EIP Final

characteristics of ethnography

1. Specific Cultural Groups 2. Outsider to the Culture 3. Attitudes, Beliefs, & Behaviors 4. Immersion

Outcome on test A predict outcome on similar test B

Predictive Validity

degrees of freedom (df)

Sample size: the number of independent pieces of information remaining after estimating one or more parameters df=(population)-1

How do you increase the power of your study

increase sample size

coorelation

strength of relationship between variables Ex:

pros of qualitative research

uses smaller sample sizes open-ended process fluid operational structure vs. rigid guidelines explains something which numbers alone are unable to reveal more flexible approach targeted and specific more affordable

When the researcher becomes immersed in the subject's way of life, observing and interviewing the subject in order to understand the culture and how beliefs and attitudes shape behavior and feelings.

Ethnography study

Level 3 evidence

Evidence provided by expert opinion, case series, case reports and studies with historical controls

Level 1 evidence

Evidence provided by one or more well designed, randomized, controlled clinical trials, including overviews (meta-analyses) of such trials

Design, quantitative data is collected first and THEN qualitative data is collected to explain the quantitative results

Explanatory Sequence

Qualitative Research Designs

-Case Study -Ethnography -Phenomenological Study -Grounded Theory Study -Content Analysis

Characteristics of case studies

1. Individuals condition 2. Unusual patient problems 3. Innovative Treatment approaches 4. Analysis and Understanding

Spearman's Rank Order Correlation Coefficient

A correlation coefficient for data that have been ranked or ordered with respect to the presence of a given characteristic (nonparametric=nominal/ordinal data)

If you have a range of scores on a test of 60-100, with a mean score of 83 and a SD of 1.5 Does the SD indicate scores were dispersed closely or widely around the mean?

Closely around mean

Two test that test sam thing agree and have similar results

Concurrent validity

The researcher collects data from interviews and codes and analyzes the data simultaneously, which may lead to research hypotheses grounded in the observations.

Grounded theory

Reliability: The degree that scores correlate between more 2 or more test administrators is what type of reliability?

Inter-rater

Two people give the test on same person gets same results

Inter-rater reliability

Appraisal of Validity and Trustworthiness

Is it a primary source? If it is a primary source - original data on the topic with no third-party commentary - do a reliability & validity check. Was it peer reviewed? Is it up to date? What research design and quality was used? What was measured? What was the sample size? Instrumentation?

Minimal clinical important difference

MCID: clinically important, to deterime the meaninfulness of the change in pt status

is a type of systematic review that synthesizes the results of qualitative studies.

Meta-Synthesis

A review article that describes previous work and gaps on a topic in the literature, has one rater review the articles, and lacks detailed methods on how articles were selected for review is an example of a:

Narrative review

Clinical Expertise

Our education, training, clinical skills and past experience

What sampling method DOES NOT apply when selecting subjects to participate in a qualitative research study?

Randomized sampling methods where subjects are selected randomly from the general population

The following is an example of which type of literature review? A review was conducted to explore and understand health risks and outcomes of homelessness in school-age children. The literature search found limited research on this topic that especially related to developing interprofessional programming for this population.

Scoping Review

What IS NOT a method for collecting data in a qualitative research study?

Standardized Test

Practice Guidelines

a type of rigorous systematic review and answer the question: "Is this treatment appropriate for my patient?" They are based on a summary of literature in a given area and translate the summaries into specific recommendations for clinical practice.

Comparative

compares difference between groups Ex: is there a difference between male and female OT grad students PA levels?

A researcher uses a scale of 1-5(strongly agree to strongly disagree) to measure students's opinions on whether we should have Final Exams. This is an ex of what level of measurement?

ordinal

Narrative Discourse/Conversation Analysis Researchers describe

the lives of individual, collect and tell stories about people lives and write narratives about people lives.

Phenomenology the researcher describes

the participants' lived experience and gives a voice to their viewpoint about a phenomenon, situation, or condition.

