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HNN108 Understanding Research Evidence

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HNN108 Understanding Research Evidence

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HNN108 Understanding Research Evidence

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Course Code: HNN108
University: Deakin University

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Country: Australia

Question:
This assessment task provides you with the opportunity to demonstrate the following Unit Learning outcomes and Deakin Graduate Learning Outcomes;Unit Learning OutcomesDescribe the different ways that health research is conducted and how research results are presentedSearch for and retrieve health information, and professional literature from online sourcesExplain the principles of appraising evidence to inform clinical practiceInterpret basic quantitative and qualitative analyses in health researchDiscuss ethical considerations associated with research
Answer:
Introduction:

Various initiatives have already been taken in order to provide care to the older adults during their end of life phase. Similarly this study aimed to promote CAREFul program in order to provide care to these individuals. From the conducted study it was found that the program was successful in improving the quality of the care of the dying specifically in the acute geriatric hospital wards. The study showed that there was significant improvement in the primary outcomes of the trial that was carried out.  A significant positive effect on symptoms and care needs was found along with an adverse effect on satisfaction with care of the family carer.  The limitations of the study involved there was some lack of caution while the implementation of the positive effects of CAREFuL. This included that that the nurses were not masked to the allocation hence this could have affected the rigidity of the study. Additionally the study showed that there was low amount of response rate obtained from the CAREFuL group in comparison to the control group. This difference between the responses could result in biasness of the findings of the study. The study showed that only 34–36% of patients present in the control and CAREFuL groups admitted to the wards gave consent to use their personal data (Beernaert et al., 2017).  
The implications of the study included that there is a requirement of optimal palliative care for the patients who are dying in order to reduce the sufferings of both the patient and their family members. A study by Vandervoort et al. (2014), showed that deficiencies present in the care of dying inpatients in the hospital setting could be best addressed through the implementation of the systems-oriented approach. This PCAD is a type of n interdisciplinary care path including a daily documentation flow sheet, and a physician order sheet. van der Steen et al., (2014) in a study argues that Inpatient Comfort Care Program (ICCP) could improve the quality of end-of-life care provided in a Veterans Affairs (VA) medical center. The study also mentioned that this program comprised of three major components namely staff education, case identification, and implementation of a Comfort Care Order Set. In comparison to the implementation of CAREFuL program, this program showed that availability of opioid pain medication at the time of death, as documented in the patients’ records, increased significantly from 57.1% to 83.2% (P.001). it also showed that the percentage of deaths that occurred in intensive care settings declined from 42.6% to 32.6% through the implementation of the program but was not statistically significant (P=.17) (Teno et al., 2013). Another goal of the intervention was to transfer patients from intensive care settings to medical units, to reduce the use of uncomfortable or painful interventions and optimize the family’s ability to spend time with the patient. In another study it was seen that the hospice movement, which had challenged the existing death-defying attitude of the healthcare system. It was also able to champion a positive attitude to caring for vulnerable and dying patients that resonates with society. In order to implement this model of care a greater emphasis needs to be given to the educational issues related to diagnosing dying. There is a need to disseminate widely the expertise in the care of dying cancer patients along with to including the non-cancer population. A clear structure for care is needed to empower generic workers if we are to achieve the requirement of the NHS cancer plan that “the care of all dying patients must improve to the level of the best.
