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Nurs 1351 > Exam > Flashcards

Exam Flashcards

1
Q

systematic reviews

A
  • Form of filtered evidence (reviews previous studies)
  • Integrates research evidence/findings (i.e., primary research)
  • Answers a specific (research or clinical) question
  • Follows explicit procedures (i.e., has a set of methods) → someone could follow their procedures and methods to reproduce the study
  • Determined in advance
  • Reproducible
  • Verifiable/Transparent
  • Offers recommendations
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2
Q

scoping review

A
  • Research question is very broad/general
  • Can include quantitative and qualitative literature
  • Follow a specific process, that is transparent and reproducible
  • Shallow - skim the literature (not deep)
  • Authors don’t critically appraise the literature (don’t determine how strong the research is) (sample size, interventions, randomization, validity, etc.)
  • Don’t necessarily make recommendations for clinical practice (because they are not appraising the literature)
  • “How is complexity theory being used in health research?” –> So many answers to this question
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3
Q

literature review/narrative review/integrative review

A
  • Not reproducible (don’t follow agreed upon methods), methods are not explicit
  • Used to make an argument for why a study should be conducted
  • Not really to answer a research question
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4
Q

meta analysis

A
  • Form a systematic review (specific form)
  • Systematic review that statistically combines the results of multiple studies together
  • Very specific question
  • All the studies included have to have answer the question in the same way (same methods)
  • “Is ___ medication better than ___ medication for ___ disease”
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5
Q

why use systematic reviews

A
  • Born from EBP - make healthcare more effective
  • Patients aren’t receiving 100% (not enough) of expected/good care
  • Patients may get care that is not needed or care that could be potentially harmful
  • Systematic review - methodological approach (ie. way) of finding, critiquing, and synthesizing research that exists on a topic to answer a specific question
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6
Q

systematic reviews

A
  • use rigorous methods to identify, appraise, and synthesize primary studies
  • provide best available objective evidence on a topic
  • filter evidence through own evidence informed practice lens
  • NOT scoping reviews
  • purpose is to:
    address a specific research question
    obtain evidence to inform clinical decisions/practice
    synthesize findings of a number of individual studies
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7
Q

systematic reviews: how it works

A
  • Research question is clearly stated (PICO)
  • Search strategy is clearly stated (terms, strategy)
  • Eligibility criteria (fit with PICO)
  • Inclusion and exclusion criteria
  • Methodology (to reduce bias) (Tools, instruments used, randomization, reliability (size, effect))
  • Studies critically appraised
  • Tables
  • Analysis
  • Recommendations
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8
Q

Why is it important to critically appraise the articles in a systematic review?

A

If you are gonna offer recommendations for clinical practice or future research you must be sure the research is strong

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9
Q

systematic reviews: summary

A
  • Rigorous analysis of a number of studies answering a clinical research question (evidence)
  • Appraisal of studies
  • Conclusion - recommendations based on strength, quality, and consistency of data in primary studies
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10
Q

Characteristics of Qualitative Research Design

A
  • Consistent with a constructivist or critical paradigm
    • Everyone creates their own reality (based on experiences, etc.)
    • There is no absolute truth to be measured
  • Flexible, elastic, emergent
  • Intense researcher involvement
  • Subjective
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11
Q

what is qualitative research?

A
  • Inquiry to explain and understand human experiences
  • Data: words or textual form
  • Conducted in natural settings that people live in every day
  • Study human experience (of health)
  • Focused on meaning
  • Explanatory, descriptive
  • Provides context
  • Answer questions, how? Or why? (not effect or associated)
  • Goal is to enhance understanding
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12
Q

steps in qualitative research

A
  • Review of the literature
    Use literature to justify question (why does it matter?)
    Asses gaps in the literature
    determine/describe phenomenon of interest
    Effects study design (data collection, analysis, etc.)
  • Study design
    Lays out the methods used to conduct the study
  • Sample
  • Setting: recruitment and data collection
  • Data collection (Interviews)
  • Data analysis
  • Findings
  • Conclusions
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13
Q

Qualitative sampling

A
  • Purposive sampling - Purposefully sample people who have experienced the phenomenon of interest
  • Snowball/network sampling
  • Maximum variation - sample people with lots of experience in health care system, and little amount of experience in health care system (get a variety of responses)
  • Inclusion/exclusion criteria
  • Description of how participants were recruited
  • Sample size
    Small sample size (could be 5-10 people)
    Text data cannot be synthesized by a computer, it all has to be synthesized by the researcher, so a few people results in a lot of data
    There is no sample size calculation (minimum sample size)
    Sample size is estimated based on convention
  • Data saturation - when your collecting qualitative data you start to hear the same things over and over again → so you don’t need to sample more people if everyone is saying the same thing
  • Description of sample
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14
Q

qualitative data collection

A
  • Naturalistic setting - where people experience the phenomenon
  • Open-ended questions to elicit narratives
  • Interviews recorded and transcribed
  • Individual or focus group interviews
  • gatekeepers
  • field notes
  • ethics and consent addressed
  • data collection and analysis are concurrent
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15
Q

pros and cons of focus groups

A

Pros - group conversation, helps to get people talking
Cons - some people can take over the conversation, not so good for difficult topics (people aren’t open to talking about touchy stuff in a group)

