This is a Research Project Health Social Care Assignment in which we discuss research concept, aim and objectives of research, data collection and research techniques.

Task 1

1. Formulate a research specification

Aim and Objective of the research

Dementia is defined as the condition of human mind in which one is not able to remember anything, faces problem in communicating with others and problems in thinking. In other words dementia can be said as the decay of mental capability of a person up to a level that it affects the daily routine of the patient. Vascular dementia is one of the most known types of dementia in which the problem arises due to insufficient flow of blood in the human brain. The disease causes a lot of emotional and financial pressure on the patient as well as the family. According to surveys it is seen that there are almost 670,000 patients of dementia in England (Barker et al, 2014). Hanwell is no exception; it is believed that every second family in Hanwell has got a dementia patient. The total cost on taking care of dementia patients in UK is about 19 billion pounds in a year.

Dementia patients need a lot of care and attention. The treatment of these patients involves lots of patience and tolerance. There are various methods in which the intervention for dementia patients can be categorized.And hence it is very important to analyse the effectiveness of intervention program in order to improve the quality of patients of vascular dementia. This research will mainly focus on the effectiveness of the intervention programs of variousdisease management groups.For the research the city chosen is Hanwell. For the collection of data we will go to various health care and social care centres where these kinds of patients are kept so that their proper care can be done.

2. Formulate and record your research project outline specification

Methodology

There is no doubt of the fact that the health and social care centres play asignificant role in taking care of these patients. In these centres several disease management interventions are done for the betterment of the quality of the treatment and the care that is given to the patients. In order to analyse the effectiveness of these interventions, samples will be collected from various social and health care centres (Cooper et al, 2012). In Hanwell there are anumber of centres which take care of the patients suffering from vascular dementia. In order to collect the data for the research we will try to keep the sample size moderate so that the best result can be achieved. If the sample size is too small or large, the result will not be accurate.

Once the data is collected, both the qualitative and quantitative analysis will be done. The quantitative analysis will give the number of social care centres which have actually allowed the disease management interventions in their care centres. The qualitative analysis will be helpful in analysing the effectiveness of those programs in improving the condition of the patients. Dementia is increasing at a very fast rate and hence it is very important to analyse the methods with the help of which proper care of these patients can be taken. Disease management intervention programs study the condition of the disease and then suggest the best approach which can improve the condition of the patient (Free et al, 2013). It is believed that if the programs are implemented properly they will definitely be helpful in improving the quality of the life of the patient.

3. Identify the factors that contribute to the process of your research projects selection and undertake a critical review of the literature

Purpose of the Research

It is very important to conduct this research project as the vascular dementia has got a lot of impact on the patient and their families. Hence it is very important to ensure that the quality of care given to them is up to the mark otherwise the problems for both patient and the families will increase. The various effects of dementia are:

• Mortality: In England, it is seen that the 3%-5% deaths are due to vascular dementia. In a survey report it is found that the rank of UK moved from 24^th to 10^th in the list of deaths due to dementia and its different types (Barker et al, 2014).
• Diagnosis: The biggest issue with this disease is that it is very difficult to diagnose it at an early stage. In Hanwell, almost 45%-50% people are there who are suffering from this disease but are not diagnosed properly (Imfeld et al, 2003).
• Hospital Care: These patients take a longer time to get cured and hence have to stay in hospitals and care centres for a very long period of time.
• Economy:As mentioned earlier, the cost of treatment of this disease is too much and hence it has got a great impact on the financial condition of the families.
• Care takers: Due to large number of patients, the numbers of caretakers are also high. It is believed that in Hanwell every third person is taking care of a dementia patient. It is a tough job to take care of a dementia patient (Murthy, 2005).
• Fear: This is a disease from which people fear the most; it is found that people are afraid of this disease even more than cancer.

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4. Research project specification, provide, and appropriate plan and procedure about the agreed research specification

Background of the Study

Interventions are mainly designed to avoid or handle the prolonged diseases in a proper organized manner. It is a methodical approach for both the patient as well as the care taker. The different interventions which are designed to improve the quality of the life of people who suffer from vascular dementia in Hanwell are as following:

• Educate the care takers: It is very important to provide proper instructions and guidelines to the care takers at the centres. There is a special method to deal with the patient of the dementia and hence it is very important to educate the care takers about those methods.
• Feedbacks: The care takers must be provided with the feedbacks about those patients who already left the centre. This will help them to understand the effect of their method of taking care (Reuben et al, 2010).
• Reminders: From time to time, the care takers must be given reminders on the procedures and the guidelines.
• Educate the patient:The treatment will not be a success without the support of the patient themselves and hence it is important to educate the patient too about the disease.
• Patient monetary incentives:Since, the treatment is costly, there are some provisions made to motivate the patient to support during the treatment. They will be provided with some monetary incentives while leaving the centre after the treatment.
• Involvement of family members: The involvement of family members is a must while taking care of the vascular dementia patients.(Robinson et al, 2010).

