In response to your peers, comment on their answers and conclusions drawn. Is there anything you can add? What questions do you have or need for further clarification? Are there any similar

Jeff Discussion:

Research Question 

Do patients who have multiple cardiac arrest events have worse outcomes than those with one cardiac arrest event? 

Variables 

Variables measured included time in cardiac arrest (continuous) and survival to discharge (categorical). The number of cardiac arrest events from 1 through 9 was also evaluated. The paper then puts this into a categorical dataset of single arrests and multiple arrests. 

Statistics Methodology 

Chi-Square tests and Fisher's exact tests were used to determine the significance of categorical variables. Student t-tests were used with continuous variables. This seems very appropriate. The nature of this study led to a lot of categorical variables, so the Chi-Square test was used frequently. The student t-test was appropriate for the continuous variables such as time in cardiac arrest because the population standard deviation is not known. 

Results 

Overall mortality in the study was 78%. There was a significant difference in survival to discharge of patients who underwent a single arrest event as opposed to a multiple arrest event (68.9% vs. 91.3%, p<.01). This shows that multiple arrest events is predictive of much higher mortality than a single event. Patients who experience multiple arrest events are much more likely to die. 

Table 

The table shows survivability to discharge in the single-arrest cohort compared to the multiple-arrest cohort. This table divides the data by the location of the first cardiac arrest. The table shows significant differences in the single code group vs the multiple code group in the field and floor subgroups. Because cardiac arrests in the field are often unwitnessed this is not a surprising finding. When looking at the in-hospital groups the floor is often associated with the highest nurse-to-patient ratios, the least direct patient visualization, and less spontaneous availability of healthcare providers trained in ACLS. 

 

Fully Answered? 

I do believe the article fully answers the question. It clearly states the question and was able to answer it with a rejection of the null hypothesis at an alpha level of < 0.01. Furthermore, the article identified multiple risk factors such as BMI and male sex that contributed to increased mortality. The article calls into question the effectiveness of resuscitation a patient after multiple arrest events.  

References 

Jones, B. A., Thornton, M. A., Heid, C. A., Burke, K. L., Scrushy, M. G., Abdelfattah, K. R., Wolf, S. E., & Khoury, M. K. (2023). Survival after multiple episodes of cardiac arrest. Heart & Lung: The Journal of Critical Care, 58, 98–103.  https://doi-org.ezproxy.snhu.edu/10.1016/j.hrtlng.2022.11.011 

Claudia Discussion:

Yahoo! Congratulations to you all on an amazing term! You did it!

Research Question

               What is the effectiveness of Health Belief Model (HBM) based education in promoting the practice of pap smears in women in Kouhdasht, Iran?

Variables

               Constructs of HBM (perceived susceptibility, perceived severity, perceived benefits, perceived barriers) over time (before and after intervention) for two groups (intervention and control). The constructs of HBM are categorical variables. Time before and after the intervention is a continuous variable.

Statistical Methods 

               Independent and paired t-tests were utilized to analyze study data. The paired t-test is appropriate to investigate the difference between the two groups (intervention and control) at two different time points, before and after the intervention was administered. The independent t-test is appropriate to determine the difference between the intervention and control groups. These tests are also appropriate because the study utilizes a small, random sample for both groups.

Results

               There was a significant difference between knowledge in the intervention group before in after intervention (p< 0.001). The knowledge in the control group saw a decline in knowledge after the intervention (Pirzadeh & Mazaheri, 2012). There was a significant difference between the means of all HBM constructs in the intervention group after the intervention compared to the baseline (p< 0.001). There was no significant difference between the means of HBM constructs within the control group after the intervention compared to the baseline (p>0.05) (Pirzadeh & Mazaheri, 2012). After the intervention, 97.14% of the intervention group had a pap smear performed, and 2.86% of the control group had a pap smear performed (Pirzadeh & Mazaheri, 2012).

Visualization

               Table 1 below visualizes the means of HBM construct scores of the intervention and control groups before and after the intervention (Pirzadeh & Mazaheri, 2012). Table 1 also includes the P-values to describe the differences between mean scores before and after the intervention. It is important to note some HBM constructs saw a decrease in mean test scores before and after intervention time. All HBM constructs saw increases in mean scores before and after the intervention, and all carry statistical significance at p<0.001 (Pirzadeh & Mazaheri, 2012).

Discussion

               In the context of the study, I feel that the research question was answered. The authors adequately demonstrated the effectiveness of HBM-based education in promoting pap smears in women in Kouhdasht, Iran. However, the authors note multiple limitations and further research implications necessary to answer the research question fully. The sample was limited to a small number of similar demographic participants referred to a single health center (Pirzadeh & Mazaheri, 2012). The one-month timeframe between baseline and experimental measurement limited the evaluation to short-term effects. Further research must follow a larger sample size of diverse, demographically different women over an extended period to ensure a more robust analysis (Pirzadeh & Mazaheri, 2012).

Reference

Pirzadeh, A., & Mazaheri, M. A. (2012). The Effect of Education on Women's Practice Based on the

Health Belief Model About Pap Smear Test.  International journal of preventive medicine,  3(8), 585–590.