Some drawbacks or challenges with qualitative research studies are

time consuming and the results are challenging to replicate

Minimum power required

80% or .8 or greater

Null Hypothesis (H0)

A statement of "no difference."

Research Evidence:

Clinically relevant research, often from the basic sciences of medicine, but especially from patient-centered clinical research

How well a test measures what it claims

Construct validity

Mixed methods design: Researchers are studying in-home caregivers' confidence of caring for a person post stroke. They administer a caregiver's confidence assessment scale in conjunction with personal interviews to see if the participants' views agree with the survey results.

Convergent Mixed

Standard Error of Measure

Estimate how repeated measures tend to be distributed around "true" score

What is p-value (probability values)?***

Refers to the probability that a condition or circumstance would happen just by chance without experimental intervention

observer as participant

Researcher interacts casually with participants, but still remains primarily an observer, and does not become a member of the group being studied.

A review article that surveys the range and extent of the literature on a broad topic of interest in an emerging area of research and is often used to determine if a systematic review is warranted is an example of a:

Scoping Review

is an exploratory assessment that reviews and summarizes emerging evidence on a broad topic.

Scoping Review

A review article that is a comprehensive summary of the literature, critically appraises literature of varied research designs (including mixed methods designs), and has multiple raters review the articles is an example of a:

Systematic Review

A comprehensive summary of the literature that critically appraises literature of varied designs detailed in a systematic manner.

Systematic review

Voluntary Response Sampling

The sample is obtained again from a group of people that are easy to contact, but instead of the researcher selecting the participants the individuals "volunteer"

Client Values:

Unique preferences, concerns, and expectations each patient brings to a clinical encounter

Describing the individual's condition or response to treatment, unusual patient problems, or innovative treatment approach and the results are key. What type of qualitative design

case study

Ordinal data

data exists in categories that are ordered but differences cannot be determined or they are meaningless. (Example: 1st, 2nd, 3rd) nonparametric testing

Nominal data

data of categories only. Data cannot be arranged in an ordering scheme. (Gender, Race, Religion) nonparametric testing

Ratio Data

data with an absolute 0. Ratios are meaningful. (Length, Width, Weight, Distance) parametric statistics

complete participant

participates fully; true identity and purpose are not known to subjects

Process of conducting qualitative research

planning, conducting observations, and considering additional issues

Semi-Structured Interviews

pre-developed questions with some flexibility if needed

Must be tied to understanding, explanation, or the development of theory about an observed phenomenon; Relies on words and images; Uses the subject's own words and narrative summaries of observable behavior to express data, not numbers

qualitative study design

Unstructured Interviews

research has a general idea of topics, but what happens during the interview leads the researcher

A type I error occurs when

you reject null when it is true "false positive"

characteristics of phenomenology

1. Ordinary Members Phenomenology focuses on the ways in which ordinary members of society attend to their everyday lives. 2. Subjective Materials Phenomenology seeks to draw meaning from complex realities through careful analysis of narrative subjective materials. 3. Voice Phenomenology gives voice to the person being studied and requires that the researcher present the subject's view of his/her world.

According to Finn et al (2005), the criteria for distinguishing between science and pseudoscience are as follows:

1. Untestable: Is the treatment unable to be tested or disproved? 2. Unchanged: Does the treatment approach remain unchanged even in the face of contradictory evidence? 3. Confirming Evidence: Is the rationale for the treatment approach based only on confirming evidence with disconfirming evidence ignored or minimized? 4. Anecdotal Evidence: Does the evidence in support of the treatment rely on personal experience and anecdotal accounts? 5. Inadequate Evidence: Are the treatment claims incommensurate with the level of evidence needed to support those claims? 6. Avoiding Peer Review: Are treatment claims unsupported by evidence that has undergone critical scrutiny? 7. Disconnected: Is the treatment approach disconnected from well-established scientific models or paradigms? 8. New Terms: Is the treatment described by terms that appear to be scientific but upon further examination are found not to be scientific at all? 9. Grandiose Outcomes: Is the treatment approach based on grandiose claims or poorly specified outcomes? 10. Holistic: Is the treatment claimed to make sense only within a vaguely described holistic framework?

