10 Essential Population Variables You Need to Measure

Title 

Holt (2010) and her colleagues chose the title for their article wisely. This title captures the variables that they set out to measure and the population for which their study presents implications. In the title, they make it clear that their study was concerned with how adherence to medications affects the quality of life of older adults.

Abstract 

The abstract that the researchers authored does indeed shed light on the main components of their study. Through the abstract, the researchers convey the purpose of the study (problem that they wished to address), the methods that they adopted, the results that they obtained and the conclusions that they made from the results.

Introduction 

Statement of Problem 

Hold and her colleagues fail to state the problem clearly and it is therefore difficult for readers to identify the problem statement. One has to examine huge amounts of text in order to determine the problem that the researchers set out to solve. Despite their failure to provide a clear and unambiguous problem statement, the researchers ensure that the statement allows them to develop a cogent and strong argument for the study. As part of the problem statement, they note that many older adults experience poor quality of life as a result of failure to adhere to medications. This statement helps to justify and set the stage for the study. The problem is significant for nursing. By exploring the problem of poor medication compliance, Holt and her team provide nursing practitioners with the insights that they need to recognize the gravity of the problem and challenge them to initiate action. The research problem, the paradigm that Holt et al. adopted and the methods that they used are aligned properly. For the study, they involved a group of older adults who took part in a survey. This method is appropriate because it enabled the researchers to focus the study on a population affected by the issue being examined. Holt and her team used a quantitative approach. This approach is proper because it made it possible for the researchers to establish the scale of failure to adhere fully to medications and how this failure shapes the lives of patients.

Hypothesis/Research Questions 

The researchers do not state the hypothesis or research questions. There does not seem to be any justification for the absence of these elements. Readers are left wondering what point the study aimed to prove and the questions that guided the researchers. Given that the research questions and hypothesis are not stated, it is not possible to determine if these elements are in line with the literature review or conceptual framework.

Literature Review 

The article by Holt et al. lacks a proper literature review. Instead of conducting an extensive and deep review, they simply identified a few articles that are related to their study. For example, they mention that there are some studies which have established a link between adherence to medication and quality of life. This mention is too general and the researchers fail to cite specific studies or literature. There is no proper synthesis of the literature and it is fair to state that the study by Holt et al. lacks a strong foundation in published literature.

Conceptual Framework 

It is customary for researchers to base their studies on conceptual frameworks. This is the case with Holt and her team. They define some concepts to make it easier for readers to better understand their article. Medication adherence and quality of life are among the concepts that they define. In their conceptual framework, they attempt to link quality of life to medication adherence. By doing this, they imbue their framework with validity and appropriateness.

Method 

Protection of Human Rights 

Researchers conducting studies involving human participants are required to take all necessary steps to safeguard the rights of these participants. They ensured that before taking part in the survey, the participants had issued informed consent. Furthermore, they submitted the study for approval by the Clinic Foundation Institutional Review Board. Since the board issued authorization, it must be that it was satisfied with the measures that Holt et al. had taken to protect the rights of the participants.

Research Design 

Holt et al. adopted a cross-sectional design for their study. Since the study’s purpose is to determine how adherence to medication affects older adults, this design is appropriate. It made it possible for the researchers to extend their observations to the general older adult population. To enhance the interpretability of their results, Holt and her colleagues performed comparisons. For example, they compared female and male participants, and participants who adhered to medication against those who failed to comply. The researchers had just one data collection point. This point was at the beginning of the study when the participants shared demographic information and details about their adherence to medication and quality of life over the phone. Having one data collection point seems appropriate since the researchers were able to gather all the information that they needed. They also designed the study such that they could minimize bias and eliminate any threats that would compromise such issues as validity. For example, they excluded participants from the black and white communities. This step was intended to ensure that the data was not corrupted by extreme cases.

Population and Sample 

The researchers offer a clear and in-depth description of the population and the sample. Older adults are the primary population whose members were recruited. The sample was made up of over 2000 older adults who had hypertension. In addition to identifying the illness from which the participants ailed, Holt and the other scholars also described the sample in terms of gender, BMI, race, age and educational attainment. It can be argued that the sample is highly representative. This is because it was selected from a facility that primarily deals with older adults. The researchers do not indicate the steps that they took to minimize sample biases and a scrutiny of their description of the methods used does not reveal any measures that they took. At over 2,000, the sample size is more than adequate. There is no mention in the text of whether the researchers employed power analysis to determine the sample size.

Data Collection and Measurement 

The researchers provide both the conceptual and the operational definitions of the concepts that they studied. In addition to stating what these concepts mean, they also describe how the concepts are measured. The definitions are indeed congruent. For example, they define quality of life as one’s emotional and physical experience following exposure to a particular illness. To measure this concept, the researchers used the RAND Medical Outcomes Study tool, a standard instrument that allows for one’s quality of life to be properly evaluated. In addition to defining variables, the researchers also operationalize them. They used a survey for operationalization. This method is appropriate since by surveying the participants, the researchers managed to gain a proper understanding of their experiences with medication adherence and quality of life. Holt et al. also used various instruments that are in line with the purpose of their study and reflect the variables being studied while applying directly to the study population. For example, to determine medication adherence, they adopted the Morisky Medication Adherence Scale. In their text, they note that this instrument is a reliable tool for measuring medication adherence among patients with hypertension. The researchers fail to provide evidence that show that the data collection methods that they used yielded reliable and valid findings. However, since they clearly describe the methods and provide adequate data, it is possible to verify the results by replicating the study.

