NURS 224, FINAL OUTLINE

What is research literacy?

- The foundation of EIP

- Ability to read, understand research, appraise and determine suitable + sound evidence

- Have the skills to make decisions + judgements about the quality and applicability of research

What is evidence-informed practice?

Using the best + most robust evidence for practice, a broad concept that takes into account research + other forms of evidence

What is evidence-informed decision-making?

Process that recognizes that evidence comes from a variety of sources incorporating all relevant factors into the decisions you make

What is primary research?

Data collected + analyzed directly by a researcher to report findings + draw conclusions (Quant, Qual, MM)

What is secondary research?

Describe, summarize, analyze, evaluate, or are based on primary source material (Meta-analyses, systematic reviews)

What is evidence?

Info/facts from a variety of both qual + quant sources that are systematically obtained

What is research?

Systematic, planned investigation of a specified problem

How do you know if research was done?

Research was done if the author wrote they followed a systematic process to reach their findings

What is quantitative research?

- Aims to describe, explain, predict

- Has a hypothesis/research questions (often, not always has a hypothesis, always has a research question)

- Data is numerical + collected using questionnaires + other instruments

- Used to determine if an intervention works OR to describe a phenomenon using numerical data

- Can be Experimental/Non-experimental

What is qualitative research?

- Aims to describe, discover, explore

- DOES NOT have a hypothesis

- Inquires into what people think, feel, believe

What is MM?

Blend of quant + qual

What is the Belmont report?

Articulates 3 primary ethical principles on which standards of ethical research conduct are based

- Beneficence

- Respect for Human Dignity

- Justice

What is Beneficence

- Minimize harm and maximize benefits

- Provide benefits for participants + the larger community

- Rights to freedom from harm + discomfort

- Right to protection from exploitation

What is Respect for Human Dignity?

- Self-determination + full disclosure

- Right to self-determination --> right to voluntary participation, drop out of a study at any time

- Right to full disclosure --> right to make informed decisions about study participation

What is Justice?

- Fair treatment + privacy

- Right to fair treatment --> equal distribution of benefits + burdens

- Right to privacy --> research can be intruding into one's lives

What are the procedures for protecting study participants?

- Risk/benefit assessment

- Informed consent

- Confidentiality procedures

- Debriefings + referrals

- Treatment of vulnerable groups

- External reviews and the protection of human rights

What is informed consent?

Participants have adequate info about the study, comprehend the info, and have the power of free choice, enabling them to consent to decline participation voluntarily

What is confidentiality?

- Anonymous: researcher cannot link participant to data

- Confidentiality in the absence of anonymity --> when confidentiality cannot be met, pledge that info provided will not be publicly reported in a manner that identifies them

- Treatment of vulnerable groups --> may be incapable of providing informed consent, pay particular attention to ethical dimensions of vulnerable persons + populations

What are External reviews + the protection of human rights?

Hospitals, universities, and institutions where research is conducted have established formal commitees for reviewing research plans

What is Indigenous storytelling?

- DIverse storytelling approaches + adaptations with Indigenous health research

- Centering Indigenous voices to disrupt dominant practices + narratives

- Reclaims, preserves, and illuminates stories

- Cathartic, healing and satisfying process for participants

- Navigating ethical complexity and other challenges

What are the 4 R's of Indigenous storytelling?

- Respect

- Responsibility

- Relevance

- Reciprocity

What are the MM research designs?

- General sequencing

- Core MM designs

What are the general sequencing designs?

- Sequential: QUAL and QUAN not collected at the same time

- Concurrent: QUAL and QUAN are collected at the same time

What are the Core MM designs?

- Convergent: QUAN + QUAL collected simultaneously, usually with equal priority, seeks comparative data on a subject

- Explanatory sequential: QUAN --> qual OR quan --> QUAL; sequential with QUAN collected in the first phase, then QUAL in the second phase; Qual phase clarifies quan phase

- Exploratory sequential: QUAL --> quan + qual --> QUAN; investigates unfamiliar subject. Qual phase informs quan phase

What is a PICO question?

- Structured format for developing focused clinical questions to find evidence-based answers

- Population

- Intervention

- Comparison

- Outcome

- CO or S context/situation

What is the PICO format for a Quan question with an intervention/exposure?

PICO

What is the PICO format for a Quan question with no intervention/comparison?

PIO

What is the PICO format for a Qual quesiton?

