Healthcare Problem: High rates of hospital readmission among patients with chronic heart failure (CHF)

Proposed Research Questions:

1. What factors beyond medical care, such as social determinants of health, contribute to hospital readmission rates among patients with CHF in [Specific geographic location]?
2. Does implementing a patient-centered education and self-management program specifically designed for CHF patients in [Specific healthcare setting] reduce hospital readmission rates compared to usual care?
3. How do healthcare providers perceive the feasibility and effectiveness of implementing a patient-centered education and self-management program for CHF patients within their practice setting?

Parameters for Ethical Research Questions:

• Do No Harm: Research should minimize risks to participants and ensure their well-being.
• Respect for Persons: Research should respect participants’ autonomy, privacy, and confidentiality.
• Justice: Research should be fair and equitable, ensuring benefits are distributed and burdens are shared fairly among all participants.

Ethical Considerations for Proposed Questions:

• Question 1: This study would require careful consideration of participant privacy, particularly when collecting data on social determinants of health.
• Question 2: This would require obtaining informed consent from participants and ensuring the intervention does not replace necessary medical care.
• Question 3: This study would need to maintain the anonymity of healthcare providers while collecting their perspectives.

Part 2: Theory/Model for Evidence-Based Intervention

Theory: The Social Cognitive Theory (SCT) by Albert Bandura

Summary: SCT posits that individuals’ behaviors are influenced by a reciprocal interaction between personal factors (beliefs, self-efficacy), environmental factors (social cues, resources), and behavioral patterns.

Why SCT is Best Suited: CHF self-management requires behavior change. SCT addresses factors influencing behavior change, including:

• Self-efficacy: Belief in one’s ability to manage CHF symptoms and prevent readmission.
• Outcome expectations: Understanding the benefits of self-management behaviors.
• Social cues and support: Providing resources and social support to encourage self-management.

Applying SCT: The patient-centered education program will:

• Enhance self-efficacy: Through educational sessions and skills training to build confidence in managing CHF.
• Address outcome expectations: By educating patients on the benefits of self-management behaviors in reducing readmissions.
• Provide social support: By offering support groups and connecting patients with CHF resources.

By incorporating SCT principles, the intervention aims to empower patients with the knowledge, skills, and social support needed to effectively manage their CHF and reduce readmission rates.