These are some of the disease management interventions to improve the quality of the life of dementia patients. Now, in the research, there will be analysis of the effectiveness of these programs.

Task 2

1. Match resources efficiently to your research question or hypothesis

It is very important to analyse the effectiveness of disease management interventions program to improve quality of life for people who lives with vascular dementia in Hanwell because on routine basis it is not an easy task to handle the patients with such a disease. There are number of challenges which the workers have to face while working with vascular dementia patients. Some of the primary challenges are like:

• Up to what extent the new things can be taught to the patients. Since they do not remember anything, hence there will be lot of changes in the behaviour of the patients. In order to ensure that the patient is able to deal with the new atmosphere, there will be a lot of new things which would be required to teach to the patient (Roman et al, 1993)
• There are several behaviours during the vascular dementia which can interfere with the treatment process; hence one must know how to cope up with such situation.
• How to ensure the involvement of family members during the course of treatment?

With the help of disease management interventions, these objectives or the challenges can be handled. In the intervention, several programs are designed in such a way that these problems can be handled. But in order to check the effectiveness of these programs this research will be helpful.The various ways with the help of which these problems can be handles are like:

New learning: New learning is directly related to memory. In vascular dementia, memory loss is the main issue. A person will learn new things and will remember only if memory is functioning in a proper way. The main problem in dementia is that the patient is not able to remember the things, even the basic daily routine also. So, one of the intervention program at a care centre in Hanwell suggested that in order to overcome this problem of the patients of vascular dementia, a process can be prepared which will include the same set of actions again and again. The set of actions need to include the basic daily routine works. This will help the patient perform his daily routine without any problem.

Behavioural Symptoms: These are the ones which a patient shows due to irritation and confusion. Since, the patient is not able to remember anything; hence everything seems new to him. This finally results into lot of anger and frustration (Toot et al, 2013). The patient usually shows his anger by throwing the things on the care takers or by using abusive language for everyone. There are chances that they can hurt themselves too. As mentioned before, the intervention program helpful in this kind of situation is to educate the caretaker as well as the patient about the situation. The care taker must be taught about the ways of communication by which they can make the patients calm down. The vascular dementia patients usually are comfortable with the people whom they trust and have faith. So, the care takers must be taught to gain trust and faith of the patients.

Include Domestic care givers:  This process suggest that the family members of the patient must be involved during the treatment process. The patients are not going to be in the care centres for ever, the treatments takes place in the hope that the patient will go home and hence the family members must also be involved in the process so that they also know how to handle the patients.The program suggested by disease management intervention is to make the family members as a part of the care centre so that they both can work in collaboration and cooperation. In this way when the patient goes back to home, the family members are not completely new to them (Vasse et al, 2013).

During the research these are the some of the programs of disease management intervention which we came across the care centres at the Hanwell. This data will be helpful in analysing the effectiveness of the programs in the quality of the life of vascular dementia patients.

2. Proposed research investigation in accordance with the agreed specification and procedures in an action plan

We have taken a complete care during the research and followed all the important specifications.

Permissions

We took all the important permissions from all the health and social care centres for the research. We ensured the members that the confidentiality of the care takers and patients will be maintained.In order to ensure the specifications, all the data that has been collected was sealed at the centreand then send to the research lab. In the lab, the data was segregated based on the samples. Our research was mostly related to the plan developers and management but still we took all the important precautions to ensure that no patient is hurt. We have taken written permissions from the families of the patients too to conduct our research in the premises.All the legal approvals were also taken by us for example in order to conduct the research at such centres one must have a legal approval from the National Health Institute (Imfeld et al, 2003).

Time

We tried our level best not to waste the time of management and the care takers as the patients need a continuous care. These patients cannot be left alone as they can harm themselves. So we ensured that we will talk to the concerned person only when the patient is sleeping or taking rest. We planned the things in such a manner so that the research gets over within the given time.

Budget

We followed the guidelines and specifications regarding the budget too and tried to wind up the research within the given budget. There are expenses involved in travelling as we need to travel from one centre to another. There was some involved in getting some of the legal proofs.

