Nursing Research 4325 ALL chapters

to search again and to examine carefully as in a diligent and systematic inquiry or study that validates and refines existing knowledge and develops a new empirical body of knowledge for a discipline or profession.

Nursing research
is a scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences nursing.

Goal of nursing
an evidence based practice that promotes quality, safe, and cost effective outcomes for patients, families, healthcare providers, and the healthcare system.

Evidence-based practice
evolves from the integration of the best research evidence with clinical expertise and patients’ needs and values.

best research evidence
empirical knowledge generated fro the synthesis of quality study findings to address a practice problem.

clinical expertise
knowledge and skills of the healthcare professional who is providing care

Components of research evidence
description, explanation, prediction, and control of phenomena

involves identifying and understanding the nature of nursing phenomena such as incidence and spread, cluster of symptoms, description of individual responses, description of health promotion and illness prevention, and determination of incidence of disease locally.

clarifies the relationships among phenomena and identifies possible reasons why certain events occur such as determination of assessment data, link to diagnosis, link of causative risk factors or causes to illness, morbidity and mortality.

estimating the probability of a specific outcome in a given situation such as the risk for a disease or injury in different populations, estimating behaviors that promote health or prevent illness and prediction of health care required bases on patient needs and values.

the ability to write a prescription to produce the desired results also known as the ability to manipulate the situation to produce the desired outcome.

History of research
began with Florence Nightingale in the Crimean war and resulted in society beginning to accept responsibility for testing public water, improving sanitation, preventing starvation, and decreasing morbidity and mortality rates.

Case Study
involves in-depth analysis and systematic description of one patient or group of similar to promote understanding of healthcare interventions.

Quality and Safety Education for Nurses
QSEN focused on developing the requisite knowledge, skills, and attitude statements for each of the competencies for pre-licensure and graduate education

essential information, acquired in a variety of ways, that is expected to be an accurate reflection of reality and is incorporated and used to direct a person’s actions.

Ways of acquiring knowledge
traditions – beliefs based on customs and trends
authority – from persons with expertise and power to influence
borrowing – appropriating and using knowledge from other fields or practices
trail and error- with this strategy knowledge is gained by experience in uncertainty and not usually shared
personal experience – enables the nurse to cluster ideas into a meaningful whole
role modeling – by imitating the behaviors of an expert.
intuition – insight into a situation that cannot be explained logically
reasoning- processing and organizing ideas to reach conclusions.
Inductive reasoning – from the specific to the general
deductive reasoning – from the general to the specific

Three research methods
quantitative, qualitative, and outcome research method

Quantitative Research
is a formal, objective, systematic process in which numerical data are used to obtain information about the world while holding the position that “truth” is absolute and that a single reality can be defined by careful measurement.

Qualitative Research
is a systematic, subjective approach used to describe life experiences and situations and give them meaning. This research method evolved from the behavioral and social sciences as a method of understanding the unique, dynamic and holistic nature of humans.

Descriptive research
explores new areas of research and describes situations as they exist in the world- it is quantitative

Correlational research
examines relationships and is conducted to develop and refine explanatory knowledge for nursing practice – it is quantitative.

Quasi-experimental and experimental
studies that determine the effectiveness of nursing interventions in predicting and controlling the outcomes desired for patients and families – it is quantitative.

Phenomenological research
is an inductive descriptive approach used to describe an experience as it is lived by an individual. it is qualitative

Grounded theory research
is an inductive technique used to formulate, test, and refine a theory about a particular phenomena it is qualitative

Exploratory- descriptive research
conducted to address an issue or prblem in need of a solution or understanding with the intent of descirbing the topic of interest and promoting understanding.

Historical research
a narrative description or analysis of events that occured in a remote or recent past

Ethnographic research
developed by the anthropologist and requires an in-depth study of members of a culture.

Outcomes research
focuses on examining the results of care and determining the changes in health status for the patient.

Evidence based guidelines
rigorous, explicit clinical guidelines that have been developed based on the best research evidence available.

Strategies used to synthesize research evidence
systematic review, meta analysis, meta-synthesis, mixed methods systematic review

What does “research” mean?
to search again or examine carefully

What is the definition of “nursing research”?
a scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences nursing practice.

How is knowledge acquired in nursing?
tradition, authority, borrowing from other disciplines, trial and error, personal experience, role modeling, intuition, reasoning, and nursing research.

What is quantitative research?
a formal, objective, systematic process in which numerical data are used to obtain information about the world.

What is qualitative research?
a systematic, subjective approach to research that is used to describe life experiences and situations and give them meaning.

What are the major categories of qualitative research?
phenomenological, grounded theory, ethnographic, exploratory-descriptive, and historical research

What are the four major categories of quantitative research?
descriptive, correlational, quasi-experimental, experimental

What is a systematic review?
a structured, comprehensive synthesis of the research literature to determine the best research evidence available to address a healthcare question.

Which two types of articles review and synthesize qualitative research studies?
Meta-synthesis and mixed-methods systematic review.

What are evidence-based guidelines?
rigorous, explicit clinical guidelines developed based on the best research evidence available in that area. They are created for health care professionals to use for making decisions in clinical practice.

What is the role of the BSN in research functions?
To locate and critically appraise studies, evidence based guidelines, protocols, and policies with assistance. Use best research evidence in practice with guidance. Assist with problem identification and data collection.

What is the role of the MSN in research functions?
Critically appraise studies to develop and revise protocols, algorithms, and policies for practice. Implement best research evidence in practice. Collaborate in research projects and provide clinical expertise for research.

What is the role of the DNP in research functions?
Participate in the development of national evidence-based guidelines. Develop, implement, critically appraise, and revise as needed protocols, policies, and evidence-based guidelines used in clinical agencies. Conduct clinical studies, usually in collaboration with other nurse researchers.

What is the role of the PhD in research functions?
Major role in conducting independent research and contributing to the empirical knowledge generated in a selected area of study. Obtain initial funding for research. Coordinate research teams of BSN, MSN, and DNP nurses.

What is a critical appraisal of research?
a careful examination of all aspects of a study to judge its strengths, limitations, meaning, and significance.

What is evidence-based practice?
Evidence-based practice evolves from the integration of the best research evidence with clinical expertise and patients’ needs and values.

What is descriptive research?
the exploration and description of phenomena in real-life situations. It provides an accurate account of characteristics of particular individuals, situations, or groups. Remember, this type of study does not show cause and effect.

What is correlational research?
the systematic investigation of relationships between or among variables. Using correlational analysis, the researcher is able to determine the degree or strength and type (positive or negative) of relationship between two variables. Remember, this type of study does not show cause and effect.

What is quasi-experimental research?
it examines causal relationships or determines the effect of one variable on another. These studies involve implementing a treatment and examining the effect of the treatment using selected methods of measurement.

What is experimental research?
an objective, systematic, highly controlled investigation for the purpose of predicting and controlling phenomena in nursing practice. Causality between the independent and dependent variables is examined under highly controlled conditions.

What are the three main characteristics of experimental research?
controlled manipulation of at least one treatment variable (the independent variable), exposure of some of the subjects to the treatment (experimental group) and no exposure of the remaining subjects (control group), and random assignment of subjects to either the control or the experimental group.

What is basic or “pure” research?
scientific investigation that involves the pursuit of knowledge for knowledge’s sake, or for the pleasure of learning and finding truth

What is applied or “practical” research?
scientific investigation conducted to generate knowledge that will directly influence or improve clinical practice. The purpose of this type of research is to solve problems, make decisions, or predict or control outcomes in real life practice situations. These findings can also be useful to policy makers as a basis for making changes to address health and social problems.

What is rigor in quantitative research?
Rigor is striving for excellence in research, and it requires discipline, adherence to detail, and strict accuracy. A rigorously conducted quantitative study has precise measuring tools, a representative sample, and a tightly controlled study design.

What is precision in quantitative research?
Precision encompasses accuracy, detail, and order. It is evident in the concise statement of the research purpose and detailed development of the study design. The most explicit example of precision is the measurement or quantification of the study’s variables.

