Nursing Research and EBP Midterm

purposive sampling

select a distinct group of individuals who either have lived the experience or the expertise in the event or experience being studied; sampling method to recruit specific persons who could provide inside information.

evidenced based practice

- research-based information, clinical expertise, and patient preferences

- a process involving the examination and application of research findings or their reliable evidence that has been integrated in scientific theories

- the research is used and includes patient preferences and improve patient outcomes.

research vs EBP

- Research is a planned and systematic activity that leads to new knowledge and/or the discovery of solutions to problems or questions.

- EBP seeks and applies the best clinical evidence, often from research, toward making patient-care decisions

AIMRAD

abstract, introduction, methods, results, discussion

abstract

Provides an overview of the study

introduction

- Statement of the problem and the purpose statement.

- Provide background information and statistics about the problem.

- A good introduction convinces the readers that the study is worth being read.

methods

- Discussion about the study design, sample, and data collection.

- Describe the target population and how the study was obtained.

results

- Authors describe the methods used to analyze the data

- Quantitative has more charts and numbers

- Qualitative has more descriptions.

analysis

A detailed examination of the elements or structure of something.

discussion

- Authors provide an interpretation of the results and discuss how the findings extend the body of knowledge

- Results should be linked to the review of the literature and theoretical framework.

- The authors discuss limitations and how to improve them in the future.

John Hopkins evidence hierarchy

- Quality is based on the strength of the design.

- High levels have randomization, large samples, and control over other variables while lower levels do not involve randomization or have smaller samples

levels 1-7 of Johns Hopkins hierarchy scale

Level 1 - considered the highest quality of evidence. Level 1 experimental study randomized controlled trial, quantitative study, systematic review of rcts, with or without meta-analysis.

Level 2 - quasi-experimental study

Level 3 - Qualitative, non-experimental study

Level 4 - Correctional, cohort studies (epidemiologic)

Level 5 - Integrative review (systematic review of non-experimental), Meta-synthesis (systematic review of qualitative studies)

Level 6 - Single descriptive study, single qualitative study, qualitative findings from mixed methods design, EBP project, Q.I. project, Case series studies, Case studies, Concept analysis

Level 7 - Narrative review, opinion of authorities

institutional review board

- Committees that review research proposals to determine whether research is ethical.

- It protects the rights of the human participants.

- Full review - necessary when a study involves vulnerable populations or the risks are not minimal

- Expedited review - If there is a minimal risk to humans.

principles of ethical research

- To ensure ethical research, researchers must adhere to three principles:

--- respect for persons (individuals should be treated as autonomous (having the ability to make decisions and those who do not have this ability (prisoners, kids, people with disabilities),

--- beneficence (principle of doing good and to not do any harm and to maximize benefits)

--- justice (equity or fairness).

Nuremberg Code

- Outlines what constitutes acceptable medical research and forms the biases of international codes of ethical conduct.

- Ethical code of conduct for research that uses human participants.

American Nurses Association Code of Ethics

advocates for the rights of human participants. Right to freedom from harm, right to privacy and dignity, right to anonymity

Informed Consent

an ethical practice requiring researchers to obtain voluntary participation by participants after they have been informed of possible risks and benefits

independent variable

- the experimental factor that is manipulated

- the variable whose effect is being studied.

dependent variable

- The outcome factor

- the variable that may change in response to manipulations of the independent variable.

- something that is being measured/measurable effect

extraneous variables

- factors that interfere with their relationship between the independent and dependent variable

- confounding variables

- Z variable

- any variables other than the independent variable that seem likely to influence the dependent variable in a specific study

PICOT question

P - Patient population

I - Intervention of interest

C - Comparison of interest

O - Outcome of interest

T - Time (this element is not always included)

null hypothesis

- A hypothesis stating that there is no relationship between the variables, the statistical hypothesis.

- Example: There is no relationship between the amount self-esteem and the adherence to a diabetic diet

directional hypothesis

- Statement describing the direction of a relationship between two or more variables.

- Example: Increased amounts of self-esteem increase adherence to a diabetic diet in adolescents with type 1 diabetes.

non-directional hypothesis

- Statement of the relationship between two variables that does not predict the direction of the relationship.

- Example: There is an association between the amount of self-esteem and adherence to a diabetic in adolescents with type 1 diabetes.

simple hypothesis

- predicts the relationship between a single dependent variable and a single independent variable.

