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Evidence Based Practice > exam 3 > Flashcards

exam 3 Flashcards

1
Q

what is assent and who gives it in research?

A

an agreement to participate in research - agreement of a child or adult to participate in the stud

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2
Q

What are the international standards for ethical research?

A

The Nuremberg Code
-Code emphasizes voluntary consent and contains guidelines related to protecting subjects from harm and balancing the benefits and risks of a study
-Qualified, ethical, beneficial, and credible
-Written in response to Nazi experiments

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3
Q

Which populations are considered vulnerable and require additional protection

A

people who are susceptible to coercion and influence - children, prisoners, economically/educationally disadvantaged

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4
Q

What are the four elements required for informed consent?

A

-disclosure
-the participant must comprehend the information
-the competence of the participant
-the persons voluntary agreement to be in the study

  • researcher must DISCLOSE essential information
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5
Q

Coercion

A

overt threat of harm or excessive reward intentionally presented by one person to another to obtain compliance

ex: money, gift cards

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6
Q

Research Misconduct

A

The fabrication, falsification, or plagiarism in processing, performing, or reviewing research, or in reporting research results.

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7
Q

Privacy

A

Freedom to determine the time, extent, and general circumstances under which private information will be shared with or withheld from others.

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8
Q

Confidentiality

A

Safe management of information or data shared by a participant to ensure that the data are kept private from others

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9
Q

Ethical Principle: Justice

A

fairness

right to fair treatment
right to privacy

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10
Q

Ethical Principle: Beneficence

A

promote good

right to protection from harm and discomfort

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11
Q

Ethical Principle: Autonomy

A

respect for persons

right to self-determination
right to full disclosure

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12
Q

questionnaires

A

are self-reported
-written
-verbal
-electronic

LOWER THAN 50% is a Poor Response Rate

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13
Q

Pros and Cons with Interviews

A

involves the participant
-structured: focused questions
-unstructured: ask participants to tell you something

Pros:
-the response rate improves

Cons: time-consuming and costly

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14
Q

Observational Measures

A

structured: records in categories that were observed like a checklist

unstructured: record sentences about what was observed like notes

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15
Q

reliability

A

consistency / precision

-test-retest reliability: more than one observer verifies it

-determines the measure of error or the scale that was used in the study

-If it is α > or equal to .80, it is CONSISTENT/reliable

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16
Q

Validity

A

extent to which an instrument reflects the concept being examined

-content validity
-construct validity

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17
Q

precision

A

comparable to reliability

degree of consistency or reproducibility of measurements made with physiological instruments

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18
Q

accuracy

A

comparable to validity

-did the instrument measure what it was supposed to measure ?

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19
Q

a nurse researcher is interested in the development of empathy in nursing students. Finding the lack of an appropriate instrument to use to study empathy in this population, the researcher has written a new instrument to gather data about the presence of empathy in nursing students.

What is the major construct of interest?

A

the major construct of interest for the new instrument is empathy

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20
Q

a nurse researcher is interested in the development of empathy in nursing students. Finding the lack of an appropriate instrument to use to study empathy in this population, the researcher has written a new instrument to gather data about the presence of empathy in nursing students.

what are the key questions the researcher needs to answer to confirm the instrument’s content validity?

A

The researcher needs to confirm how well the items on the instrument reflect the description of empathy in the literature, confirm the relevance of items on the instrument by content
experts’ evaluation, and examine potential subjects’ responses to the instrument’s items.

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21
Q

a nurse researcher is interested in the development of empathy in nursing students. Finding the lack of an appropriate instrument to use to study empathy in this population, the researcher has written a new instrument to gather data about the presence of empathy in nursing students.

what is the Cronbach alpha coefficient measure? was it considered strong?

A

internal reliability when there are multiple items on a scale 0.80 or higher is stronger

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22
Q

a nurse researcher is interested in the development of empathy in nursing students. Finding the lack of an appropriate instrument to use to study empathy in this population, the researcher has written a new instrument to gather data about the presence of empathy in nursing students.

which type of procedure would be used to assess the stability of the new instrument

A

Stability is usually measured using test-retest reliability. It is concerned with the consistency
of repeated measures of the construct. Using this technique requires an assumption that the factor
to be measured (in this case, empathy) remains the same at the two testing times and that any
change in the value or score is a consequence of random error

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23
Q

a nurse researcher is interested in the development of empathy in nursing students. Finding the lack of an appropriate instrument to use to study empathy in this population, the researcher has written a new instrument to gather data about the presence of empathy in nursing students.

