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7 pages/≈1925 words
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Health, Medicine, Nursing
Research Proposal
English (U.S.)
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Congestive Heart Failure: Literature Review (HLT-490V) (Research Proposal Sample)


Analysis and Appraisal
Write an analysis and appraisal (1,500-2,000 words): This section should build and support your case, in the reader's mind, of why your problem, purpose, and proposed solution are valid.
1.How does the article describe the nature of the problem, issue, or deficit you have identified?
2.Does the article provide statistical information to demonstrate the gravity of the issue, problem, or deficit?
4.Does the article support your proposed change?
Incorporating a Theory
1.Find a theory that will assist you in your implementation or support your solution to your problem.
2.Describe this theory in simple terms.
3.Describe why this theory supports your project.
4.Describe how you will incorporate this theory.
General Requirements:


Congestive Heart Failure: Literature Review
The Background of the Problem
Congestive Heart Failure (CHF) is a lethal disease mostly prevalent among people older than 65 years of age. The failing of the heart within this group is especially rife among patients with a history of recurrent heart failure, requiring early admissions (Vinson et al. 1990). McMurray (2010) states that 1-2% of the population in developed countries experience congestive heart failure, with high frequency lying on individuals older than 70 years old. Additionally, Neubauer (2007) points out that 30-40% of CHF patients die within one year of receiving treatment from the disease. Heart failure presumably consists of 2% of the annual health budget in the United Kingdom, while the United States requires a whooping $28 billion annually for the treatment of the disease (Neubauer, 2007). Therefore, the lethal nature of the disease and its implications in the economy of many countries cannot be understated.
The common etiologic precursors for CHF are coronary heart disease, hypertension, genetic inheritance, abuse of alcohol and viral infection among other causes (McMurray, 2010). A study done by McKee, Castelli, McNamara and Kannel (1971) for 16 years involving 5192 patients where 142 developed CHF, revealed that hypertension contributed to 75% of the etiologic precursors. Hypertension also accompanied coronary heart disease and precursive rheumatic heart disease. The study revealed that the susceptibility to succumbing to the disease within the first five years was 62% for men and 42% for women.
Neubauer (2007) also suggests a model where the heart muscles or myofibrils failing to produce enough energy needed to pump the heart. This is because the heart requires a lot of energy every day to pump more than 10,000 liters of blood around the body. In the 10,000 times it beats during the day, it uses approximately 10Kg of Adenosine Triphosphate (ATP). The complex nature of CHF makes management difficult since the disease has a recurrent habit. Many reported cases of CHF usually undergo treatment but readmission remains to be so high. Li, Nancy, and Proctor (2004) observed this scenario where an annual mortality rate of CHF patients stood at 10% despite medical intervention to the problem.
Similarly, Proctor, Nancy, Li and Dore (2000) highlight the worrying trend of readmission among CHF patients. Many of the patients who undergo medical treatment and nursing care find themselves back in the hospital despite previously receiving treatment. A study done by Hopp, Thornton, and Martin (2010) revealed that most CHF patients face great challenges after discharge from hospitals. What contribute to their prevalence to readmission are social isolation, life disruption, and ambiguity about symptoms and prognosis. Lack of proper knowledge about the disease management, social support, and handling the dying process makes many of them susceptible to readmission in acute conditions (Stewart, Marley, & Horowitz, 1999). Additionally, lack of adherence to prescribed medicine and diet also contributes to this, accounting to almost 29-47% of readmission after three to six months after original discharge (Rich, Beckham, Wittenberg, Leven, Freedland and Carney, 1995).
Factors affecting prescription compliance
Many medical practitioners have struggled to understand and solve the puzzle of recurrent CHF. Despite patients undergoing extensive pharmacotherapy, the prognosis of CHF continued to be impoverished (McAlister, Stewart, Ferrua, & McMurray, 2004). Patients once discharged with reduced CHF conditions will return several months later in worse or very severe conditions; some succumbing to the ailment finally. The need to reduce unplanned readmissions and prolong survival of CHF patie...
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