Introduction
Coronary artery bypass surgery is a surgical treatment for patients with severe uncontrolled symptoms of coronary artery disease. In the postoperative period, the patients oftentimes have blood pressure variability which impacts their life prognosis and treatment outcomes. Patients that experience such surgery most of the time have a variety of concomitant diseases such as essential arterial hypertension, congestive heart failure, and diabetes mellitus (Zhou et al., 2021). Management of comorbidities and postsurgical condition of the patient altogether requires the experience of the medical personnel and certain tactics.
The patients are at high risk of developing subsequent ischemic events and atherosclerosis progressing. That is why the postoperative treatment obligatory includes a beta-blocker, additional antihypertensives, lipid-lowering, dual antiplatelet, and antithrombotic medications after the invasive manipulation (Kulik, 2018). To improve long-term clinical results, the patient is recommended to quit smoking, lose weight, go through cardiac rehabilitation, control blood pressure daily, and stay compliant with the treatment of comorbidities (Zhou et al., 2021). Various effective strategies for controlling blood pressure are used by physicians and nurses in post coronary artery bypass surgery. This assignment will provide different types of research that could be conducted on high blood pressure management in the postoperative period of such patients and explain which study types suit the topic the most.
The Rationales
For the qualitative study, the major goal of the research might be the identification of the most effective and patient-approved strategy for high blood pressure management after coronary artery bypass surgery. In-depth interviews can provide information on how the patients got through the way of treatment they had received and if they found it helpful and robust. The questions can be oriented on the patient’s current medications, their antihypertensive therapy, and their experience with it. Additionally, the participants can answer if they had any side effects from any drugs such as cough on ACE inhibitors. Finally, the patients should name their usual blood pressure numbers and answer if they tried any of the secondary preventive therapies recommended by their physician and nurse.
Gathered data can help estimate if various drugs controlling blood pressure among patients with concomitant disorders after coronary artery bypass surgery are most effective and more comfortable for the patient than others. For instance, a combination of ACE inhibitor, calcium channel blocker, and diuretic agent compared to angiotensin receptor blockers in the same combination. Moreover, relying on patients’ motivation to improve their daily habits and activities, it is possible to assess the blood pressure of the patients after the surgery who are following secondary preventive therapies. This group of patients and their results can be compared to those who neglected smoking cessation, weight loss, and other methods.
A quantitative study is possibly the most appropriate research type for this topic as it can more precisely estimate which of the strategies are most useful based on objective information. The aim of the research will be the assessment of the patient’s outcomes by using diagnostic tools such as ambulatory 24-hour blood pressure monitoring after one month of bypass surgery. According to the average numbers of BP and its deviations from standards, the therapy will be considered matching and effective for the patient or not. To exclude additional factors that impacted BP numbers such as stress, patients’ diaries will be assessed along with monitor data.
A mixed method design unites qualitative and quantitative methods to reach the goals of the study and better understand the research issue. For nursing, this type of design is most suitable as it unites both objective and subjective data and allows investigation of the question from various perspectives. Moreover, the work of a nurse directly represents a mixed method design as the nursing professional estimates data, interprets results from diagnostic tests, and interacts with patients at the same. The interaction includes patient education, communication with them and their relatives, and making clear the treatment specialties (Aroesty & Kannam, 2020). The mixed method design can assess the antihypertensive treatment after coronary artery bypass surgery and organize in-depth interviews with the patients to identify the most effective and comfortable for the patient combination of medications. This research will be more precise with information but at the same time take a more substantial period for developing the research design, gathering data, and estimating it.
Method Most Suited for the Study
The quantitative method is most suitable for this study as it answers the question of effectiveness in the most certain and objective way. Quantitative research allows gathering reliable and accurate information that can be further based on the clinical experience of doctors and nurses. A patient’s opinion and comfort are essential, but they can also be impacted by mood, emotions, and some other personal factors. Most of the time it is almost impossible to exclude additional aspects influencing participants’ replies. Science in medicine remains the leading in identifying the guidelines strategies and treatment innovations.
Causal-comparative or quasi-experimental design of research will be the most appropriate for the initial aim to identify the most effective strategy in the management of hypertension in post coronary artery bypass surgery. This design is based on the principle of comparison which is essential for the study to identify the differences between the strategies (Asmus & Radocy, 2017). The independent variable is blood pressure as it cannot be manipulated and it defines the dependent variable, treatment strategy. The latter can be the separate pharmaceutical management and combined with secondary preventive therapies depending on the patient’s compliance. Estimating how two variables change with the help of statistical analysis can provide valid data for the most effective method of management.
This design will be the most useful as it helps receive the objective data about the research question. Finding the most effective way requires a comparison of the groups of people receiving various treatments, and quasi-experimental design is one of the most productive ways to realize that. The correlational design could be also useful for the current study goal; however, it would propose data about two groups tied with one factor, and the initial goal is to assess various treatments and identify the best ones.
Conclusion
Thus, this paper discloses various research types and addresses one question: what effective strategies are used in the management of hypertension post coronary artery bypass surgery. In the first part of the assignment, the possible proposals for qualitative, quantitative, and mixed method designs are presented. Afterward, the quantitative method is identified to be the most well-suited for the initial question, and the causal-comparative or quasi-experimental design was picked as the one allowing to identify the most effective treatment options.
References
Aroesty, J. M., & Kannam, J. P. (2020). Patient education: Recovery after coronary artery graft surgery (CABG) (Beyond the basics). UpToDate. Web.
Asmus, E. P., & Radocy, R. E. (2017). Quantitative analysis. Routledge.
Kulik, A. (2018). Secondary prevention after CABG surgery. American College of Cardiology. Web.
Zhou, Z., Chen, J., Fu, G., Zhuang, X., Hou, J., Chen, S., Huang, S., Yue, Y., Shang, L., Wang, K., Lv, L., Liang, M., & Wu, Z. (2021). Association of post-operative systolic blood pressure variability with mortality after coronary artery bypass grafting. Frontiers in Cardiovascular Medicine, 8, 717073.