NU 406 Test 3 (Research)

What is a literature review?

the process of finding/reading reports on a topic

- Summary of studies found in a research report

- Summary that you write of various studies you've examined

What are the purposes of a Lit Review?

- Summarize what is known

- Help determine topic

- Narrow the problem

- Establish theoretical framework

- Plan methodology

What are the 3 types of sources for a Lit Review?

- Primary source: first-hand source by people who actually did the study

- Secondary source: description of study written by someone else other than original researcher

- Grey literature: does not go through a commercial publisher, written by government or other source

Search strategies for a Lit Review:

- Develop a strategy

- Ask a librarian (how to improve searches - keywords, etc)

- Use resources/online sources

What are the different online databases to search for a Lit Review?

- PubMed

- EBSCOhost

- Academic Search Elite

- Gale Access

- Ovid

- JSTOR

- Proquest

PubMed includes/searches through these:

- International Nursing index

- Index medicus (Medline)

- Hospital and Health Admin Index

EBSCOhost has _____ databases, one of which is...

11;

Cumulative Index of Nursing and Allied Health Literature (CINAHL)

Gale Access has ______ databases, two of which are.....

45;

- InfoTrac Nursing and Allied Health Collection

- Academic OneFile (similar to academic search elite)

Ovid has full text access, and has access to.....

Joanna Briggs Institute

JSTOR has _________ __________

clinical journals

Intro to reading research reports

Research reports summarize.... and give a _______, ____________ description of....

- Summarize the highlights of a scientific study

- Give a brief, condensed description of the study

Intro to reading research reports

Peer reviewed. If it's blind reviewed, what does this mean?

means that person reviewing doesn't know who wrote the study

- double blind would mean that the author also doesn't know who the reviewer is

With research reports, the rate of acceptance is _____, and the validity of findings depends on....

low; depends on how study was conducted

Research reports are found in many...

research and speciality journals

Categories for content of Research Reports:

- Abstract

- Introduction

- Methods

- Results

- Discussion

- References

Contents of Research Reports:

What is the abstract?

Brief description of study

- Should contain: purpose, methodology, findings

Contents of Research Reports:

What is in the Introduction?

- Problem statement

- Research questions and/or hypothesis

- Review of related literature

- Significance of study (why it's important)

- theoretical framework

Contents of Research Reports:

What is included in the Methods section?

- Subjects: description, eligibility criteria, # of ppl in study

- Study design: overall plan; type, how they will analyze and control extraneous variables

- Instruments: methods of data collection

- Study procedures: includes human rights protection i.e. informed consent reported

Contents of Research Reports:

What is included in the Results section?

- Names of statistical tests

- Value of the calculated statistic

- Significance

Contents of Research Reports:

What is included in the Discussion section?

- Interpretation of the results: practical meaning

- Study limitations - ID weaknesses; does further studying need to be done?

- Implications: suggest uses for findings

What are some things to look out for in Research Reports?

- Compactness

- Jargon

- Objectivity

- Statistical information

What are some tips for reading research reports?

Read them:

- frequently

- slowly

- mentally translate

- statistics

- headings

What are some things to keep in mind when writing a review?

- Don't use quotes

- Discussed based on importance

- Group similar studies

- Use YOUR own words

- Don't ignore contradictory studies

- End with a state-of-the-art

When writing a review, you want to end with a "state-of-the-art." What is this?

a type of summary that tells what's been studied and what's missing - gaps in research

Theory

--

What is a theory?

a set of related statements that describe or explain phenomena in a systematic way

Theories are _________, meaning they are not proven/guaranteed

tentative

Theoretical framework

A study framework based on propositional statements from a theory

- Broad, general explanation about the relationship between concepts

- Based on one theory

- Scaffolding

Conceptual Framework

Less well-developed than theoretical framework; not tested like a theory

- Explains the relationship between concepts

- Links several theories and research experiences together

- General/vague, broad explanation of topic

What is a concept

any kind of characteristic or representation of reality

- words, pics, terms, etc; T and C

What is Construct

Term that has been created for the purpose of a theory

- Highly abstract; created to explain an idea that a theorist or scientist had

i.e. "super ego" "self-care"

Proposition statements are ____________ relationships between concepts

testable

A testable statement or assertion of the relationship between concept is....

proposition statement

What is a paradigm?

philosophy or way of thinking; worldview

What is a Metaparadigm?

A way to describe or define a discipline

Nursing: nursing, health, environment, and person (main concepts of nursing meta paradigm)

What are the main concepts of the nursing meta paradigm?

nursing, health, environment, and person

What are Models?

Symbolic representation of some phenomenon or phenomena

Who was the first person who looked at characteristics with theory development?