What is control in quantitative research?
Control involves the imposing of rules by the researcher to decrease the possibility of error, thereby increasing the probability that the study’s findings are an accurate reflection of reality.

What are extraneous variables?
they exist in all studies and can interfere with obtaining a clear understanding the relationships among study variables. Controlling extraneous variables enables a researcher to more accurately determine the effect of an independent or treatment variable on a dependent variable or outcome variable.

What is sampling?
A process of selecting subjects who are representative of the population being studied. This process may be random or non-random.

What is the research setting?
The location in which the study is conducted.

What are the three common settings for conducting research?
natural / field setting, partially controlled, and highly controlled.

What is a research problem?
an area of concern in which there is a gap in the knowledge base needed for nursing practice.

What is a research purpose?
a statement that is generated from the research problem and identifies the specific goal of the study. The purpose statement often includes the variables, population, and the setting for the study.

What is the purpose of a literature review for a research study?
to generate a picture of what is known and not known about a particular problem and to document why a study needs to be conducted. Often a ROL concludes with a summary paragraph that indicates the current knowledge of a problem area and identifies the additional research that is needed (the research problem).

What is a study framework?
A study framework is the abstract, theoretical basis for a study that enables the researcher to link the findings to nursing’s body of knowledge.

What are study variables?
Variables are concepts at various levels of abstraction that are measured, manipulated, or controlled in a study.

What is a conceptual definition of a study variable?
It provides a variable with a theoretical meaning. It can typically be found in the review of literature or in a concept analysis. It can be described as a definition or in a series of words.

What is an operational definition of a study variable?
It provides a variable with a definition that can be measured or manipulated. The measurement, instrument, or tool that is being used to measure the variable is usually the variable’s operational definition.

What are assumptions?
statements that are taken for granted or are considered to be true even though they have not been scientifically tested.

What are limitations?
restrictions in a study that may decrease the credibility and generalizability of the findings.

What is generalization?
the extension of the implications of the research findings from the sample studied to the larger population.

What is a research or study design?
the blueprint for the conduct of a study that maximizes control over factors that could interfere with the study’s desired outcome. The type of design directs the selection of a population, procedures for sampling, methods of measurement, and plans for data collection and analysis. The choice of a research design depends on what is known and not known about the research problem, the researcher’s expertise, the purpose of the study, and the intent to generalize the findings.

What is a pilot study?
a smaller version of a proposed study and researchers frequently conduct these to refine the methodology / strengthen future study design.

What is the population?
All elements (individuals, objects, or substances) that meet certain criteria for inclusion in a study.

What is a sample?
A subset of the population that was chosen for a particular study. Members of a sample are known as subjects (quantitative methods) or participants (qualitative methods).

What is measurement?
the process of assigning numbers to objects, events, or situations in accord with some rule.

What is data collection?
the precise, systematic gathering of information relevant to the research purpose or the specific objectives, questions, or hypotheses of a study. To collect data, a researcher must gain permission from the setting where the research is conducted and consent from the all of the subjects / participants. Data may be collected using the following research instruments: observation, interviews, questionnaires, physiological measurements, etc.

What is data analysis?
it reduces, organizes, and gives meaning to the data that has been collected in the study. Analysis techniques include descriptive and inferential analyses and are chosen based on the research objectives, questions, or hypotheses and the types of research instruments used.

In what section of a research article or report would you find a discussion of the major findings, limitations, of the study, conclusions drawn from findings, etc?
the discussion section

In what section of a research article or report would you find the statistical tests used to analyze the study data and the significance of those outcomes?
the results section

In what section of a research article or report would you find a description of the nature and scope of the problem being investigated and a case for the conduct of the study?
the introduction section

In what section of a research article or report would you find a description of how the study was conducted. It should also include the study design, treatment (if any), sample, setting, measurement methods, and data collection process?
the methods section

Qualitative research is a….
systematic approach used to describe experiences and situations from the perspective of the person in the situation. Qualitative research can generate rich descriptions of the experiences of patients and families that can increase nurses’ understanding of the best ways to intervene and be supportive.

What are phenomena?
Phenomena are the experiences that comprise the lives of humans. An experience is considered unique to the individual, time, and context, which is why qualitative researchers describe phenomena from the perspective of the persons who are experiencing it.

What are the major types of qualitative research?
phenomenological research, grounded theory research, ethnographic research, exploratory-descriptive, and historical research

What are four common methods for collecting data in qualitative research?
interviewing participants, conducting focus groups, observing participants, and examining written text.

What are common terms when interviewing is used as a data-collection technique?
interviews may be semi-structured to unstructured
probes are queries made by the researcher to gain more info
interviews may be transcribed to look for themes in what was said.

Facts about focus groups include:
They are designed to obtain participants’ perceptions of a specific topic in a setting that is permissive and non-threatening.
They are conducted by a moderator or facilitator.
Group dynamics can help people to express and clarify their views in ways that are less likely to occur in one-on-one interviews.

Observation is used to….
gather firsthand information in a naturally occurring situation by observing carefully and listening. The observer may take “field notes”.

Data management in qualitative research may include:
transcribing interviews and data immersion

Data analysis in qualitative research may include:
dwelling with the data
coding the data and identifying patterns or themes.
The researcher may need to engage in reflexive thought and
interpreting the data / identifying usefulness for clinical practice or further research.

Qualitative researchers seek to provide a holistic picture of phenomena guided by what four beliefs?
1. There are multiple, constructed realities because meaning is subjective (created by individuals) and inter-subjective (created by groups).
2.Knowledge is co-constructed by the persons involved in an interaction.
3. Human behavior are choices influenced by the past and present as well as by the physical, psychological, and social contexts of the behavior or experience.
4. Time and context influence individual and group perspectives.

What is bracketing?
The researcher must “bracket” or set aside their own biases and preconceptions to describe a phenomena in a naive way.

What is the outcome of phenomenological research?
To provide a thorough description of a lived experience.

What is the outcome of grounded theory research?
Fully developed grounded theory studies result in theoretical frameworks with relational statements between concepts.

What is the outcome of ethnographic research?
A written report based on the analysis of the culture.

What is an emic approach to studying cultures?
An approach that values studying behaviors from within the culture that recognizes the uniqueness of the individual.

What is an etic approach to studying cultures?
An approach that values studying behavior from outside of the culture and examining similarities and differences across cultures.

What does “going native” mean in ethnographic research?
This occurs when a researcher becomes part of the culture and loses the ability to observe clearly.

What is the outcome of exploratory-descriptive research?
This type of study is conducted with a specific research question in mind and its design does not clearly fall into one of the other qualitative research categories. The outcome of a well-designed exploratory-descriptive qualitative study is to answer the research question.

What is the outcome of historical research?
Historical researchers provide a description of events and / or a chronology of factors that affected the topic of interest. There is a greater focus on the story being told.

Name four experiments that were highly publicized for their unethical treatment of human subjects:
1. The Nazi medical experiments
2. the Tuskegee Syphilis study
3. the Willowbrook Study
4. the Jewish Chronic Disease Hospital Study

In all of these studies, while physicians were the primary investigators…nurses understood the nature of the research, identified potential research subjects, delivered treatment to the subjects, and served as data collectors.

What is the difference between therapeutic research and non-therapeutic research?
therapeutic research provides patients with an opportunity to receive an experimental treatment that might have beneficial results. Non-therapeutic research is conducted to generate knowledge for a discipline; the results of the study might benefit future patients but probably will not benefit those acting as research subjects.

What major ethical principles were created in the Declaration of Helsinki?
The investigator should….
1. protect life, health, privacy, and the dignity of human subjects
2. exercise greater care to protect subjects from harm in non-therapeutic research
3. conduct research only when the objective outweighs the risks and burdens to the subjects

What is the principle of respect for persons?
people should be treated as autonomous agents with the right to self-determination and the freedom to participate or not participate in research

What is the principle of beneficence?
encourages people to do good and “above all, do no harm.”

