Exam 1

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Exam 1
2015-01-26 23:20:40
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  1. Research def
    systematic inquiry using disciplined methods to solve problems or answer questions
  2. Nursing research def
    systematic inquiry to develop knowledge about issues of importance to the nursing profession
  3. Sources of evidence
    • tradition
    • authority
    • clinical experience; trial and error; intuition
    • Logical reasoning
    • Assembled information (e.g. quality improvement data)
    • Disciplined research
  4. Paradigm
    a world view; a general perspective on the complexities of the real world, with certain assumptions about reality
  5. Positive paradigm
    • Reality exists
    • There is a real world driven by natural causes
    • Positive assumption
    • "the subjects"
    • quantitative data
  6. positivisst assumption
    the inquirer is independent from those being studied
  7. Naturalistic paradigm
    • Reality is multiple and subjective
    • Constructed by individuals
    • Naturalist assumption
    • "The participants"
    • qualitative data
  8. naturalist assumption
    the inquirer interacts with those being studied; findings reflect this interaction
  9. Research methods
    the tecniques used to structure a study and to gather, analyze, and interpret information
  10. Nursing research provides
    • description
    • explanation
    • prediction
    • control
  11. Description
    • Identifying and understanding the nature of nursing phenomena (pain, breathing, ect) and the relationships among the phemonema to:
    • Describe what exists
    • Discover new info
    • Promote understanding of situations
    • Classify info for use int he discipline
  12. Explanation
  13. Clarifying the relationships among phenomena and
    identifying the reasons why certain events occur
  14. Prediction
    estimating and anticipating the outcomes in a particular situation
  15. control
    manipulating a situation in order to achieve a particular outcome
  16. BSN is a
    consumer of research
  17. Validity
  18. population
    group we are interested in studying
  19. reliability
    a type of consistence
  20. Knowledge building
    • We do not put our weight in just one study
    • One study application can create problems
    • If multiple studies, taken place in various
    • settings, are conducted and find similar results, it is more reliable
    • Individual studies – Research Summary – E-B
    • Guideline – Agency Protocol
  21. Ways of acquiring knowledge in nursing
    • traditions
    • authority 
    • borrowing
    • trail and error
    • personal experience
    • role modeling
    • intuition
    • reasoning
  22. Traditions
    • based on customs and trends 
    • can also narrow and limit knowledge

    Example: cardiovascular pts being required to take basin baths because thats the way it has always been done
  23. Authority
    • people with expertise and power influence opininons and behavior 
    • knowledge is obtained from the authority
  24. Borrowing
    • using knowledge from other disciplines to guide nursing practice:
    • medicine, sociology, psychology, physiology, education

    Example: using technology in nursing practice
  25. Trial and error
    • Trying to see what will work without certainty 
    • knowledge is gained from experience
    • Very time consuming
    • Contains many failures
  26. Personal experience
    Being personally involved in an event and learning from it
  27. Role modeling
    imitating the behavior of an expert

    also called mentorship when the role model is a sponsor or guide
  28. Intuition
    using an insight or understanding without logical basis
  29. Reasoning
    organizing ideas to reach conclusions
  30. Premise
    a statment of the proposed relationship between two or more concepts
  31. Inductive reasoning
    moves from specific to the general 

    a headache is an altered level of health that is stressful. A terminal illness is stressful. So, all altered levels of health are stressful

  32. Deductive reasoning
    general to specific

    Humans experience loss. Adolescents are humans. Therefore, all adolescents experience loss


    Arguements are given to reach a conclusion
  33. Phenomena
    • • The client as a person
    • • The client’s environment
    • • Nursing practice
    • • The nurse-patient relationship and communication
    • • The healthcare system