Organization, entity, individual, or event, and uses interviews, documents, reports, and observations to come up with a comprehensive description of a patient's history, current status, and response to an intervention.

Case study

The following is an example of which type of qualitative study? Impact of a Child-Based Health Promotion Service-Learning Project on the Growth of Occupational Therapy Students This study revealed the lived experiences of occupational therapy students as they embarked on a semester-long volunteer health promotion service-learning project during their entry-level master's program. Data analysis extrapolated themes from student journals, transcriptions of pre-and-post interviews, and field notes. Student roles were exemplified by what students wanted to learn, what they actually learned, and the unexpected benefits they experienced. In particular, issues with teaming, interprofessional development, and time management were discovered. The findings add to the growing literature about the benefits of service-learning as a teaching strategy and how it facilitates mindfulness of community service, communication, and clinical reasoning of future therapists. Implications for learning and practice are discussed.

b. Phenomenological

Harm Questions

Does the diagnostic procedure, treatment, or therapy increase harm to the patient - increased incidence of side effects, major safety events, hospitalization, death, disability, or major health events? Do the benefits outweigh the risks?

Prognosis Questions

Does the procedure, treatment or therapy increase the quality of life or length of mortality, or does it decrease associated complications or associated costs of care? Does the intervention of interest add value to traditional treatment?

Relevance to your Question

Does this study investigate a population similar to my client? Does the study review an intervention that I could use to advance my client's goals? Are the study's outcomes related to my question? If the study does not perfectly match my PICO elements, can it provide clinically relevant insights to guide clinical decisions?

Level 2 evidence

Evidence provided by well-designed observational studies with concurrent controls (e.g., case control or cohort studies)

Mixed methods design: Therapists are given a survey (based on a Likert scale) about their competency training patients to use assistive technology. Afterwards, the therapists participate in a focus group to get data to explain what they reported about their competency on the survey.

Explanatory Sequential Mixed Method design.

A mixed-methods study that collects quantitative data first, and THEN collects qualitative data to explain the quantitative results is an example of a/an:

Explanatory Sequential Mixed Methods Design

Design involves collecting qualitative data first to explore the topic and THEN collecting quantitative data to measure the variables indicated by the qualitative data.

Exploratory Sequence

Mixed methods design: Clients with TBI were interviewed to get their views on their ability to go shopping at the grocery store. Findings were analyzed and then a survey was developed to determine what factors posed the greatest barriers to grocery shopping.

Exploratory Sequence

A mixed-methods study that collects qualitative data first to explore the topic, and THEN quantitative data is collected to measure variables indicated by qualitative data is an example of a/an:

Exploratory Sequential Mixed Methods Design

Generalized to population, survey research, ethnographical what type of validity

External validity

Some of the arguments AGAINST using qualitative research designs are that they use a more flexible approach and can explain phenomena not easily explained or revealed with numbers and ordinal data. T/F

False

The following is an example of a Scoping Review. A review and critical analysis were conducted on mindfulness-based interventions used to reduce the risk of burnout in healthcare professionals. Articles were selected based on specific criteria that allowed different types of research designs, including mixed methods. T/F

False

Grounded Theory

Focus: Develop a theory grounded in field data Data collection methods: Interviews; open and axial coding

Narrative

Focus: Individual experience and sequence (storyteller) Data collection methods: Stories from individuals and documents

Case Study

Focus: Organization, entity, individual, or event Data collection methods: Interviews, documents, reports, and observations (Viagra created by looking at improvement at blood flow to the heart from one subject that had increased BF to penis)

Phenomenology

Focus: People who have experienced a phenomenon (lived experience) Data collection method: Interviews

Cohen's D and Pearson's Product-Moment correlation

Parametric(Ratio/interval data)

Researchers focus on how individuals have experienced a phenomenon through interviews and careful analysis.