What is the principle of justice?
it stresses that human subjects should be treated fairly in terms of the benefits and the risks of research.

How does HIPAA affect research conducted in a healthcare environment?
A person must provide his / her signed permission or authorization before that person’s PHI can be used or disclosed for research (ie. informed consent). Ask yourself: were the subjects voluntary participants and were they able to comprehend the consent form / study?
Researchers must develop research projects to comply with the HIPAA privacy rule.

What are the human rights that require protection in research?
anonymity and confidentiality
fair treatment
protection from discomfort and harm

What is coercion?
This occurs when one person intentionally presents an overt threat of harm or an excessive reward to another to gain compliance. This violates one’s right to self-determination.

What is covert data collection?
This occurs when subjects are unaware that research data are being collected. This violates one’s right to self-determination.

What is the use of deception?
The actual misinforming of subjects for research purposes. This violates one’s right to self-determination.

Who are persons with diminished autonomy?
Persons who are vulnerable or less advantaged because of legal or mental incompetence, terminal illness, or confinement to an institution. Legal and / or mental limitations may include: neonates and children, pregnant women and fetuses, mentally impaired persons, unconscious patients, the terminally ill, and persons confined to institutions.

What is a right to privacy?
the freedom that people have to determine the time, extent, and general circumstances under which their private information will be shared or withheld from others. An invasion of privacy occurs when private information is shared without a person’s knowledge or against his / her will.

What is the right to anonymity and confidentiality?
Anonymity exists when the subject’s identity can not be linked, even by the researcher, with his / her individual responses.
Confidentiality is the researcher’s management of private information shared by the subject or participant.

What is fair selection and treatment of subjects?
The right to fair selection and treatment of subjects is based on the principle of justice. People must be selected fairly and not based on social, cultural, racial or sexual biases. In addition, you cannot select certain subjects because you like them and want them to receive the benefits of the study. If you promise a benefit of a study (ie. compensation for participation) all subjects must receive it.

In research, discomfort and harm can be…
physical, emotional, social, or economic or any combination of these four.

What is the range of discomfort and harm in a research study?
no anticipated effects, temporary discomfort, unusual levels of temporary discomfort, risk of permanent damage, and certainty of permanent damage.

What are the four key elements of informed consent?
1. disclosure of essential study information to study participants
2. comprehension of this information by the participant
3. competence (comprehension) of the participant to give consent
4. voluntary consent of the participant

What is a consent form in a research study?
A written form that includes the elements of informed consent required by the DHHS and FDA regulations, and any additional requirements from the institution where the study is being conducted or the agency who is funding the study.

What is an institutional review?
In an institutional review, a study is examined for ethical concerns by a committee knowledgeable about research and clinical practice.

When are studies exempt from IRB review?
When they pose no apparent risks for the research subjects.

When do studies qualify for an expedited IRB review?
When the study poses minimal risk…or that the probability of and magnitude of harm or discomfort anticipated in the research are not greater in and of themselves than those ordinarily encountered in daily life or during the performance of routine physical or psychological examinations or tests.

What is research misconduct?
the fabrication, falsification, or plagiarism in processing, performing, or reviewing research, or in reporting research results. It does not include honest error or differences in opinion.

What is fabrication?
the making up of results and recording or reporting them.

What is falsification?
manipulating research materials equipment, or processes or changing or omitting data or results such that the research is not accurately represented in the research record.

What is plagiarism?
the appropriation of another person’s ideas, processes, results, or words without giving appropriate credit, including those obtained through confidential review of others’ research proposals and manuscripts.

A research problem…
is an area of concern in which there is a gap in the knowledge base needed for nursing practice. In a study, the research problem:
1. indicates the significance of the problem
2. provides a background for the problem
3. includes a problem statement

A research purpose…
is a clear, concise statement of the specific goal or focus of the study. It will include the population, the variables, and often the setting of the study. A clearly stated research purpose can capture the essence of a study in a single statement and is essential for directing the remaining steps of the research process.

If little is known about a subject, what type of quantitative study will the researcher start with?
They will start with a descriptive or correlational study and progress to quasi-experimental or experimental studies as knowledge expands in the area.

What is the purpose of a descriptive study?
To identify and describe concepts or variables
To identify possible relationships among variables
To delineate differences between or among existing groups

What is the purpose of a correlational study?
to examine the type of relationship (positive or negative) and the strength of relationship (weak or strong) among variables.

What is the purpose of a quasi-experimental study?
to determine the effect of a treatment or independent variable on a designated dependent or outcome variable.

What is the purpose of an experimental study?
these are conducted in highly controlled settings, using a highly structured design to determine the effect of one or more independent variables on one or more dependent variables.

How do you know a study’s problem and purpose has significance? Ask these four questions…
1. How will it influence nursing practice?
2. Does it build on previous nursing research?
3. How does it promote theory testing or development?
4. Does it address current concerns or priorities in nursing?

How do you know whether a study is feasible to conduct? Ask yourself the following questions…
1. is the problem / purpose within the researcher’s area of expertise?
2. How will the costs of the study be paid for?
3. How will you find your sample, facility, or equipment that you need for the study?
4. Is the purpose of your study ethical and are your subject’s rights being protected?

Where do research objectives, questions, or hypotheses for a study come from?
They are based on the problem, purpose, literature review, and study framework.

What’s the main job of the research objectives, questions, or hypotheses for a study?
to direct the remaining steps of the study or research process!

In other words….how will we measure the variables, how will we select subjects / participants, what statistics will we use, etc…

What is a research objective (or aim) in a quantitative study?
A clear, concise, declarative statement that is expressed in the present tense. A research objective is more likely to be used in a descriptive or correlational study design. Research objectives may focus on one or two variables and:
1.) indicate whether they are to be identified or described
2.) identify relationships among variables
3.) determine differences among two or more groups with regard to the variables.

What is a research question in a quantitative study?
A clear, concise interrogative statement that is worded in the present tense, includes one or more variables, and is expressed to guide the implementation of a quantitative study. Research questions may:
1.) describe variables
2.) examine relationships among variables
3.) use independent variables to predict dependent variables
4.) determine differences among two or more groups with regard to the variables.

**it is really only a matter of choice whether a researcher identifies objectives/aims or questions for their descriptive or correlational study.**

What is a hypothesis?
A formal statement of the expected relationship(s) between two or more variables in a specified population.

A clearly stated hypotheses includes the variables to be manipulated or measured, identifies the population to be examined, and indicates the proposed outcomes for the study.

Hypotheses influence study design, sampling methods, data collection and analysis, and interpretation of findings.

What are variables?
variables are qualities, properties, or characteristics of persons, things, or situations that change or vary. They need to be concisely defined to promote their manipulation and measurement in quantitative research.

What is an independent variable?
a stimulus or activity that is manipulated or varied by the researcher to create an effect on the dependent variable. AKA: the treatment, the intervention, or the experimental variable

What is a dependent variable?
the outcome or response that the researcher wants to predict or explain. Changes in the dependent variable are presumed to be caused by the independent variable.

What types of quantitative research studies use independent and dependent variables?
Quasi-experimental and experimental research studies definitely have independent and dependent variables.

One specific type of correlational research study, a predictive correlational study, also uses independent and dependent variables. You don’t have to know this fact for this class…we keep IV’s and DVs at the quasi-experimental and experimental levels in our class to keep it simple, but it’s something I’d like you to be aware of.

What are research variables?
Research variables are the qualities, properties, or characteristics identified in the research purpose statement and in the research objectives or questions.

They are observed and / or measured in the study. There is no “treatment” with these kinds of variables and no cause-effect relationships are examined

What kinds of quantitative research studies use research variables?
descriptive and correlational studies

What are extraneous variables?
They exist in all studies and can interfere with obtaining a clear understanding of a relational or causal dynamics within these studies.

What are confounding variables?
The extraneous variables that are not recognized until a study is in progress, or are recognized before a study is initiated but cannot be controlled.

