Tuesday, May 5, 2020

Analytic Hierarchy Process

Question: Discuss about the Analytic Hierarchy Process. Answer: Introduction Nursing is a profession, where the professionals have to focus on the health and well-being of the care givers, experiencing any kind of health related issues. In the nursing profession, professionals have to deal with patients, in long-term care for severe injury or disorder. In long-term care, different kind of patients attitudes is experienced by the professionals, which sometimes enhances nurses burnout. There are several reasons behind patients changed attitudes towards the medical staffs (1), (8). In case of patients experiencing fracture, pain is pivotal cause of changed attitude. In this research, the aim is to explore the attitude of patients in long-term care centre, who are living with fracture. With the help of this research findings, nursing professionals would be able to gain an insight of the ways, by which patients attitude can be improved. Research Aim The aim of this research is to explore the patients attitude in long-term hospital stay, living with fracture. Research question What are the attitudes of patient with fracture with long stay in the hospital? What are the factors that are influencing patients attitude in long-term hospital stay? What are the recommendations towards nurses to improve patients attitude, who are living with fracture, in long-term care? Literature Review It has been observed in the hospitals, that patients, who have experienced a severe bone fracture, stayed in hospital for longer period, it is because, recovery from bone fracture is usually time-consuming process. In elderly patients, the due to low calcium concentration and low bone mineral density, this process becomes slower. Due to long-term hospital stay, patients show changed attitude towards the nursing and other medical professionals (2), (4). It has been observed that, long-term hospital stay has several negative consequences, including co-morbidities and wound infections, worsening their health status. In a study, interviewing patients with hip fracture, in a long-term hospital care; four main themes were identified related to their hospital stay and rehabilitation, these include experience of injury, pain experience, recovery experience and the disability experience (3), (5). For instance, if a patient undergoes a hips fracture, until sole recovery, the patient experience loss of independence and disability, which induces stress related symptoms, sometimes, lead to depression and anxiety. The results include changed perception about hospital stay, recovery and nurses practices. One of the major reason behind nurses burnout and depression, while working with long term care patient is their changed behaviors towards the care givers (4). The changed attitude of the long-term patients includes negative perception about the care providers, loss of self-esteem and changed behavior towards other patients and nurses. In this study, when patients were asked about their experience in hospital stay, some of them replied that, it would be better than anything would, if they can go home. It indicates that, with longer- period of hospital stay, patients perception changes, which promote their negative attitude towards the heath care staffs (6), (7). In a study, interviewing the patients undergoing hip fracture and surgery, it has been revealed that the mean age of the patients in the long-term hospital stay is 80 years and they are very much concern about their recovery and self-independence. To understand the attitudes of patients, the immediate expectations of patients should be understood. The immediate expectations off the patients with hip fracture included expression of despair and discouragement, perception of the fact t hat the fracture is going to take a longer period of recovery, change in living situation with the threat of permanent loss of independent living (9). In this context, the factors that are influencing the attitude of long-term patient with fracture, include, patients age, non-friendly environment in the hospital, loss of independence, severity of pain, social isolation, lack of awareness about the recovery process and the pros and cons of their health status, perception of being vulnerable to be abuse and dependent on others, thoughts of uncertain future (12). It has been seen that due to lack of awareness, isolation and frustration regarding their loss of independence and isolation, patients become depressed, agitated and aggressive sometimes, which promote their negative behavior. It has several negative consequences; for instance, it influences the attitude of neighboring patients and makes it difficult for the staffs, to handle them peacefully (10). Methodology The research will be done by following primary research methodology. A primary research methodology will help the researcher to collect primary empirical data, which can be analyzed with the previous literatures on this topic (7). Here, the research would undertake a descriptive research design with mixed method of data collection. The primary data would be collected by surveying 30 patients, experiencing long-term hospital stay as a result of fracture. From the survey, quantitative data would be gathered about the patients experience during their hospital stay. On the other hand, 5 nurse managers would be interviewed for collecting qualitative data about the long-term patients attitude towards the health care processes. The random and non-random data sampling methods would be implemented for sampling the quantitative and qualitative data respectively. The research would be conducted by following the Data protection act 1998, for considering potential ethical issues during the resear ch study. Result and Discussion The primary data would be analyzed on the basis of the information revealed by reviewing the previous literatures on this topic. Expected results include negative perception about long-term hospital stay, wrong perception about nurses practices, worsening of health status, due to negative attitude and perception (11). Negative attitude of patients may enhance nurses depression and burnout. Strategies for overcoming this issue and reducing patients negative attitude would be found through the research findings. Conclusion This study findings would involve the scope of further studies in the domain of improving patients attitude towards nurses, who are in long-term hospital stay or the coping strategies of nurses for handling patients in long-term care, with severe pain due to fracture. The research findings could be used by the health care professionals for developing strategies of dealing improving relationship with long-term care patients, with disabilities. Reference List Ambrosino N, Venturelli E, Vagheggini G, Clini E. Rehabilitation, weaning and physical therapy strategies in chronic critically ill patients. European Respiratory Journal. 2012 Feb 1;39(2):487-92. Cecconi M, Fasano N, Langiano N, Divella M, Costa MG, Rhodes A, Della Rocca G. Goal-directed haemodynamic therapy during elective total hip arthroplasty under regional anaesthesia. Critical Care. 2011 May 30;15(3):1. Danner M, Hummel JM, Volz F, van Manen JG, Wiegard B, Dintsios CM, Bastian H, Gerber A, IJzerman MJ. Integrating patients' views into health technology assessment: Analytic hierarchy process (AHP) as a method to elicit patient preferences. International journal of technology assessment in health care. 2011 Oct1;27(04):369-75. Goroll AH, Mulley AG. Primary care medicine: office evaluation and management of the adult patient. Lippincott Williams Wilkins; 2012 Mar 28. Hommel A, Kock ML, Persson J, Werntoft E. The Patient's View of Nursing Care after Hip Fracture. ISRN nursing. 2012 Jul 3;2012. Horne R, Chapman SC, Parham R, Freemantle N, Forbes A, Cooper V. Understanding patients adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the Necessity-Concerns Framework. PloS one. 2013 Dec 2;8(12):e80633. Iwashyna TJ, Netzer G, Langa KM, Cigolle C. Spurious Inferences about Long-Term Outcomes. American journal of respiratory and critical care medicine. 2012 Dec 14. Iwashyna TJ, Netzer G. 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