research exam 2 terms + examples

Endurance (6MWT) in a child with cerebral palsy, Intervention is an Aquatic-based aerobic exercise program

ABA design (withdraw design)

Weight distribution in patients with hemiplegia, intervention: Activity-based therapy

ABAB design

Grounded theory research

a set of systematic inductive methods for conducting qualitative research aimed toward theory development

factorial design

a way of describing an experimental design that is based on the number of factors, most complicated, look at more than 1 IV at a time could be single factor design or multi factor design

attrition

also called experimental mortality, is of concern when it results in a differential loss of subjects = drop outs occur for specific reasons related to the experimental situation. studies with long follow up periods are prone to attrition

A study was done to show the effect of service dog partnerships on energy conservation in individuals with mobility challenges. 20 Researchers compared duration and perceived effort to complete functional tasks in 12 sessions over 6 weeks. Subjects worked with dogs to train them in the tasks in different settings, with a randomized order of testing with and without the service dog.

alternating treatment design

instrumentation bias

are concerned with the reliability of measurement. ex: if assessors in the AVERT trial we not equally trained in applying the mRs the scores could be unreliable

between subjects design

assigned to independent groups, groups 1/2 arent related, experimental vs control group

Over the 3-month follow-up period in the AVERT trial, 21 patients dropped out, 6 for unknown reasons and 15 who refused to continue participation. There was no indication that their decisions were related to their group assignment.

attrition

experimental design

between subjects, within subjects factorial

testing = reactive effects

can occur when a testing process influences the response, rather than acting as a pure record of behavior. example: when taping a session if the subjects responses are affected by knowing they are being recorded

testing = testing effects

concern the potential effects of pretesting or repeated testing on the dependent variable / the mere act of collecting data changes the responses that is being measured, increased skill or measure to do famililarity of testing

_______ validity for the HINT was established by correlating HINT scores to contemporaneous scores on the Ages and States Questionnaire.

concurrent validity (type of criterion related validity)

Megens et al19 evaluated ____ validity of the HINT by looking at both low- and high-risk infants. They recruited the low-risk group from well-baby clinics and day-care centers. The high-risk infants were recruited from neonatal follow-up programs and were considered at high risk for developmental delay because of premature birth, low birth weight, prenatal exposure to alcohol or drugs, or other major medical concerns. They found significantly different scores for the two groups, confirming that the HINT was effective in discriminating between high- and low-risk infants at 4, 5, 7, and 8 months of age.

construct validity (known groups method)

Harris and Daniels14 assessed _____ validity of the HINT using a panel of 26 researchers and clinicians from several disciplines who reviewed all three sections of the tool. They were asked to rate items based on ability to reflect important neurodevelopmental characteristics, likelihood to discriminate between infants with and without neuromotor developmental problems, clarity of wording, and not being culturally biased. Their percent agreement was evaluated and, based on their feedback, the researchers added some questions, revised wording, and expanded grading criteria for the infant assessment portion.

content validity

four metrics of QR trustworthiness

credibility (triangulation, member checking, negative case analysis), transferability (thick description, purposive sampling), dependability (audit trail, triangulation), confirmability (audit trail, triangulation, reflexivity)

With their focus on patients' early reactions after leg amputation surgery, Madsen et al41 recognized that patients gave insights during their hospital stay that were different from their perspectives weeks later when they had rationalized the experience after discharge and return home

dependability

how long it takes to complete a task, how long one can maintain a certain posture, or how long pain lasts after an activity.

duration (measurement for target behaviors in SSD)

content validity

establishes that the multiple items that make up a questionnaire inventory or scale adequately sample the universe of content that defines the construct being mesaured = tool measures content according to an expert based on theory

construct validity

establishes the ability of an instrument to measure the dimensions and theoretical foundations of an abstract construct = tool measures what its supposed to

criterion related validity

establishes the correspondence between a target test and a reference or gold standard measure of the same construct = the criteria of the tool matches other tools

Many adult day-care centers provide specialized services for older people with Alzheimer's disease. Hasselkus39 studied the experience of being a staff person in such a setting, focusing on the structure of the day's activities, interactions between staff and clients, and the meanings of those activities. The day-care program's goal was to maximize the strengths of clients, to facilitate opportunities for their self-expression, and to affirm self-worth in a structured, safe, and caring environment

ethnography

Xin et al13 used an SSD to study the effects of using a customized iPad app on self-monitoring behaviors in four students who were classified with autism spectrum disorder (ASD). Students were observed during 20-minute periods to determine if they were able to remain seated, pay attention to the teacher, and focus their work on a given assignment. Behaviors were observed in 2-minute intervals across the 20-minute sessions, with measures recorded as "+" for an occurrence of the target behavior or "-" for a nonoccurrence in each interval

frequency of occurence, interval recording (measurement for target behaviors in SSD)