What are environmental variables?
a type of extraneous variable the composes the setting in which a study is conducted. Ex: climate, family, healthcare system, governmental organizations

What is a conceptual definition of a variable?
A conceptual definition provides a theoretical meaning for a variable. The variable may be defined within the review of literature or within a theoretical framework. It is similar to a dictionary definition.

Example: What is the conceptual definition of “blood pressure”?
Answer: The force exerted by the blood against the walls of the blood vessel.

What is an operational definition of a variable?
An operational definition is derived from a set of procedures or progressive acts that a researcher performs to receive sensory impressions that indicate the existence or degree of existence of a variable. An operational definition is developed so that a variable can be measured at different times in different settings using the same definitions.

Example: What is the operational definition of “blood pressure”
Answer: The result you get when you check the blood pressure of the first subject with a manual BP cuff. 120/70

What are research concepts in qualitative research?
the concepts, ideas, experiences, situations, or events that are investigated in qualitative research.

What are demographic variables?
Attributes of subjects that are collected to describe the sample. Ex. age, gender, marital status.

What is the purpose of the literature review in a published study?
1. to describe the current knowledge of the practice problem
2. to identify gaps in the knowledge base
3. to explain how the study being reported contributed to building knowledge in this area.

What is considered a current source for a literature review?
current sources are those published within the 5 years before the manuscript was accepted for publication

What is a citation or “citing” something?
the act of quoting a source, using it as an example, or presenting it as support for a position taken. A citation within a paper should have a full reference at the end of a paper.

What is theoretical literature?
concept analyses, models, frameworks, and theories all can be mentioned within a review of literature. If so, they are considered theoretical literature.

What is empirical or data-based literature?
research studies, such as those found in journals or books, and unpublished studies such as masters theses and doctoral dissertations.

What does “peer-reviewed” mean?
It means that scholars familiar with the topic of the research read the report and validated its accuracy and the appropriateness of the methodology used in the study. Thus, the study is considered to be trustworthy.

What is a primary source?
A primary source is written by the person who originated or is responsible for generating the ideas published…typically the persons who conducted the research or generated the theory.

Use primary sources in your papers and research as frequently as possible and summarize what they say yourself.

What is a secondary source?
A secondary source summarizes or quotes content from a primary source. Authors of secondary sources paraphrase work from researchers and theorists.

Consider this…in your papers and scholarly work, only quote a secondary source when you cannot locate and read a primary source for yourself, as you are trusting the author’s interpretation / perception / bias of what they have read. What if they are incorrect….?

What is a landmark study?
Studies that may have been conducted years ago, but that are considered significant research projects that generate knowledge that influences a discipline or sometimes society as a whole.

What is a replication study?
A reproduction or repetition of a study that researchers conducted to determine whether the findings of the original study could be found consistently in different settings and with different subjects. Replication studies are important to build evidence for practice.

What is a theory?
an integrated set of defined concepts and statements that present a view of a phenomenon.

Theories are abstract…not concrete.

What are concepts?
Concepts are the basic elements of a theory. They are terms that abstractly describe and name an object, idea, experience, or phenomenon, thus providing it with a separate identity or meaning.

Concepts are defined in a particular way to present ideas relevant to a theory.

-> if they have a broad, abstract meaning they may also be called a “construct”.”

-> if they have a more narrow, concrete, well defined meaning, they may be called a “variable”.

What are relational statements in a theory?
The statements in a theory that describe how the concepts (or constructs or variables) are related to / connected to each other. These may also be called propositions.

What is a theory made of? (What are the elements of a theory?)
concepts, constructs, variables (<-- these are objects, ideas, or phenomena that are in various stages of being defined by the researcher) and relational statements. concepts / constructs / variables + relational statements = a map or model of the theory

What is a “grand nursing theory”?
Nursing theories that are abstract and very broad.

What are middle range theories of nursing?
Middle range theories are less abstract and narrower in scope than grand nursing theories. These types of theories focus on answering particular practice questions and often specify such factors as patients’ health conditions, family situations, and nursing actions. Example: Pender’s Health Promotion Model

What are practice theories?
Practice theories are even more specific than middle range theories and are designed to theoretically propose specific approaches to particular nursing practice situations. Example: Kolcaba’s Comfort Theory

What types of theories are commonly used as frameworks for quantitative studies?
middle range theories and practice or intervention theories

What is a study framework?
A framework is an abstract, logical structure of meaning, such as a portion of a theory, which guides the development of the study and enables the researcher to link the findings to nursing’s body of knowledge.

Does every quantitative study have a framework?
Yes. It may be a physiological, psychological, social, or cultural framework.

A framework guides the ________ of a study, is tested in the study, and enables the researcher to _______ the _______ of the study back to nursing’s body of knowledge.
A framework guides the development of a study, is tested in the study, and enables the researcher to link the findings of the study back to nursing’s body of knowledge.

A clearly expressed framework is one indication of a _________ ____________ quantitative study.
high quality or well developed

What is the purpose of a map or model for expressing a study or research framework?
It can graphically show the relationships of the concepts and the relational statements. Each linkage shown by an arrow is a graphic illustration of a relational statement (proposition) of a theory. It can summarize what is known about a phenomena more clearly than does a literary explanation, and should be supported by references in the literature.

What is an implicit framework?
These occur when a researcher describes basic ideas for a research or study framework in the review of literature, but stops before fully developing the ideas for a framework or identifying a specific theory / part of a theory to use.

What frameworks are used for physiological studies?
Scientific theory, which may include a framework from physiology, genetics, pathophysiology, and/or physics.

A research design is a ___________ for conducting a study.
A research design is a blueprint for conducting a study.

What is a cross-sectional design?
Examining a group of subjects simultaneously in various stages of development, levels of education, severity of illness, or stages of recovery to describe changes in a phenomenon across stages.

What is a longitudinal design?
Collecting data from the same subjects at different points in time. This is also called “repeated measures”.

Which two types of quantitative designs are considered to be non-experimental?
descriptive and correlational research designs

What are the four most commonly used types of study designs in quantitative research?
descriptive, correlational, quasi-experimental, and experimental study designs.

Why is a descriptive research design used?
to develop theories, identify problems with current practice, justify current practice, make judgments, or determine what other nurses in similar practice are doing. There is no manipulation of variables.

How is protection against bias achieved in a descriptive research design?
1. good conceptual and operational definitions of variables
2. sample size and selection methods
3. using valid and reliable instruments
4. using data collection methods that partially control the environment.

Why is a correlational design used?
to examine relationships between two or more variables in a single group.

Note: There are three types of correlational designs: descriptive correlational, predictive correlational, and model testing.

What is causality?
Causality means that things have causes and that causes lead to effects. Remember, not all studies examine cause and effect…some describe variables or examine relationships among the variables.

What is multicausality?
Very few phenomena in nursing can be clearly linked to a single cause and single effect. The presence of multiple causes for an effect is referred to as multicausality.
Ex. diagnosis, age, co-morbidities, and post-surgery complications all affect a patient’s length of stay.

What is probability?
The likelihood that something will happen. The idea of relative rather than absolute causality. Researchers will design studies to examine the probability that a given effect will occur under a defined set of circumstances.

What is bias?
A slant or deviation from the true or expected. Bias in a study distorts the findings from what the results would have been without the bias. So researchers place great value on identifying and removing sources of bias in their study, or controlling their effects on the study findings.

What is control?
Control means having the power to direct or manipulate factors to achieve a desired outcome. It is one way to reduce bias in the design of quantitative studies.

What is manipulation?
A form of control used most commonly in experimental and quasi experimental designs. Typically controlling the treatment or intervention is the most commonly used manipulation.

What is study validity?
A measure of truth or accuracy of the findings obtained from a study. The validity of a study’s design is central to obtaining quality results and findings from a study.

What are threats to a study’s validity?
A general term that relates to possible problems in a study’s design.

