Exam 1 - Study Material (Quiz 2) Flashcards
What is the purpose of research design?
- Provides blueprint/plain - this aids in solving problem/question/hypothesis
- Allows researcher to apply different levels of control
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We do all of this to say:
- Independent variable really changed the dependent variable and not something else
- To avoid bias
What should you consider when planning “control” in a study?
- Objectivity
- Accuracy
- Feasibility
- CONTROL & FIDELITY
What are some things that affect “control & fidelity” of a deisgn?
- Homogenous sample
- Constancy – Intervention fidelity
- Manipulation
- Randomization
- Validity- Internal
- Validity-External
What is the purpose for control in a study?
- To control for bias
- To ensure Accuracy- Pilot study
- You want to make sure the independent variable really lead to the change in dependent variable and not another variable
What is an Antecedent Variable?
Variables that occur within the subjects prior to the study.
Ex: A patient’s motivation to learn about their medical condition might affect how successful a diabetes education program is for him/her.
What is a ®Intervening, Extraneous or Mediating Variable?
A variable (which the reasearcher doesn’t control) that occurs between the Independent and dependent variable (such as age, gender, diet,etc), and it interferes with the operations of the variables being studied.
Ex: The type of breast cancer treatment patients expereienced.
Describe homogeneous sampling
Sampling that occurs when the researcher’s subjects have similar extraneous variables relevant to the particular study (within the same age group, same gender, etc)
What is generalizability?
Being able to apply research outcomes to other populations when analyzing and discussing the outcomes.
What is Intervention Fidelity in relation to control in a study?
Intervention fidelity involves having consistency in:
- Design - The study is designed to allow an adequate testing of the hypothesis in relation to the underlying theory and clinical processes
- Training - Ongoing training and supervision of the data collecters to assure that the intervention is being delivered as planned and in a similar manner with all subjects
- Delivery - Assessing the intervention is delivered as intended, including that the “dose” is well described for all subjects and that the dose is the same in each group, and that there is a plan for possible problems.
- Receipt - Assurance that the treatment has been received and understood by the subject
- **Enactment - Assessment that the performance of the intervention skills that the subject performs are performed as intended **
What is manipulation in relation to control?
- The addministration of a treatment, program or intervention to only one group within the study and not to the other subjects in the study to test whether a treatment or intervention affects patient outcomes.
- This leads to the creation of the Experimental (the group in which the independent variable is changed) and the control Group (where everything is held constant)
What is randomization in relation to control?
Subjects from the population are obtained in such a manner that each subject has an equal and independent chance of being selected for either group.
This eliminates bias and helps make a representative sample
What are the elements of a research design?
- Participants (WHO)
- Observations (WHAT)
- Selection of subjects (WHERE)
- Role of the investigator
What is internal validity?
- It is the degree to which it can be inferred that the experimental treatment, rather than an uncontrolled condition, resulted in the observed effects
- It asks if it is the independent variable (or something else) that caused or resulted in the chagne in the dependent variable
What are some threats to internal validity?
- History bias
- Selection bias
- Maturation bias
- Testing bias
- Mortality bias
- Instrumentation bias
What is the “history bias” threat to internal validity
It is a specific event outside the study that affects subjects and thus the study results
Ex: An investigator testing the effects of an educational program for young adults on completion of organ donation card designations. During the course of the educational program, an ad featuring a known public figure is released on facebook about he importance of organ donation and becoming an organ donor. The occurence of this information on social media with a public figure engenders a great deal of media and press attention. If the researcher finds an increase in the number of young adults who sign their organ donation cards, the researcher may not be able to conclude that the change in behavior is the result of the teaching program because it may have been influenced by the result of the information on social media.
What is the “selection bias” threat to internal validity?
It is the internal validity threat that arises when pretreatment differences between the experimental group and the control group are present.
Ex: This can occur if the sample was not random or representative of the population being studied, like if a smoking cessation program allowed self-selection of the control or experiemental group
What is the “maturation bias” threat to internal validity?
Developmental, biological or psychological processes that occur within subjects that are independent of the intervention or study variables.
Ex: In a study of new products to stimulate wound healing, one might ask wherther the healing that occured was related to the product or to the natural occurance of wound healing.
What is the “testing bias” threat to internal validity?
It is the effect that occurs from taking the same test repeatedly, influencing a subject’s responses the next time the test is completed.
