Research & EBP Exam 1 (chapters 1-3)

What are the steps to Evidence Based Practice?

1. Nursing Question

2. Research

3. Best Evidence

4. Clinical Expertise & Patient preferences

Nursing Research

Reliable evidence about issues of importance to nurses and clients

Clinical Nursing Research

Questions and issues related to nursing practice

Research

A systemic way of answering questions

Scientific method

involves using orderly procedures to gather primarily quantitative information

Evidence based practice

produced decisions that are clinically appropriate, cost effective and in positive client outcomes

Roles of Nurses in Research

Contribute an idea for a clinical inquiry, assist in collecting research information

Paradigm

Worldview or general perspective of the worlds complexities

Assumption

Principle that is believed to be true without verification

Positivist Paradigm

is a research approach based on the idea that reality exists objectively and can be measured through observation, experimentation and empirical evidence

Constructivist paradigm

began as a countermovement to positivism and is a major alternative system for conducting research in nursing

Empirical evidence

evidence that is rooted in objective reality and gathered through the senses rather than through personal beliefs

Generalizability

The ability to generalize research findings to individuals who did not take part in the study

Qualitative research

The meaning, experience, understand, explore.. think quality. Commonly associated with a constructivist/ interpretive worldview

Quantitative research

Think quantity; helps us understanding what is happening. Commonly associated with positivist/ post-positivist worldview

Mixed methods of research

involving the collection and analysis of both qualitative and quantitative data in a single study

Therapy/intervention questions

addresses by health care researchers who want to learn the benefits of specific actions, treatments, products or processes.

Diagnosis/assessment questions

Many nursing studies concern the rigorous development and testing of formal instruments to screen, diagnose, and assess patients and to measure clinical outcomes

Prognosis questions

Strive to understand the outcomes associated with a disease or a health prove, to estimate the probability they will occur, and to predict the types of people for whom the outcomes are most likely

Etiology questions

Questions that help determine the causation of harm or illness, further providing data to help limit the amount caused

Meta analysis

(quantitative), they treat the findings from one study as one piece of information, findings on the same topic from multiple studies are combined and analyzed statistically

Meta synthesis

An interpreted translation that utilizes systematically integrated findings from multiple qualitative studies, telling you what the gathered data and articles mean. (think of it as making meaning from the findings)

Meta aggregation

findings/data are summarized rather than transformed into synthesis categorizing the information (think of a bunch of recipes, this organizes what those recipes have in common)

Level of Evidence Scales

Level 1 evidence usually is considered the best (least biased) type of evidence

Study (investigation)

Addressing a research question

Study subject/ participant

People being studied or cooperating in quantitative study

Informants

Peoplee cooperating in qualitative study

Researchers/Investigators

Persons who conducts the research

Concepts

abstractions of particular aspects of human behavior or characteristics weight

Phenomena

abstracts in qualitative studies

Constructs

slightly more complex abstractions (self care)

Theories

knit concepts into a coherent system that purports to explain phenomena

Variables

A characteristic or quality that takes on different values, varies from one person to the next (examples: blood type, weight, length of stay in hospital). Used almost exclusively in quantitative research

Independent variables

The presumed cause

Dependent variable

The presumed effect

Conceptual

The abstract or theoretical meaning of a concept being studied

Operational

the operations (measurements) a researcher must perform to measure the concept and collect the desired information

Data

(singular = datum) the piece of information researches collect in a study. (quantitative researches collect numeric data, qualitative researches collect narrative data)

Experimental research

A type of quantitative research where researches introduce an intervention, most often to address therapy questions (called clinical trials in medical research)

Non experimental research

Researches collect data without intervening or introducing treatments (called observational studies in medical research)

Grounded theory research

Seeks to understand key social psychological processes that are grounded in reality

Phenomenological research

Focuses on the lived experiences of humans

Ethnographic research

Focuses on the patterns and life ways of a cultural group and strives to learn from members of a cultural group to understand their worldview and to describe their customs and norms

Conceptual phase

phase 1 of a quantitative study an idea of something

Design and Planning phase

Phase 2 operationalize, take the big abstract idea and make it operational by planning it

Empirical phase

Implement the idea

Analytic phase

Do statistics for if the intervention or observation has any clinical/statistical significance

Dissemination phase

Communicating findings to the rest of the world, for them to learn outcomes and measures you’ve found

Abstract

a brief description of the study placed at the beginning of the article. answers questions like “what were the research questions?", What were the findings?”

Introduction

Description of central phenomena, concepts or variables. Study purpose, research questions or hypotheses. Theoretical/conceptual framework

Methods Section - Quantitative

Research design, sampling plan, methods of measuring variables and collecting data

Methods Section - Qualitative

Discuss many of the same issues as quantitative researches but with different emphases

Statistical Significance

Findings are probably true and replicable with a different sample

Level of significance

How probable is it that the findings are true?

Critical Appraisal

An objective assessment of a study’s strengths and limitations and relevance, to determine if evidence can be applied to practice

Research critique

An objective assessment of a study’s strengths and limitations and relevance concerned about potential for publication

Reliability

The accuracy and consistency of obtained information

Validity

The soundness of the evidence

Credibility

a key criterion-confidence in the truth that the results are truthful and accurate

Triangulation

The use of multiple sources to draw conclusions about what constitutes the truth

Bias

a distortion or influence that results in an error in inference

Research control

involves holding constant influences on the dependent variable to better understand relationship between the independent and dependent variables

Confounding variables

Contaminating factors, extraneous variable

Randomness

Allowing certain aspects of the study to be left to chance rather than to researcher or participant choice

Blinding

Which is used in some quantitative studies to prevent biases stemming from peoples awareness

Reflexivity

the process of reflecting critically on self and attending to personal values that could affect data collection and interpretations of the data. Can be useful tool in quantitative as well as qualitative research- self awareness and introspection can enhance the quality of any study

Generalizability

Criterion used in quantitative studies to assess the extent to which the findings can be applied to other groups and settings

Transferability

The extent to which qualitative findings can be transferred to other settings

Code of ethics

1949: Nuremberg Coed: response to Nazi atrocities

1964: Declaration of Helsinki: World Medical Assn.

1978: Belmont report

1995: ANA Ethical Guidelines in the Conduct, Dissemination, and implementation of nursing research

2002: CNA: Ethical Research Guidelines for RNs

2015: ANA declares Year of Ethics: Revised Code of Ethics for Nurses with Interpretive Statements

Ethical Dilemma

A situation in which the rights of study participants are in direct conflict with requirements of a study

Beneficence

Principle: Above all, do no harm, right to freedom from harm and discomfort. Minimize harm; maximize benefits

Respect for Human Dignity

Deciding voluntarily whether to participate in a study, without risking prejudicial treatment. Having the right to ask questions, refuse answering questions and drop out of the study. Having a right to full disclosure.

Justice

Right to fair treatment; concerns the equitable distribution of benefits and burdens of research. Having the right to privacy (confidentiality, anonymity)

Procedures for Protecting Participants

Informed consent

Confidentiality procedures

Debriefings

Risk-benefit assessments

Informed Consent

Participants having an adequate amount of information about the research, and are able to comprehend the information while given the free choice in deciding to participate

Anonymity

Researchers cannot link participants to their data

Confidentiality in the absence of anonymity

Other confidentiality procedures need to be implemented, taking steps to ensure breach of confidentiality does not occur

Certificate of Confidentiality

prevents forced disclosure of confidential information to authorities

Debriefing

Sessions wehre participants can ask questions or share their concerns