RESEARCH--EXAM 1 Flashcards
(123 cards)
1
Q
o Systematic inquiry using disciplined methods to solve problems or answer questions
A
research
2
Q
o Systematic inquiry to develop knowledge about issues of importance to the nursing profession
A
nursing research
3
Q
♣ Use of best clinical evidence in making patient care decisions
A
evidence-based practice
4
Q
♣ Things that impact evidence-based practice:
A
- Research methods
- Respect patient preferences
- Provider (the nurse) expertise
5
Q
o Nursing decisions need to be based on ______
A
evidence
6
Q
o requires research methods, and EBP
♣ Projects that are focused for one institution
A
quality improvement
7
Q
♣ Established first nursing school
♣ Collected and evaluated data concerning healthcare decisions
• Used data to drive decisions!
A
o Florence Nightingale, 1850s
8
Q
more broad
A
multisite studies
9
Q
repeat search more than once
A
replication studies
10
Q
ϖ Sources of Evidence for Nursing Practiceϖ Sources of Evidence for Nursing Practice
A
tradition authority clinical experience logical reasoning assembled information disciplined research
11
Q
o gold standard
♣ Problem is that it is done on mainly high risk important issues
A
Disciplined research
12
Q
♣ A world view; a general perspective on the world’s complexities
A
o Paradigm:
13
Q
The two Paradigms
A
positivist assumption
constructivist assumption
14
Q
♣ Reality exists
♣ There is a real world driven by natural causes
♣ There is truth out there just still looking for it
A
positivist assumption
15
Q
♣ Reality is multiple and subjective, constructed by individuals
♣ There is not one answer out there but many, challenge is to appreciate there are lots of different ways of thinking about things
A
constructivist assumption
16
Q
techniques used to structure and study and to gather, analyze, and interpret information
A
Research methods:
17
Q
2 types of research methods
A
quantitative research & qualitative research
18
Q
Quantitative research—most often allied with the
A
♣ positivist tradition
19
Q
Qualitative research—most often allied with the
no numbers
A
constructivist tradition;
20
Q
♣ Orderly procedures ♣ Prespecified plan ♣ Control over context ♣ Formal measurement ♣ Seeks generalizations (Description, Exploration, Prediction & control, Explanation)
A
quantitative
21
Q
numbers
A
quantitative
22
Q
♣ Dynamic design – depends on response of participants
♣ Holistic
♣ Context-bound
♣ Humans as instruments
• Understand all experiences are different
♣ Seeks patterns
A
qualitative
23
Q
words, behaviors
A
qualitative
24
Q
purposes of nursing research
A
identification and description explorations explanations prediction & control therapy, treatment or intervention diagnosis & assessment
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o description focuses on the prevalence, size, and measurable aspects of phenomena
quantitative
26
o describes the nature, dimensions, and salience of phenomena
qualitative
27
* Begins with a phenomena of interest
* Examine the nature of phenomenon, manner in which it is manifested, and other factors to which it is related instead of describing it
o Including factors that may be causing it
explorations
28
______ methods can be used to explore the nature of little understood phenomena and to shed light on the ways in which a phenomenon is expressed
• Qualitative
29
• Seeks to understand the underlying causes or full nature of a phenomenon
explanation
30
• theories or prior findings are used deductively to generate hypothesized explanations that are then tested
quantitative
31
• – search for explanations about how or why a phenomenon exists or what a phenomenon means as a bias for developing a theory that is grounded in rich, in-depth, experiential evidence
qualitative
32
ex of prediction & control
* We can predict that a woman 40 years of age has a higher risk of delivering a down syndrome baby versus a woman 25 years of age
* We can partially control the outcome by educating women about the risks and offering amniocentesis to women older than 35 years of age
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• In many ____ studies prediction and control are key goals
quantitative
34
o Seek to identify effective treatments for preventing health problems
• Therapy purpose studies
35
_____ plays a key role in EBP
• Intervention research
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• Development of formal instruments to screen, diagnose, and assess patients and to measure clinical outcomes
diagnosis & assessment
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o The use of study findings in a practical application unrelated to the original research
o Emphasis is on translating research findings into real-world applications
research utilization
38
starting point of research utilization
o = new evidence or a research-based innovation
39
CURN stands for?
o Conduct and Utilization of Research in Nursing Project (1970s)
40
♣ Aimed to increase nurses use of research findings by disseminating research findings facilitating organizational changes, and encouraging collaborative clinical research
CURN
41
begins with the research itself/emergence of new knowledge
research utilization
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begins with a clinical question
EBP
43
♣ How can I put this innovation to good use in my clinical setting?
research utilization
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♣ What does the evidence say is the best approach to solving this problem?