Ex: Individuals generally score higher when they take a test a second time, regardless of the test.
What does “mortality” refer to in quantitative research?
It is the loss of study subjects from the first data-collection point (pretest) to the second data-collection point (post test)
What is the “mortality bias” threat to internal validity?
This bias can occur if the subjects who remain in the study are not similar to those who dropped out, affecting the results of the study.
Ex: A group of reserachers noted that they had lost subects in all 3 of their groups, and that the lack of statistical significance in their findings may have been related to an inadequate sample size even though the intervention had a positive outcome
What does “instrumentation bias” refer to in quantitative research?
A change in the instruments themselves OR change in the data collection procedures that may account for change in the dependent variable.
Ex: A researcher may wish to study types of thermometers to compare the accuracy of using a tympanic thermometer to other temperature-taking methods. A researcher must check the calibration of the termometers according to the manufacturer’s sepcifications before and after data collection
What is external validity?
- It is the degree to which findings of a study can be generalized to other populations or envrioments
- It questions under what conditions and with what types of subjects can the same results be expected to occur
What are some threats to external validity?
- Selection effects (who)
- Reactive effects (Where-how)
- Measurement effects (How-when-what)
What is “selection” in relation to a quantitative study?
The generalizability of the results to other populations
What is the “selection effects” threat to external validity?
The selection effect refers to how well or not the results of a study can be generalized to other populations.
Ex: If a sample included primarily Caucasion, non-hispanic volunteer couples, inferences about other racial groups should be made with caution
What is “reactivity” in relation to a quantitive study?
The subject’s responses to being studied
What is the “reactive effects” threat to external validity?
- It occurs when subjects respond to the investigator not because of the study procedures, but merely as an independent response to being studied.
- Also known as the Hawthrone effect
What is the “measurement effects” threat to external validity?
The administration of a pretest in a study that affects both the post test results and the generalizability of the findings to other populations
You have to make sure not to “prime” subjects so as not to affect the researcher’s ability to generalize the study to other situations / populations
What are some examples of quantitative design types?
- Experimental
- Quasi-experimental
- Non-experimental
What are some qualitative research types?
- Phenomenology
- Ethnography
- Grounded Theory
- Community Participatory
- Case
What is an experimental group?
The group in an experimental investigation that receives an intervention or treatment.
What is a control group?
The group in an experimental investigation that does not receive an intervention or treatment; the comparison group.
What is a pilot study?
It is a small, simple study conducted as a prelude to a larger-scale study that is often called the “parent study”; it helps to determine the sample size needed for a larger study.
What is “constancy” in refernce to a quantitative study?
It referes to the same methods and procedures (enviromental conditions, timing of data collection, data-collection instruments, etc) are the same for each subject.
What are experimental designs and describe them
- Experimental or Randomized Controlled Trials (RCT), Clinical Trial
- Tests true cause and effect relationships
- Most powerful- threats to internal validity are controlled
- Provide Level II Evidence
What are the Characteristics of True Experimental Study?
- Manipulation
- Control
- Randomization
What is manipulation in reference to an experimental design?
- The provision of some experimental treatment, in one or varying degrees, to some of the subjects in the study
- The process of doing “something” different or a “different”dose to each group
- That something is a treatment, medication or teaching plan
- The effect or difference is measured to assess if the different treatment was better
What is control in reference to an experimental design?
They are measures used to hold uniform or constant conditions under which an investigation occurs
What is the point of “control” in reference to an experimental design?
- Holds conditions constant
- Limits bias that could influence the dependent variable(s)
- Treatments are different
- It is acquired by manipulating the independent variable
What is “randominization” in relation to an experimental design?
- Each subject has equal chance of being in the Experimental or Control group
- It DecreaseS selection bias
- Random assignment is different than random selection
What are the different types of experimental desgins?
- Randomized controled trial
- Solomon Four-group design
- After-only experimental design
How is a randomized controled trial conducted?
- A sample is selected from the population
- Baseline data is collected (pretest)
- Subjects are randomized to either the intervention or contorl group
- Intervention group –> Postintervention data are collected
- Control group –> Postintervetnion data are collected
What do the results from a randomized controled trial indicate?
The trial shows the degree of difference, if any, between the groups at the end of the study, which indicates the confidence the researcher has in a casual link (the intervention that caused the difference) between the independent and dependent variables.
When would a randomized controled trial be conducted?
