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NSG 324 (mcp) > Chapter 9 > Flashcards

Chapter 9 Flashcards

1
Q

3 examples of research designs that use an intervention:

A

1) Experimental
2) RCTs
3) Quasi-experimental design

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2
Q

An ______ study is an example of a study that does not have an intervention but compares two groups.

A

observation

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3
Q

2 Examples of Comparisons used in research studies

A

1) You can compare the same group of individuals at different times or after an intervention period
2) you can compare two groups of people over the same time period with one getting an intervention.

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4
Q

________ variables are variables that can influence the outcome and weaken the link between the ________ and _______ variable.

A

Confounding

independent and dependent

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5
Q

Answering the question, “From whom will critical information be withheld to avert bias?”
What are the 4 options for “Blinding”

A

1) Blinding participants
2) blinding the people performing the interventions
3) blinding other staff
4) blinding the data collectors

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6
Q

2 Types of designs related to Time Frame:

A

1) Cross-sectional

2) Longitudinal design

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7
Q

______ study is considered a _______ type of study because the data was already collected before the study by someone other than the researcher.

A 
Retrospective study (looking backward)
Secondary type of study
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8
Q

A study that is looking forward

A

Prospective Cohort Study

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9
Q

Setting Selection (Location):

A

Using one site versus multiple sites

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10
Q

A Cause is the ________ _______.

An Effect is the _______.

A

Cause –> independent variable

Effect –> Outcome

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11
Q

Three criteria (traits) for establishing causal relationships:

A

1) Temporal
2) Relationship
3) Confounders

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12
Q

Temporal requires a _____ to precede an effect.

A

Cause

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13
Q

Relationship requires an _________ to be shown between the cause and effect.

A

Association

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14
Q

Confounders require the cause to be ______ that the effect cannot be caused by a _____ variable.

A

Proven

Third

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15
Q

3 Examples of Experimental designs:

A

1) RCT
2) Pretest/Post-test
3) Crossover

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16
Q

Describe a randomized controlled trial:

has an ________, a ______, and the participants are chosen _________.

A

intervention
control
Randomly

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17
Q

Some RCTs will use a _______/_______ design which measures the outcome indicator before (baseline data) and after the intervention (posttest data).

A

pretest/posttest

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18
Q

How can Randomization of a study be achieved?

A

with computer programs, but more mundane examples include pulling a name out of a hat or flipping a coin.

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19
Q

A __________ design is used when you give more than one treatment but ________ the treatments and use __________ to determine the ordering.

A

Crossover
Separate
Randomization

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20
Q

In the PICO question, what are the options for the “C” aka Comparison? (5)
Which one is the most ethical of the choices?

A

1) Usual care
2) alternative treatment
3) placebo
4) attention control
5) delayed treatment*** –> MOST ETHICAL CHOICE

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21
Q

_____ ____ is when there is a therapy in place for something and you want to compare it with the new intervention.

A

Usual care

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22
Q

A(n) ______ ________ is testing out two treatments for one outcome to see which one gets better results.
What type of issue arises with this Comparison option?

A

alternative treatment
Ethical since both treatments should benefit the patient, but if outcomes are similar the study loses power to determine if an intervention is better.

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23
Q

A _______ is a treatment expected to have no effect to compare with the intervention.

A

placebo

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24
Q

A(n) _______ ______ condition is when the control group gets attention but not the intervention.
Give Walter’s example for this:

A

attention control
An example of this is both independent and control groups receiving education on weight loss, but the intervention group is given a supplement to take in addition to the education.

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25
Q

______ _________ gives both groups the intervention, but the control group waits until later to get it.

A

Delayed treatment

This option is the most ethical of the C options.

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26
Q

Limitations of RCTs include

A

1) Interventions: the inability to test all interventions in this format
2) Randomization: the inability to randomize certain variables
3) Approval: difficulties getting administrative approval to carry out a study.
“RCTs need IRA approval” idfk..

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27
Q

A ________ study examines an intervention, offered to everyone in a population, but does not include __________.
(THINK: RCT without ________?)

A

quasi-experimental
Randomization

RCT without RANDOMIZATION

28
Q

For Quasi-Experimental Designs:

Sometimes, a ______ _____ is not included either, or may be called the _______ _____.

A

Control group

Comparison group

29
Q

For Quasi-Experimental Designs, The researchers would collect data on the outcome ____ (before/after?) the intervention started in both populations, and then…?

A

before

then after a set time interval from both populations even if the second population does not receive the intervention.

30
Q

Walter’s Example of a Quasi-Experimental Design related to nursing homes:
The first nursing home would be offered the intervention and any resident can participate.
A second nursing home would be a similar population, but the second nursing home would not receive the intervention.
An outcome like stress could be measured before the intervention in both groups and after the intervention in both groups.
What outcome is expected?

A

In the first nursing home, levels of stress are expected to go down.
The levels of stress in the second nursing home should stay about the same without an intervention.

31
Q

What would make a Quasi-Experimental Design less reliable in regards to data collection?

A

only collect post-test data

less reliable than collecting pre-test and post-test data.

32
Q

For quasi-experimental studies that do not use a comparison group, it is tough to determine if the intervention led to the change in outcome.
What’s one method to increase the reliability of the results?

A

Use a time-series design.

The text gives an example of recording data every quarter for a year, introducing an intervention, then recording data every quarter for the next year.

33
Q

A ________ design collects data over an extended period, introducing an intervention, then collecting data for a length of time.

A

time-series

34
Q

Advantages of quasi-experimental studies as compared to RCTs? For participants?

A

More practical and Easier to conduct than an RCT.
Some individuals do not want to be randomized in a study because they don’t want to be a control group, and this is avoided in this type of study.

