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Article Critique
The Effect of Education and Follow-up Provided via Tele-nursing on the Quality of Life of
Patients with COVID-19

Lauren Kegelmyer, Ashley Kovac, Chinielle Lamey, & Heather Lee

Walsh University
NURS 702
Shelly Amato-Curran PHD, APRN-CNS, CRRN, CNRN
September 18th, 2022
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Article Critique: The Effect of Education and Follow-up Provided via Tele-nursing on the
Quality of Life of Patients with COVID-19
This article critique focuses on Gündoğan (2022) exploring the effects of education and

follow-up provided via tele-nursing on the quality of life of patients with COVID-19.

Problem
The problem in this study is that COVID-19 is disturbing the quality of life of people

diagnosed through lack of knowledge and scant education which can worsen anxiety and lessen

the quality of life of people who have been diagnosed with the disease (Gündoğan, 2022). The

significance of the problem is important to nursing because nursing services can decrease anxiety

and raise the quality of life of individuals (Gündoğan, 2022). The purpose of this article is to

examine the result of education and follow-up offered via telenursing on the quality of life of

individuals diagnosed with COVID-19 (Gündoğan, 2022). An answer to the problem will

provide insight into the clinical applicability of the problem to help improve quality of life for

this population of interest. This study examined the effects of education and follow-up provided

through telenursing on quality of life (Gündoğan, 2022).

Theoretical/Conceptual Framework
In the article, conceptual framework is described as it relates the quality of life, COVID-

19, and tele-health together. It is suggested that tele-health nursing can impact quality of life for

all patients but has not been proposed to effect patients with COVID-19 (Gündoğan, 2022). The

research problem flows naturally from the conceptual framework. After the conceptual

framework, it was proposed that quality of life can improve for patients with COVID-19 through

tele-health education and follow-up (Gündoğan, 2022).

Research Hypotheses
The hypothesis was formally stated which if the effects of education and follow-up

provided through tele-nursing improved quality of life for patients with COVID-19 (Gündoğan,
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2022). The research question flows beautifully from the research problem which is the quality of

life of patients with COVID-19 (Gündoğan, 2022). This disease has negatively impacted

physical, mental health, and quality of life. Tele-health is an intervention that can provide

education and follow-up visits which has been proven to improve quality of life and easy anxiety

for patients with COVID-19 (Gündoğan, 2022). The research question was worded objectively

without coming to a clear conclusion. It was clear that the study would focus on if education and

follow-up via telehealth improved quality of life and decrease anxiety for patients with COVID-

19 (Gündoğan, 2022). The prediction was not evident, but literature suggested that tele-health

can be beneficial to improve quality of life for all patients.

Literature Review

The literature review was comprehensive and relevant to the research question. Recent

research focused on the quality of life, the impact of COVID-19, and the effects of tele-health

(Gündoğan, 2022). Quality of life was researched thoroughly by describing the relationship

between physical health and personal well-being for patients with COVID-19 (Gündoğan, 2022).

The relationship of the research study was evident. It was found that tele-health resources with

education and follow-up can reduce anxiety and positively impact quality of life for these

patients (Gündoğan, 2022). Recent research was completed ranging from 2020-2022 whereas

other research was from the 1990s. There were many articles that were flagship research that

contributed to the study (Gündoğan, 2022). Based on the previous literature, the researchers had

evidence to conduct the study to confirm the results that were found but with a larger sample size

Tele-health has a positive impact on the quality of life and patients’ wellbeing for patients with

COVID-19 (Gündoğan, 2022).

Protection of Human Rights

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Before starting the research study, ethical approval was given by the Non-Interventional

Clinical Research Ethics Committee of Kütahya Health Services University (Gündoğan, 2022).

Participants of the study were informed about the risks and benefits of the study verbally and in

written form. For those who agreed to participate in the study, informed consent was obtained.

There were low risks in the study as the measurements of the study were completed by

administering the three measurements (Gündoğan, 2022). In the ethical considerations of the

study, it was stated that the principles of the Declaration of Helsinki were ensured. Declaration

of Helsinki defines ethical principles that should be considered with participants (World Medical

Association, 2018).

Research Design

This is a semi-experimental study. Specifically, Survey research is the study design used

for this study (Tappen, 2016). Survey research is primarily used to obtain answers that can be

tallied and reported numerically, uses a sampling of the population of interest, and presents

simple descriptive statistics on a specific population (Tappen, 2016). The research design is

appropriate for the research question and purpose of the study. The study can be replicable as it

only included patients who arrived in a district hospital and had a small sample size (Gündoğan,

2022). Randomized controlled experimental studies with larger samples should be conducted.