Phenomenological study

Purposive Sampling

Subjects are not selected randomly but rather for a specific purpose by the researcher to best meet the needs of the study. This is also known as 'judgment sampling

A review article give comprehensive summary of literature of varied designs including mix-methods and has mutliple reviewers. What type of review article?

Systematic review (more detailed anaylsis)

Therapy Questions

Was the assignment of patients to treatment groups randomized? Were all enrolled patients accounted for at the conclusion of the study? Were the treatment groups similar at the start of the study?

Case studies the researcher

a comprehensive description of a patient's history, current status, and response to intervention.

Ethnographic study, the researcher describes

a culture from the perspective of an insider or those who belong to that culture.

Cohen's d

a measure of effect size that assesses the difference between two means in terms of standard deviation, not standard error

Type II error occurs when

a researcher concludes that the independent variable had no effect on the dependent variable, when in truth it did; a "false negative"

Complete Observer

a researcher who observes from the periphery, watching the scene unfold in front of them without participants aware of the research

power analysis

a statistical method to determine the acceptable sample size that will best detect the true effect of the independent variable

A mixed-methods study that send out a survey with both quantitative and qualitative questions at the same time

convergence

Pearson's Product-Moment correlation

correlation analysis technique for use with metric data

Artifacts

provide material evidence that contributes to the breadth and depth of information collected by the researcher.

Clinical practice guidelines

systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances

Grounded Theory, The researcher explains

the phenomenon being studied through the analysis of relationships among concepts. She/he develops research hypotheses to explain what is happening and perhaps why.

Statistical power

the probability that you will reject the null hypothesis when you should that the study will give a significant result if the research hypothesis is true

Critical appraisal

the process of carefully and systematically examining research to judge its trustworthiness, and its value and relevance in a particular context

participant as observer

the researcher is both participant and observer; researcher openly acknowledges the research purpose, but also takes an active role in the interaction

When researchers conduct a literature review and systematically select a number of specific studies that meet their criteria to summarize and publish the results in a literature review article, this is an example of:

Completing a literature review as a PRODUCT (SYNTHESIS)

Ethnography

Focus: Context or culture Data collection methods: Observation or interviews (Women's basketball team during their season)

Diagnosis Questions

Is the test affordable, accurate, & available in my area? Can I estimate the pretest probability of the disease in question? Will the posttest probability affect my patient management?

Convenience Sampling

The sample is obtained by "convenience" from a group of people that are easy to contact or reach

Snowball Sampling

This method is used when it is difficult to recruit participants for a study. Researchers will use participants to recruit other participants, therefore the number of people they have access to "snowballs" as they get in contact with more and more people.(wordofmouth)

minimal dectectable change

minimal amount of change that is not likely to be due to chance variation in measurement

Whats is goal of qualitative research

to identify, describe, and ultimately understand human or organizational behaviors, attitudes, and experiences and how they influence health"

Evaluating Practice guidlines

1. Are the guidelines based on credible evidence?​ 2. Does my client resemble the types of clients described in the guidelines? 3. Do I have the resources to do what the guidelines suggest? 4. Do I need specialized training or expertise to implement the guidelines? 5. Do I have the resources to get the needed training? 6. Does the client have the resources to implement the guidelines? 7. How comprehensive are the guidelines?

characteristics of Grounded Theory

1. Collecting & Analyzing Data Grounded theory is an exploratory technique consisting of systematic inductive guidelines for collecting and analyzing data to build middle-range theoretical frameworks that explains the collected data. 2. Explains Phenomenon The goal of Grounded Theory is to explain the phenomenon being studied through the analysis of relationships among concepts. 3. Research Hypothesis Grounded Theory allows the researcher to develop research hypotheses as the data unfolds using inductive processes. 4. Theory Theory can be developed as the data unfold. 5.Observations The researcher collects, codes, and analyzes data simultaneously, identifying relevant variables, which may lead to the development of theoretical concepts that are "grounded" in the observations.