Researchers designed A Very Early Rehabilitation Trial (AVERT) to study the efficacy and safety of early mobilization within 24 hours of stroke onset. Patients were recruited from 56 stroke units in 5 countries. In a single-blind , pragmatic randomized trial, they assigned 2,104 patients to receive either usual care or early out-of-bed mobilization focusing on sitting, standing, and walking. The primary outcome, measured 3 months after stroke, was the patient's score on the modified Rankin Scale (mRS), an assessment based on the level of independence or assistance needed for functional activities. The researchers hypothesized that more intensive, early out-of-bed activity would improve functional outcome at 3 months, reduce immobility-related complications, and accelerate walking

internal validity

Two testers can observe a patient performing the TUG simultaneously, each with their own stopwatch, independently recording their times.

interrater reliability

In the EI study, the neonatal health index was defined as the length of stay in the neonatal nursery adjusted for birth weight and standardized to a mean of 100. A higher score is indicative of better health. This is a(n) ______ scale because it has no true zero and the scores are standardized based on an underlying continuum rather than representing a true quantity.

interval scale

What scale is this?

interval scale

A single rater can observe and record scores from the TUG on successive trials. Part of the skill is being able to determine the exact time to click the stopwatch to start and stop the trial, as the patient rises from and sits in the chair.

intra rater reliability

triangulation

involves comparing varying sources of data to validate findings

negative case analysis

involves discussing elements of data that do not support or appear to contradict explanations that are emerging from preliminary data

member checking

involves opening up the analytical process to others, sharing preliminary findings, allowing them to offer validation, feedback, critique and alternative explanations that ultimately contribute to the credibility of findings

regression to the mean

is also associated with reliability of a test. when there is substantial measurement error there is a tendency for extreme scores on the pretest to regress toward the mean on the posttest / the extreme scores become less extreme over time

mixed design

is created when a study incorporates two IVs, one repeated across all subjects and the other randomized into independent groups

post-test only control group design

is identical to the pretest posttest design with the obvious exception that a pretest is not administered to either group / outcomes can only be assessed following the intervention

pretest post test control group design

is the basic structure of a randomized control trial with one IV. used to compare two or more independent groups that are formed by random assignment to determine if there is a significant difference between group outcomes from before to after intervention

For example, depending on the severity and type of stroke, patients in the AVERT trial could have improved within days of onset by virtue of neurological recovery.

maturation

maturation

may cause subjects to respond differently on a second measurement because they have grown older or more experienced or if healing has occured

test-retest reliability

measures the stability of scores between two points of time within the same participant measured by the correlation between responses of time 1 and time 2

In the discharge study, _________ included having participants read the coded data for accuracy.

member checking

The value of I 2 for the _______ by Lucas et al20 was 0%, indicating that heterogeneity was unlikely to be present and that the data were appropriate for pooling. This value is reported in the forest plot at the bottom of the column for out- comes (see Fig. 37-4).

meta analysis

role of researcher in ethnography studies

must have a strong bond with participants so the participant can trust and share important information

In the EI study, variables of sex and ethnicity are _________. In this case, sex is male/female (a dichotomous variable), and ethnicity was defined as Black, Hispanic, or White/Other. There were 562 girls and 520 boys. For mothers' ethnicity, 573 were Black, 119 were Hispanic, and 390 were classified as White/Other.

nominal scale

dependability

of data refers to how stable the data are over a span of time relevant to the study question at hand and the degree to which the study could be repeated with similar results

what is the difference between one way anova and two way anova

one way is used to compare three or more independent group means, the description of one way indicates that the design involves one IV or factor with three or more levels two way is used to indicate that it involves two IVs

In Madsen's study of patients with leg amputations, ________ interviews were conducted in the patients' homes 2 weeks postdischarge."Would you please start telling me what led to the amputation?" This was followed by questions about experiences and concerns during the hospital stay. Incidents that were observed during the hospital stay were brought forward to explore feelings. Participants also talked about getting home and their present concerns.

open ended interview

In the EI study, level of mother's education was ranked as 1 = "some high school," 2 = "completed high school," 3 = "some college," or 4 = "completed college." Birth order also represents a rank.