- Example: Students who eat breakfast will perform better on a math exam than students who do not eat breakfast.

complex hypothesis

- In this type dependent and independent variables are more than two.

- Example: Ex. Smoking and other drugs leads to cancer, tension, chest infections etc.

casual

- one variable, the independent variable is thought to cause or determine the presence of the other variable, the dependent variable.

- Example: Increased amount of self-esteem increase adherence to a diabetic diet in adolescents with type 1 diabetes.

associative

- A type of relationship such that when one variable changes, the other variable changes.

- Example: There is a relationship between the amount of self-esteem and adherence to a diabetic in adolescents with type 1 diabetes.

primary source

- Original data or reports of results from original research

secondary source

commentaries, summaries, reviews, or interpretations of primary sources.

narrative review

- Papers based on common or uncommon elements of works without concern for research methods, designs, or settings

- review of scientific literature in which the authors reach their own conclusions about whether the majority of studies provide evidence for or against the topic of the review

integrative review

scholarly paper that includes published non-experimental studies in the synthesis to answer clinical questions.

systematic review

a rigorous and systematic synthesis of research findings from experimental and quasi-experimental studies about a clinical problem.

meta-analysis

- A research method that estimates that the effect of an intervention by using statistical methods to analyze data from both published and unpublished single studies

- Quantitative studies.

meta-synthesis

qualitative studies, uses words to describe human behaviors.

three criteria for true experimental design

control, manipulation, and randomization

randomized control trials

- assigns participants to either the experimental or control group

- the selection, assignment, or arrangement of elements by change

quasi-experimental

- research designs involving the manipulation of the independent variable but lacking random assignment to experimental and comparison groups.

Non-experimental designs

research designs that lack manipulation of the independent variable and random assignment.

control of extraneous variables

- Factors that interfere with the relationship between independent and dependent variables; confounding variables; Z variable.

random sampling

random sampling is the technique for selecting elements (ex. Participants charts) whereby each has the same change of being selected.

random assignment

Random assignment is an assignment technique in which participants have an equal chance of being assignment to either the treatment or the control group.

internal validity

- the degree to which one can conclude that it was the IV, not the extraneous variables, that caused the change in the DV.

- focuses on a causal relationship between variables

- Assuming there is a true relationship, is the relationship a causal one?

external validity

- the degree to which the results of the study can be generalized to other participants, settings, and times.

- Assuming a causal relationship between the cause-and-effect constructs, can we generalize to other persons, places, or times?

threats to internal validity

- maturation

- selection bias

- history

- testing

- instrumentation

- morality

maturation

a threat when participants change by growing or maturing.

selection bias

a threat when the change in dv is a result of the characteristics of the participants before they entered a study

- when the change in the DV is a result of differences in the characteristics of participants rather than a result of the IV.gbbbggggbbbbbb hn]

history

- a threat when the dv is influenced by an event that occurred during the study

testing

a threat when a pretest influences the way participants respond on a post test

instrumentation

a threat when there are inconsistencies in data collection

morality

a threat when there is a loss of participants before the study is completed, threat of morality.

statistical conclusion validity

the degree that the results of the statistical analysis reflect the true relationship between the independent variable and the dependent variable

construct validity

a threat to validity when the instruments used do not accurately measure the theoretical concepts.

hawthorne effect

Participants' behaviors may be affected by affected by personal values or desires to please the experimenter; reactivity.

cross sectional designs

Nonexperimental design used to gather data from a group of participants at only one point in time; study design to measure cause and outcome variables as each exists in a population or representative sample at one specific point in time

retrospective design (case control)

- research designs when researchers look back in time to determine possible causative factors.

longitudinal designs (prospective)

designs used to gather data about participants at more than one point in time.

experimental designs

- designs involving random assignment to groups and manipulation of the independent variable.

- look for differences between participants in the treatment group compared to the control group.

classic experimental design

- contain three key features: independent and dependent variables, pretesting and post testing, and experimental and control groups

Two-group pretest-post-test design

- participants are randomly assigned to the experimental or control group and are measured before and after the intervention

- considered to be the classic experimental design

- allows researchers to examine within-subjects results as well as between-subjects results

Two-group posttest only

participants are randomly assigned to an experimental or control group and measured after the intervention.

