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Research Project Proposal – The Use of Pnuemonia Vaccine for Prevention of COPD Quynh Doan South University Online Introduction  The analysis entails determining whether the current approaches to dealing with COPD exacerbations are sufficient or whether there is a need to take additional steps to solve this problem.  COPD exacerbations have been on the rise and present enormous suffering among the people who contract the disease.  Researchers have linked lung infections to Streptococcus pneumoniae bacterium and they therefore regard it as a serious problem that should be resolved.  However, most of these researchers agree that there is a need to solve the situation with urgency as it has proved to be very challenging, significantly burdening families, individuals and communities who have been exposed to the illness. Research problem  Exacerbations of COPD have created an enormous socioeconomic burden among the populace.  Current research has associated frequent exacerbations with an increase in health care costs as well as a declining state of health and wellness within society.  One option for the health practitioners is to recommend the use of influenza and pneumococcal vaccines to prevent the disease and help foster a healthy population free of the disease. Problem statement  Despite the aforesaid efforts by the researchers to facilitate effective management and self-care in pneumonia patients, gaps still exist concerning whether the patients are aware of the benefits of using Pneumonia vaccine to reduce COPD exacerbations.  Vaccination is one of the methods that have been applied at the clinical level as a preventive measure for COPD exacerbations.  Currently, there are two types of Pneumonia vaccines which include the pneumococcal conjugate vaccine (PCV13) and the pneumococcal polysaccharide vaccine (PPSV23). Research Purpose  The purpose of this research is to determine whether the use of pneumococcal vaccine can help reduce or prevent the cases of COPD exacerbations.  There is no debate as to the clinical or applicable value of the use of the vaccine, as it has been used effectively and tested to be useful.  However, its application as a public health measure to combat COPD exacerbations has not been studied.  While we can hypothesize that the vaccine can play a key role in preventing COPD exacerbations, it is important to recognize that there could be other underlying factors that influence the prevalence of COPD exacerbations and not just the absence of a vaccine. Research Questions, Hypothesis, and Variables  The research question for this study is stated as follows: “Does the use of pneumococcal or influenza vaccine prevent or decrease COPD exacerbations?”  H1: There is evidence that COPD patient receiving pneumonia vaccine will show to have decrease reoccurrence of exacerbations.  H0: No evidences found on reduced COPD exacerbations cases for patient receiving vaccine compare to those that did not receive pneumonia vaccination on the number of exacerbations. Literature review  The aim of my research proposal is to determine the impact of pneumonia vaccines and their overall value in respect to decreased exacerbation of COPD.  It is important however to note that self-care and self-managemetn significantly depends on the knowledge available to the patient.  When patients have significant knowledge of the existing health services for their disease processes, they are likely to demand for the same and eliminate any myths and perceptions that have previously held them back in utilizing the same.  This study therefore supports the hypothetical position that the nurses and care provides have to take responsibility in teaching and educating patients and families on the importance of vaccines and this can only happen in an environment where communication and interaction with the patient population is significantly high. Cont’  This study by Santibáñez et al provided the researchers with an insight as they determined that 16.4 %of the respondents had severe exacerbations varying from 9.3% to 44% on the scale.  This research informs the need to regard patients who have had more than one instance of COPD exacerbations to consider more direct means for preventing the occurrence, and this includes the choice of vaccines.  A similar or related study by Tsiligianni et.al sought to utilize the cases of four patients who at one time had an acute exacerbation of COPD.  The study aimed to provide clear guidelines available and was utilized to prevent exacerbations among COPD patients. Cont’  Fromer discusses the role of proactive measures in the management of COPD patients.  In this article the author notes that in as much as the management of COPD is concerned, there is a tendency by the healthcare providers to regard acute rescue techniques as the best strategies for managing COPD exacerbations.  In a study by Fromer, Verbrugge, Boer & Georges they analyze how Dutch nurses managed patients with COPD in a bid to improve self-care and self-management techniques.  Acorss the literature, there is an agreement across the various research entities and groups that the 23-valent pneumococcal vaccine can play a key role in the management of COPD and particularly to prevent the cases of progression of the illness to severity. Theoretical Framework  The Behaviorist Learning Theory focuses on understanding the stimuli and responses that control learning in individuals.  The learning process is regarded as one that is guided by the various factors that modify the environment, allowing that patients must adapt in relation to those changes.  In utilizing this theory, the assumption is that the internal aspects of the patient do not have any influence on the behaviors and it is the environment that technically shapes behaviors. Application of Theory  The Behavior Change Theory can be applied in the concepts of this study. Health provider can recognize behaviors critical to health; evaluate the requirements of the person and counsels’ specific health behaviors.  Apparently, COPD can be managed or prevented effectively in cases where vaccination is regarded as one of the strategies.  In this research, the idea is to determine the value of vaccines in management of COPD exacerbations and at the same time ensure that the general population appreciates the benefits of the vaccines.  The idea is to increase education between the individual patient and the care provide where by the care provider act as the entity that modifies the environment to enable conditioned response. Methodology Sample/Setting  For this research, the researcher will use a sample of 156 people.  A sample less than this will not be accurate and will not be a true reflection of the study.  Using a sample greater than this one will have some financial implications on the researcher as it will costly and hence will not allow the researcher to work within the budget.  For this research, we will collect data from patient chart number and primary care office. Data from this source is reliable and hence suitable for a researcher to use. Sampling Strategy  The research will employ probability sampling: cluster sampling to get the data needed for the complete research.  In this approach, the researcher will select samples from the whole group of people suffering from COPD and use the samples for further study.  The researcher will employ probability sampling and select units at random.  A key reason for using this approach is that it will allow the researcher to make statistical inferences from the samples. Research Design  For this study, the researcher will employ experimental design specifically, completely randomized the design.  The randomized, controlled trial describes the aim of showing whether there is any difference between individuals who have used the pneumonia vaccine and those who have not received the vaccine.  This approach is also helpful to enable analysis of the data using statistical tools such as Excel and SPSS.  The individuals who have received the vaccine will be followed for one year of observation and their condition recorded. Extraneous Variables  Health conditions of the individuals could also produce different results as the bodies of different people suffering from the condition could respond to the exposure to influenza and pneumococcal vaccines in a variety of ways.  