What would a test-retest reliability value of 0.85 represent for the newly developed instrumen

A

A value of 0.85 is very solid test-retest reliability for the new scale, indicating that it is
consistently measuring empathy with repeat testing and recognizing that students’ level of empathy
varies somewhat over time

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24
Q

a nurse researcher is interested in the development of empathy in nursing students. Finding the lack of an appropriate instrument to use to study empathy in this population, the researcher has written a new instrument to gather data about the presence of empathy in nursing students.

What information would the researcher share in a published report about the development of this
new instrument

A

The researcher would describe the theoretical consideration that went into the
development of the instrument and discuss the facts about the instrument, including what type
instrument it is, scaling, length, readability, scoring, and interpretation of results. Then the researcher
would summarily describe each assessment conducted to provide evidence of the instrument’s
validity and reliability. At the minimum in this scenario, this would include assessment of test-retest
reliability and homogeneity, computing the Cronbach’s alphas for each, and at least one measure of
convergence, using an available instrument measuring empathy or a similar concept.

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25
Q

critical appraisal should be a(n)

A

balanced appraisal of a study’s strengths and weaknesses

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26
Q

3 steps of critically appraising a study

A
  1. identifying the steps of the research process in studies
  2. determining the study’s strengths and weaknesses
  3. evaluating the credibility and meaning of study findings

-interpretation of findings
-limitations
-conclusions

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27
Q

critical appraising guidelines for each section of a research article

apply the guidelines to be able to critique research articles

A
  1. writing quality
  2. title
  3. authors
  4. abstract
  5. research problem - why is this an issue
  6. purpose - does it clarify what the study is about
  7. literature review
  8. framework or theoretical perspective
  9. research objectives, questions, or hypothesis
  10. variables
    -demographics, independent, dependent, research variables or concepts, conceptual and operational definitions
  11. research design
  12. sample
  13. setting
  14. measurement
    -strategies used, scales and questionnaires, observation, interviews, physiological measures, adequacy of measures, validity and reliability
  15. data collection
    -how, who, is it ethical ??
  16. data analysis
    -procedures, statistical significance??
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28
Q

what is the purpose of critically appraising studies in nursing?

A
29
Q

why is it important to perform an intellectual critical appraisal of a study?

A

-strengths
-weaknesses
-credibility
-meaning
-significance for practice

30
Q

research utilization involves

a. communication of research findings
b. observing outcomes from changing practice
c. use of knowledge in practice
d. all of the above

A

d. all of the above

31
Q

strongest evidence

A

-meta-analysis, systematic review
-integrative reviews
-experimental studies

32
Q

weakest evidence

A

-descriptive surveys
-qualitative studies
- correlational studies
- quasi-experimental studies

33
Q

sampling in research my be defined as

A

selection of a subset of a population to represent the whole population

34
Q

2 ways to define sampling criteria

A

homogenous sample: as similar as possible so as to control for extraneous variables

heterogeneous sample: represents a broad range of values
-used when a narrow focus is not desirable

35
Q

refusal rate

A

percentage of subjects who declined to participate in the study

-80 subjects approached and 4 refused
4 / 80 = 0.05 = 5%

10% OR LESS

36
Q

acceptance rate

A

percentage of subjects who consented to be in the study
we want it to be > 90% !!!!!

-80 subjects approached and 76 accepted
76/80 = 0.95 = 95%

37
Q

sample attrition

A

withdrawal or loss of subjects from a study

-attrition rate = number of subjects withdrawing / the number of study subjects x 100

38
Q

sample retention

A

number of subjects who remain in and complete a study

39
Q

types of probability sampling

A

simple random sampling - usually generated

stratified random sampling - good to use when you want a good distribution of ethnicity or gender

cluster sampling - like from zip codes

systematic sampling - every 3rd person or every ___ person out of a list

40
Q

ePersonal health Record

A

a private, secure application through which a individual may access, manage, and share his or her health information

41
Q

Population

A

the entire set of individuals or elements that are the focus of the research.

42
Q

Accessible population

A

is the portion of the target population to which the researcher has reasonable
access.

43
Q

Inclusion Criteria

A

the characteristics that the subjects must possess to be part of the target population

Examples:
the criteria here must include a definition of “students” and “students who are fulfilling parenting
responsibilities.” Therefore, possible inclusion criteria are students who are taking a minimum of a certain number of credit hours, such as “12 credits hours,” and have custody of a child younger than the age of 18 who resides in their home

44
Q

Describe how the researcher would determine the sample size

A

the researcher would run a power analysis to determine sample size

45
Q

Elements

A

individual units of the population and sample

46
Q

Target population

A

an entire set of individuals or elements who meet the sampling criteria.