EBP
45
o Basing clinical decisions on research findings and other factors (patient preferences & experience of healthcare provider)
o Efforts to personalize evidence to fit a specific patient’s needs and a particular clinical situation
EBP
46
* Series of online libraries containing only systematic reviews
* Huge database of summarized literature
* Aim is to help providers make good health care decisions by preparing and disseminating systematic reviews of the effects of health care interventions
Cochrane Collaboration
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Dr. Archie Cochrane proposed an ____ _____ for weighing evidence/making decisions
evidence hierarchy
48
♣ Evidence-based medicine pioneer at McMaster Medical School
o David Sackett
49
o Involve ranking evidence sources according to the strength of evidence they provide
o Ranking may depend on the type of question being asked
evidence hierarchy
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how does an evidence hierarchy look?
o Picture inside front cover – focus on inside
51
o Refers to research findings that are methodologically appropriate, rigorous, and clinically relevant for answering pressing questions
best evidence
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♣ Questions not only on the about the efficacy, safety, and cost effectiveness of nursing interventions but also about the reliability of nursing assessment tests, the causes and consequences of health problems, and the meaning and nature of patients’ experiences
best evidence
53
ϖ Challenges in Implementing EBP
research-related barriers
nurse-related barriers
organizational barriers
54
ex of research-related barriers
♣ Scarcity of strong research evidence
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ex of nurse-related barriers
♣ Inadequate skills in locating and appraising evidence
| ♣ Doesn’t know how to find & assess the literature
56
ex of organizational barriers
♣ Lack of financial support and staff release time for EBP
57
♣ Has been selected from primary studies and evaluated for use by clinicians
(AKA summarized sources)
preappraised evidence
58
2 examples of preappraised evidence
systematic review
clinical practice guidelines
59
o Integrate evidence about a topic in rigorous, systematic way
systematic review
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o Give specific recommendations for evidence-based decision making
o Developed when a small group of experts analyze existing literature and propose guidelines
• Clinical practice guidelines
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examples of summarized evidence
Systematic Reviews
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♣ Integrate findings across quantitative studies statistically
♣ Treats the findings from the study as one piece of information
♣ Findings from multiple studies on the same topic are combined and then all of the information is analyzed statistically in a manner similar to that in a usual study
♣ Individual studies are the unit of analysis instead of study participants
♣ Provides an objective method of integrating a body of findings and of observing patterns that might not have been detected
o Meta-analyses
63
♣ Integrate and amplify findings across qualitative studies
| ♣ Less about reducing information and more about interpreting it
o Meta-syntheses
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Three widely referenced models for Evidence-Based Nursing Practice
♣ ACE Star Model of Knowledge Transformation
♣ The Stetler model of research utilization to promote EBP
♣ The Iowa model of EBP to promote quality care
65
ϖ Major Steps in EBP
ask questions
search for
integrate
assess effectiveness
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P
population
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I
intervention
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C
comparison
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O
outcome
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T
time
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o Research evidence needs to be integrated with
♣ Your own clinical expertise and knowledge
72
ϖ Appraising the Evidence for EBP
what is the quality of the evidence?
what is the evidence/magnitude of effects?
how precise are estimates of effects?
is there evidence of side effects/benefits?
What are the costs of applying/not applying the evidence?
Is there relevance to my clinical situation?