3. How relevant data was recorded and collected

In our research project we collected data with the help of interview and questionnaire. For the interview we took the appointment with the care takers and the intervention program developer. We also interviewed some of the family members, so that the exact effect of the intervention can be known. We searched for some of the vascular dementia patients who were discharged from any of the social care centre. The conversation with healed patients would be more helpful in analysing the effectiveness of the disease management interventions in improving the quality of the life.

The questionnaire was mainly prepared to get an idea from the care takers about the intervention programs. The questionnaire consisted of both open and closed questions. The closed questions were to get the idea about the program directly and open questions were to get the point of view of the care takers about the intervention programs.

With the help of these methods, we were able to collect enough data for the analysis and get the accurate result.

Task 3

1. How appropriate research evaluation techniques were used

With the help of our research technique, we were able to get the accurate result for our research. With the quantitative research method, we came to know that in almost every care centre the intervention programs are being followed. The number of the centre which were flowing the intervention programs was almost equal to the number of care centres present in Hanwell and hence this proves that the all the centres feels that the intervention programs are helpful in improving the life of patients suffering from vascular dementia.

With the help of quantitative analysis, we came to know that almost all the care takers were quite happy with the programs suggested by the developer team as it gives them the direction to work. With the help of the program, the care takers come to know about the methods which can help them to handle the patients with more care and attention.

By analysing the result of both the methods i.e. qualitative and quantitative it is clear that the disease management intervention programs helps a lot in improving the quality of the life for people who lives with vascular dementia in Hanwell. Since I got the results accurately, I can conclude that the methods used by me for the research were appropriate.

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2. How results were interpreted and analysed in terms of the original research specifications

Data analysis and interpretation of the data are the two most important parts of any of the research.The various methods used by us to interpret the quantitative data are by taking the mean of all the samples. We also used the method of standard deviation at some places. We used standard deviation method so that we can know the reliability of our result.In order to get the qualitative result from the questionnaires and interview, we read the statements and answers of various people again and again. Then we grouped the similar kind of responses and at the last stage we tried to get a pattern from all the statements and answers in different groups.

Limitations

We faced some of the limitations also during our research. There were many care takers who were not ready to give their time as they were handling more than one patient and hence they do not have spare time. There were some care takers who were dealing with the patients who were in the advanced stage of their disease and hence it was not possible to leave them alone and give time for our research.

3. Recommendations and areas for further considerations

There was no doubt in the fact that the disease management intervention programs have got a significant role in the improvement of the quality of the life of people with vascular dementia, but still there is one aspect which should be taken care by them. There should be some program which can tell the care takers about the proper use of medicines at the proper time. Many a times, when the patients go out of control, a high dose drug is given to them, which can have some negative effects on them. So there must be some program which can educate the care takers about the usage of drugs on patients.

References

Barker, R., Ashby, E. L., Wellington, D., Barrow, V. M., Palmer, J. C., Kehoe, P. G. ...& Love, S. (2014). Pathophysiology of white matter perfusion in Alzheimer’s disease and vascular dementia Brain, 137(5), 1524-1532 Cooper, C., Mukadam, N., Katona, C., Lyketsos, C. G., Ames, D., Rabins, P., ... & Livingston, G. (2012). Systematic review of the effectiveness of non-pharmacological interventions to improve quality of life of people with dementia. InternationalPsychogeriatric, 24(06), 856-870 Free, C., Phillips, G., Galli, L., Watson, L., Felix, L., Edwards, P., ... & Haines, A. (2013). The effectiveness of mobile-health technology-based health behaviour change or disease management interventions for health care consumers: a systematic review. PLoS medicine, 10(1), e1001362 Imfeld, P., BrauchliPernus, Y. B., Jick, S. S., & Meier, C. R. (2013) Epidemiology, Co-Morbidities, and Medication Use of Patients with Alzheimer's Disease or Vascular Dementia in the UK. Journal of Alzheimer's Disease,35(3), 565-573 Murthy, R. S. (2005). Human resources for mental health: challenges and opportunities in developing countries. Int Psychiatry, 2, 5-7 Reuben, D. B., Roth, C. P., Frank, J. C., Hirsch, S. H., Katz, D., McCreath, H., ... & Wenger, N. S. (2010). Assessing care of vulnerable elders—Alzheimer's disease: A pilot study of a practice redesign intervention to improve the quality of dementia care. Journal of the American Geriatrics Society, 58(2), 324-329

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