Assignment: Control and Management of Heart Failure among African Americans
Assignment Control and Management of Heart Failure among African Americans
My clinical issue is on heart failure among African American adults and how the use of community health workers based group education results in better control and management of the disease. Heart failure develops when cardiac function is abnormal, and the heart fails to pump blood at a rate proportional to the requirements of body organs or when the heart only pumps sufficient blood with an increased diastolic filling pressure (Ziaeian & Fonarow, 2016). Heart failure is prevalent among African Americans compared to other racial groups, and it begins to develop in young adults. Besides, the prevalence of heart failure in individuals below 50 years is twenty-fold higher among African-Americans compared to the white population (Devereaux, 2019). Factors that predispose African Americans to heart failure include low levels of high-density lipoproteins, hypertension, obesity, and chronic kidney disease.
Methods
When choosing peer-reviewed journal articles, I looked up for articles that conducted studies on heart failure among African Americans. I also searched for articles that studied the factors that put African Americans at risk of heart failure. I searched for articles that examined the impact of community health workers in improving the health outcomes of patients with heart failure and in the management of cardiovascular diseases.
Literature Review
The first article is a pilot study by Vohra et al. (2018) on the impact of community health workers in the management of Heart Failure. The study aimed to assess the effect of community health workers (CHWs) on hospital readmissions and emergency department (ED) visits for a patient with heart failure in an urban setting. The research participants of the study were patients with a primary diagnosis of acute decompensated heart failure. In the study, heart failure patients hospitalized were screened for a pilot program to receive weekly home visits by a CHW. The enrolled patients were matched using 31 variables with retrospective control patients hospitalized with a diagnosis of heart failure who did not receive CHW visits (Vohra et al., 2018). The number of hospitalization and emergency department visits were compared for the six months following the enrollment versus the six months prior. The study revealed that there was a reduction in ED visits and hospitalization among patients visited by a CHW while there was an increase in ED visits and hospitalization in control patients (Vohra et al., 2018). CHW may reduce the utilization of healthcare services for patients with heart failure without adversely impacting mortality. The study will support my PICOT question since it focuses on the impact of CHWs in achieving better control and management of heart failure.
Woda et al. (2015) conducted a study on the factor that influences the self-care behaviors of African Americans with heart failure. The study aimed to understand the influences of heart failure self-care among low income, African Americans. Subjects used in the study were residents of a large Midwestern city whose population are individuals with low income and have a large population of African Americans (Woda et al., 2015). Individuals with low income and disabled adults above 55 years whose average yearly income was less than $13,537 were recruited for the study. The study employed a descriptive community-based participatory research design, and a photovoice method was utilized for data collection and analysis (Woda et al., 2015). The study found that social support, friendly companionship, and heart failure diet influenced individuals in engaging in heart failure self-care behaviors. The study supports my PICOT question as it explores the factors that affect self-care behaviors in African Americans with a diagnosis of heart failure.
Carter et al. (2018) conducted a study on the impact of implementing community health worker-patient pairings at the time of hospital discharge. The study utilized a randomized control trial design to determine if linking hospitalized patients with chronic disease to community health workers can decrease 30-day readmissions (Carter, Walton, Donelan & Thorndike, 2018). Three hundred fifty adults with chronic illnesses that are at an increased risk for readmission were recruited for the study. The intervention group of 175 subjects was linked with a CHW. The study found that connecting a chronically ill patient with a CHW is associated with decreased hospitalization (Carter et al., 2018). The article supports my PICOT question since it addresses the impact of CHWs in reducing hospitalization among patients with chronic diseases.
Krishnamoorthy et al. (2016) conducted a study on the Obesity and Heart Failure epidemics among African Americans. The study aimed to explore the relationship between obesity and health outcomes, such as mortality and heart failure in African Americans
(Krishnamoorthy et al., 2016). The research subjects were a community sample of 5292 African Americans taking part in the Jackson Heart Study. The study utilized a retrospective study design (Krishnamoorthy et al., 2016). The study found out that obesity and morbid obesity were common in the community sample of African Americans (Krishnamoorthy et al., 2016). Both obesity and morbid obesity were linked with increased heart failure and heart failure hospitalization. The article will support my PICOT question since it will provide information on the factors that contribute to heart failure and hospitalization in African Americans.
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A study by Heo et al. (2016) aimed to explore patients’ perceptions of heart failure symptom status and the causes and impact on their daily lives in male and female Caucasian and African American patients with heart failure. The subjects of this study were African Americans and Caucasian patients with a diagnosis of heart failure. The study applied a qualitative research design using a semi-structured open-ended interview guide (Heo et al., 2016). The study revealed that African American patients perceived significant difficulties in living with heart failure symptoms (Heo et al., 2016). This article supports my PICOT question since it focuses on the impact of heart failure on African American males and how the symptoms can be better be construed and managed.
Comparison of the Peer-Reviewed Articles
The study by Woda et al. had several study limitations, for instance, the purposeful selection was limited to subjects that self-identified as African American, had heart failure, and was above 55 years (Woda et al., 2015). The study was not designed to be generalizable, but to render a complete understanding of what influences HF self-care behaviors. The study by Carter et al. was limited by inadequate qualified CHWs and eligible patients declining to participate in the research study (Carter et al., 2018). The article by Krishnamoorthy et al. was limited by the fact that the participants were from the southern United States, and the findings may not be generalized to African Americans living in other USA regions (Krishnamoorthy et al., 2016). There were no controversies that came up in the course of the research studies.
The similarities in the study articles include the findings that reveal that African Americans are at a higher risk of developing heart failure, and the factors that put them at risk of heart failure include obesity and poor self-care habits. Besides, people with heart failure with poor self-care behaviors are hospitalized or visit the ED more frequently than those trained on how to manage their condition at home. The studies also reveal that CHWs have had a significant impact on improving the health outcomes of people with heart failure by helping patients manage their condition at home and providing health education.
Areas of Further Study
Research studies have revealed that African Americans have the highest prevalence of Heart failure compared to other racial groups. One major factor that increases the risk of heart failure is obesity. Besides, the use of CHWs has had a significant impact on reducing hospitalization and improving the quality of life among patients with heart failure. However, it is unknown whether better health outcomes are sustained after the CHWs terminate their contact with patients. Further studies on the long-term impact of CHW in helping patients with heart failure need to be conducted. Besides, research is required on more effective interventions to help patients manage heart failure symptoms to lower the adverse effects on daily lives.
Conclusion
Therefore, African-Americans suffer from cardiovascular diseases at a higher rate compared to other races. The usage of community health workers based group education enables them to improve the quality of their lives. Various articles have been published concerning the issue of African Americans suffering from heart conditions with all of them agreeing that the African-American population is more predisposed to it than other ethnicities.
In Part A, you described the population and quality initiative related to your PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) statement. In this assignment, you will formalize your PICOT and research process.
Use the GCU Library to perform a search for peer-reviewed research articles. Find five peer-reviewed primary source translational research articles.
In a paper of 1,250-1,500 words, synthesize the research into a literature review. The literature review should provide an overview for the reader that illustrates the research related to your particular PICOT. Include the following:
1.Introduction: Describe the clinical issue or problem you are addressing.
2.Methods: Describe the criteria you used in choosing your articles
3.Synthesize the Literature: Part A: Discuss the main components of each article (subjects, methods, key findings) and provide rationale for how this supports your PICOT; Part B: Compare and contrast the articles: Discuss limitations, controversies, and similarities/differences of the studies.
4.Areas of Further Study: Analyze the evidence presented in your articles to identify what is known, unknown, and requires further study.
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.