ordinal scale

MMT has typically been used to grade strength according to the patient's ability to move against gravity and hold against an examiner's resistance. Using a 12-point _______ (from 0 = "no contraction" to 12 = "normal strength"), the researchers questioned the sensitivity of MMT grades to change. They collected strength data for 20 subjects over multiple trials using MMT grades and percent of maximal voluntary isometric contraction (MVIC) using a strain gauge (ratio scale). The graph presents results for shoulder flexion, showing that there was a substantial range of strength within a single MMT grade. For example, MVIC ranged from 10% to 52% for an MMT score of 7. An MVIC of 30% could be graded between 4 and 9 on the MMT scale. These methods provide varying sensitivity, which will affect determination of progress and change over time. The choice of tool, therefore, could make a distinct difference in evaluative decisions.

ordinal scale

Researchers evaluated the _______ validity of the HINT by administering the test to a sample of children at 3 to 12 months of age and then performing the Bayley Scale of Infant Development-II at 17 to 22 months. They found that there was a weak correlation for the HINT and Bayley-II Mental Scale (r = -.11), but a moderate correlation with the motor scale (r=-.49)

predictive validity (type of criterion related validity)

Despite an increased focus on patient and family involvement in healthcare, these concepts remain poorly defined in the literature. Olding et al73 completed a _________ to investigate the range of literature on patient and family involvement in critical and intensive care settings

scoping review

In the case study of integration of OT in primary care, Donnelly47 used ________ interviews to cover five categories, including roles, physical space, community collaborations, collaborative practice, and administrative processes. Additional questions were also included in the interview guide to fit the individual's position, such as the executive director who did not have clinical responsibilities

semi structured interview

what is an ANOVA

statistical test to compare means between more than two groups of people

within-subjects design

subjects act as their own controls, taking someones measurements today then again in two weeks

Blanchard et al53 compiled a ________ to look at the effectiveness of corticosteroid injections compared to physical therapy intervention for adhesive capsulitis. They evaluated six randomized trials, with varied quality and sample sizes. They found that the corticosteroid injections had a greater effect on mobility in the short term (6-7 weeks) com- pared to physical therapy, but with no difference in pain. At 1 year, there was no difference in shoulder disability be- tween the two groups, with a small benefit in terms of pain for those who got the injection.

systematic review

Reddy et al12 did a __________ that looked at various therapies for pressure ulcers. Out of 103 RCTs, 54 directly evaluated different types of dressings. The studies were published from 1978 to 2008. They focused on patients of varied ages, in acute and long-term care, rehabilitation, and home settings, used varied outcome measures, and studied outcomes between 1 and 24 weeks. The authors concluded that the evidence did not show any one single dressing technique to be superior to others. However, most studies had low methodological quality (see Chapter 37) and they recognized the need for further research to better under- stand comparative effectiveness

systematic review

if the end of a tape measure is incorrectly marked, such that markings actually begin 0.25 inch from the end of the tape, measurements of height will consistently record values that are too short by 0.25 inch. We can correct this error by cutting off the extra length at the end of the tape

systemic error

The Falls Efficacy Scale-International (FES-I) is a 16-item self report questionnaire that assesses fear of falling. 4-point Likert scale ("Strongly Disagree" to "Strongly Agree"), patients are asked to rate their concerns about the possibility of falling when performing specific activities, with higher summative scores indicating greater fear. The FES-I is a self-report inventory completed by an individual using pencil and paper. It has been evaluated for __________ reliability by asking subjects to repeat the inventory on two separate occasions one week apart

test retest reliability

In the study of the FES-I, a 1-week interval was considered reasonable to ensure that significant changes in balance or fear of falling were unlikely but sufficient for subjects to no longer be influenced by recollection of their initial answers

testing interval

convergent validity

the extent to which a test correlates with other test of closely related constructs

discriminant validity

the extent to which a test is uncorrelated with tests of distinct of contrasting constructs = tool gives high scores for well people and low scores for sick people

predictive validity

the extent to which the target test can predict a future reference standard = tool predicts significant differences among different groups

concurrent validity

the extent to which the target test correlates with a reference standard taken at relatively the same time = tool gives similar scores as other tools on the same subject

ethnography

the method by which researchers attempt to understand a group or culture by observing it from the inside, without imposing any preconceived notions they might have. a qualitative method where researchers observe and/or interact with a study's participants in their real-life environment. explores natural occurring viewpoints and cultural patterns of a particular group

