Research Midterm Exam 1

steps to the research process

1. identify the research question 2. review the literature 3. identify the theoretical framework 4. select a design/methodology 5. implement the study 6. analyze the data 7. draw conclusions (results) 8. Disseminate the findings

steps to the EBP process

1. spirit of inquiry 2. ask PICOT ? 3. search for evidence 4. level and appraise the evidence 5. integrate the evidence with clinical expertise and patient preferences and values 6. eval. the outcomes 7. disseminate the EBP results

Nursing Theory

A set of interrelated concepts that structure a systematic view of phenomena for the purpose of explaining or predicting

Theoretical Framework

A theoretical framework shows how the research fits into what is already known and Shows how the research makes a contribution to the problem being studied *Theoretical Framework Flows from the Review of the Literature*

Purpose Statement

Aim of study derived from problem statement purpose= to solve the problem *look in the aims/objective section*

Quantitative Designs

Are categorized as Experimental or Nonexperimental Experimental: researchers actively introduce and intervention Nonexperimental: researchers are bystanders; collect information without introducing an intervention

Types of Hypotheses

Associative- RELATIONSHIP between DV and IV Causal: IV causes the presence of or change in another variable DV Simple: 1 DV, 1 IV Complex: 3 or more variables Nondirectional: statement of the relationship between the variables that does not predict the direction of the relationship (ice and elevation affect pain level) Directional: describes the direction of a relationship between two or more variables (ice and elevation REDUCE pain level) Null: no relationship, no affect between variables Research: indicates the relationship between two or more variables exists (can be causal, associative, simple, complex, directional, nondirectional)

causality & probability

Causality: the relationship between cause and effect; there can be multiple causes or factors that contribute to an outcome Probability: likelihood or chance that an event will occur in a situation; because it is very difficult to prove anything with 100% certainty we determine with probability

Gray Literature

Conference proceedings, theses, technical specifications and standards, bibliographies, technical and commercial documentation, official documents, or anything not published commercially but still of value

history (threat to internal validity)

DV is influenced by and event that occurred during the study

Quantitative Designs: Experimental and Nonexperimental

Experimental: researchers activelyintroduce and intervention Nonexperimental: researchers are bystanders; collect information without introducing an intervention

peer reviewed/refereed

Experts and editors rigorously evaluate a manuscript submitted for publication The process is designed to ensure high quality of published works

Research Misconduct

Fabrication- making things up Falsification- changing data Plagiarism- copying work, not citing work

External Validity

GENERALIZATION the degree to which the results of a study can be generalized to other subjects, settings and times take into consideration the sample, the setting, and the time in which the study took place

Types of Variables

Independent (IV): variable that is observed or manipulated to determine the effect on another variable; variable that influences the outcome; the Cause, the Intervention Dependent (DV): outcome variable - one that is measured for change after treatment applied; The Effect, the Outcome Confounding/Extraneous: factors that interfere with the relationship between the IV and DV; often not planned for; age, weather, etc. Try to plan for them in advance

Research Design

It is the blue print or specific plan that will be used to meet the stated purpose of the research study.

How does theory fit into research?

It is the researcher's perspective about how the concepts and variables of interest in a study fit together

Institutional Review Board IRB (sometimes called ethics review board)

Main Purpose: protection of human subjects research cannot move forward without this approval

Quasi-Experimental

Missing random assignment and/or control group Medium level evidence on most ranking systems

The Variables

Phenomena that can be directly measured or Qualities, properties, or characteristics of people, groups, or objects that can be measured indirectly May be derived from abstract concepts

Qualitative Research Study

Phenomenology (experiences) Grounded Theory (collecting data to develop a theory) Ethnography (study of people in their own environment) Historical (describe and examine events of the past to understand the present and anticipate potential future effects)

PICO(T)

Population Intervention Comparison Outcome Time

Theoretical Frameworks, Conceptual Frameworks, and Models

Present a broad, general explanation of the relationships between the concepts of interest in a research study Important because they help to organize the study and provides a context for interpreting the findings. The Framework provides the structure of a study that links theory concepts to study variables, it frames how the researcher decides to define the study variables (conceptual definitions)

Types of Evidence

Primary: Original information authored by the person or people responsible for creating it (research studies) Secondary: Interpretations of primary sources, commentaries, reviews, etc. (ie literature reviews, meta-analysis, systematic reviews, integrative reviews, biographies Gray Literature: Conference proceedings, theses, technical specifications and standards, bibliographies, technical and commercial documentation, official documents, or anything not published commercially but still of value

Critically appraising the ethics of a study

Purpose- just to make sure the study is ethical, no shady business.

