exam 3 Flashcards
what is assent and who gives it in research?
an agreement to participate in research - agreement of a child or adult to participate in the stud
What are the international standards for ethical research?
The Nuremberg Code
-Code emphasizes voluntary consent and contains guidelines related to protecting subjects from harm and balancing the benefits and risks of a study
-Qualified, ethical, beneficial, and credible
-Written in response to Nazi experiments
Which populations are considered vulnerable and require additional protection
people who are susceptible to coercion and influence - children, prisoners, economically/educationally disadvantaged
What are the four elements required for informed consent?
-disclosure
-the participant must comprehend the information
-the competence of the participant
-the persons voluntary agreement to be in the study
- researcher must DISCLOSE essential information
Coercion
overt threat of harm or excessive reward intentionally presented by one person to another to obtain compliance
ex: money, gift cards
Research Misconduct
The fabrication, falsification, or plagiarism in processing, performing, or reviewing research, or in reporting research results.
Privacy
Freedom to determine the time, extent, and general circumstances under which private information will be shared with or withheld from others.
Confidentiality
Safe management of information or data shared by a participant to ensure that the data are kept private from others
Ethical Principle: Justice
fairness
right to fair treatment
right to privacy
Ethical Principle: Beneficence
promote good
right to protection from harm and discomfort
Ethical Principle: Autonomy
respect for persons
right to self-determination
right to full disclosure
questionnaires
are self-reported
-written
-verbal
-electronic
LOWER THAN 50% is a Poor Response Rate
Pros and Cons with Interviews
involves the participant
-structured: focused questions
-unstructured: ask participants to tell you something
Pros:
-the response rate improves
Cons: time-consuming and costly
Observational Measures
structured: records in categories that were observed like a checklist
unstructured: record sentences about what was observed like notes
reliability
consistency / precision
-test-retest reliability: more than one observer verifies it
-determines the measure of error or the scale that was used in the study
-If it is α > or equal to .80, it is CONSISTENT/reliable
Validity
extent to which an instrument reflects the concept being examined
-content validity
-construct validity
precision
comparable to reliability
degree of consistency or reproducibility of measurements made with physiological instruments
accuracy
comparable to validity
-did the instrument measure what it was supposed to measure ?
a nurse researcher is interested in the development of empathy in nursing students. Finding the lack of an appropriate instrument to use to study empathy in this population, the researcher has written a new instrument to gather data about the presence of empathy in nursing students.
What is the major construct of interest?
the major construct of interest for the new instrument is empathy
a nurse researcher is interested in the development of empathy in nursing students. Finding the lack of an appropriate instrument to use to study empathy in this population, the researcher has written a new instrument to gather data about the presence of empathy in nursing students.
what are the key questions the researcher needs to answer to confirm the instrument’s content validity?
The researcher needs to confirm how well the items on the instrument reflect the description of empathy in the literature, confirm the relevance of items on the instrument by content
experts’ evaluation, and examine potential subjects’ responses to the instrument’s items.
a nurse researcher is interested in the development of empathy in nursing students. Finding the lack of an appropriate instrument to use to study empathy in this population, the researcher has written a new instrument to gather data about the presence of empathy in nursing students.
what is the Cronbach alpha coefficient measure? was it considered strong?
internal reliability when there are multiple items on a scale 0.80 or higher is stronger
a nurse researcher is interested in the development of empathy in nursing students. Finding the lack of an appropriate instrument to use to study empathy in this population, the researcher has written a new instrument to gather data about the presence of empathy in nursing students.
which type of procedure would be used to assess the stability of the new instrument
Stability is usually measured using test-retest reliability. It is concerned with the consistency
of repeated measures of the construct. Using this technique requires an assumption that the factor
to be measured (in this case, empathy) remains the same at the two testing times and that any
change in the value or score is a consequence of random error
a nurse researcher is interested in the development of empathy in nursing students. Finding the lack of an appropriate instrument to use to study empathy in this population, the researcher has written a new instrument to gather data about the presence of empathy in nursing students.