35
Q

Disadvantages of quasi-experimental studies? (2)

A

Less generalizability of the findings due to increased bias

Increased chance for confounding variables to influence the results.

36
Q

A _____________ study is one in which an intervention is not introduced and is also known as _________ study.

A

nonexperimental

observational

37
Q

ADVANTAGES and DISADVANTAGES of Nonexperimental studies:

A

Important because some interventions cannot be tested experimentally, but relationships can be tested.

Non-experimental studies are not able to be used to support a practice change*

BUT, they can be used to amass data to lead to other studies.

38
Q

At best, Nonexperimental studies can lead to _______ ________ but NOT specific _________.

A

educational recommendations

Interventions

39
Q

Name the two types of study designs and two types of research associated with nonexperimental/observational studies?

A 
Designs:
1) Prospective/Cohort design 
2) Case-control design 
Research:
1) Correlational research
2) Descriptive research

“A Prospective Case was ‘designed’ to Correlate and Describe the Nonexperimental ‘research.’

40
Q

________ research determines an association but does not prove cause and effect.

A

Correlational

41
Q

A ______ design begins with a presumed cause, looks for a presumed effect.
Give Walter’s example related to smokers and nonsmokers:

A

Prospective/Cohort design
The text gives an example of gathering a group of adults who smoke, a group who doesn’t smoke, and comparing the incidence of lung cancer in both groups. It would be unethical to have one group of people start smoking with a RCT, so non-experimental design studies are an option to determine the relationship between smoking and cancer.

42
Q

A ________ design involves starting with the effect or outcome and looking retrospectively at patient data to observe for potential causative variables.
The researchers compare this to individuals _____ (with/without?) the effect or outcome to further identify causative variables.

A

case-control

The researchers compare this to individuals WITHOUT the effect or outcome to further identify causative variables.

43
Q

A _______ study observes for the prevalence of something without determining a relationship.

Give an example.

A

descriptive

For example, a study might investigate the incidence of depression in a nursing home.

44
Q

A descriptive _______ study measures the incidence without linking a cause.
Give Walter’s example measuring hunger and thirst in patients with new-onset diabetes.

A

Descriptive Correlational study
-determines if traits have a relationship that is not casual

Observing two signs or symptoms present in a population.
We now know that polydipsia and polyphagia are symptoms of diabetes, but they do not cause diabetes.

45
Q

In a __________ design, data is collected at one point in time.

A

cross-sectional

46
Q

In a ________ design, data is collected at multiple times or over an extended period.

A

Longitudinal

47
Q

Controlling the study content is important to reduce ____.

A

Bias

48
Q

Methods of control (4):

What two additional methods for control were previously mentioned?

A

(1) Script
(2) Homogeneity
(3) Matching
(4) Statistical control

blinding and randomization

49
Q

Methods of control: Script

During the informed consent process, the researcher reads a script to describe everything so there is no ________.

A

Tool used when communicating to patients.

VARIATION

50
Q

Methods of control:
_________ is a method of restricting a study to individuals who have confounding variables and subsequently canceling out the effect of the confounding variable.
Give Walter’s example related to age as a confounding variable:

A

Homogeneity

For instance, if age was a confounding variable then participants could be restricted to a certain age range.

51
Q

Methods of control:

________ involves developing a comparison group with the same confounding variables as the control group.
When might this control technique become difficult to do?

A

Matching

If you have more than two variables it becomes difficult to do.

52
Q

Name the 4 Types of Validity?

A

1) Statistical validity
2) Internal validity
3) External validity
4) Construct validity

53
Q

Study Validity:

What factors are related to statistical validity? (2)

A

1) statistical power

2) Clearly defined and different interventions

54
Q

Statistical Validity:

Statistical power relates to the ______ ____, the larger the ______ the more powerful.

A

sample size

sample

55
Q

Statistical Validity:

For an intervention to be clearly defined, the intervention needs to be different from the _______.

A

Control

56
Q

Study Validity:

_______ validity is the extent it can be inferred that the independent variable causes the outcome.

A

Internal

57
Q

Threats to internal validity include (5):

A

1) temporal ambiguity
2) selection
3) history
4) maturation
5) attrition.
Selection refers to selecting participants rather than using randomization.
History refers to outside events that can influence participants cooperation with the study.
Maturation refers to time’s effect on the outcome.
Attrition or people leaving the group can impair the population diversity and become a confounding variable.

58
Q

Threats to internal validity:

_______ _________ occurs when the cause does not occur before the effect.

A

Temporal ambiguity

59
Q

Threats to internal validity:

_________ refers to selecting participants rather than using randomization.

A

Selection

60
Q

Threats to internal validity:

_______ refers to outside events that can influence participants’ cooperation with the study.

A

History

61
Q

Threats to internal validity:

__________ refers to time’s effect on the outcome.

A

Maturation

62
Q

Threats to internal validity:

________ or, people leaving the group, can impair the population diversity and become a confounding variable.

A

Attrition

63
Q

Study Validity:

What two types of studies are more likely to face threats to internal validity?

A

Quasi-experimental studies and correlational studies are more likely to face threats to internal validity.

64
Q

Study Validity:
________ validity concerns the ability to apply the study findings to the general population.
The ______ needs to be representative of the population.

A

External

The sample needs to be representative of the population.

65
Q

Study Validity:
What design method can increase external validity?
Name a study example:

A

Multisite studies are a method to increase external validity.
Systematic reviews can gather studies on a similar intervention in multiple environments to increase external validity.

66
Q

Study Validity:
_________ validity involves inferences from the particulars of the study to the higher order constructs they are intended to represent. Is an intervention appropriate? This is discussed more in the next chapter. The biggest weakness to construct validity is a lack of blinding because participants may be aware of the intervention and that can influence the outcome.

A

Construct

NSG 324 (mcp) (21 decks)

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