NURS 8200 Discussion: Correlations

According to Gray et al. (2021), Quantitative research is conducted to describe variables or concepts, examine relationships among variables, and determine the effect of an intervention on an outcome. Correlational research is one of the four types of quantitative research methods available for scientists to use. Correlational research involves the systematic investigation of relationships between two or more variablesthat have been identified in theory (Gray et al., 2021).

Identified Healthcare Problem and Research Question

The healthcare problem I selected is schizophrenia, the research question formulated is can Vitamin D be used to decrease the positive, negative, and cognitive symptoms of schizophrenia?  Another hypothesis is that vitamin D has a neuroprotective effect on

grey matter. Schizophrenia has been describe by Wu et al, (2020), as a complex mental disorder characterized by the problem of emotion, thinking and behavior.  The prevalence of schizophrenia varies in geographical regions (Neriman et al, 2021). There are many theories surrounding the causes of schizophrenia. One theory is that exposure to low maternal vitamin D levels in the fetus and low 25OHD levels in the neonatal period increase the risk of developing schizophrenia in later years (Berridge, 2018). Because vitamin D is the only vitamin that can be synthesized in the human body, the amount synthesized depends on age, skin color, season, ethnicity and duration of sun exposure (Neriman et al, 2021).

Null Hypothesis

According to Stanton (2020), testing and rejecting the null hypothesis is a routine part of quantitative research, but relatively few organizational researchers prepare for confirming the null or, similarly, testing a hypothesis of equivalence (e.g., that two group means are practically identical. The main purpose of the null hypothesis significance test (NHST) is to reject the null in order to gather support for an alternative hypothesis (Stanton, 2020). The null hypothesis in the research question on the use of vitamin D in patients with schizophrenia is do use of vitamin D supplements decrease the incidence of schizophrenia?

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Prediction for Expected Relationship

My prediction for the expected relationship between the variables  is a positive one. Statistical analysis can be performed in SPSS 27 or similar application. T-tests and chi-square tests are used to compare patients. Prediction models are tested with multiple linear regressions. Variables such as male/female, age, height, weight, BMI, grey matter volume, white matter volume and S-25(OH)D. S-25(OH)D levels correlated positively with grey matter (p< .02), whole brain (p< .02) and peripheral grey matter (p< .05) (Berg et al., 2018). In one study  by McGarth et al., 2004). Vitamin D supplements during the first year of life was associated with a reduction of the incidence of schizophrenia males (Risk ratio (RR)=0.08, 95% CI 0.01-0.95; RR=0.12, 95% CI 0.02-0.90)

References

Berg, A.O., Jorgensen, K.N., Nerhus, M., Athanasiu, L., & Popejoy, A.B. (2018). Vitamin D levels, brain volume, and genetic archtecture in patients with psychosis. PLOS ONE Vol. 13(8): e0200250. doi: 10.1371/journal.pone.0200250

Berridge, M.J. Vitamin D deficiency: infertility and neurodevelopmental diseases (attention deficit hyperactivity disorder, autism, and schizophrenia). American Journal of Physiol (2018);314(2):C135-51. https://doi.org/10.115223

Gray, J.R., Grove, S.K., & Sutherland, S. (2021). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (9th ed.). Saunders Elsevier

McGarth, J., Saari, K., Hakko, H., Jokelainen, J., Jones, P., Jarvelin, M.R., Chant, D., & Isohanni, M. (2004). Vitamin D supplementation during the first year of life and risk of schizophrenia: a Finnish birth cohort study. Elsevier, Volume 67, Issues 2-3, 1 April 2004, Pages 237-245

Neriman, A., Hakan, Y. & Ozge, U. (2021). The psychotropic effect of vitamin D supplementation on schizophrenia symptoms. BMC Psychiatry (2021) 21:309. https://doi.org/10.1186/s12888-021-03308-w

Stanton, J.M. (2020). Evaluating Equivalence and confirming the Null in the Organizational Sciences. SAGE Journals. https://doi-org.ezp.waldenulibrary.org/10.1177/1094428120921934

Wu, J., Xu, J., Chen, W. & Sun, D. (2020). The group sparse canonical correlation analysis method in the imaging genetic research. IEEE Xplore. Retrieved from the Waldenulibrary databases

Sample Answer 2 for NURS 8200 Discussion: Correlations

You make interesting statements which I agree with. Correlational research is a type of non-experimental research in which the researcher measures two variables and assesses the statistical relationship between them with little or no effort to control extraneous variables (Curtis, Comiskey & Dempsey, 2016). There are many reasons that researchers interested in statistical relationships between variables would choose to conduct a correlational study rather than an experiment. The first is that they do not believe that the statistical relationship is a causal one or are not interested in causal relationships. This is actually where people often go wrong – there is a difference between a correlational study and a causal study. In your research, for example, while you might find a relationship between the independent and dependent variable, this does not necessarily imply a cause-effect relationship. Thoughts?