PI-CO (context)

Why use PICO?

Ensures that your question will result in your ability to potentially implement a pratice change in your clinical practice

What are Boolean Operators?

- AND (more specific)

- OR (broader)

- NOT (filtering out terms)

- Parentheses (group terms to control the order)

- Quotation marks (search for an exact phrase)

- Asteriks (truncation symbol for variations of a word)

What is Peer-review?

- Scholarly

- Ensures that only studies with methods + findings that have been evaluated by other experts in the field + determined to be high quality and original are published

- If not peer-reviewed/scholarly, you do not move on to quality appraisal

What are characteristics of Peer-reviewed articles?

- Authors clearly identified + expertise demonstrated

- Few graphics, often an abstract

- Long (20+ pages)

- Ample references

- Formal writing with jargon + vocab familiar to other experts

- Dates at the beginning/end of the paper indicating the paper is peer-reviewed

What is the anatomy of a research paper?

- Abstract: summary of the research, aim/purpose, methods, results/findings, and implications

- Introduction: introduces the topic, relevance + significance, background research, purpose of the study

- Methods: describes HOW the study was conducted, participant recruitment, data collection (measures) + analysis

- Results: describes what was found in the study (numbers if quant, quotes/themes if qual)

- Discussion: discusses the findings in relation to other published literature, limitations + implications

What is bracketing?

- The researcher must "bracket" or set aside their own biases and preconceptions to describe a phenomena in a naive way

- Method rooted in phenomenology, setting aside beliefs + assumptions to view research data more objectively

- Reflective journaling to bracket out opinions

What is reflexivity?

- The process of reflecting critically on the self and of attending to personal values that could affect data collection and interpretations of the data

What is validity?

Determines if a study truly measures the intended concept, ensuring accuracy + relevance

What is internal validity?

- Ensuring a study produces valid, accurate results

- Uncontrolled, extraneous factors such as differences between participants are not responsible for the outcome

- Differences at baseline pose a threat to internal validity

- Similar participant characteristics at baseline counters bias and increases internal validity

- A higher internal validity = more likely the better a study was done

What is reliability?

Consistency with which an instrument measures what it is intended to measure

- Ex. Does the QOL assessment tool really measure QOL?

What is internal consistency?

- Measurement of the concept is consistent in all parts of the test

What is Cronbach's coefficient alpha?

Widely used index for internal consistency

What is the range for Cronbach's coefficient alpha, and what coefficient is considered especially desirable?

Cronbach's coefficient alpha ranges between 0-1.00, and a coefficient of 0.80 or higher is especially desirable as it shows reliability of the tool

What is a power analysis?

- Power is the probability that a statistical test will detect a significant difference that exists.

- A power analysis can assist you to identify the sample size you will need to avoid a Type II error (or to ensure that a significant difference exists).

A high number of dropouts, greater than ___ is a threat to internal validity

20%

What are characteristics of qualitative research?

- Aims: describe, discover, explore

- Guided by: purpose statement/research Q; QUAL research does not have a hypothesis, as it is exploratory

- Data collection: interviews (1:1 or focus groups), journaling, art, photos; observation, gathering documents/artifacts/records; stories, narratives, description of experiences

- Looking for: how people describe, narrate, interpret, and behave in relation to how they think, feel, and understand + believe. Understanding the human perspectives from the POV of the participants/observer

- Type of data: transcripts, fieldnotes, language-focused, descriptive + captures human-experience

- Researcher involvement: close to participants, researcher is embedded in data collection, relationships are established through data collection

- Examples: Study to understand experiences of the elderly living in LTCCs

What is Ethnography?

- What are they doing/ Why are they doing this? What artifacts represent their values, beliefs, and ways of organizing themselves?

- Learning from groups

- Level of intimacy with the members of the cultural group

- Three types of info collected; cultural behaviour, cultural artifacts, and cultural speech

- Blend of fieldwork + written test

What is Grounded Theory?

- What is going on here? What is this study of? What does this incident indicate? What is actually happening in the data?

- Aims to understand the meaning that people had that influences their behaviour + actions

- Uncovers patterns from participant's accounts

- Develops new theories directly from data, discovering patterns, concepts --> leading to an abstract theory about a social process/experience

What is phenomenology?

- What is the meaning of the lived experience? Why this word? Why this expression?

- Understanding people's everyday life experiences

- What is the essence of this phenomenon as experienced by these people and what does it mean?