Florence Nightingale

Theory Development

What happened in the 50's - 70's?

Started to recognize that nurses have own body of knowledge and terms

Starting to differentiate nursing from other professions

Theory Development

What happened in the 80s - 90s?

- Looked at how we provide care in specific situations

- Separated ourselves from others like therapists, etc.

- What are the things we do?

Theory Development:

What happened in the 21st century?

Focus on interdisciplinary; working with others

Positivism

Worldview which focuses on absolute truth

- strive to discover explanations through scientific method

Postpositivism

Worldview that says that absolute truth does not exist

- all science has a subjective component

Ex: everything should be subjective to needs of that pt

There are 4 main concepts of the meta paradigm of nursing (person, health, environment, nursing).

What are 4 statements that link these together? the discipline of nursing is concerned with....

Discipline of nursing is concerned with:

- Principles and laws governing human processes

- Human health patterns in the environment

- Nursing actions that benefit humans

- Human processes of living and dying

Metaparadigm of nursing; the discipline of nursing is concerned with human health patterns in the environment, such as...

Weight loss

Stopping smoking

Not taking full course of antibiotics

Frameworks and Models - theories

--

Grand theories

an attempt to explain a broad range of phenomena

Most older nursing theories are _________ theories

grand

Types of grand theories

King's Open System (Theory of Goal Attainment)

Levine's Conservational Model

Orem's Model of Self-Care

Roy's Adaptation Model

Neuman's Health Care Systems Model

Open System/Theory of Goal Attainment

King;

- 3 Interacting dynamic systems: personal (individual), interpersonal (groups), and social (society)

- Nursing is a process of action, reaction, and interaction

- Nurses and patients share information to find mutual goals

What is the theory in which nurses and patients share information to find mutual goals?

King's Open System/Theory of Goal Attainment

What are the three interacting dynamic systems in the Open System/Goal Attainment theory?

- personal (individual)

- interpersonal (groups)

- social (society)

the Open System / Theory of Goal Development says that nursing is a process of....

action, reaction, and interaction

Conservation Model

Levine;

grand theory that individuals are holistic beings; nurses maintain person's wholeness

- Conservation: being able to function when challenged - energy; structural, personal, & social integrity

What is conservation, according to Levine's conservation model?

the ability to do things even when challenged

Levine's Conservation model conserves these things...

- Energy (to do what needs to be done)

- Structural integrity

- Personal integrity (self-worth)

- Social integrity

Model of Self-Care

Orem;

grand theory that talks abt a person's ability to perform self-care

- Concepts: agency, demand, deficit; nursing agency

Concepts of the Model of Self-Care

Orem;

- Agency: ability to do something

- Demand: the need to do something

- Deficit: inability to meet demands

Nurse agency: nurses provide care when they cannot - self-care agency is not available

Orem's Model of self-care led to what 3 theories?

Theory of Nursing Systems

Theory of Self-care deficit

Theory of self-care

Adaption Model

Roy;

grand theory about nursing care for biopsychosocial beings in constant interaction with the changing environment

- 4 response models: physiological, self-concept; role function, interdependence

Roy's Adaptation Model is a grand theory about nursing care for _________________ beings in constant interaction with a __________ environment

biopsychosocial; changing

according to Roy's Adaptation Model, we are adaptive systems with coping mechanisms with 4 response models:

- Physiological

- Self-concept

- Role function

- Interdependence

Health Care Systems Model

Neuman;

grand theory that focuses on a person as a complete system with interrelated parts and factors

- person maintains balance and harmony by: adjusting to stress & defending against tension-producing stimuli

- Wellness is equilibrium

The Health Care Systems Model focuses on the person as a complete system with what interrelated parts/factors?

- Physiological

- Psychological

- Sociocultural

- Spiritual

- Developmental

According to the Health Care Systems Model (Neuman), one maintains balance and harmony by:

- Adjusting to stress

- Defending against tension-producing stimuli

According to the Health Care Systems Model (Neuman), wellness is _______________.

equilibrium

Middle-Range theories are/have...

- Narrow focus

- Small number of concepts

- Some are from other disciplines

Practice theories are...

- Micro-theories

- Situation specific

These are Middle-Range Nursing theories:

- Theories of Uncertainty in Illness

- Pender's Health Promotion Model

- Theory of Self-Efficacy

- Theory of Caring

- Theory of unpleasant symptoms commonalities

- Prescriptive Theory of acute pain management in infants and children

This middle-range theory is pertinent to acute and ongoing chronic illness

- i.e. have chronic situation like renal failure and don't know what's next; pregnant and don't know when nausea will ever end...