73
♣ Identification of a clinical practice problem in need of a solution
♣ May arise in the course of clinical practice or in the context of quality assessment or quality improvement efforts
♣ Likely to be clinically relevant and to have staff support if the problem is one that numerous nurses have encountered
o Problem focused triggers
74
♣ Readings in the research literature
♣ Clinical relevance and applicability of the research might need to be assessed
o Efforts designed to result in a formal policy or protocol affecting the practice of many nurses
o Knowledge focused triggers
75
♣ Determines the implementation potential of an innovation in a particular setting
♣ Several issues should be considered; esp. the transferability of the innovation, feasibility of implementing it, and the cost-benefit ratio
o Implementation Potential/Environmental Readiness
76
quantitative examples
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subject
constructs
variables
numerical data
cause-effect
deductive reasoning
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qualitative examples
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informant
more broad
phenomena
narrative descriptions
patterns of association
inductive reasoning
```
78
types of places the information is gathered
research settings
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specific location for the research
research sites
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• Offer a larger and often more diverse sample of participants
♣ Multisite Studies
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♣ Abstractions of particular aspects of human behavior of characteristics (e.g., pain, weight)
o Concepts
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♣ Slightly more complex abstractions, composed of concepts (e.g., self care)
o Constructs
83
♣ Knit concepts into a coherent system that purports to explain phenomena
♣ Explanation of some aspect of reality
o Theories
84
♣ researchers start with a theory and using deductive reasoning make predictions about if that theory were true
Quantitative theory
85
♣ : theory is often the product of research, researchers use information from study participants inductively to develop a theory rooted in their experiences
Qualitative theory
86
o Characteristic or quality that takes on different values, i.e., that varies from one person to the next
variable
87
ex of variables
♣ Blood type, weight, length of hospital stay, method of pain measurement
88
variables are used in
quantitative research
89
types of variables
continous
categorical
independent variable
dependent variable
90
♣ Range of values on a continuum
| • Height, test score
o Continuous variable
91
♣ Grouped variable
♣ Choice of statistical analysis is more limited
• Female, male
• Type of pain management method
grouped variable
92
♣ Presumed cause or direction of effect of a dependent variable
♣ Variable influenced by dependent variable, can be cause or effect
independent variable
93
think of the IV as the _____ bc it influences the outcome of the dependent variable
intervention
94
♣ Presumed effect of response to an independent variable
o Dependent (outcome) variable
95
o no independent/dependent variables just “research variables”
Descriptive quantitative research
96
o Independent and Dependent variables can also be used to indicate ______ ___ ______ rather than cause and effect
direction of influence
97
♣ Abstract or theoretical meaning of a concept being studied
♣ Dictionary definition
♣ E.g. pain definition
o Conceptual definition
98
♣ Operations (measurements) a researcher must perform to measure the concept and collect the desired information
♣ How you are going to measure that concept
♣ E.g. faces pain scale to measure pain level
o Operational definition
99
o Pieces of information researchers collect in a study
data
100
o Bond or connection between variables/two or more phenomena
relationships
101
* (causal) relationship (e.g. lung CA and smoking)
| * Only determined by experimental research or a whole lot of observational research
♣ Cause-and-effect
102
* (functional) relationship (e.g., gender and life expectancy)
* e.g. Risk factors – association btw risk factors and dx
♣ Associative
103
ϖ Major Classes of Quantitative Research
experimental research
non experimental research
104
♣ Researchers actively introduce an intervention or treatment – most often to address therapy questions
experimental research
105
experimental research
| is called ____ ____ in medical research
clinical trials
106
• Introducing an intervention, doing something to the group
experimental research
107
♣ Researchers are bystanders and collect data without intervening or introducing treatments
non experimental research
108
non experimental research is called ___ ____ in medical research
observational research
109
♣ May study different groups but study what is existing, they do not introduce anything different or have the groups doing anything – they may compare them
non experimental research
110
♣ Seeks to understand key social psychological processes that occur in a social setting
♣ Sociological perspective
♣ The social and psychological phases that characterize a particular event or episode
grounded theory research
111
♣ Focuses on the lived experiences of humans
♣ Some try and describe the experiences and some try and interpret
♣ Approach to thinking about what life experiences of people are like and what they mean
phenomenological research
112
♣ Focuses on the patterns, lifeways, and experiences of a cultural group in a holistic fashion
♣ How different cultural groups make sense of their lives
♣ Strive to learn from members of a cultural group, to understand their world view, and to describe their customs and norms
♣ Not necessarily a specific ethnic group but a group of people who share the same values, etc. (e.g. nightshift workers)
♣ Typically engage in extensive fieldwork often participating to the extent possible in the life of the culture under study
ethnographic research
113
* Follow a format similar to journal articles
| * 10-20 minutes to describe key features of the study
oral reports
114
• Simultaneously present visual displays summarizing their studies while conference attendees walk around the room looking at these displays
poster sessions
115
♣ Papers often subjected to peer review
• Reviewed by other researchers, nurses
Peer reviews are often blind
journal articles
116
what does it mean when it says peer reviewed articles are blind?
reviewers are not told names of authors and vice versa
117
content of research journal articles Acronym
IMRAD
118
what does IMRAD stand for?
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introduction
method
results
abstract
discussion
```
119
o Brief description of the study placed at the beginning of the article
o Answers questions like “What were the research questions?, What methods were used to address the questions?
abstract
120
• sets the stage for presenting what the researcher did & learned; immediately after abstract
o Background, make a case for why this is an important topic to read about, gaps in the literature, what theoretical frameworks are used
o Always ends with the research question, hypothesis, aim, or goal of the study
intro
121
o Plan, procedures for how to collect the data, who is going to be in the study, what tool is going to be used to collect data on, how it is going to be evaluated
method
122
o Facts, results of data analysis, means, statistical differences, etc.
o Presents the findings
results
123
o What the researcher believes about the facts; was the sample size too small, etc.
o This is what needs to be done next, recommendations for future practice, research, and educations
o Conclusion about the meaning and implications of the findings
discussion