Think about it: strengths and threats to a study’s validity provide a major basis for making decisions about whether a study’s findings are accurate and should be used in practice….or not.

Validity is something that you are being asked to learn about and evaluate as a strength or weakness of a research article that you are critiquing. What are the four major types of validity identified in your textbook?
statistical conclusion validity
internal validity
construct validity
external validity

What is statistical conclusion validity?
This type of validity is concerned with whether conclusions about relationships or differences drawn from statistical analysis are an accurate reflection of the real world.

What is internal validity?
This type of validity is focused on determining whether a study’s findings are accurate, or are more the result of the influence of extraneous variables.

What is construct validity?
This type of validity is concerned with the fit between the conceptual definition of a variable and the instrument that is chosen to measure the variable (does it measure what it says it measures).

What is external validity?
This type of validity focuses on how well or to what extent the study’s findings can be generalized beyond the sample used in the study.

Which research designs are most likely to be used to test causality or cause and effect?
quasi-experimental and experimental designs

What are some essential elements of experimental research (part one)?
random assignment of subjects to groups
precisely defined independent variable / intervention
researcher-controlled manipulation of the independent variable / intervention
researcher control of the experimental situation and setting,

What are some essential elements of experimental research (part two)?
including a control or comparison group
clearly identified sampling criteria
carefully measured dependent variables

What is intervention fidelity?
When a published study does a good job of clearly describing the essential elements of the intervention and the consistent implementation of the intervention during the study.

Who is included in the experimental group?
The group of subjects who will be receiving the intervention or treatment.

Who is included in the control group?
The group of subjects who are not exposed to the intervention or treatment. Sometimes they are also described as “receiving standard care”

When do we use a quasi-experimental design?
The use of a quasi-experimental design facilitates the search for knowledge and examination of causality in situations in which complete control is not possible. There are many types of quasi-experimental design types. See figure 8-11 for an example.

When do we use experimental designs?
The purpose of experimental designs is to examine cause-and-effect relationships between the independent and dependent variables under highly controlled conditions. The most common experimental design in nursing studies is a pre-test / post-test design with experimental and control groups. See figure 8-12 for an example.

What is a randomized controlled trial (RCT)?
A carefully designed experimental study that uses large numbers of subjects to test the effects of a treatment and compare the results with those of a control group that has not received the treatment (or that has received traditional treatment). Subjects are drawn from a reference population using clearly defined criteria, and then are randomly assigned to treatment or control groups. Baseline states must be comparable in all groups included in the study. The same treatment is consistently given and outcomes are measured consistently.

What is a sampling plan or sampling method?
a sampling plan or sampling method outlines the strategies used to obtain samples for studies. There are two major types of sampling plans: probability and non-probability.

What is a sample?
The sample defines the selected group of people (or elements).

What is a population?
The population is a particular group of individuals or elements (such as a group of people with Type II Diabetes) who are the focus of the research.

What is the target population?
The target population is a group of individuals who meet a particular set of sampling criteria, such as: female, 18 years or older, new diagnosis of type II diabetes, not on insulin.

What is the accessible population?
The portion of the target population to which the researcher has reasonable access. The accessible population might include elements within a country, state, city, hospital, nursing unit, or primary care clinic…such as the diabetics in a primary care clinic in Arlington, TX.

What is an element?
The individual units of the population and sample are called elements. An element can be a person, event, behavior, or any other single unit of study.

Remember: when elements are persons, they can be called subjects or participants depending on the research design.

What is generalization?
Generalization extends the findings from the sample under study to the larger population. The quality of the study and the consistency of the study’s findings with the findings from previous research in this area influence the extent of the generalization.

What is sampling criteria (or eligibility criteria)?
A list of characteristics essential for eligibility or membership in the target population. Sampling criteria may consist of inclusion and exclusion sampling criteria.

What is inclusion sampling criteria?
the characteristics that the subject or element must possess to be a part of the target population.

What is exclusion sampling criteria?
the characteristics that can cause a person or element to be excluded from the target population.

What is the benefit of making a sample as homogenous as possible?
It helps to control for extraneous variables.

What does representativeness of a sample mean?
It means that the sample, the accessible population, and the target population are alike in as many ways as possible. In quantitative research, you need to evaluate representativeness in terms of the setting, characteristics of the subjects, and the distribution of values on variables measured in the study.

What is random variation?
The expected difference in values that occurs when different subjects from the same sample are examined.

The difference is random because some subjects will score higher and others will be lower than the average (mean) population value. (Think: IQ scores…we don’t all have the same IQ.)

As the sample size increases, random variation decreases, improving representativeness of the results.

What is systematic variation (or systematic bias)?
A consequence of selecting subjects whose measurement values differ in some specific way from those of the general population. (Think: A study about attitudes about health behaviors. What if we only ask nurses? They may view this differently than if we just took a sample of adults from the general population.)

Because these subjects have something in common, their values tend to be similar to others in the sample, but different from the values that might be achieved in the general population. This can introduce bias into the results.

What is a refusal rate?
the percentage of subjects who declined to participate in the study.

What is an acceptance rate?
the percentage of subjects who agreed to participate in the study.

What is sample attrition?
the withdrawal or loss of subjects from a study that can be expressed as a percentage.

What is sampling?
Sampling involves selecting a group of people, events, behaviors, or other elements with which to conduct a study.

What is the definition of a probability sampling method?
In a probability sampling method, every person (element) of the population has an opportunity to be selected for the sample.

Probability sampling methods increase the sample’s representativeness of the target population.

What are the four types of probability sampling methods?
simple random sampling
stratified random sampling
cluster sampling
systematic sampling

What is simple random sampling?
Simple random sampling is achieved by randomly selecting elements from the sampling frame.
Ex. names on a slip of paper and draw from a basket, using a random numbers table, etc.

What is stratified random sampling?
Stratified random sampling is used in situations in which the researcher knows some of the variables for the population that are critical for achieving representativeness. Typical variables used include: age, gender, ethnicity, diagnosis, etc.

Stratification ensures that all levels of the identified variables are adequately represented in the sample.

What is cluster sampling?
In cluster sampling, a researcher develops a sampling frame that includes a list of all the states, cities, institutions, or organizations in which elements of the identified populations can be linked. A random sample of these can then be used in the study.

What is systematic sampling?
Systematic sampling is used when an ordered list of all members of the population is available. The process involves selecting every kth individual on the list, using a starting point selected randomly.

What is non-probability sampling?
Not every element of the population has an opportunity for selection to be used in the sample. This method is more commonly used in nursing studies.

What are the five types of nonprobability sampling?
convenience sampling
quota sampling
purposeful or purposive sampling
network or snowball sampling
theoretical sampling

What types of non-probability sampling are more commonly used in quantitative research studies?
convenience and quota sampling

What types of non-probability sampling are more commonly used in qualitative research studies?
purposive, network, and theoretical sampling

What is convenience sampling?
Subjects are asked to be in the study because they are “in the right place at the right time”. It provides little opportunity to control for biases. Convenience samples are inexpensive, accessible, and usually less time consuming to obtain than other types of samples. They are common in healthcare studies.

What is quota sampling?
Convenience sampling with a strategy to ensure the inclusion of subject types likely to be underrepresented in the convenience sample, such as females, minority groups, the elderly, etc. The purpose of quota sampling is to replicate the proportions of subgroups present in the target population. It may help to decrease bias.

How does one ensure an adequate sample size in quantitative studies?
It is evaluated using a power analysis. Power is the ability of the study to detect differences or relationships that actually exist in the population.

The minimum acceptable level of power for a study is 80%. This power level results in a 20% chance that the study will fail to detect existing effects (Type II error). A power analysis is done BEFORE a study is conducted to know how many subjects you will need.

What is effect size?
The effect is the presence of a phenomenon examined in a study. The effect size is the extent to which an identifiable effect is present (or that the null hypotheses is false). FYI: effect sizes are expressed as numbers and may be small, medium, or large in size.