3x3=9 groups

the number of groups is the products of the digits that define the design

transferability

the results should be able to be applied in some way to other people in similar situations

In the previous example of day care study, Hasselkus39 provides a detailed description of the setting in terms of the staff makeup, client characteristics, the location, and the types of spaces available for daily activities. She also reports details about daily schedules and staff guidelines regarding monitoring clients.

transferability (using thick description)

In the study of staff in adult day care, Hasselkus checked her perceptions of meanings regularly against those of the staff.

triangulation

what is a one way ANOVA

used for a one way design with one IV

two way design with 2 repeated measures

used in studies with more than 1 IV

parallel forms reliability

used to assess the consistency of the results of two tests constructed in the same way from the same content domain

randomized block design

used when a researcher is concered that an extraneous factor might influence differences between groups, one way to control this effect if to build a variable into the design as an IV. This is used when an attribute variable called a blocking variable is crossed with an active IV

what is constant comparison in grounded theory

which can be seen as the "core category" of grounded theory, includes that every part of data, i.e. emerging codes, categories, properties, and dimensions as well as different parts of the data, are constantly compared with all other parts of the data to explore variations, similarities / each new piece of information is compared to data already collected to determine where the data agree or conflict

data saturation

A point when data collection can cease. It occurs when the information being shared with the researcher becomes repetitive. Ideas conveyed by the participant have been shared before by other participants; inclusion of additional participants does not result in new ideas.

inter-rater reliability

A measure of how similarly two different test scorers would score a test.

Children diagnosed with autism spectrum disorder (ASD) often experience anxiety. It is important to determine, however, whether measures of ASD can distinguish between anxiety and ASD symptoms as separate constructs, or whether these two traits are part of a common neurological process. This information is essential to determine appropriate diagnostic and intervention strategies. Renno and Wood26 studied 88 children with ASD, aged 7 to 11 years, who were referred for concerns about anxiety. They used two methods—standardized interviews and questionnaires—to assess both ASD severity and anxiety they were able to document that the two measures of autism had correlated scores, as did the two measures of anxiety—indicating _______ validity They were also able to show that the scores of autism and anxiety did not have high correlations—indicating _______ validity

- convergence validity - discriminant (divergent) validity

Types of Validity

- face - content - criterion (concurrent) - construct -discriminant -internal

In the motor skills study, a total of 3,092 citations were identified through the electronic and hand searches. After duplicate and ineligible citations were removed, 190 full-text articles were screened for eligibility requirements. A standard form was used for reviewers to assess study eligibility (available as a supplement). The final synthesis was based on nine papers.

Prisma (preferred reporting items for systematic reviews and meta analysis)

internal consistency reliability

Reliability assessed with data collected at one point in time with multiple measures of a single construct. A measure is reliable when the multiple measures provide similar results.

repeated measures designs

Research designs in which each subject participates in all conditions of the experiment (i.e., measurement is repeated on the same subject). also called within subjects design (comparing people to themselves) major advantage is the ability to control for the potential influence of individual differences

Recall the description of the Functional Gait Assessment (FGA), presented earlier. The FGA is a 10-item scale that assesses a person's ability to balance while walking. Each item is scored 0 to 3, with lower scores indicating greater impairment. Beninato and Ludlow74 studied the FGA with 179 older adults to determine if items mapped along a meaningful continuum, determine if the spread of tasks was sufficient to measure patients with varying functional abilities, and describe psychometric properties of individual items.

internal consistency

Vascular leg amputations often occur in frail and vulnerable populations. Rehabilitation generally focuses on gait training, rather than the patient's experience. Madsen et al41 designed a study to answer the question, "What is the main concern of patients shortly after having a leg amputated and how do they resolve it?" Understanding this experience can inform providers as to patient needs during hospitalization as well as planning for care post-discharge. Researchers sought to build a theoretical model to explain patients' behavior shortly after having a leg amputated as a result of vascular disease. Through observation and interviews, researchers collected data using the _________method, covering the period 4 weeks postsurgery in 11 patients. Data were examined for patterns until saturation occurred, yielding categories that focused on the patients' main concern: "How do I mange my life after having lost a leg?" These included being overwhelmed, facing dependency, managing consequences and building up hope. Continuing to systematically compare categories (i.e., ____________), researchers put the pieces together to explain observed behavior, eventually leading to a theoretical premise. The researchers identified that patients went through three phases as they realized they were experiencing a life-changing event: losing control, digesting the shock, and regaining control. These categories supported a core theory they termed "Pendulating," describing how patients were swinging both cognitively and emotionally throughout the process.

