Exam 1 - EBP practice

Question 1

What is verifiable knowledge on which to base belief and action?

Answer 1

evidence

Question 2

What is an approach to public (population) health care practice in which the public (population) health nurse is aware of the evidence in support of his or her clinical practice, and the strength of that evidence?

Answer 2

Public health nursing evidence-based practice (EBPHN)

Question 3

What does EBPHN use?

Answer 3

Uses the highest quality of knowledge in providing care to produce the greatest impact on a population’s health status and health care

Question 4

What does EBPHN include?

Answer 4

1. Knowledge & research*
2. Clinical expertise & judgment
3. Input from community members and other stakeholders

Question 5

How is evidence brought together in public?

Answer 5

1. Knowledge & research*
2. Clinical expertise & judgment
3. Input from community members and other stakeholders

Question 6

Compared to EBN, EBPHN has what?

Answer 6

1. Is more often based on quasi-experimental and observational rather than experimental designs
2. Has a smaller volume of evidence
3. Has outcomes which are longer
4. Impacts team rather than individual decision-making

Question 7

What does critical appraisal of evidence involve?

Answer 7

includes evaluating research for it’s quality, applicability and strength.

Question 8

What do researchers use to assess the strength of scientific evidence?

Answer 8

ranking systems

Question 9

What is level 1 of evidence?

Answer 9

Evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCTs), or evidence based clinical practice guidelines based on systematic reviews of RCTs

Question 10

What is level 2 of evidence?

Answer 10

Evidence obtained from at least one well-designed RCT

Question 11

What is level 3 of evidence?

Answer 11

Evidence obtained from well-designed controlled trials without randomization (quasi-experimental)

Question 12

What is level 4 of evidence?

Answer 12

Evidence from well-designed case-control and cohort studies (studies of prognosis)

Question 13

What is level 5 of evidence?

Answer 13

Evidence from systematic reviews of descriptive and qualitative studies

Question 14

What is level 6 of evidence?

Answer 14

Evidence form a single descriptive or qualitative study

Question 15

What is level 7 of evidence?

Answer 15

Evidence from the opinion of authorities and/or reports of expert committees

Question 16

What is a “summary of evidence, typically conducted by an expert or expert panel on a particular topic, that uses a rigorous process to minimize bias for identifying, appraising and synthesizing research findings to answer a specific clinical question and draw conclusions about the data gathered?”

Answer 16

systematic review

Question 17

What 3 things does a systematic review include?

Answer 17

1. a specific answerable question
2. an explicit and repeatable process
3. clearly identified criteria for studies to be included and excluded.

Question 18

What is a specific method of statistical synthesis used in some systematic reviews, in which the results form several studies are quantitatively combined and summarized?

Answer 18

meta-analysis

Question 19

True or false: systematic reviews of RCTs and meta-analysis provide stronger evidence than traditional reviews of the literature because of the rigor of the review.

Answer 19

true

Question 20

What kind of study has an experimental group that receives a treatment or intervention (the independent variable) introduced or manipulated by the researchers, and a control group that receives standard care?

Answer 20

RCT

Question 21

What about RCTs is special?

Answer 21

true experimental design and are the gold standard for evaluating cause and effect

Question 22

What do RCTs support?

Answer 22

RCTs supporting health promotion or disease prevention interventions are hard to find.

Question 23

What are RCTs appropriate for evaluating? what is the downside of RCTs?

Answer 23

a. many interventions in medicine

b. are often ethically or practically undesirable in public health.

Question 24

What is a design in which the independent variable (e.g., treatment) is manipulated or introduced by the researchers, but where there is a lack of random assignment or a control group?

Answer 24

quasi-experimental

Question 25

What is easier to find in quasi-experimental?

Answer 25

evidence

Question 26

What is quasi-experimental used to establish?

Answer 26

cause and effect

Question 27

What type of sample does a quasi-experimental study use?

Answer 27

convenience sample`

Question 28

what type of study is one which researchers select a group of people with an outcome of interest (cases) and another group without that outcome (control)?

Answer 28

case-control study (retrospective)

Question 29

What are case-control/retrospective studies used for?

Answer 29

rare conditions or disease outbreaks.

Question 30

What do case-control/retrospective studies determine?

Answer 30

a factor (exposure, intervention or experience) is associated with a particular outcome.

Question 31

what type of study is a longitudinal, usually prospective study, where a cohort is broken into groups based on exposure (such as diet, exercise, oral contraceptives)?

Answer 31

cohort study

Question 32

What happens with groups in a cohort study?

Answer 32

The groups are followed over a period of time to determine health outcomes.

Question 33

What are case-control or cohort studies used to establish? not establish?

Answer 33

Both these studies are used to establish the magnitude of associations and risk, not cause and effect.

Question 34

What kind of studies describe, observe, or document a phenomenon?

Answer 34

descriptive studies

Question 35

What kinds of studies are those that collect data in non-numerical terms using techniques such as interviews, observation, case studies, participatory observation, participatory action research, and focus groups.

Answer 35

qualitative studies

Question 36

What kind of data is collected in qualitative studies?

Answer 36

often subjective data

Question 37

What is the purpose of qualitative studies?

Answer 37

with a purpose of understanding and tends to be holistic in nature.

Question 38

What kind of design are descriptive studies?

Answer 38

cross sectional design

Question 39

what is unique about the timing of data collection in descriptive studies?

Answer 39

All data (personal characteristics, potential risk factors, exposures, health status and health outcomes) is collected at the same point in time.

Question 40

What kinds of studies examine the relationship between exposure and disease with population-level data rather than individual-level data?

Answer 40

ecological studies

Question 41

What are are compared in ecological studies? rather than what?

Answer 41

Demographics and statistics for groups or geographical areas are compared. Rather than individuals’ characteristics.

Question 42

Studies that use participatory observation collect data through what?

Answer 42

through personal involvement (participating and possibly living) with a group of people or community

Question 43

What is a self reflective inquiry that researchers and participants undertake together to improve the health of a community?

Answer 43

Participatory action research or PAR

Question 44

What is a form of research where data is collected from an group of people answering questions and interacting with each other?

Answer 44

a focus group

Question 45

What is the lowest level of evidence based on?

Answer 45

based on expert opinions (not supported with a higher level of evidence).

Question 46

What are also included in the lowest level of evidence?

Answer 46

(non systematic) literature reviews.

Question 47

What type of design is used in some studies where more than one design/method and so the evidence generated may fall into more than one level?

Answer 47

mixed method design