Procedures 

The study did not involve an intervention. As noted earlier, it was simply intended to establish the association between quality of life and medication adherence. From the description that Holt et al. provide, it can be concluded that they collected data in a fashion that eliminated bias. For instance, they began the recruitment process with a large population that was narrowed down to a smaller sample. It could be that the data collection method suffered from such issues as incompetence. This is because the researchers do not indicate if those who collected the data received any training.

Results 

Data Analysis 

Given that they do not state the research questions or hypotheses, it is difficult to say if the data analysis approaches that Holt et al. adopted addressed these elements. However, the researchers used statistical methods that seem appropriate. For instance, they performed Chi-square tests and analysis of covariance. These analysis methods are appropriate because they made it possible for the researchers to compare the experiences of participants who adhered to medication and those who did not. Holt and her team understood that they needed to ensure that their data analysis accounts for confounding variables. This must be why they conducted multinomial logistic regression. The purpose of this analysis was to ensure that all the observations that they had made were directly related to the variables in questions and not the result of some confounding variable. The researchers fail to state if and how they attempted to minimize type I and type II errors. A close examination of the text does not reveal that they took any measures to minimize these errors. Holt and her team do not indicate if they encountered the missing values problem and how they resolved it.

Findings 

Holt et al. clearly present information about statistical significance (using p-values) and confidence intervals. They also offer clear summaries of their findings. To make it easier for readers to understand the findings, the researchers make use of tables and graphs. The details that the researchers provide in their findings section are so detailed that it should be possible for other researchers to easily conduct a meta-analysis.

Discussion 

Interpretation of Findings 

Holt et al. place the interpretation of their findings within published literature and the conceptual framework of their study. For example, they cite previous studies which have determined that failure to adhere to medication could set the stage for poor quality of life. By mentioning these studies, the researchers essentially indicate that their study confirms what is known about the relationship between quality of life and medication adherence. The main finding that the researchers obtained is that older adults with poor emotional and physical quality of life are likely to fail to adhere to medications. Through this statement, Holt and her colleagues essentially suggest that there is a causal link between medication adherence and quality of life. This inference is justified because their own data showed that poor quality of life occurs together with poor medication adherence. Furthermore, as Holt et al. state, other researchers have also established this relationship. One of the limitations of the study is that the data was acquired from self-reports issued by participants. This limitation raises questions about the interpretations that the researchers make. However, since these interpretations are in line with what other researchers have determined, it can be concluded that the interpretations are reasonable and valid. These scholars do not state if their findings can be generalized to the overall population. However, given that the sample was obtained from a large population of older adults, it is fair to conclude that the findings are indeed generalizable.

Implications/Recommendations 

In their conclusion, Holt et al. note that their study has implications for further research and clinical practice. They state that the study can be used by practitioners to understand how they can use quality of life outcomes to determine whether patients are adhering to medications. Additionally, these scholars call on other researchers to conduct further studies to clearly establish the link between quality of life and medication adherence. The stated implications are reasonable. The researchers do not make any bold or grandiose claims. Instead, using the findings of their study, they advise the research community and medical practitioners regarding how medical adherence relates to quality of life among hypertensive older adults.

Global Issues 

Presentation 

It is important for researchers to ensure that their texts are well written. Good writing goes a long way in enhancing understanding. Holt et al. must have understood this. This is because they wrote their article using simple language that does not distract from their core message. Furthermore, the article is properly organized. For example, similar themes are grouped under clear headings. The researchers also ensured that there is proper flow and coherence. For example, they begin with a brief introduction before proceeding to describe their methodology. Next, they discuss their findings before concluding with a note on the implications of their study. This natural and smooth flow makes it easier for readers to understand the text. Nurses are among those who are likely to benefit immensely by reading the text. Holt and her team wrote it in a way that makes the findings easily accessible. The findings are not hidden behind heavy text or pointless information. Instead, the researchers present their findings clearly and properly.

Researcher Credibility 

The credibility of a researcher is as important or even more critical than the studies that they conduct. All the researchers are professionals in institutions which focus their effort on human health. For instance, Holt works at the Center for Health Research and is affiliated with the Ochsner Clinic Foundation. Her professional qualifications imbue her with the authority to conduct research on an issue as important as what their study addressed. The same can be said about Holt’s colleagues. Therefore, one can read and accept the article with the assurance that it was authored by professionals who are deeply knowledgeable, extensively experienced and passionately committed to safeguarding human health.

Summary Assessment 

It is true that the study by Holt et al. has some limitations that erode its persuasive appeal. However, even with these limitations, I personally accept the findings of the study as the truth. I find the findings to be valid. This opinion is based on the fact that to arrive at these findings, Holt and her team conducted a rigorous study that followed established research protocols. More importantly, the findings echo what other researchers have observed. There is no doubt that the study presents evidence that can be integrated into nursing practice to enhance patient outcomes and improve service delivery. For example, as noted previously, the primary finding that Holt et al. obtained is that failing to adhere to medications expose older patients to an elevated risk of poor health outcomes. Using this information, nursing practitioners can initiate interventions to encourage patients to adhere to medications, thereby enabling the patients to experience improved quality of life.

References

Holt, E. W., Muntner, P., Joyce, C. J., Webber, L., & Krousel-Wood, M. A. (2010). Health related quality of life and antihypertensive medication adherence among older adults. Age and Ageing, 39, 481-7.