Managing Acute Coronary Syndrome

The cases of elderly patients with multiple comorbid conditions have become rampant in the today’s society. This calls for a practical study on how to manage this condition to help in establishing ways of managing the condition among the elderly. This will assist them on how to live with the condition. This study aims at exploring the different ways in which comorbid conditions in elderly people can be managed by both the patients and the caregivers. It will specifically focus on the various ways of managing the condition among the elderly that have been identified. Moreover, in a bid to add to the available information, the study will also focus on the various options which are not yet applied in managing the condition.

This will be possible through conducting a thorough study on the current research in the area, while also sampling out individual patients and caregivers to find out unique ways in which they are managing the condition. I believe that with these insights, new and better ways of managing the condition that are relevant to individual patients will be uncovered and used to manage a condition that is becoming widespread among the elderly. The study will also help in exploring the available literature on the subject and glean for useful information in those literatures which has not yet been put to use.

Background Information/Research Design

A survey will be conducted among the in-patients and out-patients spread across the country. This will take into account the findings of the national agency for comorbid patients which indicates that though such cases of the conditions are still localized, they are increasing. I will, therefore, sample out 10 hospitals, which have a record of having attended to patients with these conditions. These hospitals must be spread across the country to help in gathering information that is representative of the situation in the country. Similarly, I will conduct a study in homes by collecting contacts of those patients who have previously been treated in public hospitals but discharged. The contacts selected randomly but distributed evenly across the area of study will be used in making a follow up to these patients. 100 patients, 10 from each of the sampled hospitals, will to be considered for the study.

The information gathered from the survey on the selected patients will be compared to that obtained from the literature review, which also presents a number of methods of managing the conditions. The trained research assistants will then attend to several hospitals to administer the questionnaires. These hospitals will be informed a week prior to the time of the actual study so as to give the patients enough time to prepare for the questions. The structured interviews will not be used during the process of collecting data. Instead, the researchers will seek to engage the patients in an informal interview so as to enable them to find their views on their conditions and how they are managing it. The resulting information will then be analyzed and the findings disseminated to all the stakeholders and other interested parties.

In its theoretical framework, the study will follow the interpretive perspective together with the situational approach. In this case, the study will concentrate on the situational approach to the management of comorbid conditions at a personal level and infer how each form of management could be used by other patients. In particular, the situational approach will be suited since it will give a clear picture on the modalities of managing the condition in a localized environment. The study will also utilize the identification of the need to observe conversations in the hospital set up together with that of interviewing the patients to comprehend their ways of managing comorbid conditions.

The study will, therefore, employ the following methods in carrying out the research in accordance with Kothari theories;

1. literature review on comorbid conditions,
2. observation of patients and caregivers,
3. interviewing of patients,
4. carry out a situational analysis of field notes and interview notes and make a report on the finding based on the relevant theories and the result of the empirical study.

Literature Review

According to Devlin et al, (2008, p. 8), comorbid conditions among older people encompasses several conditions. Such conditions include renal dysfunction, dementia, peripheral artery disease, previous heart failure, and previous myocardial infarction. All these conditions contribute a large percentage of deaths among the elderly. Studies have shown that the conditions occur among the elderly of both sexes (Devlin et al, 2008, p. 8)). They further observe that many of the elderly patients admitted in the hospital have comorbid conditions, which most probably have a weighty effect on their diagnosis and management.

Devlin et al, (2008, p. 8) report a study in which they had found out that age is a factor that influences the occurrences of comorbid conditions. However, they have argued about the current statistics, which indicates that this factor is increasingly becoming insignificant as cases of comorbid conditions increase among people of younger age. They also noted that the early researchers had documented best ways of managing the conditions among people of older age leaving out the younger generation. This fact prompted Devlin et al (2008), to argue that the new ways of managing the conditions should cut across all the ages. This points out to the need of investigating how management is done for older patients (Kothari, 2008, p.5).

On the other hand, Hope, Heimberg & Turk (2010, p.15) have noted that the management of comorbid conditions can never be harmonized. This is because these cases are individualistic in a manner that each patient tends to have a particular condition from the others. In some cases, the patient is likely to posses two or more conditions which make management complicated and unique. Hope, Heimberg & Turk (2010, p.18) found out that because most of the existing clinical approaches describe particular methods of managing a given case, they can never be applied on their own in a situations where there are multiple cases. Evidently, continued research in the area of managing comorbid conditions is advisable according to the findings be Hudak & Dougherty (2011, p.20). Equally, Hwang & Bermanzohn (2001, p.8) in their study of clinical approaches to management of the disorder conditions found out that a combination of different cases in comorbid conditions continues to call for research in the area.

Limitations

Time factor will be the main limiting factor in this research as respondents are to be reached in far areas which may require more time. Similarly, there will be financial constraints since the study is involving and extensive. Moreover, some of the respondents are likely to be very ill to respond to questions while at the same time some people may also be unwilling to give out their patients for an interview as most of the comorbid conditions are considered as terminal diseases.

Delimitations

The researchers will plan and make prior arrangement with the facilities that will be identified for the study. This will enable the establishment of a rapport with the sampled respondents. The research assistants will also be thoroughly trained to ensure that they are well versed with the condition and how to treat the patients when administering the research questions. Additionally, the research will also avoid the use of such methods of data collection as structured questions, which may be boring to the patients and make them withdraw from the interview.