Final Review Flashcards
practice based on the best available evidence, patient preference, and clinical judgement
Evidence based practice
changing practice based on the results of a single research study
research utilization: shifting from this model to EBP would be more likely to improve patient outcomes and provide more cost-effective methods of care. Many nursing questions cannot be answered in a single study.
three models of EBP
ACE star model of knowledge transformation
Iowa Model of EBP*
Model of diffusion of innovation
devote 15 mins/day to reading evidence related to a clinical trial
sign up for emails that offer summaries of research studies in your area of interest
use a team approach when considering policy changes to distribute the workload among members
bookmark websites having clinical guidelines to promote faster retrieval of info
evaluate available technologies to create time-saving systems that allow quick and convenient retrieval of information at bedside
negotiate release time from patient care duties to collect, rad, and share information about relevant clinical problems,
search for already est clinical guidelines bc they provide synthesis of existing research
strategies for overcoming barriers to adopting EBP
model of diffusion of innovations
model to assist in understanding how new ideas come to be accepted into practice
systematic study that leads to new knowledge and/or solutions to problems or questions
research
identify the research question conduct a review of literature identify a theoretical framework select a research design implement the study analyze the data draw conclusions disseminate findings
steps of the research process
descriptive explanatory predictive basic or applied quantitative or qualitative
categories of research
concerns persons, health, nursing practice, and environment
nursing research
research concerned with providing accurate descriptions about phenomena
descriptive research
research concerned with identifying relationships among phenomena
explanatory research
research that forecasts precise relationships between dimensions of phenomena or differences between groups
predictive reserach
research to gain knowledge for the sake of gaining knowledge
basic research
research to discover knowledge that will solve a clinical problem
applied research
research that uses numbers to obtain precise measurements
quantitative research
research that uses words to describe human behaviors
qualitative research: the world is NOT objective-there can be multiple realities bc the context of the situation is different for each person and can change with time
verifiable by experience through the five senses
empirical evidence: a focus of quantitative research
primarily linked to quantitative research
reasoning that moves from the general to the particular
deductive reasoning
reasoning that moves from the particular to the general and is associated with qualitative approaches
inductive reasoning: take a particular idea and express an overall general summary about the phenomena
control and manipulation of situations
analysis of numbers with statistical tests
larger number of subjects
quantitative research strategies
naturalistic: allows situations to unfold without interference
analysis of words to identify themes
smaller numbers of participants
qualititative research strategies
nonexperimental
corretational
quasiexperimental
experimental
possible designs of quantitative research
phenomenology
ethnography
grounded theory
historical
possible designs of qualitative research
the first section of a research paper that provides an overview of the study
abstract
part of a research particle that states the problem and the purpose
introduction
an unbiased, comprehensive, synthesized description of relevant previously published studies
review of literature
the structure of a study that links the theory concepts to the study variables
often describes the relationships among general concepts and provides linkages to what is being measuring in the study.
often combined with review of literature
provides the structure for the study by lining the abstract to the empirical
theoretical framework
major portion of a research article describing the study design, sample, and data collection
methods section
component of a research article that reports the methods used to analyze data and characteristics of the sample
results section
portion of a research article that interprets results and how findings extend the body of knowledge
discussion section
information for each article cited in a research report
list of references
a broad generalization that describes, explains, and predicts occurrences that take place around us
grand theory
first nurse researcher
systematic collection and analysis of data to id factors that contribute to morbidity and mortality rates of british soldiers during the Crimean War
ENVIRONMENTAL FACTORS ARE CRITICAL INFLUENCES ON THE HEALTH OF INDIVIDUALS
Notes on Nursing: What it Is, and What it is Not (1946)
florence nightingale
Goldmark and Brown reports
asserted nurses needed university education, not hospital diploma programs
western interstate commission for higher education (1957)
nursing research incorporated into graduate curricula; provided a structure for the advancement of nursing science
nurse education
nurse-patient relationship; characteristics of ideal nurse
clinical problems and clinical outcomes-protection of human rights
cost effectiveness measures in nursing-nursing recognized as a science and guaranteed federal funding
public concerns about the inequitites of healthcare delivery
development of nursing research focus
proposed first regulations to protect human subjects
Dept of health, education, and welfare in 1973–> developed IRBs
This report identified ethical principles that are foundational for the ethical treatment of individuals participating in studies funded by the federal govt
respect for persons
beneficience
justice
The Belmont Report
caused significant changes in the way health care was reimbursed
Diagnosis-Related Groups of the 80’s
the purpose of this database is to collect and evaluate unit-specific nurse sensitive data from hospitals in the US
*many of these measures are used by hospitals that have received MAGNET Recognition for nursing excellence
National Database of Nursing Quality Indicators (NDNQI)
ethical code of conduct for research that uses human subjects
Nuremberg Code
a study during which subjects were denied treatments so that the effects of the disease could be studied
conducted by United States Public Health Service
natural course of untreated syphilis
Tuskegee Study
an unethical injection of cancer cells to subjects without their consent
Was the body’s inability to reject cancer cells due to cancer or the presence of a debilitating chronic illness?