47
Q

sample

A

the selected group of people or elements from which data are collected for a study. (subjects, participants)

48
Q

exclusion criteria

A

characteristics that can cause a person or element to be excluded from the target population

49
Q

sampling in research

A

selection of a subject of a population to respresent the whole population

50
Q

homogenous sample

A

as similar as possible to control extraneous variables

51
Q

heterogeneous sample

A

represents a broad range of values
-used when a narrow focus is not available

52
Q

sampling error

A

difference between the population mean and the mean of the sample

53
Q

random variation

A

the expected difference in values that occurs when different subjects from the sample are examined (the difference is random)

54
Q

Which of the following has NOT been identified as a barrier to using research knowledge in nursing practice?

A. findings are communicated primarily to other researchers
B. Nursing studies have adequate replication
C. Practitioners often do not value research
D. Researchers-originated studies often do not solve pressing clinical problems

A

B. Nursing studies have adequate replication

55
Q

what is the Grove Model for implementing EBP

A

nurses identify a practice problem, search for the best research evidence, and note that an evidence-based guideline has been developed to manage the problem

-how guidelines are developed

56
Q

What factors would you consider in instituting a practice change?

A

-will it take a long time
-what support is needed to make the change
-are there barriers to instituting the change in the agency

57
Q

Types of Barriers

A

Clinical barriers:
do not read research reports. lack education, biased, don’t know how to implement findings

Administration barriers: research not values, limited change in agency or change is not based on research, limited sources

58
Q

translational research

A

an evolving concept - the translation of basic scientific discoveries into practical applications

59
Q

PHR types

A

standalone (untethered):
-lack interoperability with other systems and require manual data entry ex: Microsoft word, excel, google

connected (tethered): EHR patient portal
-direct communication with healthcare providers, ability to request medication refills, appointment self-scheduling, and integrations with several sources. ex: labs, providers

60
Q

what are the key components of PHRs

A

information that is entered by the consumer and/or data from other sources - pharmacies, labs, and health care providers

61
Q

Describe key factors leading to the widespread adoption of electronic PHRs.

A
62
Q

technical implementation for PHRs

A

Data privacy and security
-patients list privacy concerns when involving caregivers’ proxy access

Usability and user interface design
-factors of usability testing - target goals

Ease of interoperability
-data exchange standards like continuity of care

Data sources
-EHR, pharmacies, social media

63
Q

Summarize the challenges of adoption for PHRs.

A

Digital divide :
Individuals of lower socioeconomic status, ethnic minorities, those with low eHealth literacy, and older individuals are less likely to adopt PHRs

Provider engagement :
Patient encouraged by the HCPs to use their online medical record were two times more likely to access their online medical record compared to those who weren’t encouraged

Awareness of functionality :
In 2018, patients said they did not have a need for an online medical record but increased awareness like self-scheduling and medication refills can drive adoption

64
Q

evidence-based practice centers and translational research.

A

The evidence-based practice centers develop evidence reports and technology assessments on topics relevant to clinical and other healthcare organization and delivery issues – that are common, expensive, or significant - (AHRQ)

Translational research is the process of turning observations in the laboratory, clinical, and community into interventions that improve the health of individuals and the public

65
Q

what does IRB stand for and what does it do?

A

Institutional review boards (IRBs) are organized in universities and clinical agencies to examine the ethical aspects of studies before they are conducted

-responsible for approving studies and addressing any research violations that may occur in a study

exempt: no risk to subjects in a study
expedited: minimal risk
complete (full review): > than minimal risk

66
Q

Who is Henrietta Lacks and how were her rights violated?

A

Her cervix tumor cells (cancerous) were LITERALLY just shared for research purposes. Not cool.
They offer her cells “widely” to be basically experimented on

67
Q

what are standards for ethics in the US

A

belmont report:
-written in response to the Tuskegee Syphilis Study
identified ethical principles w/ selecting subjects, informing risks and benefits and getting consent

Tuskegee study - African American men w/ syphillis were studied without consent and were untreated

68
Q

Measurement Error

A

systematic error:
the variation in measurement is in the same direction and is not reliable

random error:
the difference is without a pattern
ex: punching the wrong key when entering data into the computer

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