What does qualitative research do?

1. Explores how human behavior is philosophically different than quantitative research designs 2. Describes the nature of humans and how individuals perceive their own experiences within a specific social context 3. Uses the subject's own words and narrative summaries of observable behavior to express data, not numbers 4. Relies on words and images 5. Tied to understanding, explanation, or the development of theory about an observed phenomenon

Pseudoscience:

A pretended or spurious science; a collection of related beliefs about the world mistakenly regarded as being based on scientific method or as having the status that scientific truths now have

Results and Conclusions

Are there limitations & bias? What is the significance of the results (e.g., Effect size? Implications for your practice? Relevance? Generalizable?)?

Systematic Reviews

At the top of the evidence pyramid are systematic reviews. Systematic reviews provide the strongest research evidence, since they answer specific research questions in review of existing literature. They employ a specific methodology to reduce bias (i.e., identify, evaluate, and summarize), which leads to credible sources of evidence. Qualitative (Meta-Synthesis) Quantitative (Meta-Analysis)

Structured Interviews

oral administration of a written questionnaire

The following is an example of which type of qualitative study? The Use of Animal-Assisted Therapy in Combination with Physical Therapy in an Inpatient Rehabilitation Facility Background Animal-assisted therapy (AAT) is a growing form of intervention in the field of rehabilitation often with the goals of decreasing pain, anxiety, and depression. There is a lack of literature on the use of AAT in inpatient rehabilitation facilities (IRF). Materials and methods This patient was treated with standard of care physical and occupational therapy in an IRF with the addition of AAT within 32% of the therapy sessions. AAT sessions focused on sitting and standing tolerance, standing balance, endurance, ambulation, stair negotiation and kitchen mobility. Clinical measures included the 6 Minute Walk Test (6MWT), the Functional Independence Measure (FIM) total score and the FIM motor subscale score. Clinical findings From admission to discharge from the IRF, change was noted in the areas of sitting tolerance, total FIM score, the motor subscale score of the FIM, and on 6MWT distance. Due to other therapies simultaneously occurring, no conclusions on AAT as a treatment can be made. AAT did provide more opportunities for this patient to engage in therapeutic activities. Conclusion AAT was used during PT, in attempt to facilitate participation and distract from pain in order to work on therapeutic activities and achieve the patient's functional goals. This case report can be used as a model for other IRF therapy programs interested in AAT, can provide information about a therapeutic modality and hopefully will inspire future rigorously designed research studies. Denzer-Weiler, C., & Hreha, K. (2018). The use of animal-assisted therapy in combination with physical therapy in an inpatient rehabilitation facility: A case report.

Case study

A mixed-methods study that collects quantitative and qualitative data at the same time is an example of a:

Convergent Mixed Methods Design

Design involves collecting quantitative and qualitative data at the same time (agreement between both results)

Convergent mixed (ex: Effect of Ice cream: metabolic panel and interviewing how subject feels)

The following is an example of which type of qualitative study? Delivering High Quality Hip Fracture Rehabilitation: The Perspective of Occupational and Physical Therapy Practioners. Aim: The majority of post-acute hip fracture rehabilitation in the US is delivered in skilled nursing facilities (SNFs). Currently, there are limited guidelines that equip occupational and physical therapy practitioners with a summary of what constitutes evidence-based high quality rehabilitation. Thus, this study aimed to identify rehabilitation practitioners' perspectives on the practices that constitute high quality hip fracture rehabilitation. Methods: Focus groups were conducted with 99 occupational and physical therapy practitioners working in SNFs in southern California. Purposive sampling of facilities was conducted to capture variation in key characteristics known to impact care delivery for this patient population (e.g., financial resources, staffing, and patient case-mix). Questions aimed to elicit practitioners' perspectives on high quality hip fracture rehabilitation practices. Each session was audio-recorded and transcribed. Data were systematically analyzed using a modified grounded theory approach.

