Chapter 12 Understanding Mixed Methods Research, Quality Improvement, and Other Special Types of Research Flashcards

(37 cards)

1
Q

Mixed Methods Research

A

Research that integrates quantitative and qualitative
data and strategies in a single study or coordinated
clusters of studies

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2
Q

Advantages of Mixed Methods Research

A

Complementarity

Practicality

Enhanced validity

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3
Q

Purposes and Applications of Mixed Methods Research

A

Instrument development

Intervention development

Hypothesis generation and testing

Explication

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4
Q

Concurrent Approach

A

Qualitative and quantitative data are collected at the same time

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5
Q

Sequential Approach

A

Qualitative and quantitative data are collected in phases

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6
Q

Convergent Parallel Design

A

Obtain different, but complementary, data about the central phenomenon under study—i.e., to triangulate data sources

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7
Q

Explanatory Design

A

Sequential designs w/ quantitative data collected in the 1st phase, followed by qualitative data collected in the 2nd phase

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8
Q

Exploratory Design

A

Sequential MM designs, with qualitative data being collected first

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9
Q

Quality Improvement (QI)

A

Involves assessments of a problem in patient care
with the aim of improving clinical care and patient
outcomes within a healthcare organization to
develop improvement science

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10
Q

QI Interventions

A

Quality Improvement Interventions include:
- Provider education (teaching healthcare teams how
best to manage situations)

- Provider reminders (providing decision support materials to prompt healthcare professionals to undertake some action)

- Patient education (increasing patient’s understanding of a prevention or treatment strategy)

- Patient reminders (reminding patients to keep appointments or adhere to regimens)

- Structural changes (creating care coordination or case management systems)
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11
Q

Root Cause Analysis (RCA)

A

” 5 Whys”

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12
Q

Plan-Do-Study-Act (PDSA) Approach

A

Plan: Develop strategies or interventions
Do: implement interventions and collect data
Study/Check: run analysis on collected data
Act: dissemination of outcome results as appropriate for practice changes

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13
Q

Which type of research involves an intervention?

A) Survey research
B) Clinical trials
C) Secondary analyses
D) Methodological research

A

B) Clinical Trials

Rationale: Studies that involve an intervention include
clinical trials, evaluation research, and nursing
intervention research. Outcomes research, surveys,
secondary analyses, and methodological research do
not involve an intervention.

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14
Q

Clinical Trials

A

Studies that develop clinical interventions and test
their efficacy and effectiveness

Undertaken to evaluate an innovative therapy or
drug are often designed in a series of phases

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15
Q

Phase I of Full Clinical Trial

A

Designed to establish safety, tolerance, and dose

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16
Q

Phase II of Full Clinical Trial

A

Seeks preliminary evidence of effectiveness—a pilot test often using a quasi-experimental design

17
Q

Phase III of Full Clinical Trial

A

Fully tests the efficacy of the treatment via a randomized clinical trial (RCT), often in multiple sites
- Sometimes called an efficacy study

18
Q

Phase IV of Full Clinical Trial

A

Focuses on external validity (effectiveness) of an intervention in the general population
- Emphasis on generalizability

19
Q

Practical/Pragmatic Clinical Trials

A

Help in making decisions in real-world application

20
Q

Pragmatism

A

A paradigm often associated w/ MM research, which provides a basis for a position that has been stated as the “dictatorship of the research question”

21
Q

Evaluation Research

A

Examines how well a specific program, practice,
procedure, or policy is working

22
Q

Process Analysis

A

Often undertaken to obtain descriptive
information about the process by which a
program gets implemented and how it actually
functions

23
Q

Economic Analysis

A

Assess whether program benefits outweigh its monetary costs

24
Q

During which phase of a full clinical trial would an
efficacy study be done?

A) Phase I
B) Phase II
C) Phase III
D) Phase IV

A

C) Phase III

Rationale: Phase III fully tests the efficacy of the treatment via a randomized clinical trial (RCT), often
in multiple sites; this phase is sometimes called an
efficacy study.

Phase I finalizes the intervention; phase II seeks preliminary evidence of effectiveness, usually via a pilot test; and phase IV focuses on long-term consequences of the intervention and on generalizability (sometimes called an effectiveness
study).

25
Nursing Intervention Research
Describes an approach distinguished by a distinctive process of planning, developing, & testing interventions—especially complex interventions
26
Comparative Effectiveness Research (CER)
Involves direct comparisons of two or more health interventions Seeks insights into which intervention works best for which patients Sometimes referred to as patient-centered outcomes research
27
Health Services Research
Designed to document the quality and effectiveness of health care and nursing services
28
Focus of Health Services Research
Often focuses on parts of a healthcare quality model developed by Donabedian Key concepts: o Structure of care (e.g., nursing skill mix) o Processes (e.g., clinical decision making) o Outcomes (end results of patient care)
29
Outcomes Research
Subset of health services research Comprises efforts to understand the end results of particular health care practices and to assess the effectiveness of health care services Represents a response to the increasing demand from policymakers and the public to justify care practices in terms of improved patient outcomes and costs
30
Survey Research
Obtains quantitative information (via self-reports) on the prevalence, distribution, and interrelations of variables in a population Used primarily in correlational studies and to gather information from nonclinical populations Secures information about people’s actions, intentions, knowledge, characteristics, opinions, and attitudes May be cross-sectional or longitudinal
31
Modes of Collecting Survey Data
Personal (face-to-face) interviews: Tend to yield the highest quality data but are very expensive Telephone interviews Self-administered questionnaires  Distributed by mail or the Internet
32
Tell whether the following statement is True or False. Telephone interviews provide the best quality data for survey research. A) True B) False
B) False Rationale: Personal interviews used with survey research tend to provide the highest quality data, but they are very expensive.
33
Secondary Analysis
Study that uses previously gathered data to address new questions Can be undertaken with qualitative or quantitative data Cost-effective; data collection is expensive and time-consuming. Secondary analyst may not be aware of data quality problems and typically faces “if only” issues (e.g., if only there was a measure of X in the dataset).
34
Delphi Surveys
Developed as a tool for short-term forecasting The technique involves a panel of experts who are asked to complete several rounds of questionnaires focusing on their judgments about a topic of interest. Multiple iterations are used to achieve consensus.
35
Methodological Research
Studies that focus on development, validation, and evaluation of research tools and instruments Can involve qualitative or quantitative data
36
Examples of Methodological Research
Developing and testing a new data collection instrument Testing the effectiveness of stipends in facilitating recruitment
37
Guidelines for Critical Appraisal of Mixed Method Studies
Was the study exclusively qualitative or exclusively quantitative? If so, could the study have been strengthened by incorporating both approaches? If the study used an MM design, did the inclusion of both approaches contribute to enhanced validity? In what other ways (if any) did the inclusion of both types of data strengthen the study & further the aims of the research? In a QI project, were adequate methods used to identify the root cause of the problem being addressed? Was PDSA (or another QI model) used to guide the process, and was it used appropriately? Was a good research design used to assess the effects of the QI changes?