Because this design minimizes the effects of many threats to internal study validity or bias, it is a strong design for testing cause-and-effect relationships, BUT IT IS NOT A PERFECT DESIGN.
How is a solomon four-group experimental design conducted?
- Sample is selected from the population
- Subjects are randomized
- Basline data is collected (Pre test) –> Intervention group –> postintervention data are collected
- Basline data is collected (Pre test) –> control group –> postintervention data are collected
- No baseline data is collected (No post test) –> Intervention group –> postintervention data are collected
- No baseline data is collected (No post test) –> control group –> postintervention data are collected
What are some problems with the solomon four-gorup experimental design?
- More expensive to conduct
- Threat of mortality (drop out) is a problem
How is an after-only experimental design conducted?
- Sample is selected from the population
- Subjects are randomized
- Intervention group –> Postintervention data are collected
- Control group –> Postintervention data are collected
What are some strengths of an after-only experimental design?
Useful to test the effects that are expected to be a major problem, or when outcomes cannot be measured beforehand (postoperative pain management).
What are the advantages and disadvantages to an experimental design?
- Advantages-Most powerful, causal, fewer threat to validity, control
- Disadvantages- All variables can not be manipulation ethically; can’t always randomize, impractical sometimes, mortality, Hawthorne effect, costly, ample sample available
What are Quasi-Experimental Designs used for? Describe this experimental design
- Intend to test cause and effect when full control is not possible
- Has experimental treatment but lacks randomization or a control group
- Provides level III evidence
What are the different types of quasi-experimental designs?
- Nonequivalent control group design
- After-only nonequivalent control group design
- One-group (pretest-posttest) design
- Time series design
How is a nonequivalent control group quasi-experimental design conducted?
- Experimental group –> Baseline data is collected (pretest) –> intervention is applied –> postintervention data are collected
- Control group –> Baseline data are collected (pretest) –> Data are collected again
What are some weaknesses to the nonequivalent control group quasi-experimental design?
- The researcher has weakened confidence in assuming that the experimental and comparison groups are similar at the beginning of the study.
- Threats such as internal validity, selection bias, maturation bias, testing bias, and mortality bias are all possible w/ this design
How is an after-only nonequivalent control group quasi-experimental design conducted?
- Experimetnal group –> intervention is applied –> postintervention data is collected
- Control group –> data is collected
What are some issues with the after-only nonequivalent control group quasi-experimental design?
- Randomization is not used to assign subjects to groups and makes the assumption that the two groups are equivalent and comparable before the introduction of the independent variable
- There is no way of assessing the validity that the two nonrandomly assigned groups are comparable at the onset of the study
How is a one-group (pretest-postetst) quasi-experimental design conducted?
Experimental group –> baseline data is collected (pretest) –> intervention is applied –> Postintervention data is collected
What are some characteristics of the one-group quasi-experimental design?
- Data is cllected before and after an experimental treatment on one group of subjects
- In this design there is no control group, no randomization (there is nothing to enhance internal validity)
How is a time series quasi-experimental design conducted?
Experimental group –> data is collected –> data is collected –> intervention is applied –> postintervention data is collected –> postintervention data is collected
What are time series quasi-experimental designs used for?
- Useful for determining trends over time
Data is collected multiple times before the introduction of the treatment to establish a baseline point of reference on outcomes
What are the advantages and disadvantages to Quasi-Experimental Designs?
- Advantages- practical, feasible, and generalizable may be only way to get data, good when full control not possible, still have treatment
- Disadvantages- not clear cause and effect, threats to internal validity, selection bias, not randomized
What are some sources of bias in experimental and quasi-experimental studies?
SOURCES OF BIAS found in:
- Data Collection
- Sampling
- Instruments
- Conceptualization
What is “power analysis”?
The mathematical procedure to determine the number for each arm (group) needed to test the study’s variables.
What is the “treatment effect”?
It is the impact of the independent variable/intervention on the dependent variable
What is the effect size?
In experimental studies, it is the presumed effect of the independent or experimental variable on the outcome
What does the term “a priori” mean?
It means to control extraneous variables before initiating the intervention by design or while conducting statistical analyses
What is a literature review?
- A systematic and critical appraisal of the most important literature on a topic.
- It is a key step in the research process that provides the basis of a research study
What is the purpose of a literature review?