Reference

Curtis, E. A., Comiskey, C., & Dempsey, O. (2016). Importance and use of correlational research. Nurse researcher, 23(6), 20–25. https://doi.org/10.7748/nr.2016.e1382

Sample Answer 3 for NURS 8200 Discussion: Correlations

I am also very concerned about patient compliance! It is such a vital issue when it comes to patients outcomes and overall wellbeing.

Suggest an alternative perspective based on additional evidence drawn from readings or after synthesizing multiple postings.

The main problem identified here revolves around nurse-patient communication and its significant impact on patient adherence to treatment plans. This issue highlights the vital role of effective communication in fostering patient-centered care, where the preferences, needs, and values of patients are paramount in clinical decisions. The research question proposed is whether there’s a correlation between effective nurse-patient communication and patient adherence to treatment plans, leading to a discussion that sets the stage for an in-depth exploration of the dynamics between healthcare providers and patients (Panahi, et al. 2022).

From an alternative perspective, one might consider the bidirectional nature of communication and its broader impact beyond just adherence. This perspective acknowledges that while effective communication from nurses is crucial, patient engagement and the quality of their responses also play a significant role in the communication process. The model of communicative action proposed by Habermas could serve as a theoretical foundation, emphasizing mutual understanding and the intersubjective agreement between nurses and patients as critical components of effective healthcare communication (Kwame & Petrucka 2021).

Moreover, this alternative view would explore the concept of shared decision-making (SDM) as a core element of patient-centered care, suggesting that the decision-making process itself, when shared between nurse and patient, could directly influence patient adherence. SDM involves the patient and nurse (or healthcare provider) working together to make decisions, taking into account the best clinical evidence available, as well as the patient’s values, preferences, and circumstances. This process inherently requires and fosters effective communication, mutual respect, and understanding (Fiorillo, et al. 2020).

Incorporating this perspective, the dependent variable remains patient adherence to treatment plans, but the independent variables could be expanded to include measures of patient engagement, quality of patient responses, and the degree of shared decision-making practiced. This broader set of variables acknowledges that effective communication is not a one-way process but involves active participation from both nurses and patients.

The expected relationship in this alternative perspective would still be positive, but with a nuanced understanding that the pathway to improved patient adherence is mediated through enhanced patient engagement and shared decision-making. These factors encourage a deeper connection to treatment plans, as patients feel their views are respected and considered in the decision-making process (Fiorillo, et al. 2020).

Factors that might affect the outcome in this expanded model include the patient’s previous experiences with the healthcare system, personal autonomy, readiness to engage in their healthcare, and the level of trust in healthcare providers. For example, a patient’s previous negative experiences might hinder open communication and trust, affecting their willingness to participate in shared decision-making and, consequently, their adherence to treatment plans. Conversely, a supportive and empowering communication environment can enhance trust, engagement, and ultimately adherence (Lotfi, et al. 2019).

This alternative perspective encourages a holistic view of the nurse-patient communication process, acknowledging the complexity of human interactions in healthcare settings and the multifaceted nature of patient adherence. It also highlights the importance of considering both the provider’s and the patient’s contributions to effective communication and shared decision-making as central to improving health outcomes.

References:

Fiorillo, A., Barlati, S., Bellomo, A., Corrivetti, G., Nicolo, G., Sampogna, G., Stanga, V., Veltro, F., Maina, G., Vita, A. (2020).The role of shared decision-making in improving adherence to pharmacological treatments in patients with schizophrenia: a clinical review. Annals of General Psychiatry. 19(2) 43-49. doi: 10.1186/s12991-020-00293-4

Kwame, A. & Petrucka, P. (2021).A literature-based study of patient-centered care and communication in nurse-patient interactions: barriers, facilitators, and the way forward. BMC Nursing. 20(1) 15-18. doi: 10.1186/s12912-021-00684-2.

Lotfi, M., Zamanzadeh, V., Valizadeh, L., Khajehgoodari, M. (2019). Assessment of nurse–patient communication and patient satisfaction from nursing care. Nursing Open. 6(3) 1189-1196. doi: 10.1002/nop2.316.

Panahi, S., Rathi, N., Kamumura, A. (2022). Patient Adherence to Health Care Provider Recommendations and Medication among Free Clinic Patients. Sage. February 2022. doi: 10.1177/23743735221077523.