Another variable is age, which may make it difficult to determine how various age groups might respond to the treatment or exposure to influenza and pneumococcal vaccines, and hence might provide undesirable results.  To control the extraneous variables, individuals chosen for the study must possess a standard metabolic rate, must not have had any other health related issues, such as heart disease, and must not have suffered any allergic conditions in the past. Instruments  Individuals for this study will be collected and subjected to regular observation.  One group will be provided with the vaccines, while the other group will not receive the vaccine.  After six months, all study subjects will be observed to determine whether or not those receiving the vaccines demonstrate remarkable improvement in their health conditions.  The researcher will also employ CAT questionnaire for the study. Description of the Intervention  Once the researcher gathers the data for the study and proves that indeed the use of the vaccine have a positive impact in reducing the incident occurring, the researcher will take a personal initiative to offer advice to the providers, health practitioners and parents on the benefits of providing patients with the vaccine.  The intervention of targeting specific populations and engaging other influential leaders to promote vaccination.  As indicted by Jarrett, Wilson, O'Leary, Eckersberger, & Larson, the greatest invention for success in behavior change is knowledge, awareness or attitudes through eduction embedded into rountine processes were found to be the most effective in changing attitude toward behavior change and self- managements. Data Collection Procedures  Data for this study will come from observation of the conditions of the patients before and after being exposed to the vaccine.  For the observation, the researcher will make observations for both groups involved in the study and record their condition.  At regular intervals, they will observe the condition of the patients and record them.  At the end of the year, the researcher will have recorded the data at three-month intervals and will have obtained enough data to determine who has developed the condition and who has not.  Data collected through the observation will span enough time to make reliable observations of both groups. The data collected via observation will be stored in an Excel spreadsheet. Data Analysis  To examine the research question, a dependent sample t test will be conducted to examine if mean differences exist patient receiving pneumonia vaccine and those that did not receive the vaccine.  Dependent sample t test for paired means is an appropriate statistical analysis if each of the two samples can be matched on a particular characteristic.  Given an alpha at 0.05, when a calculated t-value is larger than the critical t-value, after considering degrees of freedom (df) for dependent samples (N – 1), the null hypothesis will be rejected.  The dependent samples test of correlated mean differences assumes a normal distribution or a curve that is bell shaped and symmetrical. The assumption of normality will be examined with a One-Sample Kolmogorov-Smirnov (KS) test. Ethical Issues  When performing the study, the research will take into consideration various ethical issues.  The first issue is confidentiality. Individuals involved in the research study must have their information protected as much as possible.  Another issue of concern is voluntary participation. For this research, participants will be completely informed concerning the study and must provide their written consent in order to participate.  The risk of harm is another matter of concern for the study group patients. All possible risks will be explained beforehand, and the option to move out of the study at any time will be treated with the utmost respect, especially since the treatment may precipate unforeseen negative health issues. Limitations of Proposed Study  Numerous barriers could arise during the study. One of the limitations could be cultural bias or selection bias.  Selection bias might compel the researcher to collect data from a specified region and a particular group of people.  The data collected could be considered unreliable insofar as it will not provide an accurate picture of the entire population.  Another limitation of this research is the lack of sufficient skills to gather the data. Very few researchers have performed a study on the subject and hence the researcher will lack abundant, reliable sources to use during the study. Implications of the limitations for practice  The presence of the defects could have profound impacts on the practice.  The limitations could have different levels of likelihood and magnitude.  However, the limitation could influence the researcher to collect and analyze the data in a manner that could give a wrong impression of the data.  This move could negatively affect the nursing practices as wrong data could result in the implementation of an approach that would not be helpful.  The limitations also could lead to a rise in the mortality rates due to the implementation of a wrong approach.  This method, therefore, calls for more research in this field to come up with more precise and reliable data for the nursing practices. Conclusion  COPD is a chronic illness that can be managed. There is no single strategy or at least one that is known to researchers that can accurately be regarded the only suitable method for m management of COPD.  However, at the primary level of prevention, the use of PCV13 in children or the PPSV23 in adults.  Healthcare providers therefore have a role to inform the patients about the usefulness of efficacy of pneumonia vaccines.  However, there are significant barriers associated with the use of vaccines and these could be due to cultural or religious beliefs.  The nurse or the healthcare provider employ demonstrate excellent negotiation skills as they inform and educate these groups about the truths and myths associated with vaccines. References  Aliakbari, F., Parvin, N., Heidari, M., & Haghani, F. (2015). Learning theories application in nursing education. Journal of education and health promotion,4.  Braungart, R. G., & Gramet, P. R. (2010). Applying Learning Theories to.Health professional as educator: Principles of teaching and learning, 55.  Burge, S., &Wedzicha, J. A. (2013). COPD exacerbations: definitions and classifications. European Respiratory Journal, 21 (41 suppl), 46s-53s.  Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.  Jarrett, C., Wilson, R., O'Leary, M., Eckersberger, E., & Larson, H. J. (2015). Strategies for addressing vaccine hesitancy - A systematic review. Vaccine,33(34), 41804190.doi:http://dx.doi.org.southuniversity.libproxy.edmc.edu/10.1016/j.vaccine.2015.04 .040  Evensen, A. E. (2010). Management of COPD exacerbations. American family physician, 81 (5), 607-613.In Chronic Obstructive Pulmonary Disease. PloS one, 11(6), e0158727.  Fromer, L. (2011). Implementing chronic care for COPD: planned visits, care coordination, and patient empowerment for improved outcomes. Int J Chron Obstruct Pulmon Dis, 6, 605-614.  Tsiligianni, I., Goodridge, D., Marciniuk, D., Hull, S., & Bourbeau, J. (2015). Four patients with a history of acute exacerbations of COPD: implementing the CHEST/Canadian Thoracic Society guidelines for preventing exacerbations. NPJ primary care respiratory medicine, 25, 15023. doi:10.1038/npjpcrm.2015.23  Verbrugge, R., Boer, F., & Georges, J. J. (2013). Strategies used by respiratory nurses to stimulate self‐management in patients with COPD.Journal of clinical nursing, 22(19-20), 2787-2799.  Williams, V., Hardinge, M., Ryan, S., & Farmer, A. (2014). Patients' experience of identifying and managing exacerbations in COPD: a qualitative study. NPJ primary care respiratory medicine, 24, 14062.  Yasin, A. B. U. L., & Tevfik, Ö. Z. L. Ü. (2012). Global Initiative for Chronic Obstructive Lung Disease Gold 2011: What Was Changed in New Guide?.Turkiye Klinikleri Archives of Lung, 13(2), 1.
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Research Project Proposal – The Use of Pnuemonia
Vaccine for Prevention of COPD
Quynh Doan