Jewish Chronic Disease Hospital Study
An unethical study involving coercion of parents to allow their children to participate in the study in exchange for admission to a long-term care facility
Mental health clinic stopped admitting patients unless they agreed to participate in hepatitis study
Willowbrook studies
based on Roger’s model on diffusion of innovation
provides specific strategies organizations can use to improve adoption of an EBP innovation
Translational Research Model
modifying policies and standards
modifying medical record forms
senior administrator education and support
orientation of new staff members
four interventions described in the Translational Research Model to promote excellence in nursing and move EBP forward
RNEL
Research Article National Guideline Expert opinion lit review type of evidence to support policy changes
APN
organization
Joanna Briggs Institute
International
Policy committee
organizational
AHRQ
national
Librarian
Regional level
NINR
national
Staff nurse
individual nurse level
adopted by World Medical Association in 1964; provides guidelines for physicians conducting biomedical research. Informed consent is hallmark
declaration of Helsinki: is more specific about what constitutes ethical scientific research than Nuremberg Code
voluntary consent is absolutely necessary for participation in research. Conduct avoiding harm, producing results that benefit society, and allowing participants to withdraw at will were deemed ethical. Became the standard to other codes of conduct
Nuremberg Code
right to freedom from harm
right to privacy and dignity
right to anonymity
human rights as research subjects as defined by ANA Commission on Nursing Research
a committe that reviews research proposals to determine that research is ethical
institutional review board (IRB)
gap in knowledge that requires a solution
research problem
identified through personal clinical experience, professional literature, current nursing theories, previous research, and national initiatives
research problems
must inclde the scope of the research problem, the specific population of interest, the independent and dependant variables, and the goal or question the study intends to answer; should implicitly or explicitly indicate that the proposed study is ethical, feasible, and of significant interest to nursing
problem statement
indicates the aim of the study; is derived from the problem statement
purpose statement
when one variable changes, the other variable changes
associative relationship: caution: association does not equal causation
when one variable determines the presences of change in another variable
causal relationship of an associative hypothesis
a hypothesis describing the relationship between two variables
simple hypothesis
a hypothesis describing the relationship between three or more variabes
complex hypothesis
a hypothesis that states that a relationship exists between two variables, but it does not predict the direction or nature of the relationship
nondirectional hypothesis: commonly used in exploratory and descriptive studies
when a _______ hypothesis is used, a rationale is included in the problem statement explaining why a directional relationship cannot be predicted between the variables
nondirectional hypothesis
no relationship among variables
null or statistical hypothesis
factors that interfere with the relationship between the independent and dependent variables
confounding variables or extraneous variables Z
present original information by the person or people responsible for creating it
primary evidence
resulting summaries, commentaries, reviews, or interpretations of primary sources
secondary sources
experts and editors rigorously evaluate a manuscript submitted for publication
peer review
works written and edited by professionals in the discipline for other collegues
scholarly literature
written for professionals in a discipline using a more casual tone than scholarly literature
trade literature
written to inform or entertain the general public
popular literature
most traditional type of review
based on common or uncommon elements of works without concern for research methods, designs, or settings
narrative reviews
review of literature in most published articles is a traditional narrative review
scholarly papers that synthesize published studies to answer questions about phenomena of interest
“generalizations about substantive issues from a set of studies directly bearing on those issues”
typically found in peer-reviewed professional publications
Ganong is credited with clarifying the steps of conducting this type of review
integrative review
scholarly papers that combine results of studies into a measurable format and statistically estimate the effects of proposed interventions
unlike an integrative review, this type of review includes only works that are similar or identical so that like-comparisons can be made and include both published and unpublished work