grounded theory design, constant comparison method

cross over design

half the subjects are assigned treatment one first, the other half getting treatment two- After a washout period, the subjects receive the alternative treatment, should only be used when the patients disease will not change over time

carryover effect

happens when one subject is exposed to multiple treatment conditions, can be reduced by allotting sufficent time between successive treatment conditions to allow for complete dissapation of previous effects

In the AVERT trial, we would be concerned if the clinical staff changed during the course of the trial, or if patients were involved in other activities during the trial that could affect their outcomes. We would also be concerned if patients were receiv- ing other treatments, such as occupational therapy, which could influence their functional recovery.

history

What are the threats to internal validity?

history, maturation, attrition, testing effects + reactive effetcs, instrumentation, regression to the mean, selection

2x3x4

includes 3 ivs with 2, 3 and four levels respectively

3x3

includes two IVs with 3 levels each

what is a two way anova

indicates 2 ivs, each iv may have 2 or more levels

Four types of reliability

inter-rater, test-retest, parallel forms, internal consistency

Consider a hypothetical functional assessment composed of six items: walking, climbing stairs, carrying 5 pounds, reaching for a phone, dressing, and getting in and out of a car. Each item is scored on an ordinal scale from 1 to 5, with 5 reflecting complete independence. The maximum possible total score is 30, which would indicate that an individual was fully independent in all items. We collect data on 14 patients.

internal consistency

There has been little research on the prevalence of borderline or overt dehydration. To our knowledge, there have been no qualitative studies that uncover, describe, and analyze the multiple but preventable factors that contribute to dehydration in nursing homes. The purpose of this 5-year anthropological study was to investigate the social, cultural, institutional, and clinical factors that influence eating behavior in nursing homes. These researchers observed what family caregivers and staff did to assist and support the older residents during meal times and took detailed notes about behaviors and gestures to encourage eating and drinking. In addition to the objective data of what residents ate and drank, data revealed widespread differences in patient health over that timeframe that could be directly linked to a systematic lack of time to provide support to eat. Detailed observations showed that many residents could eat and drink if someone were there to encourage and assist them.

qualitative research as a way of understanding sociocultural aspect

Previous research has documented numerous medical, demographic, and lifestyle variables that predict pressure ulcers within the population with SCI. However, a recent review suggests that additional evidence is needed to more adequately document the degree of ulcer-risk associated with psychological and behavioral factors that are relevant to primary and secondary intervention efforts. The aim of this article is to identify overarching principles that explain how daily lifestyle considerations affect pressure ulcer development as perceived by adults with SCI. The results of this study showed that far from forgetting what they had been taught, most patients worked diligently to adhere to their pressure relief protocols, despite obstacles. Data revealed, for example, instances where wheelchair equipment broke down or transportation services never arrived, challenging individuals' ability to take optimal care of their skin. The study reminded the therapists that "real life" poses major challenges to pressure ulcer prevention, and teaching patients to shift weight and use a properly inflated wheelchair cushion is not sufficient.

qualitative research as a way to gain exploratory insight of a phenomenon

If a patient is fidgeting while their height is being measured, _____ errors may cause the observed scores to vary in unpredictable ways from trial to trial. The examiner may be inconsistently positioning herself when observing the tape, or the tape may be stretched out to a greater or lesser extent during some trials, resulting in unpredictable errors.

random error

in the EI study, mother's age (years) and child's birth weight (grams) are examples of

ratio scale

credibility

refers to actions that are taken to ensure that the results of a QR study are believable

confirmability

refers to ensuring as much as possible that findings are due to the experiences and ideas of the participants rather than the characteristics and preferences of the researchers

selection

refers to factors other than the experimental intervention that can influence outcomes when groups are not comparable at baseline. leaves open the potential for threats to internal validity that may affect the groups differently

reflexivity

refers to systematic consideration of how researchers shape and are shaped by the QR process

history

refers to the confounding effect of specific events, other than the experimental treatment, that occurs after the introduction of the IV or between pretest and posttest

In the study of the discharge process, the research team was composed of internal medicine physicians. The team held regular sessions to achieve consensus on coding. They also addressed ______ by using an interdisciplinary team of physicians and behavioral scientists to review their analyses from multiple perspectives.

reflexivity

thick descriptions

reporting study details that make comparisons across studies possible, such as the participant characteristics, study setting, sources of data and collection techniques and data collection period