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16
Q

gatekeepers

A

People who inadvertently keep certain participants from joining a study
Ex: you are selecting nurses to talk about working conditions in the emergency department, manager will pick the most positive nurses to do the study (keep the negative ones out)

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17
Q

qualitative data analysis

A
  • immersion - Researcher must immerse themselves in the data (get to know the data) (read the data multiple times)
  • constant comparison - As the researcher comes up with new findings, constantly compare to the old findings
  • bracketing - Researcher trying to become aware of their assumptions, thoughts, beliefs, biases, experiences related to research. Become conscious of how those things affect the research
  • Interpretation of meaning; description of process; description of experience
  • Codes, categories, themes - Coming up with different codes for data, categorizing data, look for patterns in the data (themes)
  • Researcher interprets meanings - Subjective
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18
Q

qualitative findings

A

​​Use participants’ own words (direct quotations) to support themes
Describe phenomenon, process

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19
Q

qualitative discussion

A

Compare findings with literature
Suggest implications for practice, education, research, policy
Limitations

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20
Q

reflexivity

A
  • process for understanding how a researchers perspective can influence the research
  • Acknowledge biases (bracketing)
  • Journal
  • Researcher affects interviews; interviews affect researcher (going native - how the researcher can become like the participants)
  • Be open to findings
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21
Q

rigor in qualitative research

A
  • Researcher–participant interaction (reflexivity)
  • Researcher as instrument
  • Trustworthiness (e.g., credibility, auditability, fittingness)
  • Triangulation - looking at a phenomenon from 3 different ways
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22
Q

credibility

A

degree of truth in the findings

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23
Q

Auditability

A

being very clear in how the research was conducted/data was collected (clear in how you arrived at your findings)

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24
Q

fittingness

A

how meaningful the findings seem to everyday practice

25
Q

triangulation

A
  • looking at a phenomenon from 3 different ways
  • Data, investigator, methodological
  • Data - collecting data at different times, places, __
  • Investigator - get 3 different people to collect data
  • Methodological - use 3 different methods to conduct research
26
Q

meta synthesis

A

Systematic review of qualitative research
Synthesis of findings
Integrates findings and summarizes evidence that is relevant to practice

27
Q

qualitative research designs

A 
Grounded theory
Case studies 
Historical
Ethnography
Phenomenology
Participatory action
28
Q

qualitative research: importance to nursing

A
  • Use findings to improve patient care
  • Provides new perspectives
  • Provides insight to patient experiences
  • Expands understanding
  • Gives voice to those unheard
  • Contributes to instrument development
  • helps to develop theory
29
Q

phenomenology

A
  • Purpose: to understand lived experience
  • Moving away from post-positivism
  • Based on constructivism
  • To describe a phenomenon
  • For topics that have not been studied or need a new perspective
  • Making sense of experience: How people perceive it, describe it, feel about it
    To establish context and meaning
  • Intersubjectivity - people share a common world (body and space in time)
30
Q

descriptive (husserl)

A
  • Description of the lived world
  • Essence
  • Describe as how people see it/how people perceive things
31
Q

interpretive/hermeneutic

A
  • Meanings, relationships (between phenomenon/experiences)

- Viewed through a historical/cultural context (lens)

32
Q

phenomenology sampling

A
  • Purposive sampling - select participants who are living or have lived the phenomenon of interest
  • Sample size
    For depth of understanding rather than breadth
    About 6-10 participants
  • Sample recruitment should continue until data saturation (no new themes or themes are fully developed)
33
Q

phenomenology data collection

A
  • Interpretation from text or the written word (eg. charting notes, emails, etc)
  • Interview
  • Open ended questions
  • Bracketing or reflection to check biases/assumptions
34
Q

phenomenology data analysis

A
  • Begins with data collection (can happen simultaneously with data collection during phenomenology)
  • Moving from participants descriptions to researchers synthesis (put everything together) (researcher interprets)
  • According to philosophy
  • Results in a description of participants lived experience of the phenomenon under stud
35
Q

phenomenology findings

A
  • Researcher interprets
  • Present findings as themes
  • Use of direct quotations to illustrate
36
Q

phenomenology summary

A
  • Provides understanding of context and meaning of experiences
  • Depth rather than breadth (small sample size allows you to go deep)
  • Based on philosophy
  • Descriptive, interpretive, hermeneutic
  • Researcher/participant relationship
  • Bracketing or reflexivity
  • Results in descriptions of participants lived experiences of a phenomenon
  • Supported by direct quotes from interviews
37
Q

ethnography

A
  • Based on constructivist paradigm
  • Study of cognitive models or patterns of behavior of people within a culture
  • Seek to understand another way of life from the perspective of people experiencing it
  • Focuses on patterns of behaviors within a culture (attitudes, beliefs, and practices of the group)
  • Culture is dynamic (changes)
  • Unstated rules
  • Can be broad or very specific
  • Example: Culture of neonatal unit
38
Q

ethnography: roots

A
  • Anthropology, sociology
  • Study of culture (attitudes, practices, beliefs of a group)
  • Understand way of life from perspective of people experiencing it
  • Understanding context in natural setting
  • Detailed description of everyday life: “make the familiar strange”
39
Q

emic perspective

A

Insider view of the culture (within)