What would a test-retest reliability value of 0.85 represent for the newly developed instrumen
A value of 0.85 is very solid test-retest reliability for the new scale, indicating that it is
consistently measuring empathy with repeat testing and recognizing that students’ level of empathy
varies somewhat over time
a nurse researcher is interested in the development of empathy in nursing students. Finding the lack of an appropriate instrument to use to study empathy in this population, the researcher has written a new instrument to gather data about the presence of empathy in nursing students.
What information would the researcher share in a published report about the development of this
new instrument
The researcher would describe the theoretical consideration that went into the
development of the instrument and discuss the facts about the instrument, including what type
instrument it is, scaling, length, readability, scoring, and interpretation of results. Then the researcher
would summarily describe each assessment conducted to provide evidence of the instrument’s
validity and reliability. At the minimum in this scenario, this would include assessment of test-retest
reliability and homogeneity, computing the Cronbach’s alphas for each, and at least one measure of
convergence, using an available instrument measuring empathy or a similar concept.
critical appraisal should be a(n)
balanced appraisal of a study’s strengths and weaknesses
3 steps of critically appraising a study
- identifying the steps of the research process in studies
- determining the study’s strengths and weaknesses
- evaluating the credibility and meaning of study findings
-interpretation of findings
-limitations
-conclusions
critical appraising guidelines for each section of a research article
apply the guidelines to be able to critique research articles
- writing quality
- title
- authors
- abstract
- research problem - why is this an issue
- purpose - does it clarify what the study is about
- literature review
- framework or theoretical perspective
- research objectives, questions, or hypothesis
- variables
-demographics, independent, dependent, research variables or concepts, conceptual and operational definitions - research design
- sample
- setting
- measurement
-strategies used, scales and questionnaires, observation, interviews, physiological measures, adequacy of measures, validity and reliability - data collection
-how, who, is it ethical ?? - data analysis
-procedures, statistical significance??
what is the purpose of critically appraising studies in nursing?
why is it important to perform an intellectual critical appraisal of a study?
-strengths
-weaknesses
-credibility
-meaning
-significance for practice
research utilization involves
a. communication of research findings
b. observing outcomes from changing practice
c. use of knowledge in practice
d. all of the above
d. all of the above
strongest evidence
-meta-analysis, systematic review
-integrative reviews
-experimental studies
weakest evidence
-descriptive surveys
-qualitative studies
- correlational studies
- quasi-experimental studies
sampling in research my be defined as
selection of a subset of a population to represent the whole population
2 ways to define sampling criteria
homogenous sample: as similar as possible so as to control for extraneous variables
heterogeneous sample: represents a broad range of values
-used when a narrow focus is not desirable
refusal rate
percentage of subjects who declined to participate in the study
-80 subjects approached and 4 refused
4 / 80 = 0.05 = 5%
10% OR LESS
acceptance rate
percentage of subjects who consented to be in the study
we want it to be > 90% !!!!!
-80 subjects approached and 76 accepted
76/80 = 0.95 = 95%
sample attrition
withdrawal or loss of subjects from a study
-attrition rate = number of subjects withdrawing / the number of study subjects x 100
sample retention
number of subjects who remain in and complete a study
types of probability sampling
simple random sampling - usually generated
stratified random sampling - good to use when you want a good distribution of ethnicity or gender
cluster sampling - like from zip codes
systematic sampling - every 3rd person or every ___ person out of a list
ePersonal health Record
a private, secure application through which a individual may access, manage, and share his or her health information
Population
the entire set of individuals or elements that are the focus of the research.
Accessible population
is the portion of the target population to which the researcher has reasonable
access.