The statistical test tells you whether the variables are related or there is a difference between the groups. The effect size is then calculated to examine the STRENGTH of the relationship or the SIZE of the difference between the groups.

So…do a power analysis before the study starts to be sure you get the right sample size for your study. Then…calculate the descriptive and inferential statistics on your data. Last, calculate an effect size after the statistical tests are completed.

Which types of quantitative studies require larger numbers of subjects?
Descriptive and Correlational = larger numbers of subjects because the researchers may examine more than one variable and extraneous variables may affect subjects’ responses.

Quasi-experimental and experimental = smaller numbers of subjects because there is more control in the desig,

If the number of variables you are studying goes up, then what probably needs to happen to your sample size?
It will need to go up or become larger (because of data analysis on subgroups created by using multiple variables).

What is purposeful sampling?
The researcher will consciously select certain participants, elements, events, or incidents to include in the study. The goal is to obtain information-rich cases from which the researchers can obtain in-depth information needed for their studies. (Used in qualitative studies.)

What is network sampling?
Also known as “snowball, chain, or nominated sampling”. Used to locate subjects that might be difficult or impossible to obtain in other ways. Takes advantage of social networks and the fact that friends tend to have characteristics in common. Can be used in both qualitative and quantitative studies.

How do you know when the number of subjects in a qualitative study is adequate?
When saturation of information (redundancy) and verification of information (further confirmation of hunches, relationships, or theoretical models) occurs.

What is the research setting?
The site or location used to conduct a study.

What are three common settings for conducting nursing research?
natural / field setting, partially controlled, and highly controlled settings.

In which setting does descriptive and correlational studies, and all qualitative studies take place?
a natural or field setting, which is a uncontrolled or real-life situation or environment. Note: the researcher does not manipulate / control / change this environment.

What is measurement?
Measurement is the process of assigning numbers or values to individuals’ health status, objects, events, or situations using a set of rules.

What are direct measures?
Direct measures involve determining the value of concrete things, such as height, weight, temperature, (accuracy and precision are important).

What are indirect measures?
Indirect measures attempt to measure something that is an abstract idea, a characteristic, or a concept, such as pain, stress, caring, coping, depression, anxiety. Rarely, if ever, can a single strategy measure all aspects of an abstract concept.

What are the four levels of measurement?
nominal (data is a category only – gender, kidney stone)
ordinal (data is in categories that can be ranked – pain, dyspnea with ADLs)
interval (data is in categories with equal numerical distances between them and no absolute zero point – temperature)
ratio (data is in categories, has equal numerical distances and has an absolute zero point – weight)

What is measurement error?
The difference between what you measured…and what the real or “true” measure of the variable is. The amount of error in any measure varies. There could be considerable error in one measurement and very little in the next. Measurement error exists in both direct measures (like blood pressure) and indirect measures (like pain).

What are the two types of measurement error?
random error and systematic error

What is random measurement error?
the difference between the measured value and the true value without pattern or direction (random). So the more times you measure the value (and average those values together)…hopefully the closer you are getting to the person’s true value or score (unless your random error rate is high).

Example: Think about taking the NCLEX over and over…

What is systematic measurement error?
the variation in measurement value from the calculated average is always in the same direction. For example: most of the variation may be higher or lower than the average that was calculated.

Example: Why does my scale at home routinely weigh me at 150lbs in the morning….but the scale at the MD’s office weigh me at 157lbs for an 0830 appointment?!?!

What is reliability?
Reliability is concerned with the consistency of the measurement method.

What are the three aspects of reliability testing?
stability, equivalence, and homogeneity

What is stability?
A type of reliability testing that focuses on the consistency of results when a test is repeated. It is also called test-retest reliability. It is expressed as an “r” value with higher numbers = greater test-retest reliability.

What is equivalence?
A type of reliability which involves the comparison of two versions of the same pencil and paper instrument or two observers who are observing (or grading) the same event.

Two versions of the same test = alternate forms reliability
Two judges rating the same person = inter-rater reliability

It is expressed as an “r” value with values above .8 = greater IRR or alternate forms reliability.

What is homogeneity?
A type of reliability testing that is used with pencil and paper testing. It addresses the correlation (or relationship) of each question on the test to other questions on the test. It basically asks…are the questions all asking about the same basic constructs? This is also known as internal consistency.

What statistical test is used to check a pencil and paper test for homogeneity or internal consistency?
A Cronbach’s alpha or a Kuder-Richardson’s 20. Both of these are expressed as an “r” value with values above .8 = high internal consistency.

Note: internal consistency is checked every time a pencil and paper test is used. If your article for critique used a questionnaire of some sort, then they should report this number for both the questionnaire’s development or past use AND the current sample.

What is validity?
How well does the instrument reflect the abstract concept being measured?

Hint: validity exists on a spectrum. It is not an all or nothing phenomenon. We try to determine the degree of validity an instrument or questionnaire has for a specific sample or situation.

When looking at a measure or questionnaire for validity, we typically descrive this as content validity. Content validity can be broken down into two subtypes. What are they?
Content and predictive validity.

What is content validity?
The extent to which the measurement / questionnaire / scale includes all of the major elements or items relevant to the construct being measured.

How do you prove this?
1. do the items in the scale reflect the description from the ROL?
2. how do content experts rate the items on the scale?
3. how might potential subjects respond to items on the scale?

What is evidence of validity from contrasting groups?
Identifying groups that are expected (or known) to have contrasting scores on a questionnaire.

Example: administering a questionnaire about depression to two groups of people, one group with known depression, one group without, and comparing their scores.

What is evidence of validity from convergence?
Evidence of validity from convergence is determined when a relatively new instrument is compared with an existing instrument that measures the same construct. They are given to a group of people at the same time and then the scores are compared.
Example: two questionnaires that measure depression

What is evidence of validity from divergence?
Evidence of validity from divergence is determined when a relatively new instrument is compared with an existing instrument that measures the opposite or unrelated construct. They are given to a group of people at the same time and then the scores are compared.

Example: a questionnaire that measures hope and despair

What is important to ask regarding physiological measures?
Their accuracy (validity), precision (consistency/reliability), and sources of error of measurement.

If a diagnostic / screening test is very sensitive, what does that mean?
The proportion of patients with the disease who have a positive test result. A highly sensitive test is good at identifying a patient with the disease / disorder and has a low percentage of false negatives.

If a diagnostic / screening test is very specific, what does that mean?
The proportion of patients without the disease who have a negative test result. A highly specific test is good at identifying a patient without the disease / disorder and has a low percentage of false positives.

What are observational measurements?
Observational measurements involve an interaction between the study participants and the observer(s) where the observer has the opportunity to watch the participant perform in a specific setting. They may be structured or unstructured observations.

What is an interview?
An interview involves verbal communication between the researcher and the subject during which information is provided to the researcher. Interviews may be structured or unstructured.

What is a questionnaire (instrument / tool / survey / measurement)?
A printed self-report form designed to elicit information through written or verbal responses of the subject. It tends to have less depth than an interview. It may gather information about facts, beliefs, attitudes, opinions, knowledge, or intentions of the subject / participant. Some questionnaires may include open-ended questions.

What is the typical response rate for a mailed questionnaire?
25 to 40%

What is a rating scale?
A rating scale lists an ordered series of categories of a variable that are assumed to be based on an underlying continuum.

Ex. Rate your pain on a 1 – 10 scale with 10 being the worst….

What is a likert scale?
A type of rating scale that typically has four, five or seven categories that address agreement, evaluation, or frequency. It is used to determine the opinions or attitudes of study subjects.

Ex. strongly agree, agree, uncertain, disagree, strongly disagree.

What is a visual analog scale (VAS)?
A visual analog scale is typically used to measure the strength, magnitude, or intensity of individuals’ subjective feelings, sensations, or attitudes about symptoms or situations. The VAS is usually 100mm long with right angle stops at either end and descriptive anchors for the phenomenon being measured. Subjects are asked to place a mark on the line to describe the intensity of the sensation or feeling.