Grounded Theory

1 person gives the test multiple times same results

Intra-rater reliability

A review article that contains statistical analysis of the outcomes from quantitative studies is an example of a:

Meta-Analysis

Quantitative studies on the effectiveness of multifactorial intervention in preventing falls among older adults were selected and reviewed using a statistical analysis of results to compare treatments

Meta-Analysis

A review article that synthesizes results of qualitative studies is an example of a

Meta-Synthesis

A review was conducted on interprofessional healthcare interventions for individuals with substance abuse problems. The review integrated and analyzed findings from multiple qualitative studies

Meta-Synthesis

is a statistical method used in a systematic review that mathematically analyzes the results of quantitative studies. (Highest level-quantitative data)

Meta-analysis

The following is an example of which type of qualitative study? A Qualitative Analysis of Burn Injury and Recovery on Peer Support Websites Methods: This qualitative enquiry began with a comprehensive overview of burn narratives on survivor peer generated websites. We conducted a purposeful sampling of 21 biographies posted on burn survivor peer and patient support websites. Participants with greater than 30% burn injury were included that provided narrative and discourse regarding burn recovery and survivorship. Underlying story arcs, meaning behind sentences and shared language of the experience were investigated using thematic analysis. Results: Four themes were identified: retelling of the traumatic event; social support; body image, the new normal; and rebirth and transformation. Accounts reflected the traumatic nature of the event with slowed downtime, attention to details and heightened recall.

Narrative Discourse

A descriptive review of the literature that summarizes previous work and gaps in the literature.

Narrative Review

A review was conducted to describe the literature on patients safety in the elderly with Parkinsons' Disease. The review included articles that identified interprofessional intervention approaches, sources of the evidence, and reported outcomes

Narrative Review

Researchers study one or two individuals, gathering data through the collection of their stories, reporting individual experiences, and chronologically ordering the meaning of those experiences.

Narrative study

The following is an example of which type of qualitative study? Hip-Fracture Care in Rural Southwestern Ontario: A Study of Patient Transitions and Physiotherapy Handoffs Purpose: To examine information exchange by physiotherapists during care handoffs of patients with hip fractures in a rural health care setting. Methods: This study used observation and interviews of 11 networks of patients with hip fracture (n ¼ 11), family caregivers (n ¼ 8), and health care providers (n ¼ 24). Patients were followed from acute care through each subsequent care setting. Data were supplemented by health care records and policy documents. Results: Findings revealed that handoffs were less successful when information transfer was untimely or incomplete. Family caregivers experienced challenges in obtaining information required to facilitate the handoff, especially when direct contact with physiotherapists was not possible as a result of distance or other factors. Physiotherapists had to navigate multiple data sources to retrieve important information and managed information gaps in various ways. Information flow was often unidirectional and suggested no further clinical accountability for the discharging physiotherapist. Conclusions: Providing information in a structured and timely fashion facilitated physiotherapy handoffs. Inadequate handoffs compromised continuity of care, delayed progress in rehabilitation, and resulted in families' missing information of vital importance to their caregiving role. A multi-directional exchange of information is needed between patients, families, and health care providers across care settings. Johnson, H., Forbes, D., Egan, M. Y., Elliott, J., Stolee, P., & Chesworth, B. M. (2013). Hip-fracture care in rural southwestern Ontario: An ethnographic study of patient transitions and physiotherapy handoffs.

d. Ethnographical

Using a mixed-methods design can

decrease bias and increase validity of a study by triangulating data sources.

Interval Data

differences between values can be found but is NO absolute ZERO. Examples: temperature F, time parametric statistics

A researcher immerses themsleves in the way of life in order to examine the attitudes and challenges of caregivers for family members with CVAs what type of qualitative design

ethnology

highly controlled, experimental, correlational what type of validity

internal validity

cons of qualitative research

more time consuming data is subjective limited generalizability due to small sample sizes & not statistically analyzed challenging to replicate results data can be missed if the wrong questions are asked