True Experimental Studies

RCT Independent and dependent variable high level evidence on most ranking systems

Threats to external validity

Reactivity: the influence of participating in the study on the subjects Hawthorne effect: subjects' behaviors are affected by personal values or desires to please the experimenter

random assignment

Subjects have an equal chance of being in either the treatment or the control group

random assignment

Subjects have an equal change of being in either the treatment or the control group

random sampling

Technique for selecting elements when each has the same chance of being selected

AGREE II (Appraisal of Guidelines Research & Evaluation)

The AGREE II consists of 23 key items Looks at purpose, clinical questions, population, Evaluates the evidence Evaluates the clearness of the guidelines Looks at the feasibility Looks at conflict of interest

International Support for EBP

The Cochrane Collaboration, Sigma Theta Tau International, Joanna Briggs

study validity

The ability to accept the results as logical, reasonable, and justifiable based on the evidence presented

Statistical Conclusion

The degree that the results of the statistical analysis reflect the true relationship between the DV and IV Type II Error: researchers inaccurately conclude that there is no relationship between IV and DV

External Validity

The degree to which the results of a study can be generalized to other subjects, settings, and times

randomization

The selection, assignment, or arrangement of elements by chance

What is the difference between a Theoretical Framework, Conceptual Framework or Model?

Theoretical framework- well tested by research. existed for a long time. used many times, well tested. *(Theoretical-Tested...both start with T) Ex: Maslows Conceptual- created for a specific study ; untested

Instrumentation (threat to internal validity)

There are inconsistencies to data collection

Mortality (threat to internal validity)

There is loss of subjects before the study is completed

Quantitative Research Study

True Experimental Quasi-Experimental Non-Experimental

Number of Variables

Univariate: A study is considered univariate if it only has one variable. The only type of study that can have one variable is a descriptive study because all cause and effect studies have at least 2 variables. Bivariate: A study is considered bivariate if it has 2 variables, 1 IV and 1 DV. Multivariate: A study is considered multivariate if it has more than 2 variables. It could be either more than 2 IVs and 1 DV, 1 IV and more than 2 DV or 2 or more IVs and 2 or more DVs

testing (threat to internal validity)

a pretest can influence the results of a postest

Meta-Analysis

a procedure for statistically combining the results of many different research studies The "studies of Studies" highest level evidence on most ranking systems

concept analysis

a published document designed to help the reader become familiar as possible with a CONCEPT (variable)

Systematic Review

a rigorous and systematic synthesis of research findings about a clinical problem high to medium level of evidence on most ranking systems

integrative review

a scholarly paper that synthesizes published studies to answer questions about phenomena of interest can combine quant. and qual. research

Literature Review- simply put

a scholarly research step that entails identifying and studying all existing studies on a topic to create a basis for new research *look for different types of sources within the lit. review: primary, secondary, clinical practice guidelines

Study Validity

ability to accept results as logical, reasonable, and justifiable based on the evidence presented

Literature Reviews

authors decide which works to exclude, usually one/two authors, considered expert opinion and low level evidence

EBP Triad

best research evidence, patient values, clinical expertise best evidence- emphesis is on identifying and evaluating the best available evidence as a tool for solving problems. found in literature and other sources. evaluated using evidence hierarchy ranking systems patient vales- understand the whole patient and SDOH clinical expertise- apply decision making and clinical judgment skills as they make ebp decisions. balance patient's clinical state and circumstances, the evidence, and the patient's preferences

metapradigm

broad concepts core to nursing; used to define and explain the nursing theories. PERSON, ENVIRONMENT, HEALTH, AND NURSING. think- healthy environment is healthy for healing. environment impacts the health and recovery of patients

rapid critical appraisal

can be used as a tool to narrow down search findings to evidence that applies to the PICO(T) question.

selection bias (threat to internal validity)

characteristics of subjects affect the DV (unplanned) People who choose to be in a study may produce better outcomes

conceptual

defines the concepts, sounds like a dictionary definition. usually derived from the theoretical framework

Phenomenology

describes the lived experience to achieve an understanding of an experience from a participants perspective most data from this type of research is obtained from fieldwork, particularly interviews

Non Experimental

descriptive correlational survey retrospective case-control medium level evidence on most ranking systems

Longitudinal

either experimental or non-experimental, design used

internal validity

extent to which we can draw cause-and-effect inferences from a study The IV did what it said it did threats to this: selection bias, history testing, instrumentation, mortality, statistical conclusion

Theories

help make research findings interpretable guide researchers understanding of the what and why help stimulate research by providing direction THE LENS THROUGH WHICH THE RESEARCH IS VIEWED/CONDUCTED (PROVIDES PROSPECTIVE)

Operational

how the variable will be MEASURED

study design/methodology qualitative constructivist paradigm

hypothesis generative (inductive) subjective seeks in-depth understanding perceptions, experiences, narratives, explorers phenomena Researcher may be part of the process flexible design small sample sizes

Study design/methodology: quantitative/positivist paradigm

hypothesis testing (deductive) objective and quantifiable measurable statistical analysis seeks generalization