Sampling

The target population was clearly selected, and the selection procedures clearly defined.

The inclusion criteria were persons who tested positive for the coronavirus at the emergency

clinic of a state hospital in Turkey who had a positive CT lung scan and order for isolation

between April 1, 2021, and October 1, 2021 (Gündoğan, 2022). Other aspects of the inclusion

criteria were persons older than 18, having the ability to read, speak and write in Turkey, and
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ability to answer physical and mental status questions. Also, individuals who were unable to hear

or speak on the phone were excluded (Gündoğan, 2022). The potential sample size was justified,

but there was no mention of potential sample biases described. Randomization would not have

been the best method due to the specific inclusion criteria that needed to be met.

Data Collection
Three instruments were used including a patient information form to collect demographic

data, the Duke Health Profile, and tele-nursing follow-up form to assess symptoms or

recommendations (Gündoğan, 2022). The rationale was provided for each instrument. A pretest

and posttest design before and after the educational intervention and counselling were used for

data collection. The Duke Health Profile comprises 17 items which assess the patient’s quality of

life (Gündoğan, 2022). The reliability and validity of the scale for the Turkish population was

confirmed through Cronbach a coefficents which were similar from previous use of the scale.

The instruments used in this study were appropriate for sample size as well as the theoretical

framework and were congruent with the research question and goal (Gündoğan, 2022).

Quantitative Analysis
The research design of semi-experimental using pretest and post-tests fits the quantitative

analysis for the research study. Data from the instruments was analyzed by using the Statistical

Package for the Social Sciences for Windows which was appropriate for the study (Gündoğan,

2022). Descriptive statistics were used that found mean, or standard deviation, values for the

continuous variables and a number, or percentage, for categorical variables. Pretest and post test

data were analyzed using the paired sample t-test which was suitable for this study because they

were from a similar group of people where the results correlated (Tappen, 2016). Findings

showed that health scores of patients with COVID-19 improved in terms of physical, mental, and

social health. Also, the patient’s pain, anxiety, and depression decreased because of the
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education and follow-up via telehealth (Gündoğan, 2022). The statistical result is clearly

represented, and all numerical values are clearly categorized. There are two graphic displays in

the research study, demographic characteristics, and comparison of the Duke Health Profile,

which are easy-to-read, simple, and clear (Gündoğan, 2022).

Threats to Internal and External Validity

This study only accounted for patients that were seeking care at a district hospital, the

sample size was small and semi-experimental. Both factors threaten the validity of the study by

limiting the results and providing less information to base future care off. To combat this, the

Duke Health Profile was utilized, this considered characteristics such as age, marital status, sex,

education, and living status. The Duke Health Profile ensured that participants were thoroughly

assessed and accounted for, eliminating unmeasurable variables. This study completed by

Gündoğan (2022), was then compared to similar studies to aid in determining validity. In

comparison to similar studies, the study was on par with research done elsewhere.

Conclusions & Recommendations

The sample size causes some limitations in the study (Gündoğan, 2022). The population

studied was small and only involved those seeking medical care at a district hospital. Data results

of the study showed that mental health was improved with telehealth nursing (Gündoğan, 2022).

The conclusion of the research done suggests that utilization of telehealth to provide education

and follow up care resulted in decreased reports of depression or anxiety (Gündoğan, 2022). The

study acknowledges that patients tend to report more of their symptoms to nurses and encourages

them to have a greater role in telehealth visits. This research can be utilized in practice because

as COVID-19 cases continue to rise it provides a framework for the importance of continued

care and how that can be navigated by way of telehealth (Gündoğan, 2022).
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References
Gündoğan, S. (2022). The effect of education and follow-up provided via tele-nursing on the

quality of life of patients with COVID-19. The Journal of Continuing Education in

Nursing, 53(8), 365-371. https://doi-org.wa.opal-libraries.org/10.3928/00220124-

20220706-07

Tappen, R. M. (2016). Advanced nursing research: From theory to practice (2nd ed.). Jones &

Bartlett Learning.

World Medical Association (2018). Declaration of Helsinki: Ethical principles for medical

research involving human subjects. (2018). Quarterly of the Horizon of Medical

Sciences, 24(3), 1–7.