- In-depth conversations where th researcher gains entrance into the participant's world, to have full access to their lived experience

- Bracketing + reflexivity are used here

Why is qualitative research important for EIP?

- Provides deep, contextual understanding of human experiences, behaviours, and the "how" and "why'

- Helps generate hypotheses for quant studies

- We learn more about our topic

- Quant research tells us what works, qual research tells you how it works

- This make qual research fundamental for evidence-informed PCC

What is data saturation?

- Point where collecting more data yields to no new insights, themes, or patterns

- Indicates the data set is rich enough to answer the research Q, ensuring depth + rigor

- Helps establish credibility for trustworthiness

What is rigor?

Scientific quality

What are characteristics of quantitative research?

- Aims: describe, explain, predict; objective

- Guided by: hypothesis/research Q; scientific method

- Data collection: numerical data, questionnaires, objective measurement data; quantifiable

- Looking for: determine if an intervention works OR to describe a phenomenon with numerical data

- Type of data: numerical, from questionnaires/measurement data; displayed as statistics; data obtained through measurability, calculability

- Researcher involvement: distant from participants; impersonal data collection; researcher separated

- Examples: study to identify depressive symptoms within the elderly living in LTCCs

What are experimental designs?

- The strongest design

- Used to determine the effect of an intervention

- Has an IV and DV

- The Independent Variable CAUSES variation/changes in the Dependent Variable

- RCTs and Quasi-Experimental study

What is a RCT?

- Randomized-controlled trial

- A TRUE experimental study

In order to have a true experimental study, what characteristics are needed?

- Intervention

- Control group

- Randomization

What is randomization and why is it important?

- Researcher randomly allocates participants to intervention/control group

- Each participant has an equal chance of being in the intervention/control

- Decreases bias

- Ensures equal characteristics at baseline

What is a quasi-experimental study?

- A not true experimental study

- Lacks a control or randomization or both

What is a non-experimental design?

- Describes a relationship between two or more variables

- Does not use an intervention, can be reflected as a PIO question

- Case-control, cross-sectional, cohort study, ecological

What is a case-control study?

Comparing people with a specific disease/outcome of interest (cases) to people from the same population without that disease/outcome (control)

What is a cross-sectional study?

Used to gather data from a group of subjects at only one point in time

What is a cohort study?

Studies of a selected/target group measuring variables OVER TIME

What is an ecological study?

Unit of analysis in a population/community

What are descriptive statistics?

- How samples are first analyzed

- Used to describe frequencies + patterns of numbers within a data set

- Presenting summaries of data generated during a study

- Mean, median, mode, range

- A question this could be used to answer: How many participants were involved in a study?

What are inferential statistics?

- Conducted to make decisions about whether variables in a study are correlated

- Looks at relationships between 2 or more variables

- The findings from the research sample are extended beyond the research

- Ex. using descriptive statistics to describe depression + perceived stress; using inferential statistics to see if there is a relationship between depression and other variables such as, perceived stress, disease during pregnancy, and family income

What are information and communication technologies?

The use of information software and enabling technologies to deliver health-care services/to facilitate better health

What are cinical examples of ICTs?

- Electronic records

- Workstations

- Capillary blood glucose

- Nursing central app

What are non-clinical examples of ICTs?

- E-mail

- Personal computers

- Online learning (Moodle)

- Microsoft Word

How can ICTs enhance EIP?

- Research literacy

- Increase quality, safety, and efficiency in patient care delivery

- Digital health is inherently person-centered, allowing patients and their families track/manage/improve their health

How can ICTs hinder EIP?

- Health websites + apps may contain poor quality health content/provide unsupported claims, and issues with confidentiality and security of private data

- Apps may mislead users with figures/data that are unreliable

- Lack of a uniform best practice approach to evaluate mobile health apps

What is the correct implementation of evidence-informed practice?

Describing the current evidence about a procedure + asking the client’s perspective

What does EIP look like?

Information from scientific research + evaluation that is systematically obtained and reviewed

What does EIP look like with patients and families?

Asking perspectives of client and explaining procedures

What is this process describing? “Identify research problem, collect data, analyze systematic findings, and make conclusions”

Conducting research + contributing new evidence

What part of the research paper includes: background info and justifies the need of the research study?

Introduction

What is the rationale for using PICO in research?

Enhance specificity and sensitivity in your literacy search

What does the Cronbach’s value find?

Internal consistency