|Type of paper:
|Nursing care Human services Psychological disorder
The research problem in Linman, Benjenk, and Chen's article relates to the problem adults diagnosed with psychological distress face, and how primary caregivers can implement functions in medical homes to assist these victims. Adults with PD have multifaceted primary care needs. In most cases, it is the primary care practitioners who double up as mental health providers for these adults suffering from (PD) psychological distress. The article, therefore, investigates how these primary care providers can implement practices for adults with PD. From a brief overview of the paper's background and literature, it is clear that the knowledge informing the study problem is borrowed from already existing research. As primary home care providers for the elderly with psychological distress, nurses face the challenges of doubling up as counselors too. Finding this research will solve the problems these practitioners face by suggesting how they can go beyond their regular practice to help these victims. The purpose of this research is to investigate primary practitioners' changing medical home roles as far as caring for adults with PD is concerned.
The concept explored in the study background and literature review section is how older adults with the psychological disorder face numerous economic and psychological barriers which complicate doctors' recommendation for the following treatment. Adults suffering from PD may not be easily accessible to medical homes that offer comprehensive primary care, treatment and coordination due to the mentioned challenges. Besides, these homes may only offer business hour and same-day appointment for covered individuals. All the references used in the article were current between 2010 and 2019. The choice of reference may be so because the concept discussed in the paper is relatively new with limited studies available.
Even though there are no clearly defined theoretical concepts in the paper, the general assumption made by the researchers relates to the research. From my understanding of the article, the theory of the study borrows a bit from psychology theory but a significant part of the paper come from nursing theories. Linman et al. (2019) do not explicitly state the theoretical framework of the research, but upon reading through the introduction and literature older people, one can quickly identify the approach applied in the paper. Due to the complicated nature of the theoretical framework in the research, I would suggest that medical homes implement newer functions through primary care providers to cater for adults with PD.
The paper's main dependent and independent variable are functions of medical homes and psychological distress, respectively. The definition of the two variables is given in separate sections. From my assessment, the two descriptions are concrete and measurable as demonstrated by the tools, such as Kessler Psychological Distress Screening Assessment. The research question/hypothesis is clearly stated in the paper, thus, an examination of whether elderly individuals with psychological distress are probable to get primary care from practices that undertake medical home functions for older people without PD.
For a comprehensive analysis of the topic, the paper applies both qualitative and quantitative designs. To gain an understanding of the underlying concept of the research, the authors used qualitative research in analyzing past data. Additionally, to quantify the problem, the paper applies a quantitative method which generated numerical information transformed into statistics. The reasoning used in the article can be termed as inductive since the authors, from the beginning, made a broader generalization about the medical home functions that primary care practitioners can do for the elderly suffering from PD. From the data gathered and analyzed, the authors came to a conclusion about the topic. Data from the 2015 Medical Expenditure Panel Survey on House Hold Components and Medical Organization Survey was used to derive the study population. The participants from MEPS were up to 9494 and 4818 provider practices working in 7350 households also agreed to participate. Sampling method was predominantly carried out via telephone, up to 92.9%, and the paper does not mention the studying setting. Since the researcher knew who they will get information from, they applied the non-probability sampling technique. This research used internal reliability to assesses the strength of the outcome. The measurement tool applied, K6, in the study, is valid and widely used in determining how participants feel about a particular issue. Also worth noting is that the survey addressed crucial ethical consideration, which is mainly lack of consent by participants since the data was publicly available.
Due to the nature of the complexity of the sampled population, the data analysis tool used is STATA 15. The authors presented the result as a summary of the experimental outcome after a study. In the article, the results are presented as an explanation of the issue with the use of figures and tables indicating the statistical problems aside from the experimental errors. From the presentation, one finding is clear; in most of the country, older people suffering from PD get their primary care at practices with useful medical home functions the same way as individuals without PD. Therefore, adults with psychological disorders stand to benefit from primary care derived from medical home practices due to complex psychological and medical comorbidity.
In sum, there are some limitations associated with the study. The first is that they used to survey, MOS, was fielded first in 2015, meaning that there are no data available for comparison. A second limitation is that the study did not check if the participants received care from other primary providers. Finally, the elderly MOS interviewed may have limited knowledge about the practices of primary care delivery. On the other hand, the study's strength is that it covered a considerable number of people, validating the result. The outcome of this research can is generalized to represent the need for home health for the elderly with PD. After an assessment of the limitations of the paper, coupled with the high number of participants, it is safe to assume that the information in this research presents an overall outcome among PD individuals. Delivery of primary care has been changing over the last decade or so as evident in the discussion. One area where this is true is in caring for adults with mental illness in medical homes. Practical medical home functions will increase access to vital care for this population who may otherwise miss out due to the previously mentioned factors. When fully adopted and implemented, medical home functions will benefit adults with PD. This research is relevant for nursing practice, specifically those in medical homes since it introduces new concepts not discussed earlier. As a primary care practitioner, the extensive knowledge discussed herein is vital for implementing patient-centered practice that will benefit the PD victims in the long run.
Linman, S., Benjenk, I., & Chen, J. (2019). The medical home functions of primary care practices that care for adults with psychological distress: a cross-sectional study. BMC Health Services Research, 19(1), 1-11.retrieved from https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3845-8
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