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What is the definition of Evidence?
Available body of facts or information indicating weather a proposition is true or valid
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What could evidence be?
- experience
- ppl
- books/journals
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What is evidence used for?
making informed decisions about effectiveness of healthcare interventions/treatments
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What are the 3 most important words in medicine?
I dont know
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What is the definition of EBP?
- integration of the best research evidence with clinical expertise and patient values.
- Meant to improve pt care
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What are the different types of EBP studies?
- Cohort- longitudinal study involving two groups, one with treatment/1 without
- RCT-treatment vs. non
- Qualitative Studies- subjective, from the pt's perspective
- Systematic Reviews- summary of evidence for specific Qs, based on various studies
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Name the 5S Hierarchy of Evidence from bottom to top
- Studies
- Syntheses
- Synopses
- Summaries
- Systems
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What is the direction of the pyramid for the 5S hierarchy of evidence?
The higher up, the less risk of bias and the more it applies to more peopel
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What is the best study for cause-and-effect?
RCT
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What is a systematic review of RCT?
provides review of multiple RCT, give a more accurate and less biased view on the intervention
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What must you look for in studies?
methods of assembly of guidelines and assure that they are sound and trustworthy
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What is the knowledge action cycle?
- ID a problem
- Adapt knowledge to a local context
- Assess barriers to knowledge use
- Select,Tailor and implement interventions
- Monitor
- Evaluate outcomes
- Sustain knowledge use
- (Repeat if necessary)
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What is the EBP process?
- Ask a Question
- Research the answer
- Critically appraise data
- Implement intervention
- Evaluate effectiveness
- (Repeat as necessary)
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What is the definition of research?
"the systematic investigation into and the study of materials and sources in order to establish facts and reach new conclusions"
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What does Nursing Research develop knowledge for?
- Build Scientific Foundation for practice
- Prevent disease and disability
- Manage and Eliminate symptoms of illness
- Enhance palliative care
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What are the two types of research?
- Quantitative (Objective)
- Qualitative (Subjective)
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What is Quantitative Research?
Using numerical data
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What is Qualitative Research based on?
Based on observation
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What are the 2 types of Quantitative Research Designs?
- Experimental-introduce intervention/Treatment
- Non-Experimental- Observational Research
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What types of studies are considered Experimental?
- RCT or Quasi-experimental (non-randomized)
- studies that induce a cycle of cause-and-effect
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What types of studies are considered non-experimental
- cohort, case control, surveys
- studies that collect data
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What are 3 types of Qualitative Research?
- Grounded Theory- no theory to start
- Phenomological Theory- Observing a phenomena
- Ethnographic Research- researching patterns in cultures/ethnicities
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What is grounded theory?
- "starting from the ground up"
- Starting without a theory
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What is a Phenomonological Theory?
Research a life experience through the people that have experienced it
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What is ethnographical theory
studying patterns and lifestyles of different ethnicities and cultures
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What is a conceptual definition?
an abstract theory to be studied
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What is an Operation Definition?
The "operations" needed to measure and collect information on a concept
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What is a Causal Relationship?
Does X cause Y, Cause-and-Effect
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what is an example of a causal definition?
perception of pain
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What is an example of an operation definition?
using a pain scale from 1-10 to measure pain
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What is an associative relationship?
Is there an association between X and Y?
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What are the two types of relationships between X and Y?
Causal and associative
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What are the 3 criteria for causality?
- 1. There must be a shown correlation between X and Y
- 2. X must cause Y before time does
- 3. There is not confounding (3rd party) factor that could have caused Y
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What is an independent variable?
What is being manipulated (x)
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What is a dependent Variable?
What is being measured (y)
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What is biological plausability?
That the causal relationship should agree with evidence from physiological studies (must be consistent with biological findings)
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What is a continuous variable?
- A measurement
- ex. Weight, Height
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What is a categorical variable?
- A category
- ex. Gender, Marital Status
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What is a hypothesis?
A statement on the relationship between X and Y
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What are 2 types of hypotheses?
- Directional: X will cause Y to get better/worse
- Non-Directional: X will cause something to happen to Y
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What is a directional hypothesis?
X will cause Y to get better/worse
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What is a non-directional hypothesis?
X will cause something to change in Y
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What is a research hypothesis?
States the prediction of a relationship
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What is a null hypothesis
There is NO relationship between X and Y
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What is important to remember about hypotheses?
They are either supported or not, never proved or unproved
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What are the 4 levels of measurement?
- Nominal
- Ordinal
- Interval
- Ratio
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What is nominal measurement?
- numbers assigned to categories
- ex. 1=male, 2=female
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What are ordinal measurements?
- Rankings, but not equidistant
- ex. Letter grades: A, B, C, D
- 1st place, 2nd place, 3rd place
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What are interval measurments?
- rankings, equidistant, NO absolute 0
- ex. temperature
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What are Ratio measurements?
- Ranking, equidistant, absolute 0
- ex. distance
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What is the equation for errors of measurement?
obtained score = true score +/- error
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What is an obtained score?
actual data collected from a study
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What is a true score?
data obtained from a study that is infalliable
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What is a measurement error?
- error measurement caused by factors that distort data
- ex. biases, contaminantes
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What is reliability?
that a measurement is consistent
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what is validity?
- That an instrument measures what it says it measures.
- ex. a thermometer measures the right temp
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What is stable and consistent measurements (reliability)
2 people taking the same measurement
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What is stability/equivalence (reliability)
same person gets same measurement at 2 different times
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What is internal consistency (reliability)?
- the instruments are measuring the same attribute
- ex. 2 BP cuffs are measuring the same BP for one pt
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What is internal validity?
the extent that we know x causes y
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What is external validity?
extent that the study can be generalized to a larger peopulation
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What are the 4 aspects of validity?
- Face
- Construct
- Criterion-Related
- Content
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What is Face validity?
The instrument is measuring what it is supposed to
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What is content validity?
Are there enough measurements (content) to compare the validity?
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What is criterion-related Validity?
Do the measurements accurately predict the outcome?
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What is construct validity?
- Does the study/instrument measure the right thing?
- is the pain scale actually measuring pain?
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What is a Construct Convergent Validity?
Do different tests measuring the same thing agree?
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What is construct discriminant validity?
Do different tests measuring the same thing differ?
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What are threats to validity?
- Selection threats-biases
- History Threat- other events causing Y
- Maturation Threat-Time causing Y
- Mortality/Attrition Rate- loss of participants
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What is homogenity validity?
little variation between measurements
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What is heterogeneity variability?
The measurements vary greatly
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What does PICOT stand for?
- population (who are you studying)
- intervention (what are you doing)
- comparison (what can you compare it to)
- outcome (what is the outcome)
- time (in what time frame)
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Interrater- reliability
2 people, 1 measurement
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Intrarater-reliability
1 people, 1 measurement
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