    Different purposes require different methods
  34. The most important piece of a research study from the planning perspective is your
    research question
  35. How you word your questions leads....
    how you word your purpose which affects how you word your methods
  36. Purposes of Individual studies
    • • Understand a health, illness, or healthcare experience
    • • Develop a theory
    • • Describe a health-related happening
    • • Measure the strength of relationships between several health-related events or states
    • • Test a hypothesis about the effectiveness of an intervention
  37. Qualitative research methods
    • phenomenologic research 
    • ground theory research 
    • ethnographic research 
    • historical research
  38. qualitative research characteristics
    • • Philosophical origin: naturalistic, interpretive, humanistic
    • • Focus: broad, subjective, holistic
    • • Reasoning; dialectic, inductive
    • • Basis of knowing: meaning, discovery, understanding
    • • Theoretical focus: theory development
  39. quantitative research methods
    • • Descriptive research
    • • Correlational research
    • • Quasi-experimental research
    • • Experimental research
  40. quantitative research characteristics
    • • Philosophical origin: logical positivism
    • • Focus: concise, objective, reductionistic
    • • Reasoning: logistic, deductive
    • • Basis of knowing: cause-and-effect relationships
    • • Theoretical focus: tests theory
  41. _____________ _____________ find true evidence of support
    research findings
  42. Focus of outcomes of research
    • pt and families
    • providers 
    • health care systems
  43. Systematic review (integrated research Reveiw)
    A systematic and comprehensive identification, analysis, summarization of all research related to a specific topic or practice problem
  44. Why is research important for evidence-based practice?
    develops empirical knowledge base
  45. Evidence-based clinical practice guidelines
    • • Conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of high-quality, cost-effective health care
    • • Synthesis of knowledge for development of guidelines, standards, protocols or polies to direct nursing interventions and practice
  46. Using science as the basis for clinical protocols...
    • Gets beyond:
    • Personal opinion
    • Power plays
    • Tradtion/routine
    • Nursing staff convenience

    • Using the nursing science that exists
    • Produces the best pt outcomes
  47. Protocol
    a set of specific care actions for a pt population that has been endorsed by the hospital, agency, primary care clinic, or healthcare facility
  48. Developing an E-B protocol
    • • identify a clinical question/issue/goal
    • • Locate and summarize the science
    • • Translate the science into a clinical protocol that works for the agency
  49. TYpes of research evidence
    • • Existing e-b guideline (shortcut; best for practice)
    • • Science summary (medium path)
    • • Individual studies (long trek; best for learning)
  50. the article format is a
    road map displaying why the study was done, how it was done, and what was found
  51. Approach to reading a research article:
    • credibility- was it conducted well
    • Relevancy- usable for my pt population
  52. Reading a report of an individual study
    starting point: Is this a report of an original research study?
  53. Essential Elements of a Research study
    • • A specific research question, hypothesis, or purpose
    • • Systematic methods of data collection and analysis
    • • Results
    • • Findings
  54. Format of a study report
    • • Title
    • • Abstract- less than 300 words
    • • Intro- Research question, purpose, and hypotheses
    • • Methods
    • • Results
    • • Discussion/Conclusion
    • • References
  55. Research question
    • A concise, interrogative statement written in the present tense and including one or more variables/concepts
  56. Research questions focus on
    • describing variables
    • specifying the pop being studied
    • examining testabel relationships among variables
  57. Research questions should:
    • o Define specific question area
    • o Reflect a review of the literature
    • o Identify the potential significance to nursing
    • o Reflect the feasibility of studying the research question
  58. A variable is
    an atribute or property in which organisms vary (people, events, objects)
  59. Independent variable (IV)
    the variable that has the presumed effect on the dependent variable (DV)

    It is maniuplated or not manipulated
  60. Dependent variable (DV)
    the presumed effect that varies with a change in the independent variables (IV)

    o Not manipulated
  61. The Clinical Question: “PICO” Model
    • • Patient/Population/ Problem (among ________)
    • • Intervention/ Exposure (does _________)
    • • Comparison (versus _______)
    • • Outcome (affect _____________)
    • • P- Infants at increased risk for ICI
    • • I- how well clinical features predict
    • • C- not using clinical features
    • • O- predicting ICI
  62. Study purpose
    • • Aim or goal the researcher hopes to achieve
    • • Suggests the type of design to be used
    • • Implies the level of evidence to be obtained (discover, explore, or describe vs. compare, test the effectiveness of…)
    • • Purpose statement examples: 
    • o The purpose of this study was to examine outcomes of the existing brief psychiatric treatment program
    • o The aim of this study was to describe the scientific basis…
  63. Hypothesis
    formal statement of the expected relationships between two or more variables in a specified population that suggests an answer to the research question 