What is data collection?
Data collection is the process of acquiring the subjects and collecting the data for the study. The actual steps of collecting the data will be specific to each study and based one the study’s design and measurement techniques.

What are the tasks of data collection?
selecting / recruiting subjects
collecting data in a consistent way
maintaining research controls as indicated in the study design

What are statistical techniques?
Analysis procedures that are used to examine, reduce, and give meaning to the numerical data gathered in a study. For our class, there are two major categories for statistics: descriptive statistics and inferential statistics.

What are descriptive statistics?
Descriptive statistics are summary statistics that allow the researcher to organize data in ways that give meaning and facilitate insight. They are calculated to describe the sample (ie. demographic statistics) and key study variables.

What are inferential statistics?
Inferential statistics are designed to address objectives, questions, and hypotheses in studies to allow inference from the study sample to the target population. They help us to: identify relationships
examine predictions
determine differences among groups

How does a researcher describe a sample?
Variables relevant to the sample are called demographic variables (age, gender, educational levels).
Demographic variables are usually described with descriptive statistics.

When a researcher uses a survey or questionnaire, how do they know it is reliable? Hint: What statistic is used, and what is considered to be a “good number”?
Reliability of a survey or a questionnaire is tested using a statistical test called a Cronbach’s alpha.
A Cronbach alpha value greater than .80 means that the questionnaire is considered to be reliable.
Note: Researchers will report Cronbach alpha values for PAST use of the survey or questionnaire (in other studies) and in the CURRENT study.

What is the purpose of conducting an exploratory analysis?
An exploratory analysis is used to examine all of the data descriptively.

What is probability theory?
It is used to explain the extent of a relationship, the probability that an event will occur in a given situation, , or the probability that an event can be accurately predicted.

What is decision theory?
Decision theory assumes that all of the groups in a study used to test a particular hypothesis are components of the same population relative to the variables under study. This expectation is expressed as a null hypothesis in which there is no difference between the groups.

What is the alpha, or “level of statistical significance” for most nursing studies and what does that mean?
The alpha, or level of statistical significance for most nursing studies is 0.05. This is the probability level at which the results of the statistical analysis are judged to indicate a statistically significant difference between the groups.

If the p value is less than or equal to 0.05, then the result is considered to be statistically significant. Decision theory requires that this cutoff point be absolute.

What is generalization?
the application of information that has been acquired from a specific instance to a general situation.

Generalization extends the implications of the findings from the sample studied to a larger population.

What is a Type I Error?
A Type I error occurs when the null hypothesis is rejected when it is true.

In plain terms…this means, that the researchers conclude that significant results exist in a study, when really, they don’t.

What is a Type II Error?
A Type II error occurs when the null hypothesis is accepted when it is false.

In plain terms…this means the researchers conclude that the study results are non-significant when in reality…the results were significant!

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).

The minimum acceptable power level is .80

What is effect size?
The degree to which the phenomenon is present in the population, or the degree to which the null hypothesis is false.

Identify four types of descriptive statistics.
There are four types of descriptive statistics:
frequency distributions (gender, ethnicity, marital status data)
measures of central tendency (mean, median, mode – age data)
measures of dispersion ( range, variance, standard deviation, confidence intervals, standardized scores, and scatterplots)

What is the purpose of conducting a confirmatory analysis?
A confirmatory analysis is used to confirm expectations regarding data from objectives, questions, or hypotheses. Inferential statistics are used, and investigators can generalize the study findings to the appropriate accessible and target population.

What are chi square and analysis of variance (ANOVA) tests used for?
To identify differences among groups in a research study.

How does a researcher determine what (inferential) statistical test to use? (Yikes!!!)
There’s no easy answer to this one. Usually it’s a combination of the following:
the study’s purpose
the use of questions, objectives, or hypotheses
the study’s design (use of groups??)
the level of measurement of the variables (nominal, ordinal, interval, etc)

A correlational design investigates relationships between or among variables in a single population. What is the inferential statistical test most commonly used with this design?
A pearson product-moment correlation {sometimes this is just called a pearson’s r or just an (r2)}. The results range from -1 to +1.

What are the possible results that you could have with a Pearson’s product-moment correlation?
A negative (inverse) relationship (the result will be close to -1)
A positive relationship (the result will be close to +1)
No relationship. (the result will be close to 0)

What does factor analysis do?
Factor analysis examines interrelationships among a large number of variables and disentangles those relationships to identify clusters of variables that are most closely linked. It can aid in the identification of theoretical concepts or be useful in the development of a new questionnaire.

What does regression analysis do?
Regression analysis can be used to predict the value of one variable when the value of one or more other variables is already known.

Example: can we predict the length of a hospital stay of a patient with a certain diagnosis?

What statistics can be used to determine causality?
chi-square, t-tests, ANOVAs, and ANCOVAs

What are the five possible results you may find as a result of your statistical analysis?
1. significant results that agree with those predicted by the researcher.
2. nonsignificant results
3. significant and unpredicted results (results are the opposite of those that were predicted by the researcher)
4. mixed results
5. unexpected or serendipitous results

What are some characteristics of significance in studies / significant studies?
the findings make an important difference in people’s lives
you can generalize the results far beyond the study’s population / it affects large numbers of people
it generates more research
it contributes to theory development / becomes a theory
it has implications for other disciplines besides nursing
it is frequently referred to in the literature

What is clinical importance?
Clinical importance is the practical relevance of the findings. There is no common agreement about how to evaluate the clinical importance of a finding.

What are limitations of a study?
Limitations are problems or restrictions in a study that may decrease the generalizability of the findings.

Evidence based practice is the conscious integration of _____ with _____ and _____ in the delivery of quality, cost-effective health care.
Evidence based practice is the conscious integration of best research evidence with clinical expertise and patient needs and values in the delivery of quality, safe, cost-effective health care.

What are some barriers to evidence-based practice?
nursing lacks research / evidence for certain nursing interventions.
evidence is based on population data and may be difficult to apply to people as individuals.
agencies / administrators may not always provide resources to

What are some ways that agencies / administrators do not provide support for the implementation of EBP?
1.) not providing access to research journals, sources of synthesized research findings, or evidence-based guidelines
2.) inadequate knowledge on how to implement EBPchanges in practice.
3.) heavy workloads with limited time to make evidence-based changes in practice.
4.) limiting RN’s authority to change patient care based on research findings
5.) limited support from administrators or medical staff to make evidence-based changes in practice.
6.) providing limited funds to support research-based changes for practice
7.) providing few rewards for RNs delivering evidence-based care to patients and families.

What are the benefits of implementing EBP?
improved outcomes for patients, providers, and healthcare agencies.
the evidence has been synthesized by teams of researchers and clinicians to develop strong evidence-based guidelines for practice.
the evidence is easily accessible
it helps agencies meets accreditation requirements and assists with obtaining magnet status

What is a systematic review?
A structured, comprehensive synthesis of the research literature to determine the best research evidence to address a healthcare question.

What is a meta-analysis?
A meta-analysis statistically pools the results from previous studies into a single quantitative analysis that provides the highest level of evidence for an intervention’s efficacy.

What is a meta synthesis??
A systematic compilation and integration of qualitative study results to expand understanding and develop a unique interpretation of study findings in the selected area.

What is a metasummary?
A summarizing of findings across qualitative reports to identify knowledge in a selected area.

What are the elements of a PICO question?
P: population or participants of interest
I: intervention needed for practice
C: comparisons of interventions to determine the best for practice
O: outcomes needed for practice

What are the two triggers that initiate a need for a change or an evidence-based practice project?
a problem-focused trigger or a knowledge-focused trigger

What are some typical problem-focused triggers in the Iowa Model of Evidence-Based Practice?
risk management data
process improvement data
internal / external benchmarking data
financial data
identification of a clinical problem

What are some typical knowledge-focused triggers in the Iowa Model of Evidence-Based Practice?
new research or other literature
national agencies or organizational standards and guidelines
philosophies of care
observation from institutional standards committee

If a topic is a priority for the organization, what is the next step in the Iowa Model?
form a team and assemble the relevant research and related literature

What are the steps to piloting the change in practice?
select the outcomes to be achieved
collect baseline data
design and implement EBP guidelines
pilot the new guidelines on the unit(s)
evaluate the process and outcomes
modify the new practice guideline as needed

Once you have piloted the change in practice what should you do?
Consider whether the change is appropriate for adoption in practice. If so, insititute the change, continue to collect data, and share your results!!