Sample Answer 4 for NURS 8200 Discussion: Correlations

Post a brief description of the selected problem that you identified for the focus of this Discussion and include your research question. Be specific. 

The problem that I have selected for the focus of this discussion is nurse communication and patient adherence. Effective nurse-patient communication plays a crucial role and adherence to treatment plans and is essential for providing patient-centered care. Patient-centered care involves respecting and responding to individual patients’ needs, preferences, and values in clinical decisions (Edgman-Levitan & Schoenbaum, 2021). Respectful communication between nurses and patients can lead to better patient understanding, trust, satisfaction, and improved adherence to medication and treatment plans. Clear communication reduces uncertainty and allows patients to make informed decisions about their health. Additionally, effective communication enhances social support and safety which contributes to positive patient outcomes. My research question is, “Does effective nurse-patient communication correlate with patient adherence to treatment plans?”

Explain your null hypothesis and alternate hypotheses for your research question and identify the dependent and independent variables that you would recommend to best support the research study. 

My null hypothesis states that there is no effect or no correlation between effective nurse-patient communication and patient adherence to treatment plans. My alternate hypothesis is that there is a correlation between effective nurse-patient communication and patient adherence to treatment plans.

I would recommend the dependent variable to be patient adherence to treatment plans. Measurement of adherence can include factors such as medication adherence and treatment plan adherence. Medication adherence can be measured by whether patients followed prescribed medication regimens consistently. Treatment plan adherence can be measured by measuring whether patients adhere to lifestyle changes, follow-up appointments, and other aspects of their treatment plan.

I would recommend the independent variable to be effective nurse-patient communication. The components of effective communication can include clear information delivery, active listening, empathy and respect, and patient engagement (Kwame & Petruka, 2021).

Then, explain your prediction for the expected relationship (positive or negative) between the variables that you identified. 

I predict a positive relationship between effective nurse-patient communication (independent variable) and patient adherence to treatment plans (dependent variable). A positive relationship suggests that as the quality of nurse-patient communication improves, patient adherence to treatment plans also increases (Gray & Grove, 2020). When nurses communicate effectively, patients are more likely to understand their treatment plans, instructions, and the importance of adherence. Clear communication fosters trust, reduces uncertainty, and empowers patients to actively participate in their care. Patients who feel heard, respected, and well-informed are more motivated to follow treatment recommendations.

Why do you think that sort of relationship will exist? What other factors might affect the outcome? Be specific and provide examples.

As previously mentioned, I expect a positive relationship to exist. Effective nurse-patient communication is likely to positively impact patient adherence to treatment plans. When nurses communicate clearly, patients better understand their treatment instructions, potential side effects, and the rationale behind specific recommendations. Trust fosters confidence in following treatment plans. Effective communication empowers patients to actively participate in their care decisions by becoming partners in their own health management.

Other factors that can affect adherence includes health literacy, cultural and language barriers, social support, financial constraints, psychosocial factors, patient beliefs and attitudes, provider-patient relationship, treatment complexity, side effects, and forgetfulness (Thompson & Haskard-Zolnierek, 2020). First, patients with low health literacy may struggle to comprehend complex medical information, even with effective communication. Simplifying instructions and using plain language is crucial. Diverse patient populations may require varying communication needs. Cultural competence and language proficiency play a significant role. Patients with strong social support systems are more likely to adhere to treatment plans. Financial constraints such as cost of medications, access to healthcare, and insurance coverage impact adherence. Anxiety, depression, and stress can affect adherence. A patient’s beliefs about illness, treatment efficacy, and perceived benefits influence adherence. Beyond communication, the overall relationship between nurse and patient matters. Complex regimens that involve multiple medications, dietary restrictions, and lifestyle changes can also pose challenges. Fear of adverse effects may deter adherence. Patients may forget to take medications or follow treatment schedules.

References

Edgman-Levitan, S., & Schoenbaum, S.C. (2021). Patient-centered care: Achieving higher quality by designing care through the patient’s eyes. Israel Journal of Health Policy Research, 10(1), 1-5.

Gray, J. R., & Grove, S. K. (2020). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (9th ed.). Elsevier.

Kwame, A., & Petrucka, P. M. (2021). A literature-based Study of patient-centered Care and Communication in nurse-patient interactions: barriers, facilitators, and the Way Forward. BMC Nursing, 20(158), 1–10. https://doi.org/10.1186/s12912-021-00684-2Links to an external site.

Thompson, T. L., & Haskard-Zolnierek, K. B. (2020). Physician Communication and Patient Adherence to Treatment. Medical Care, 47(8), 826–834. https://doi.org/10.1097/mlr.0b013e31819a5acc