Problem Statement and Research Question
The research is devoted to testing a palliative care (PC) nurse practitioner-led (NP) intervention method the Co Creation of Possibilities (CP) described by Bergdahl, Benzein, Ternestedt, Elmberger, and Andershed (2013). CP includes the discussion of the needs and goals (wishes) of the patients that are not connected to healthcare but may be affected by the state of health, approving them or substituting them with more attainable ones, and co-creating a plan for fulfilling them. Bergdahl et al. (2013) have found out that NPs use CP with PC patients suffering from various illnesses instinctively, but they are not always successful. The model of CP proposed by the authors may assist in understanding the intervention and provide a ground for informed CP activities that can fulfill the functions of health-related education and support. Apart from that, the authors expect CP to . In other words, informed CP is likely to help NPs improve the quality of life (QoL) of patients in palliative care (PC) in several ways, but this method has not been researched yet. The presented study is aimed at changing this fact.
The PICOT research question will be formulated as follows: in PC patients being treated by an NP, does the as compared to current standards (Melnyk & Fineout-Overholt, 2011)?
The independent variable (CP training) is meant for NPs, and the PICOT question targets an NP intervention, which is why the sampling will be aimed at contacting PC NPs (possibly in a PC clinic). Some NP characteristics (especially experience) will be taken into account, but they will not be used to stratify the sample. The findings, therefore, are intended to be generalized to PC NPs in general, which corresponds to the problem statement. At least 10 NPs would be required for each of the groups (the intervention and control group). The number is explained by feasibility: a smaller sample is unlikely to provide sufficient generalizability, but since each of the NPs is supposed to have a number of patients, the qualitative and quantitative data to be analyzed will increase significantly with every new NP. Tracing the work of NP with multiple patients is needed to define how likely the intervention is to change the practice of each of them. To improve the population representation and sample generalizability, the number of NPs can be increased if it is deemed feasible. The NPs from the final sample will be assigned to the control or intervention group randomly to improve the validity of the experiment (Coryn & Hobson, 2011). Thus, the sample will correspond to the research design as described below.
Since the sampling is randomized, the research can be considered an experiment (Polit & Beck, 2014). Still, it is a field experiment with a correspondent possibility of contamination (Johnson & Christensen, 2014). The study will be longitudinal (one year) to ensure that there is a temporal relationship between the exposure and the outcome (El-Masri, 2014, p. 16). The variables will be assessed before and repeatedly after the NP training (pretest-posttest) to trace the changes in NPs work.
To evaluate the proposed intervention as suggested by the research problem, the mixed methods will be used: both quantitative and qualitative data will be gathered. In general, the mixed methods research is believed to be more comprehensive as it is not limited to using only one type of data, which has been leading to its increasing popularity in various fields of study, including nursing, business, and human resources (Cameron & Molina-Azorn, 2014; Polit & Beck, 2014).
The necessity for both types of data in this research is explained by the expected outcomes (the expectations are based on the theoretical framework and literature review). The QoL is going to be assessed with the help of specifically developed questionnaires, and the physical state of the patient will be defined through disease-specific parameters. The and the NP-patient relationship will be assessed with the help of closed and .