Hypothesis

intelligent guesses ONLY IN QUANTITATIVE RESEARCH must be empirically testable lend objectivity to scientific investigations even if it is not supported in the findings, the study still has merit *not true or false, but supported or not supported* Derived from the problem statement or the research question Sometimes not formally listed but can be implied If not formally listed, infer the hypothesis from the purpose statement within the article (unless otherwise directed) Includes Dependent and Independent variables that are linked to the problem statement and research question Predicts the relationship between the variables Hypotheses also need to be ethical, feasible, and relevant to nursing research practice

Research Question

interrogatory statement describing the variables and population of the research study flows from the problem statement and study purpose, and is often the interrogatory form of the problem statement

Probablity

likelihood that a particular event will occur

Secondary types of evidence

literature reviews, meta-analysis, systematic reviews, integrative reviews, biographies

Expert opinion

lowest level of evidence on most ranking systems.

cross-sectional

non-experimental design used to gather data from a group of subjects at only one point in time

Literature Review

provides background information about the problem statement and: -provides a context for the research study -justifies the research study (support the purpose) -shows where the research fits into the existing body of knowledge to support the research questions -enables the researcher to learn from previous studies and theory on the subject -highlights flaws in previous research to support the research problem -outlines gaps in previous research to support the research problem *look for different types of sources within the lit. review: primary, secondary, clinical practice guidelines

Threats to external validity

reactivity hawthorne effect

Clinical Practice Guidelines

recommendations based on evidence that serve as useful tools to direct clinical practice Should be periodically updated (be sure to check the publication date Only those created with rigorous standards should be considered for practice Example: Appraisal Guidelines Research and Evaluation (AGREE II)

Conflict of Interest (COI)

refers to situations in which financial or other personal considerations may compromise, or have the appearance of compromising a researcher's professional judgment in conducting or reporting research. Ex: Research on Tylenol and they received a grant from the makers of Tylenol & helping fund the research = conflict of interest A COI, in itself, is not a bad thing. In fact, it often comes as a result of successful business partnerships and hours of hard work, all of which uphold the highest standards of integrity. COIs should always be disclosed by the author(s) of a research article.

Research VS EBP questions

research question = idea that the researcher will study and examine. it is the first step of any research study EBP question= identifies a problem in which the answer may already exist in the evidence. it is a focused question question that will assist the nurse in performing a relevant search of the evidence (ex: PICOT)

Research VS EBP

research- generates new knowledge EBP- applies knowledge generated by research to practice

Retrospective

researchers look back intime to determine possible causative factors; NEVER EXPERIMENTAL, why? Case-control: design that looks at people who already had the disease

Journal

resources of a scholarly or professional nature but may not meet the highes standards for publication as peer-reviewed/refereed sources

Meta-synthesis

scholarly papers that combine results of qualitative studies

Threats to internal validity

selection bias history maturation testing instrumentation mortality statistical conclusion

Periodical

something that is published PERIODICALLY

Prospective

studies over time with presumed causes that follow subjects to determine if the hypothesized effects actually occur

Maturation (threat to internal validity)

subjects change by growing older....more experience gained OVER TIME

Nursing Research

systematic inquiry designed to develop evidence about issues of importance to nurses and their clients

Magazine

targeted for general reading audience

Random Sampling

technique for selecting elements when eacc has the same chance of being selected

Manipulation

the ability of a researcher to control the IV

manipulation

the ability of the researcher to control the independent variable

Control

the ability to manipulate, regulate, or statically adjust for factors that can affect the dependent variable

control

the ability to manipulate, regulate, or statistically adjust for factors that can affect the dependent variable

National support for EBP examples- collaboration among nurses and other health care professionals to affect practice changes

the agency for healthcare research and quality (AHRQ) National Guideline Clearinghouse (NGC), AWHONN, AACN, and the National Institute of Nursing Research (NINR)

anonymity

the condition of being unknown- the project does not collect identifying information of individual, or the project cannot link individual responses with participants identities

internal validity

the degree to which one can conclude that the independent variable produced changes in the depdent variable the IV did what it said it did treats to internal validity: selection bias, history, testing, instrumentation, mortality, statistical conclusion

reactivity (threat to external validity)

the influence of participating in the study on the subjects

Causality

the relationship between cause and effect

Randomization

the selection, assignment, or arrangement of elements by chance

Barrier's to EBP

time, research not valued, lack of knowledge, lack of skills to find evidence, lack of resources, lack of skills to read evidence, resistance to change*, organizational values

Internal Validity

uncontrolled/confounding variable that affects the end result of the study

Bias

when extraneous variables influence the relationship between IV and DV

bias

when extraneous variables influence the relationship between the IV and DV

Research Problem

why the research is important. what is the problem they're trying to solve? *area of concern where there is a gap in the knowledge* that requires a solution identified through: personal clinical experience, professional literature, previous research that revels gaps in knowledge, current nursing theories, national initiatives

concepts

words or phrases that convey a unique idea that is relevant to a theory