ideas for nursing research challenge

hi guys! happy new year if I haven't had a chance to see you guys on the floor.  I really like the ideas that have been floating around so far, and I'd like to add a couple of my own.  Here goes:

1. I really like the idea of evaluating quality of life post-transplant.  It would be interesting if there was a way we could evaluate longitudinally- i.e. at time of transplant, 3 mos and 6 mos and maybe even at 1 year post-tx (I don't know what our time limitations are).  This could be generalized to all tx groups. It would also be very interesting in comparing the different organ groups and whether the QOL varies amongst different groups.  We could conduct a survey using a QOL tool and possibly use the same one at 3 and 6 months.  The one issue that comes instantly to mind is repeated testing. Could be flawed as pts often are prepped when repeating testing and may answer as they assume is expected.  Does that make sense?  Anyway, that is one idea. 

2. I also really like the idea of using the internet as a support group tool, especially for lung tx recipients.  Combining with what Mo had spoken about in regards to different lung tx pts not being able to mix (because of cepacia status), it could be a great tool at increasing communication across different lung tx pts themselves and provide greater support all around. 

The one thing that I think will be a struggle is developing a support group that will provide adequate needs for all transplant groups.  We would have to conduct a needs assessment to really understand what pts might want from a support group.  The other issue we will run into is finding means for evaluation.  It could get tricky but I think we just need to think about it carefully.

Now, I just wanted to throw another idea into the pot.  Here is the reference from the article, found in the journal Liver Transplantation:. It was published recently in Oct 2010.

Miyazaki et al. (2010). Patients on the waiting list for Liver Transplantation: Caregiver Burden and Stress. Liver Transplantion, 16(10) 1164-1168. 

you can access the article remotely from home. I've also saved a pdf copy which I will email to you all as well.  All you have to do is go to UHN libraries from home and look up the journal title, "Liver Transplantation."  You should be able to navigate to get to the article, but let me know if you need help finding it. 

Basically, the idea behind this article is to look at caregiver stress and burden, specifically for pre-livers.  As we all know, pre-livers themselves are a distinct care group and create huge impact on both pts and their caregivers.  As pts deterioriate, caregivers often need to cope with changes to their loved ones that they do not anticipate, especially dealing with increasing encephalopathy, and body image changes (e.g. gross ascites, jaundice). 

The article itself focuses on caregivers and their coping with stress for pre-livers.  This is an interesting group to study and possibly, a support group for pre-liver caregivers could be very helpful.  Sometimes, pts deteriorate quickly and many family members are overwhelmed with the rapid decrease in mental status.  Caregivers are unsure of what to do and often seek out medical staff or admit their loved ones to ER as they are unable to cope with the pts at home.

From a clinical perspective, the management of a pre-liver patient can be very stressful..  I'm sure all off us (whether we have had years of experience or a couple of months) can echo how challenging care for a pre-liver can be.  The other idea I have is looking into research of an intervention for nurses faced with the challenge of providing care for a pre-liver. 

I know my idea once again has narrowed down the organ groups but i'm just throwing in my two cents.  Just wanted to make our pot of stew more juicy.... to be continued!!

Looking forward to all your excellent ideas!!!

Liz :)