grew from narrative reviews when the increasing amounts of numerical data grew too cumbersome
especially useful as sources of evidence when large randomized trials are not feasible
meta-analyses
a rigorous, methodical synthesis of r
scientific tools which are used to summarize and communicate the results and implications of otherwise unmanageable quantities of research
systematic reviews
unpublished reports, conference papers, and grant proposals
often indicative of up and coming hot topics in the field
grey literature
using a reference list to identify sources of evidence
citation chasing
describes the broad catch of retrieved records
research strategy best used when the information being sought is uniquely detailed, a new topic or procedure, or has not been widely written about in literature
recall
a search strategy that narrows the parameters of the search
this search strategy is best when the information being sought has been written about in a number of authoritative sources by a number of knowledgeable people.
the search can be narrowed without undue concern abut the loss of some relevant records bc it is likely the search contained needed information in the retrieved records
precision
often best for searching full text or citation records
keyword search
search operators that are words that specify the relationship between two or more search terms
Boolean operators
a search strategy that uses a symbol at the end of a group of letters forming the root search term
the ability to retrieve records of search terms that share a common root
truncation
use of this word will narrow your Boolean search
and
use of this word will broaden your Boolean search
or
use of this word will narrow your boolean search
NOT
woman, women, wom?n
wildcard search
putting parenthesis around a phrase to search for it exactly as entered, to search two or more boolean operators
nesting
words such as a ,the, and, in that are so commonly used that they can hinder accurate record retrieval
stopwords
standardized hierarchial lists that represent major subjects within a database
heart attack and myocardial infarction
controlled vocabularies
technique for searching subject headings that identifies all records indexed to that term
exploding
nursing’s premier subject-specific database
CINAHL
Four broad concepts core to nursing: person, environment, health, and nursing
metaparadigm
a word or phrase used to communicate a specific key idea to others
properties that are inferred bc they cannot be directly observed
construct
words or phrases that convey a unique idea that is relevant to a theory
building blocks of theories
concept
concepts are joined together to form _________
which is a statement about the relationship between 2 or more concepts
proposition
measures of the variables being studied
empirical indicators
a concept at the abstract level is comparable to a ______ at the operational level
variable
A _____ at the abstract level is comparable to a hypothesis at the operational levels
proposition
Quantitative research typically ____ theory, while qualitative research typically ____ theory
tests; builds
______ are a set of concepts linked by propositions that explain phenomena. They provide a belief system to guide practice
Theories
what will an appropriate research design do?
reflect an integration of the theoretical and empirical literature that was presented in the review of the lit section
used for the purpose of examining causality
experimental designs
used for the purpose of descriving a phenomenon in detail, explaining relationships and differences among varibales, and predicting relationships and differences among variables
nonexperimental designs
what is the main difference between experimental and nonexperimental designs?
role or researcher:
in experimental designs, researcher actively manipulates IV (independent variable)
In nonexperimental designs, researchers are observers noting the occurrence of the variables of interest and trying to determine relationships and differences.
relationship between cause and effect
causality
causal variable
independent variable (IV)
multicausality
when outcomes have many causes
likelihood or chance that an event will occur in a situation
probability; probability assertions leave open the possibility that there are other causes and factors affecting the result seen in the DV
ability to manipulate, regulate, or statistically adjust for the multitude of factors that can influence the DV
control: necessary to make assertions about cause and effect
refers to the ability of researchers to control the IV
manipulation: an important aspect of control
factors that interfere with the relationship between the independent and dependent variables
extraneous variables: confound or confuse the effect of the IV and the DV
How do you control for extraneous variables?
