a period of 30-45 minutes for those in the experimental group; 4 clients in the morning and 4 clients in the evening. FINDINGS In order to find out the significance for difference in the mean pre test and post test knowledge and psychological integrity in both group, the data is subjected to independent sample‘t’ test and the findings are presented in Table 1. Table 1 Significance of difference in the mean pretest knowledge and Psychological Distress score among patients undergoing Hemodialysis Variables Group Mean SD ‘t’ Value ‘p’ Value Knowledge Experimental 19.13 2.862 3.574 0.001 Control 16.13 3.598 Experimental 16.47 3.702 -0.520 0.605 Control 17.00 4.226 Psychological Distress Table 2 depicts the significance of difference in the mean post test knowledge and psychological distress score of experimental and control group. The above table revealed that the mean post test knowledge score of experimental group is significantly higher than the mean post test knowledge of the control group (t (58) = 3.574, p <0.05). Hence it is evident that there is significant enhancement in knowledge in the experimental group after implementing planned nursing interventions. There is no statistically significant difference between mean post test psychological distress score of experimental and control group (t (58) = -0.520, p >0.05). To assess significance of difference in mean pretest and post test scores of patients undergoing maintenance Hemodialysis in the experimental and control group, the data is subjected to paired‘t’ test and the findings are presented in Table 3 and 4. Table 3. Significance of difference in the mean pretest and post test knowledge and psychological distress of experimental group n=30 n=60 Variables Group Mean SD ‘t’ Value ‘p’ Value Knowledge Experimental 15.13 2.816 -.573 0.569 Psychological Distress Control 15.63 3.399 Experimental 18.97 3.828 Control 4. Asha Nair-15-19.pmd 17.23 17 4.264 1.657 0.103 Variables Experimental Group Mean SD ‘t’ Value ‘p’ Value Knowledge Pre Test 15.13 2.816 -7.780 0.000 Post Test 19.13 2.862 Pre Test 18.97 3.828 8.975 0.000 Post Test 16.47 3.702 Psychological Distress 3/21/2013, 2:31 AM 18 International Journal of Nursing Education. January-June., 2013, Vol.5, No. 1 Table 3 depicts significance of difference in the mean pretest and post test knowledge and psychological distress of experimental group. From the above table it is evident that the mean post test score of knowledge in experimental group is significantly higher than the mean pretest scores, (t (29) = -7.780, p<0.05) and the mean post test score of psychological distress in experimental group is significantly higher than the mean pretest scores, (t (29) = 8.975, p<0.05). Thus the study findings indicate that planned nursing intervention is effective in improving knowledge and psychological distress of patients undergoing maintenance Hemodialysis. The significance of difference in the pretest and post test knowledge and psychological distress scores of patients undergoing maintenance Hemodialysis in the control group is tested by paired‘t’ test the finding were presented in Table 4. Table 4: Significance of difference in the mean pretest and post test knowledge and psychological distress scores of control group n=30 Variables Control Group Mean SD ‘t’ Value ‘p’ Value Knowledge Pre Test 15.63 3.399 -1.945 0.062 Post Test 16.13 3.598 Pre Test 17.23 4.264 1.651 0.109 Post Test 17.00 4.226 Psychological Distress Table 4 depicts the significance of difference in the mean pretest and post test knowledge and psychological distress scores of control group. The above findings shows there is no statistically significant difference between mean pretest and post test knowledge scores (t (29=-1.945, p>0.05) and mean pretest and post test psychological distress scores (t (29= 1.651, p>0.05) of patients in the control group. Thus the intervention has no effect on patients in the control group. population, 45.0% had nuclear family. More than half (71.7%) were from rural area.60% of the respondents undergo Hemodialysis for more than one year, and (66.7%) of the respondents were doing Hemodialysis