    Statement that predicts the outcomes of a study 

    Directional or non-directional
  64. Theory then _______ then _______ then _________
    • Theory
    • Hypothesis
    • Observation
    • Confirmation
  65. Theory guides?
  66. Difference between Theoretical propositions and research hypotheses
    Theoretical propositions

    broader, higher level of abstraction 

    lay workers --- health promotion opportunity ----adoption of healthy behavior

    Research hypotheses

    more specific than theoretical propositions

    trained volunteers at lunch ---- opportunity to task health living questions--- performance of healthy behaviors
  67. Empirical
    how your going to measure it
  68. Conceptual definitions
  69. Elements of ethical research
    • • 1. Protecting human rights
    • • 2. Understanding informed consent
    • • 3. Understanding institutional review of research
    • • 4. Balancing benefits and risks in a study
  70. Ethical dilemma in conducting research
    a situation in which the rights of study participants are in direct conflict with requirments for a rigorous study
  71. Ethical vs. unethical research
    ethical studies protect subjects are carried out using scientific principles
  72. Unethical research includes:
    • o Scientific misconduct
    • o Fraud, research protocol violations
    • o Fabrication, falsification, forging of data
    • o Plagiarism
    • o Putting subjects at risk without consent
  73. Ethical Principles from the Belmont Report
    • • 1. Principle of Beneficence: Above all, do no harm
    • o Right to protection from harm and discomfort
    • • Beneficence- Maximize good
    • • Non maleficence- minimize harm
    • o Right to protection from exploitation

    • • 2. Principle of Respect for Human Dignity o Right to self-determination (absence of coercion)
    • o Right to full disclosure (absence of deception or concealment)

    • 3. Principle of Justice o Right to fair treatment o Right to privacy (confidentiality, anonymity)
  74. Procedures for protecting study particpants
    • • Risk benefit assessments
    • • Informed consent
    • • Confidentiality procedures
    • • Debriefings and referrals
    • • Treatment of vulnerable groups
    • • Institutional Review Boards and external reviews
  75. Informed consent means that paricipants
    • have adequate info about the research
    • can comprehend that info
    • have free choice in deciding whether to participate in or withdraw from the the study
  76. Typical documentation for informed concent
    • a consent form
    • implied consent (e.g. self-administered questionairs)
    • process consent (qualitative studies)
  77. Vulnerable groups
    • • Children
    • • Mentally or emotionally disabled
    • • Severely ill or physically disabled
    • • Terminally ill
    • • Institutionalized people
    • • Pregnant women
  78. Sampling
    selecting a group of poeple events behaviors, or other elements with which to conduct a study
  79. Members of the sample can be called
    the subjects or particpants
  80. Target population
    the entire set of individuals (or elements) who (that) meet sampling criteria
  81. Accessible population:
    the portion of target population to which the researcher has reasonable access
  82. Element
    an individual unit of a population
  83. Inclusion criteria
    people that can be in the study
  84. Exlusion criteria
    people that cannot be in the study
  85. Generalization
    • Extending the findings from the sample under
    • study to the larger population

    • The extent is influenced by the quality of the
    • study and consistency of the study’s findings
  86. Representativeness
    the sample, the accessible population, and the target population area are alice in as many ways as possible
  87. In representativeness, we need to evaluate
    • setting
    • characteristics of subjects ( age, gender, ethnicity, income, education)
    • distribution of values on variables measured in the study
  88. Sampling error
    difference between the population mean and the mean of the sample

    happens by random chancer, or if we bias the study in any way
  89. Refusal rate
    percentage of subjects that declined to participate in the study
  90. sample mortality
    withdrawal or loss of subjects from a study 

    this rate should be reported in published study
  91. Random sampling
    increases the representativeness of the sample based on the target poulation
  92. control group
    used in studies with random sampling
  93. comparison group
    not randomly determined

    used in random sampling
  94. Sampling frame
    a listing of every member of the population, suing the sampling criteria to define membership in the population
  95. Sampling plan
    outlines strategies used to obtain a sample for a study 

    • Probability sampling plans
    • Nonprobability sampling plans