Theories of uncertainty in Illness

This middle-range theory is an extension of the health belief model and focuses on enhancing wellness through promotion

- finding what motivates ppl to do things and getting them to do the things they don't want to do to promote their health

Pender's Health Promotion Model

Pender's Health Promotion Model:

This middle-range theory is an extension of the health belief model and focuses on enhancing wellness through promotion

- finding what motivates ppl to do things and getting them to do the things they don't want to do to promote their health

This middle-range theory focuses on the feeling of a meaningful action causing a person to act on it

- if they feel like they have the power/ability to do something, it motivates them to do it

Theory of Self-efficacy

Theory of Self-efficacy:

This middle-range theory focuses on the feeling of a meaningful action causing a person to act on it

- if they feel like they have the power/ability to do something, it motivates them to do it

This middle-range theory looks at ways of caring for patients that have loss and how nurses enhance their recovery

Theory of Caring

This middle-range theory looks at the commonalities between experiencing the same symptoms and different conditions and how nurses can help with the experience

- commonalities will help others bc understand symptoms pts have

Theory of Unpleasant Symptoms

This practice theory has a three step guideline on how to assess and treat pain in children

Prescriptive Theory of Acute Pain Management in Infants and Children

What are some other, non-nursing models?

- Health Belief Model (Becker) explains health-related behavior

- Lazarus's Stress and Coping Model explains people's methods of dealing with stress

- Nursing Graduate Readiness: specific skills and aptitudes make up readiness

What is the Health Belief Model (Becker)?

Explains health-related behavior

- Modifying factors of health affect our individual perceptions of health and likelihood of action

Lazarus's Stress and Coping Model explains...

people's methods of dealing with stress

What is the Nursing Graduate Readiness model?

Specific skills and aptitudes make up readiness

Knowledge (base circle) prepares you; along with professionalism, initiative, compassion, technical skill, confidence, critical thinking - all things needed in nursing; Christ-centered focus at the center of everything

Integrating theory in Nursing Research

Choose a theory ________

early

When integrating theory in nursing research, you should choose a theory early.

You should do/use these things when choosing a theory...

- Theory from nursing

- Combine two nursing theories

- Theories from other disciplines

- Combine theories from nursing and other disciplines

Deductive vs Inductive reasoning (r/t theories)

Deductive: starting with theory, developing research from that (general to specific)

Inductive: Start with info/data from a study and generating a theory from it (specific to general)

What are some purposes of theories?

- Make scientific findings meaningful and generalizable

- Help understand why phenomena occur

- weave together facts and findings in an orderly framework

- Provide direction and motivation for further study

Purposes of theories:

They make findings _________ and _________

meaningful; generalizable

-recognizing patterns

Purposes of theories:

They help you understand why....

why phenomena occur

Purposes of theories:

They weave together ______ and _________ in an __________ ___________.

facts and findings; orderly framework

Purposes of theories:

They provide _________ and ___________ for further ________.

direction and motivation; further study

What are the 9 steps of theory testing in nursing research?

1. Review various theories

2. Select best theory for research purpose

3. Review literature r/t theory

4. Develop hypothesis or questions based on theory

5. Define variables based on theoretical definitions

6. Choose instruments that mesh with theory

7. Describe findings in light of theory

8. Relate conclusions to theory

9. Determine if theory s supported by study

Ethical

--

When ethical dilemmas occur during research, there is a concern about...

protection of nursing research participants

Regarding ethical dilemmas and nursing research, the division between.... .... can be blurred

division between research and expected practice

- between role as researcher and healthcare provider

These are some historical events in unethical studies/research

- Nazi and Japanese war experiments

- Tuskegee syphilis study

- Live cancer cells in Jewish pts

- Immunizations given during testing

Nazi and Japanese war experiments

This unethical event used prisoners to test limitations and drug and diseases by exposing prisoners to diseases without consent

Tuskegee syphilis study

In 1932, this study did not give treatment correctly and followed the subjects until they died or the study was finished

- Did not give treatment to black men in study; did not tell them that a treatment existed, just let them continue with sickness and die

Live cancer cells in Jewish patient

At hospital in New York, cancer cells were injected into the elderly Jewish

- Not done/meant to give them cancer, meant to try to build up immunity(?) against cancer, but it was still wrong

Immunizations given during testing

Immunizations given during measles epidemic

- Did not explain to parents that the vaccine wasn't fully tested; parents didn't get full information

What are 3 universal codes of ethics?

- Nuremberg Code (1947)

- Universal declaration of Human Rights (1948) (UN)

- Declaration of Helsinki (1964) (WMA)

What was the first official code of ethics for research and when was it written?

Nuremberg Code; 1947