Inclusion Criteria
the characteristics that the subjects must possess to be part of the target population
Examples:
the criteria here must include a definition of “students” and “students who are fulfilling parenting
responsibilities.” Therefore, possible inclusion criteria are students who are taking a minimum of a certain number of credit hours, such as “12 credits hours,” and have custody of a child younger than the age of 18 who resides in their home
Describe how the researcher would determine the sample size
the researcher would run a power analysis to determine sample size
Elements
individual units of the population and sample
Target population
an entire set of individuals or elements who meet the sampling criteria.
sample
the selected group of people or elements from which data are collected for a study. (subjects, participants)
exclusion criteria
characteristics that can cause a person or element to be excluded from the target population
sampling in research
selection of a subject of a population to respresent the whole population
homogenous sample
as similar as possible to control extraneous variables
heterogeneous sample
represents a broad range of values
-used when a narrow focus is not available
sampling error
difference between the population mean and the mean of the sample
random variation
the expected difference in values that occurs when different subjects from the sample are examined (the difference is random)
Which of the following has NOT been identified as a barrier to using research knowledge in nursing practice?
A. findings are communicated primarily to other researchers
B. Nursing studies have adequate replication
C. Practitioners often do not value research
D. Researchers-originated studies often do not solve pressing clinical problems
B. Nursing studies have adequate replication
what is the Grove Model for implementing EBP
nurses identify a practice problem, search for the best research evidence, and note that an evidence-based guideline has been developed to manage the problem
-how guidelines are developed
What factors would you consider in instituting a practice change?
-will it take a long time
-what support is needed to make the change
-are there barriers to instituting the change in the agency
Types of Barriers
Clinical barriers:
do not read research reports. lack education, biased, don’t know how to implement findings
Administration barriers: research not values, limited change in agency or change is not based on research, limited sources
translational research
an evolving concept - the translation of basic scientific discoveries into practical applications
PHR types
standalone (untethered):
-lack interoperability with other systems and require manual data entry ex: Microsoft word, excel, google
connected (tethered): EHR patient portal
-direct communication with healthcare providers, ability to request medication refills, appointment self-scheduling, and integrations with several sources. ex: labs, providers
what are the key components of PHRs
information that is entered by the consumer and/or data from other sources - pharmacies, labs, and health care providers
Describe key factors leading to the widespread adoption of electronic PHRs.
technical implementation for PHRs
Data privacy and security
-patients list privacy concerns when involving caregivers’ proxy access
Usability and user interface design
-factors of usability testing - target goals
Ease of interoperability
-data exchange standards like continuity of care
Data sources
-EHR, pharmacies, social media
Summarize the challenges of adoption for PHRs.
Digital divide :
Individuals of lower socioeconomic status, ethnic minorities, those with low eHealth literacy, and older individuals are less likely to adopt PHRs
Provider engagement :
Patient encouraged by the HCPs to use their online medical record were two times more likely to access their online medical record compared to those who weren’t encouraged
Awareness of functionality :
In 2018, patients said they did not have a need for an online medical record but increased awareness like self-scheduling and medication refills can drive adoption
evidence-based practice centers and translational research.
The evidence-based practice centers develop evidence reports and technology assessments on topics relevant to clinical and other healthcare organization and delivery issues – that are common, expensive, or significant - (AHRQ)
Translational research is the process of turning observations in the laboratory, clinical, and community into interventions that improve the health of individuals and the public
what does IRB stand for and what does it do?
Institutional review boards (IRBs) are organized in universities and clinical agencies to examine the ethical aspects of studies before they are conducted
-responsible for approving studies and addressing any research violations that may occur in a study
exempt: no risk to subjects in a study
expedited: minimal risk
complete (full review): > than minimal risk
Who is Henrietta Lacks and how were her rights violated?
Her cervix tumor cells (cancerous) were LITERALLY just shared for research purposes. Not cool.
They offer her cells “widely” to be basically experimented on
what are standards for ethics in the US
belmont report:
-written in response to the Tuskegee Syphilis Study
identified ethical principles w/ selecting subjects, informing risks and benefits and getting consent
Tuskegee study - African American men w/ syphillis were studied without consent and were untreated
Measurement Error
systematic error:
the variation in measurement is in the same direction and is not reliable
random error:
the difference is without a pattern
ex: punching the wrong key when entering data into the computer