According to the reports by WHO, there is a need for palliative care for around 20 million people in a worldwide basis. There is a requirement for the management of symptoms that includes pain (Gomes et al., 2013). This is an important aspect of palliative care, along with psychological, spiritual and social support. The implications for the study involve concerns about uncontrolled symptoms and quality of care has been identified from across the respondent groups. Vigorous, research exploring the best mediations and drugs to oversee manifestations will decrease trouble for the two patients and families, and lessen conceivable damage of ebb and flow medications. Administration of manifestations might be impartial over various care settings, to empower patients to remain in their favoured place of care. At long last, and potentially out of the blue, an extent of medicinal services experts both distinguished themselves and reacted as clinicians, and patients or carers. Palliative care is everyone’s business and the after effects of this supplementary investigation feature the requirement for pressing endeavors to enhance understanding consideration, maintained by a strong research prove base.
The limitations of the research study incorporates that researchers were not able define respondents’ reports, or unlawful further inside and out data as would be standard in a subjective meeting, the respondents concentrated on regions important to them, without impact from the specialists. In spite of the fact that the scientists were not able affirm the character of respondents, because of the mysterious idea of the information and the reactions were harmonious with people who had involvement of the results they portrayed (Baillie et al., 2018).
The dying patients confront the unpredictable difficulties that debilitate the passionate, physical and the profound uprightness. An investigation uncovers that there is a solid assertion between the finish of life mind members meanings of what is included a decent passing. Most more established Americans presently confront constant disease and handicap in the last long periods of life. These last years can demonstrate excruciating and troublesome for wiped out and debilitated elderly individuals, who may experience issues discovering consideration to address their issues. This period is frequently unpleasant and costly for families (Chan & Webster, 2013). As right now designed, social insurance and network benefits just are not sorted out to address the issues of the substantial and developing number of individuals confronting a significant lot of dynamic ailment and inability before death. This blends a developing assortment of research on the issue of ceaseless ailment in the last period of life. Albeit family providing care has been seriously examined in the previous decade, little consideration has been paid to the effect of end-of-life mind on parental figures who are relatives of people with dementia or to the guardians’ reactions to the demise of the patient (Vandervoort et al., 2014).
References:
Beernaert, K., Smets, T., Cohen, J., Verhofstede, R., Costantini, M., Eecloo, K., … & Deliens, L. (2017). Improving comfort around dying in elderly people: a cluster randomised controlled trial. The Lancet, 390(10090), 125-134. Retrieved from: https://doi.org/10.1016/S0140-6736(17)31265-5
Chan, R. J., & Webster, J. (2013). End?of?life care pathways for improving outcomes in caring for the dying. Cochrane database of systematic reviews, (11). Retrieved from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008006.pub3/abstract
Goddard, C., Stewart, F., Thompson, G., & Hall, S. (2013). Providing end-of-life care in care homes for older people: A qualitative study of the views of care home staff and community nurses. Journal of Applied Gerontology, 32(1), 76-95. Retrieved from: https://doi.org/10.1177/0733464811405047
Gomes, B., Calanzani, N., Gysels, M., Hall, S., & Higginson, I. J. (2013). Heterogeneity and changes in preferences for dying at home: a systematic review. BMC palliative care, 12(1), 7. Retrieved from: https://doi.org/10.1186/1472-684X-12-7Baillie, J., Anagnostou, D., Sivell, S., Van Godwin, J., Byrne, A., & Nelson, A. (2018). Symptom management, nutrition and hydration at end-of-life: a qualitative exploration of patients’, carers’ and health professionals’ experiences and further research questions. BMC palliative care, 17(1), 60. Retrieved from: https://doi.org/10.1186/s12904-018-0314-4
Teno, J. M., Gozalo, P. L., Bynum, J. P., Leland, N. E., Miller, S. C., Morden, N. E., … & Mor, V. (2013). Change in end-of-life care for Medicare beneficiaries: site of death, place of care, and health care transitions in 2000, 2005, and 2009. Jama, 309(5), 470-477. doi:10.1001/jama.2012.207624
van der Steen, J. T., Radbruch, L., Hertogh, C. M., de Boer, M. E., Hughes, J. C., Larkin, P., … & Koopmans, R. T. (2014). White paper defining optimal palliative care in older people with dementia: a Delphi study and recommendations from the European Association for Palliative Care. Palliative medicine, 28(3), 197-209. Retrieved from: https://doi.org/10.1177/0269216313493685
Vandervoort, A., Houttekier, D., Vander Stichele, R., Van der Steen, J. T., & Van den Block, L. (2014). Quality of dying in nursing home residents dying with dementia: does advanced care planning matter? A nationwide postmortem study. PloS one, 9(3), e91130. Retrieved from: https://doi.org/10.1371/journal.pone.0091130

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