Solomon 4 group design

- experimental design

- involving four groups

- some receive the intervention, others serve as controls, some are measured before and after the intervention, others are measured only after the intervention.

factorial design

Experimental designs allowing researchers to manipulate more than one intervention

crossover design

- experimental designs that use two or more treatments; participants receive treatments in a random order

- a type of longitudinal design

- the patients "cross over" from one treatment to the other

- smaller sample sizes are needed because only one group of participants is required, and participants serve as their own controls

Quasi-experimental designs

- Research designs involving the manipulation of the independent variable but lacking random assignment to experimental and comparison groups

- answer questions that ask about differences between groups

- They either lack randomization or a control group, which makes claims of cause and effect weaker than in true experimental designs

Descriptive: provide a picture of a phenomenon of interest

A nursing phenomenon is frequently described as an experience (e.g., fatigue) or related experiences that influences health status and is relevant to nursing practice (e.g., postpartum fatigue, post-traumatic stress disorder, burnout, job satisfaction, maternal child attachment, care coordination)

Correlational designs

- describe relationships noted between variables

- Nonexperimental designs used to study relationships between two or more variables.

4 types of qualitative research

1. phenomenology

2. grounded theory

3. ethnography

4. historical

phenomenology

A type of qualitative research that describes the lived experience to archive understanding of an experience from the perspective of the participants

grounded theory

A type of qualitative research that examines a process of a phenomenon and culminates in the generation of a theory.

ethnography

A type of qualitative research that describes a culture

historical

A type of qualitative research used to examine events in the past and guide the future

data saturation

- In qualitative research when there is no new information being obtained and repetition of information is consistently heard.

- means that the sample size is sufficient

memoing

- A technique used in qualitative research to record ideas that come to researchers as they live with the data

bracketing

A strategy used by qualitative researchers to set aside personal interpretations to avoid biases

gatekeeper

Person who facilitates or hinders the entry of the researcher into a particular group or setting

trustworthiness

the quality, authenticity, and truthfulness, and truthfulness of findings from qualitative research

credibility

the truth of believability of findings

tranferability

whether findings from one study can be transferred to a similar context: application of findings to a different situation

dependability

consistency in the findings over time; auditability; findings are reflective of data

confirmability

the rigorous attempts to be objective and the maintenance of audit trails to document the research process; findings can be substantiated by participants

audit trail

documentation that includes field notes, a methods log, and a reflective journal to detail a researcher's decision making in qualitative studies

constant comparison

a method for inductively categorizing and comparing qualitative data for analysis

persistent observation

when the researcher has spent sufficient quality time with participants while attempting to describe and capture the essence of the phenomenon

peer debriefing

- researcher enlists the help of another person, who is a peer, to discuss the data and findings

referential adequacy/triangulation

use of different research methods in qualitative research to gather and compare data

member checking

researcher goes back to participants and shares the results with them to ensure the findings reflect what participants said

open coding

the grouping of qualitative data into categories that seem logical

data reduction

the simplification of large amounts of data obtained from qualitative interviews or other sources

informant/participant

individuals in a qualitative study

probability sampling

- when each element in the population has an equal chance of being selected for inclusion within the study sample

- requires that an accessible population be identified, a sampling frame created, and random selection used

simple random sampling

- randomly selecting elements from the accessible population

- randomly selecting elements from a sampling frame, which can be done in various ways

- The most common way is using a computer program to randomly select a sample from the sampling frame

stratified random sampling

- selecting elements from an accessible population that has been divided into groups or strata

- researchers must first assign participants of the accessible population into strata, next, participants are randomly selected from each stratum to yield a representative sample

cluster sampling

- random sampling method of selecting elements from larger to smaller subsets of an accessible population; multistage sampling

- Cluster sampling is useful for large populations or those spanning a large geographic area, in which it would be time and cost prohibitive to meet with each potential participant

systematic sampling

sampling method in which every kth element is selected from a numbered list of all elements in the accessible population; the starting point on the list is randomly selected

convenience sampling

nonprobability sampling method in which elements are selected because they are easy to access

nonprobability sampling

- convenience sampling

- quota sampling

- purposive sampling

- Snowball/network

- theoretical sampling

quota sampling

nonprobability sampling method involving selection of elements from an accessible population that has been divided into groups or strata.

snowball/network sampling

recruitment of participants based on word of mouth or referrals from other participants

representativeness

the degree to which elements of the sample are like elements in the population