- To develop a strong knowledge base to conduct a research study or an evidence-based practice/quality improvement project
- To determine what is known and unkown about a subject, concept, or problem
- To determine gaps, consistencies, and inconsistencies in the literature about a subject, concept, or problem
- Discovers unanswered questions and helps to generates research questions/hypotheses
- Discovers conceptual traditions
- Helps to narrow design and methods
- Helps to determine need for replication
What does a literature review do?
- It reveals concepts and/or theories or conceptual models from nursing and other disciplines that can be used to examine problems.
- Critically evaluates the literature pro and con to the study’s purpose.
- Concludes with a summary statement pulling the literature together to show how it under pins the study’s purpose, objective, aim, question and hypothesis
- Critical review not a criticism
What are the steps of the quanitative and qualitative research process?
- Theoretical/Conceptual Framework
- Primary Sources
- Research Question & Hypothesis
- Design & Method
- Outcome of Analysis
What is the purpose of a theoretical or conceptual framework in a literature review?
It presents the context for studying the problem and can be viewed as a map for understanding the relationships between or among the variables in quantitative studies.
What are primary sources?
Research articles and books by the original author.
Ex: Material qritten by the person who conducted the study, autobiographies, diaries, films, letters, artifacts, and can be published or unpublished
What are secondary sources?
Published articles or books that are written by persons other than the indicidual who conducted the research study or developed the theory
Ex: response/commentary/crtique of a research study, a theory paraphrased by others, an edited textbook (our research textbook)
How does the literature review affect a research question or hypothesis?
It helps to determine what is known and not known, to uncover gaps, consitencies or inconsitencies, or to disclose unanswered questions to generate and refine research questions and/ or hypotheses
How does a literature review affect the design and method of a research study?
The literature review exposes the strengths and weaknesses of previous studies in terms of designs and methods and helps the reseracher choose an appropriate design and method, including sampling strategy type and size, data collection methods, setting, measurment instruments, and effective data analysis methods.
How does the literature reivew affect the outcome analysis of a study?
It is used to help the researcher accurately interpret and discuss the results/findings of a study, the researcher will use the literature reivew and uses the literature to interpret and explain the study’s findings.
What are the different types of scholarly lterature?
- Conceptual
- Data-based
What is conceptual scholarly literature?
Also known as theoretical literature and would include a chapter in a book on (about) family theory. Integrative reviews or a clinical article.
What is data based scholarly literature?
Also known as research literature (empirical) and would include both qualitative and quantitative research reports
How would you critique a literature review?
- Was a brief synthesis of each article included with limitations and contributions to current study?
- Check the purpose /research question
- Check the type of design
- Check the sample type and size
- Check how the data was collected
- Check the measurement instruments
- Was there Reliability & Validity?
- Check the findings
- Review the conclusion
How does a literature review aid evidence based practice or quality improvement?
- Uncovers a new practice or supporting evidence for a practice
- Promotes EBP, policies, standards Provides a synthesis of information
A research question helps guide the study, a PICO question helps guide an EBP project.
What is the purpose of reviewing literature as a consumer?
It is to uncover the best available evidence on a given topic that has been generated by research studies that can potentially be used to improve clinical rpactice and patient outcomes
What is the “6S” hierachy of pre-appraised evidence?
A model that assits clinicians in their search for the highest level of evidence; the main use for the 6S hierarchy is for efficiently identifying the highest level of evidence to facilitate your search on your clinical question or problem
What are the different levels of organization of evidency in the 6S hierachy?
- Computerized decision support system - Integrates evidence-based clinical infromation into an electronic medical record
- Summaries - Includes clinical practice guidelines, electronic evidence-based textbooks, and evidence-based guidlines that provide recommendations based on high quality evidence
- Synopses of syntheses - Provide a pre-appraised summary of a systematic review. Some include a commentary related to strength of evidence and applicability to a patient population
- Syntheses (Systematic reviews) - These provide a synthesis of research on a clinical topic and use strict methods to search and appraise studies.
- Synopses of studies - A summary of a single study that has been appraised by an expert who provides an overview and appraisal of the study, including a commentary on the study’s context and practice implications.
- Studies - Addresses single stuides that have been pre-appraised.
What are referred journals?
- A journal that has a panel of internal and external reviewers who review submitted manuscripts for possible publication, and the reviewers use a set of scholarly criteria to judge whether a manuscript meets the publication journals standards
- They are also the perferred mode of communivating on almost any subject
What are electronic databases?