thrice a week. Diabetes Mellitus (51.7%) was the most common co-morbidity among the clients undergoing maintenance Hemodialysis. The mean post test score of knowledge and psychological distress in experimental group is significantly higher than the mean pretest scores, (t (29) = -7.780, p<0.05) and, (t (29) = 8.975, p<0.05). This revealed that planned nursing intervention is effective in improving the knowledge and psychological integrity of persons undergoing Hemodialysis. CONCLUSION On the basis of the findings, the researcher concluded that planned nursing intervention using information booklet with specific guidelines, to End Stage Renal Disease patients on maintenance Hemodialysis could significantly improve compliance. Nurses working with this group of patients can actively engage in compliance enhancement interventions such as patient education, motivation and stress reduction strategies. REFERENCES 1. 2. 3. DISCUSSION In the total study population 56.6% of patients were of age group 31-50 years. With respect to sex; majority (80%) of them were males. most of the respondents (71.7%) were married. Among the respondents 41.7% were educated up to high school. (46.7%) were unemployed, presently not capable of doing any job. (33.3% ) of respondents were in the very low income group. Among the 60 respondents, majority (91.7%) were Hindus and Muslims. In the total study 4. Asha Nair-15-19.pmd 18 4. 5. Andrew S. Narva. American journal of kidney diseases, National Kidney Disease Education Program make the kidney connection; March 2009. Vol 53, no 3, supplement 3, pp s115-s120. February18, 2009. : http://www.nkdep.nih.gov/ resources/make the kidney connection.htm Burden of disease project. World health organization (WHO); September 2009:http:// www3.who.int/whosis/menu.cfm? Path= evidence, burden&language=english.. Hailey B. J, Moss S. B .Compliance behavior in patients undergoing Hemodialysis, a review of the literature. Psychology, Health and Medicine: Volume 5, Number 4, 1 November 2000. pp. 395406(12) :http://www.ingentaconnect.com / content /routledg/ cphm/2000/00000005/ 00000004/art00006 Kutner NG.Improving compliance in dialysis patients, does anything work?. 2001. SepOct;14(5):324-7:http://www.ncbi.nlm.nih.gov/ pubmed/11679097 Cameron C.Patient compliance, recognition of factors involved and suggestions for promoting 3/21/2013, 2:31 AM International Journal of Nursing Education. January-June., 2013, Vol.5, No. 1 19 6. 7. 4. Asha Nair-15-19.pmd compliance with therapeutic regimens. J Adv Nurs: 1996 Aug; 24(2):244-50: http:// www.ncbi.nlm.nih.gov/pubmed/8858426 Joseph Chilcot .Depression on Dialysis .Nephron Clin Pract: 2008;108:c256-c264 (DOI: 10.1159/ 000124749): http://content. karger.com/ produktedb/produkte.asp? typ= fulltext&file= 000124749 Antonio R L. Screening for depression in Hemodialysis patients: Associations with diagnosis, treatment, and outcomes in the 19 8. DOPPS. Kidney International; 2004,66, 2047– 2053; 1755.2004.00977:http://www.nature.com/ ki/journal/v66/n5/abs/4494850a.html Curtis CE, Rothstein M, Hong BA. Stage-specific educational interventions for patients with endstage renal disease: psychological and psychiatric considerations.. National Center for Biotechnology Information, U.S. National Library of Medicine2009 Mar; 19(1):18-24 http:// www.ncbi.nlm.nih.gov/pubmed/19341059 3/21/2013, 2:31 AM Copyright of International Journal of Nursing Education is the property of Dr. R.K. Sharma and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use.

Tutor Answer

tutoraxel
School: UIUC

Attached.

Running head: A LETTER TO THE AUTHOR OF THE RESEARCH STUDY

A Formal letter to the Author of the Research Study
Student’s Name
University Affiliation

A LETTER TO THE AUTHOR OF THE RESEARCH STUDY

2

The group’s name
The group’s address
Email

December 12, 2018

To,
The Author of the Research Study,
Nair,
Town
Address
Dear Sir,
Subject: Failure to Use a Sufficiently Large Enough Sample during the Study
The article on effects o...

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Anonymous
Thanks, good work

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