South University Online

INTRODUCTION
• Are current approaches to dealing with COPD exacerbations are sufficient? Is there a

need to take additional steps to solve this problem?
• COPD exacerbations have been on the rise and present enormous suffering to victims
• Researchers have linked lung infections to Streptococcus pneumoniae bacterium and they
therefore regard it as a serious problem that should be resolved.
• It’s critical to solve the situation with urgency as it has proved to be very challenging,
significantly burdening families, individuals and communities who have been exposed to
the illness.

RESEARCH PROBLEM
• Exacerbations of COPD have created an enormous socioeconomic burden among
the populace.
• Frequent exacerbations match with an increase in health care costs & decline state
of health and wellness within society.
• Health practitioners recommend the use of influenza and pneumococcal vaccines to
prevent the disease and help foster a healthy population free of the disease.

PROBLEM STATEMENT
• Gaps still exist concerning whether the patients are aware of the benefits of using
Pneumonia vaccine to reduce COPD exacerbations.
• Vaccination is one of the methods that have been applied at the clinical level as a
preventive measure for COPD exacerbations.
• Currently, there are two types of Pneumonia vaccines which include the pneumococcal
conjugate vaccine (PCV13) and the pneumococcal polysaccharide vaccine (PPSV23).

RESEARCH PURPOSE
• Determine whether the use of pneumococcal vaccine can help reduce or prevent the

cases of COPD exacerbations.
• There is no debate as to the clinical or applicable value of the use of the vaccine, as it
has been used effectively and tested to be useful.
• However, its application as a public health measure to combat COPD exacerbations has
not been studied.
• There could be other underlying factors that influence the prevalence of COPD
exacerbations and not just the absence of a vaccine.

RESEARCH QUESTIONS, HYPOTHESIS, AND VARIABLES
• “Does the use of pneumococcal or influenza vaccine prevent or decrease COPD
exacerbations?”
• H1: There is evidence that COPD patient receiving pneumonia vaccine will show to have

decrease reoccurrence of exacerbations.
• H0: No evidences found on reduced COPD exacerbations cases for patient receiving
vaccine compare to those that did not receive pneumonia vaccination on the number of
exacerbations.

LITERATURE REVIEW
• The aim of my research proposal is to determine the impact of pneumonia vaccines and
their overall value in respect to decreased exacerbation of CO...


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