Databases that are use to find journal sources of research and conceptual articles on a variety of topics, including doctoral dissertations.
What are the 5 steps to evidence based practice?
- Ask
- Gather
- Asess/appraise
- Act
- Evaluate
How would you formulate a PICO question?
Patient Population
- What group do I want information on?
Intervention
- What event do I want to study?
Comparison
- Compared to what? Better or worse than no intervention at all or than another intervention
Outcomes
- What is the effect or intervention
How far back in time must a search go?
A general timeline for most academic or evidence-based practice papers/projects is to go back into the literature atleast 3 years, and perferably 5 years, although some research projects may warrent going back 10 or more years
What is “controlled vocabulary” in reference to a electronic database?
The terms that the indexers have assigned to the articles in a database.
What are boolean operators in reference to electronic databases?
Words used to define the relationships between words or groups of words in literature searches
Ex: “AND”, “OR”, “NOT”
What are frameworks?
Structure of concepts and/or theories used as the basis for development of the study –research question , hypotheses. It is the study’s underpinnings.
What are conceptual frameworks?
Framework consisting of concepts pulled together as a map for a study; the theory is not tested, it is just a look at the framework
What are theoretical frameworks?
Structure of concepts that exists (it is tested) and is a ready made map for a study
What is the function of a framework?
- Clarifies concepts
- Identifies and states underlying assumptions of study
- Specifies relationship among and between concepts
- Model-symbolic representation of concepts
What is a theory?
- A set of interrelated concepts that provides a systematic view of a phenomenon
- It provides a foundation and structre that may be used for the purpose of explaining or predicting another phenomenon.
- It is like a blueprint or a guide for modeling a structure
- Research and practice are linked with theory.
What is a concept?
The image or symbolic representation of an abstract idea; it is the key identified element of a phenomenon that is necessary to understand it.
What is a conceptual definition?
It defines or explains a concept as it is rooted in the theoretical literature; it gives the general meaning of a concept.
Ex: Conceptual definition of “hospital stay” = Time during which a person is a registered patient at a hospital
What is a construct?
A complex concept, usually comprising more than one concept and are built or “constructed” to fit a purpose.
Ex: Helath promotion, maternal-infant bonding, and health-seeking behaviors are examples
What is a model?
A graphic or symbolic representation of a phenomenon; it can depict a phenomenon that is not directly observable and is expressed in language or symbols
What is an operational definiton?
- It defines what instruments will be used to asses the presence of the conept and wil be used to describe the amount of degree to which the concept exists.
- It specifies exactly how the concept will be measured
Ex: operational definition of “hospital stay” =
Sum of days as registered patient beginning with admission day and concluding with dismissal day
What are the different theories used by nurses?
- Biomedical - Germ, Pain, Genetic theory
- Behavioral - Developmental, human needs, and stress theories
- Sociologic - System theory, Cultural diversity
- Learning - Behavioral learning
- Leadership - Change Theory
What are the 3 different types of theories used by nurses?
- Grand nursing theories
- Middle range nursing theories
- Situation specific nursing theories
What are grand nursing theories?
Theories that describe the disciple of nursing as a whole
Ex: . Neuman’s Model unique, Each person is a composite of factors and characteristics normal range of responses that are referred to as normal Line of defense (LOD).
What are middle range nursing theories?
Theories that contain a limited number of concepts arnd are focused on a lmited aspect of reality; as a result they are more easily tested through research and are more readily used as frameworks for research studies
What are situation specific nursing theories?
These theories are more specific than middle range theories and are composed of a limited number of concepts (Micro Range, Practice or Prescriptive); they are narrow in scope and explain a small aspect of phenomena and processes of interest to nurses and are usually limitedt o specific populations or field of practice
Ex: The theory of heart failure self-care
How would you evaluate a framework?
You would ask:
- Is a framework clearly identified?
- Is the framework appropriate for the topic?
- Are the concepts and variables clearly and appropriately defined?
- What are the conceptual and operational definitions?
- Is the basis for the hypothesis(es) clear and consistent?
What is the deductive process when testing research?
- The process of deriving hypotheses from theory, testing them, and poloying experimental research methods from that process
- Have a hypothesis derived from theory and test it – Quantitative
- Using this process is called Theory Testing Research
What is the inductive process when testing research?
- Does not have a theory but tests concepts and develop themes or a theory – Qualitative.
- Research using this is called Theory Generating Research