40
Q

etic perspective

A

Outside perspective (researcher)

41
Q

ethnographic methods

A
  • participant observation
  • interview (in depth) (individual or focus group)
  • artifacts/document review
42
Q

ethnography: interview

A
  • In-depth
  • Individual or focus group (elicit a collective view)
  • Members of cultural group experiencing phenomenon
  • Called informants (people who inform us about the culture - interviewees) and gatekeepers (people who let us into the culture)
43
Q

ethnography: observation

A
  • In the field
  • Document field notes (structured or unstructured)
  • Participant observer
    • Complete
    • Observer as a participant
    • Participant as observer
  • Attentive to how researcher affects behaviors
    • Prolonged engagement mitigates researcher effect (get used to the researcher and kind of forget about them being there)
  • Ethics: do not include people who do not give consent
44
Q

artifacts/document review

A

Tools (assessment tools)
Policy documents
Organizational policies, visions, value statements

45
Q

ethnography analysis

A

Data collected and analyzed concurrently
Synthesized by the researcher
Codes, categories, themes
Added framework or critique used to guide analysis

46
Q

ethnography findings

A
  • Rich description
  • Participant quotations
  • Focus on all three sources of data (not just interviews) (observation, document review, interviews)
  • Pictures of artifacts
47
Q

purpose of grounded theory

A
  • Systematic method consisting of several flexible strategies for constructing theory through analyzing qualitative data
  • Systematic set of procedures used to explore the social processes that guide human interactions and to inductively develop a theory on the basis of these observations
  • Utilize and inductive process to generate substantive theory about a social phenomenon
  • Create and in depth and context based knowledge base from the participants unique experiences
  • Generate theory about dominant social processes
  • Theory that emerges is grounded in the data
48
Q

why use grounded theory

A
  • When a theory is not available to explain or understand a process
  • Theories may be available but they are developed and tested on a different sample or populations of the researcher’s interest
  • The power of grounded theory studies relies on its tools to understand empirical world and construct a theory to explain phenomena of interest
  • Theory is constructed and derived from data collected during the research process and not chosen prior to the beginning of research
    ANALYZES PROCESSES
49
Q

philosophical foundations of grounded theory

A
  • Sociology
  • Symbolic Interactionism
  • Human beings behave and act based on the meaning it has for them
  • Meaning is interpreted and derived through social interaction
  • GT about meanings, processes, agency action in social contexts
  • Reveals processes
50
Q

traditional grounded theory

A
  • Glaser
  • positivist
  • reality to be determined
  • categories emerge from data
  • researcher not involved
  • little influence from literature
  • rigorous, prescriptive, theoretical coding
51
Q

reformulated grounded theory

A
  • Strauss & Corbin
  • post positivist to constructivist
  • reality to be interpreted
  • categories identified, applied, and tested
  • researcher interprets data
  • axial coding - to explain properties and relationships around concepts
52
Q

constructivist grounded theory

A
  • Charmaz
  • constructivist to post modern
  • data co-constructed
  • truth is local/multiple
  • researchers interpretive understanding rather than explanation
  • researcher actively involved
  • learn from participants, multiple interviews
  • represent as narrative or story
  • matrix - micro/macro conditions influencing interactions
53
Q

features of grounded theory

A
  • Study of processes, interactions, behaviors, experiences
  • Eg. through illness, a care delivery system, or organizational pathway
  • Generates or adds to theory
  • Seeks explanation rather than description
54
Q

Grounded Theory: Data Collection

A
  • Mainly in-depth interviews
  • Open ended questions
  • Observation
  • Documentation
55
Q

grounded theory sample

A
  • Purposive
  • Theoretical - Sampling method used to select experiences that help the researchers test ideas and gather complete information about developing concepts. Researchers seek participants who can further clarify the emerging concepts. A way of collecting data, and deciding what data to collect based on the theory and categories that emerge from your data.
  • Snowball
  • Saturation
56
Q

grounded theory: data analysis

A
  • Concurrent with data collection
  • Iterative
  • Open coding
  • Line by line
  • Categories expanded, developed, or collapsed
  • Constant comparison method
  • Continuously comparing new categories with data
  • Theoretical memos
  • Axial coding
  • Define relationships among themes
57
Q

grounded theory findings

A
  • Often a visual presentation, narrative, theoretical propositions, model
  • Detailed description of the theory
  • Explains, interprets, or predicts the process involved
  • Defines relationships between concepts
58
Q

strengths of grounded theory

A

Most prescriptive in describing methods

Focus on processes

59
Q

limitations of grounded theory

A

Can get complicated

Nurs 1351 (3 decks)

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