What are evidence based guidelines?
Evidence based guidelines contain the best research evidence that has been synthesized by a panel of experts into comprehensive, current directions for using research in practice.

According to Melynk et al (2012), what is the IOM’s goal for EBP for 2020?
The IOM’s 2020 goal is that 90% of all clinical decisions be evidence-based.

According to Melynk et al (2012), what are some of the positive outcomes from implementing EBP?
higher quality of care, improved patient outcomes, decreased healthcare costs. It assists organizations to attain high reliability. In addition, by implementing EBP, nurses feel like they have voice in advocating for patients and impoving the quality of care they deliver.

According to Melynk et al (2012), what types of things facilitate EBP adoption?
strong beliefs that EBP improves patient care and outcomes
a solid foundation of knowledge and skills
access to EBP mentors
and organizational cultures that support evidence-based care

According to Melynk et al (2012), How do nurses in this survey feel about EBP?
Nurses surveyed across the country are ready for and do value EBP.

According to Melynk et al (2012), what are the top five barriers to EBP implementation as reported by the nurses in the survey?
organizational culture (P&P, politics, or a “we’ve always done it that way” philosophy)
lack of EBP knowledge / education
lack of access to evidence / information
manager / leader resistance

According to Melynk et al (2012), what are the top five things that would help implement EBP as reported by the nurses in the survey?
access to information
clearinghouse of evidence-based practice information (online)
organizational support / awareness

According to Melynk et al (2012), who is a potential barrier to nurses implementing EBP in their daily practice?
physicians (5% of respondents reported this)
fellow nurses (7% of respondents reported this)
nurse leaders and managers (8% of respondents reported this)

According to Melynk et al (2012), what kinds of things can organizations do to create a culture that supports evidence-based practice?
build a supportive culture for EBP
provide the time, educational skills building sessions, and resources necessary for staff nurses to implement EBP
create EBP mentors to work with staff nurses to consistently implement and sustain EBP.

According to Peterson et al (2014), what two books call for nurses to incorporate research evidence into their clinical practice?
the ANA’s Scope and Standards of Practice
the ANA’s Code of Ethics

According to Peterson et al (2014), what is the purpose of determining the level of evidence from a study?
The purpose of determining the level of evidence and the critiquing the study is to ensure that the evidence is credible (ex. reliable and valid) and appropriate for inclusion into practice.

According to Peterson et al (2014), what type of evidence is considered to be strongest?
systematic reviews of RCT’s are the strongest
findings from experimental research is stronger than non-experimental research
similar findings from more than one study are stonger than findings from just one study

According to Peterson et al (2014), in AACN’s 2012 rating scale level “A” evidence reflects…
the highest form of evidence and includes meta analyses and meta-syntheses of the results of multiple controlled trials with results that consistently support a specific action, intervention, or treatment.

According to Peterson et al (2014), in AACN’s 2012 rating scale level system, grouping together A, B, and C levels of evidence would result in…
evidence-based recommendations for practice

According to Peterson et al (2014), in AACN’s 2012 rating scale level system, grouping together D, E, and M levels of evidence would result in…
expert opinion or manufacturer’s recommendations for practice

According to Peterson et al (2014), clinicians should do what two things before implementing research into practice?
1.) examine individual studies to determine if the results were obtained by using sound (reliable and valid) scientific methods

2.) determine the clinical relevance of the research (ex. are the results applicable to and feasible in clinical practice)

According to Peterson et al (2014), why did the AACN develop practice alerts?
To address both nursing and multidisciplinary activities of importance. They focus on the care of the critically ill patient or their environment. Practice alerts are reviewed / updated every three years and are designed to do the following:
1.) close the gap between research and practice
2.) provide guidance
3.) standardize practice
4.) identify and inform about new advances and trends

According to Makic et al (2014), what percentage of clinicans consistently implement evidence-based care? How many decades might it take for original research to be put into routine nursing practice?
10 – 15% consistently implement evidence-based care.

It may take up to two decades for original research to be put into routine nursing practice.

According to Makic et al (2014), how often do people naturallly shift their body position and what promotes this?
About every 12 minutes, which is prompted by sensory cues.

According to Makic et al (2014), what are the three interventions suggested for critically ill patients and turning / mobility / skin breakdown?
turning patients every two hours (or more frequently)
advocate for the use of support surfaces therapies (specialty beds)
good skin care practices, providing nutritional support, and encouraging early mobility

According to Makic et al (2014), what are typical challenges reported by nurses in meeting frequent turning standards?
hemodynamic instability
patient obesity
lack of equipment or available peers to reposition patients effectively
lack of time

According to Makic et al (2014), what are the consequences of a lack of sleep?
worsening symptoms, physical and cognitive dysfunction, mood instability, and fatigue

According to Makic et al (2014), what stage of sleep is most restorative?
REM Sleep, the fourth stage, is considered the most restorative and valuable stage of sleep

According to Makic et al (2014), what can nurses do to improve the patient’s sleep cycle?
modifications of the enviroment (ex. reduce noise and light)
cluster care to minimize sleep disruptions
limit sedation
optimizing mechanical ventilation modes that enhance sleep
assessing for the presence of the s/sx of delerium
providing early mobility
using complimentary therapies (massage, music, etc.)
develop nurse-driven protocols to help provide consistent medical and non-medical interventions that help to promote sleep

According to Makic et al (2014), why is auscultation an unreliable method for accurately detecting placement of a feeding tube in pediatric patients?
because sounds can be transmitted to the epigastric area (in this population) regardless of the location of the tube tip. This concern is even more exaggerated in infants and young children because of their smaller torsos. It cannot reliably differentiate respiratory from gastric placement, nor can it differentiate gastric from intestinal placement.

According to Makic et al (2014), what is the best method for predicting insertion length, and what is the best way to confirm placement of a feeding tube when radiography is not available?
Radiography. Other methods when daily radiography for confirmation is not feasible include pH testing of the aspirate, aspirate color. Whenever there is doubt about the tip of the tube’s location, do not use and request an x-ray.

According to Makic et al (2014), what are the risk factors for venothromboembolism in hospitalized medical patients?
hospitalization, cancer, previous VTE, reduced mobility, already known thrombophilic condition, recent trauma / surgery, elderly age, heart / respiratory failure, acute MI, acute infection or rheumatologic disorder, obesity, ongoing hormonal treatment

According to Makic et al (2014), what is the role of the nurse in the prevention of venothromboembolism?
assessing all patients upon admission to the ICU for risk factors and anticipating orders for prophylaxis based on that risk assessment.

ensuring that chemical and mechanical therapies are maintained to reduce the risk of VTE.

early mobility / exercise is also an important intervention in the prevention of VTE.

Guided by research questions and data are collected from a small number of subjects allowing an in depth study of phenomenon Qualitative Describes phenomena seeks to test hypothesis/ answer research questions using statistical methods Quantitative WE WILL WRITE A CUSTOM …

Research -To search again or to examine carefully -“A diligent, systematic inquiry or study that validates and refines existing knowledge and develops new knowledge.” Moderator/Facilitator -Conducts a focus group WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY …

One of the primary foundations for evidence-based nursing practice is Medical knowledge. Research results. Everyday health care. Textbook information. Research results Within the process of providing evidence-based nursing care, which types of research results are incorporated to ascertain the plan …

1. Which item below correctly describes the U.S. Bureau of Labor Statistics predictions by 2020? a. Positions that historically required registered nurses will be filled by unlicensed personnel. b. The job growth rate for RNs will surpass job growth in …

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