Student Name
Chamberlain University
NR 715 Week 1 The Theory- Practice Gap and Nursing Research
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Date
Coronary Heart Disease (CHD) is one of the most common and severe cardiovascular illnesses across the globe. It remains the third leading cause of mortality for both men and women. According to the Centers for Disease Control and Prevention (CDC, 2021), an individual in the United States dies from CHD approximately every 36 seconds, underscoring its urgent impact on public health systems.
The clinical management of CHD is complicated due to the frequent presence of comorbid conditions, including diabetes, hypertension, and hyperlipidemia. These overlapping health issues increase the complexity of treatment and long-term care, making it difficult for providers to manage patient outcomes effectively.
The economic implications of CHD are equally alarming. The U.S. healthcare system spends nearly $363 billion annually on CHD-related care, which includes costs of medications, hospitalizations, and lost productivity (CDC, 2021). Furthermore, individuals with underlying metabolic issues such as elevated cholesterol, diabetes, or high blood pressure are at a much higher risk of developing CHD, regardless of gender.
For this assignment, the quantitative study chosen was “Gender-specific associations between coronary heart disease and other chronic diseases” conducted by Murray, Bode, and Whittaker (2019). It was published in the Journal of Geriatric Cardiology (Volume 16, Issue 9, pp. 663–670).
The researchers utilized data from the German Health Interview and Examination Survey for Adults (DEGS1), which is a large, nationally representative survey involving 8,152 adults aged 18–79 years. This study employed a two-step stratified cluster design to ensure diversity and minimize sampling bias (Murray et al., 2019).
From this larger dataset, participants were filtered to include adults aged 40–79 years with a prior history of CHD, including those with myocardial infarction, coronary artery bypass grafting (CABG), or percutaneous coronary intervention (PCI). After applying inclusion criteria, the final sample size was 547 participants, comprised of both men and women.
Sampling Element | Details |
---|---|
Survey Source | German Health Interview and Examination Survey (DEGS1) |
Initial Sample Size | 8,152 adults (ages 18–79 years) |
Filtered Criteria | Adults aged 40–79 years with prior CHD |
Final Sample Size | 547 participants (male and female) |
Sampling Design | Two-step stratified cluster design |
Inclusion Conditions | CHD with or without myocardial infarction, CABG, or PCI |
The study by Murray et al. (2019) employed a quantitative, cross-sectional design. Its purpose was to examine gender-specific associations between CHD and coexisting chronic illnesses. The authors presented a clear rationale, emphasizing the burden of comorbidities, but the scope was broad, since CHD was compared with multiple chronic conditions, which at times diluted the depth of analysis.
The data were obtained from a national survey of 547 participants aged 40–79 years. Findings indicated that CHD was most significantly associated with four chronic diseases: hypertension, coronary artery disease (CAD), diabetes, and lipid disorders.
One of the most notable findings was that females with CHD had higher odds of developing hypertension compared to males, which suggests gender-based disparities in disease progression and risk. However, a key limitation was that the diagnosis of CHD relied on self-reported data, which can compromise accuracy. Despite this limitation, the results were consistent with findings from other European population health surveys.
Appraisal Criteria (John Hopkins Tool) | Assessment |
---|---|
Research Design | Quantitative, cross-sectional |
Clarity of Purpose | Clearly defined |
Sample Representation | Nationally representative (Germany) |
Strengths | Large dataset; gender-specific analysis |
Weaknesses | Reliance on self-reported data; overly broad condition comparisons |
Quality Rating | Level III, Poor Quality (C) |
The study offered valuable insights into the relationship between CHD and chronic comorbidities across genders. Through regression modeling, the authors concluded that CHD is strongly linked to hypertension, CAD, diabetes, and lipid disorders.
The results also highlighted that while CHD impacts both genders, its clinical presentation differs. For example, CHD in women tends to appear 7–10 years later than in men, possibly due to the cardioprotective effects of estrogen before menopause. Despite this delay, CHD is still a leading cause of death among older women, making gender a crucial factor in clinical risk assessment (Murray et al., 2019).
The article by Murray et al. (2019) emphasizes the intricate relationship between CHD and other chronic conditions, particularly when analyzed through a gender-specific lens. For healthcare providers, the findings reinforce the importance of early screening, lifestyle management, and targeted interventions for high-risk populations with diabetes, hypertension, hyperlipidemia, and CAD.
While the study was strengthened by its large national dataset and focus on gender differences, its weaknesses included the use of self-reported data and the broad range of chronic illnesses examined, which limited precision. Using the John Hopkins Appraisal Tool, the article was rated as Level III, Poor Quality (C).
Even with these limitations, the study makes an important contribution by drawing attention to gender disparities in CHD outcomes. It underlines the critical need for personalized care strategies, especially for women who often present later with CHD but remain at equally high risk for adverse outcomes.
Centers for Disease Control and Prevention. (2021). About multiple cause of death, 1999–2019. National Center for Health Statistics. CDC WONDER Online Database. https://wonder.cdc.gov/
Murray, M. K., Bode, K., & Whittaker, P. (2019). Gender-specific associations between coronary heart disease and other chronic diseases: Cross-sectional evaluation of national survey data from adult residents of Germany. Journal of Geriatric Cardiology, 16(9), 663–670. https://doi.org/10.11909/j.issn.1671-5411.2019.09.004
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