Clinical Problems Associated With Caring For Chronic Illnesses
The clinical problem that interests me is learned helplessness (LH) and patient outcomes during hospitalization. I work with transplant patients and of course most have had a long history of chronic disease, one being either ESRD or ESLD. When I was looking up research articles in response to learned helplessness and outcomes, I couldn’t find any that stated interventions used to decrease hospital stay aside from one stating social support may influence LH in a positive manner. Research problem: Does learned helplessness decrease patient outcomes in hospitalized patients? The target population and setting would be hospitalized patients with chronic conditions. Variables would include social support and hospital staff.
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Reference: Clinical Problems Associated With Caring For Chronic Illnesses
Huang, J., Shi, Y., Chen, Y., Tang, L., & Zhang, Z. (2024). How social support influences learned helplessness in lung cancer patients: the chain mediation role of individual resilience and self-efficacy. Frontiers in psychology, 15, 1436495. https://doi.org/10.3389/fpsyg.2024.1436495 Clinical Problems Associated With Caring For Chronic Illnesses
All posts (original and replies) should be substantive and contribute to the understanding of the topic. Your response can support the view of the other person, lend a different viewpoint, or provide additional information. In addition, a peer response can be a question which, if answered, would improve upon the other student’s original idea. Provide rationale for your views and cite the work of others if needed. No credit will be given for peer responses such as “good job” or “I agree.”
Must include at least one citation related to your topic. Posts should be made within your group discussion forum. Reply to two peers.
Discussion by BL
Nasal injuries related to Bubble Continuous Positive Airway Pressure (BCPAP) interfaces among neonates in the Neonatal Intensive Care Unit (NICU) is a clinical problem in my area of interest. BCPAP nasal masks cover a larger surface area than nasal prongs but are not as invasive. A systematic review on this subject stated that BCPAP nasal masks have less risk of nasal injuries according to their findings, but explains that more quality research studies are needed to validate these findings (Prakash et al., 2022)Clinical Problems Associated With Caring For Chronic Illnesses. I hypothesize that the BCPAP nasal masks contribute to fewer nasal injuries than the BCPAP nasal prongs. I would like to research whether there is a difference in the prevalence of nasal injuries between patients using BCPAP nasal masks versus nasal prongs. However, there is a gap in the current research literature about this clinical problem. Most research on the difference between BCPAP nasal masks and nasal prongs has focused on the amount of distending pressure that each interface actually delivers. There have been few studies that focus on nasal injuries caused by the two interfaces. I have developed a research problem stating this gap in the literature: Does the interface of BCPAP nasal masks lead to fewer pressure injuries than the BCPAP nasal prongs? The target population would be neonates in the NICU receiving BCPAP via nasal masks and nasal prongs. The variables include nasal injuries, BCPAP nasal masks, and BCPAP nasal prongs interfaces. The setting is the NICU.
References
Prakash, R., De Paoli, A. G., Oddie, S. J., Davis, P. G., & McGuire, W. (2022). Masks versus prongs as interfaces for nasal continuous positive airway pressure in premature infants. Cochrane Database of Systematic Reviews, 11(11), CD015129. https://doi.org/10.1002/14651858.CD015129 Clinical Problems Associated With Caring For Chronic Illnesses
There are various clinical problems associated with caring for hospitalized chronically ill patients. Your identified clinical problem is learned helplessness and its impact on patient outcomes for patients hospitalized following chronic illnesses. According to Thomson and Kyle (2021), learned helplessness is a psychological condition where individuals, after experiencing repeated negative situations and stress, perceive the state as uncontrollable, often leading to giving up on improvement. I agree with you that chronically ill patients, having been exposed to related stress, are highly affected by the condition, negatively impacting their patient outcomes. Additionally, learned helplessness can reduce the patient’s motivation for self-care, worsening the condition and increasing the risk of hospital readmission. Therefore, the clinical problem needs attention. You mentioned a research gap in the literature and studies focusing on the response to learned helplessness among chronically ill patients. Therefore, I support your research problem of whether learned helplessness is associated with decreased patient outcomes in hospitalized chronically ill patients. I suggest you could also hypothesize whether social support helps address learned helplessness among hospitalized patients with chronic conditions, using your identified variables, such as social support and hospital staff. Overall, your post is succinct and logical.
Reference
Thompson, S. C., & Kyle, D. J. (2021). The role of perceived control in coping with the losses associated with chronic illness. In Loss and Trauma (pp. 131–145). Routledge. https://doi.org/10.4324/9781315783345-11
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Discussion Response to BL
Your identified clinical problem of interest, nasal injuries related to Bubble Continuous Positive Airway Pressure (BCPAP) interfaces among neonates in the Neonatal Intensive Care Unit (NICU). Even though you mentioned that nasal masks are less invasive than nasal prongs, a study by Pascal and Wielenga (2023) found that both BCPAP nasal masks and prongs have caused nasal pressure injuries to patients. In addition, you hypothesized that BCPAP nasal masks contribute to fewer nasal injuries than BCPAP nasal prongs. Therefore, I agree with your research question; the difference in the prevalence of nasal injuries between neonate patients using BCPAP nasal masks versus nasal prongs is valid, considering their possibility to cause nasal injuries among neonates in the NICU has already been confirmed. You also mentioned that there is available research literature on the problem, focusing on the differences in distending pressure that each interface uses. However, there is a gap in research focusing on prevalence. Your identified target population (neonate patients in the NICU receiving both BCPAP via nasal masks and nasal prongs) and variables (nasal injuries, BCPAP nasal masks, and BCPAP nasal prongs interfaces) are appropriate for the suggested research question. Overall, your post it well structured and presented.
References
Pascual, A., & Wielenga, J. M. (2023). Nasal pressure injuries among newborns caused by nasal CPAP: An incidence study. Journal of Neonatal Nursing, 29(3), 477-481. https://doi.org/10.1016/j.jnn.2022.09.006