careful selection of participants, use of consistent data collection procedures, randomization, or by using certain statistical tests
*Without careful control of extraneous variables, bias can be introduced into the study
results when extraneous variables influence and distort the relationship between IV and DV
bias
the selection, assignment, or arrangement of elements by chance
randomization
technique for selecting elements whereby each has the same chance of being selected
random sampling
subject have an equal chance of being in either the treatment or the control group
random assignment: increases the likelihood that extraneous variables that may affect the DV will be equally distributed between the two groups
What is an effective way to control for extraneous variables?
randomization
random sampling is often difficult in health-related reasearch, so what to researchers use instead?
convenience samples with random assignment to control/comparison vs intervention groups
When groups are different, researchers will need to apply __________ to control for the effect of extraneous variables on the DV
statistical tests
comparisons are made about hte same subjects at two or more points in time or on two or more measures: ie pre and post intervention testing
within-groups design
ability to accept results as logical, reasonable, and justifiable based on the evidence presented
study validity
truth or accuracy of the results
validity
forces that can change the results of studies
threats
two primary types of validity
internal and external validity
the degree to which the results of this study can be generalized to other subjects, settings, and time
external validity
the degree to which the instrument or empirical indicator actually measures the theoretical concept of interest
construct validity r/t external validity
the degree to which we can conclude that it was the IV, not the extraneous variables, that produced the change in the DV
internal validity
the confidence we have that the results from the statistical analysis accurately reflect the true relationship between the IV and DV
statistical conclusion validity r/t internal validity
occurs when the change in the DV is a result of differences in the characteristics of subjects before they entered a study, rather than the IV
selection bias; reduce by use of random assignment to groups
a threat to internal validity when the dependent variable is influenced by an event that occurred during the study
history threat; decrease this by using a control group who would have been exposed to the same event, but not the IV
a threat to internal validity when subjects change by growing or maturing
maturation: control group may decrease threat
a threat to internal validity when there are inconsistencies in data collection
instrumentation threat: use consistent instruments and evaluate interrater reliability to determine the degree of consistency among individuals collecting data
a threat to internal validity when a pretest influences the way subjects respond on a posttest
testing
a threat to internal validity when there is a loss of subjects before the study is completed
mortality threat: increases with study duration
attrition rate refers to study drop out rate: if high, author should provide an analysis and explanation for the drop out rate
the degree that the results of the statistical analysis reflect the true relationship between the IV and DV
statistical conclusion validity: does not happen if researchers make a type II error
were the instruments of measurement reliable?
when researchers inaccurately conclude that there is no relationship between IV and DV when a relationship does actually exist
type II error: more likely to occur in smaller sample sizes
changes noted in the DV can be a result of subject _____ instead of the IV
aka Hawthorne effect
reactivity: influence of participating in a study of the responses of subjects
how do you control from threats of reactivity?
double blind experimental designs: even decreases experimenter expectancy
if the sample does not represent the population
effects of selection limit the ability to generalize to the population
retrospective designs
DV already occurred, IV cant be manipulated, subjects cant be randomly assigned, therefore, retrospective designs are never experimental
often used in epidemiological studies
nonexperimental designs used to gather data from a group of subjects ar only one point in time
cross-sectional designs: difficult to est causality bc only gathering data once. IV and DV data collected at same time.
cheaper, more time efficient with less threat to mortality, maturation, and testing
a specific type of nonexperimental cross-sectional design where more than one group of subjects is studied
cohort comparision: allows researchers to draw conclusions about variavles over time even though data were collected at only one point in time
retrospective designs
cohort comparison
longitudinal designs
allow researchers to track data over time
usedto gather data about subjects at more than one point in time.
may be experimental or nonexperimental
aja prospective designs
longitudinal design
studies over time with presumed causes that follow subjects to determine if the hypothesized effects actually occur
prospective designs
longitudinal design where the same subjects provide data at multiple points in time
panel design
t type of longitudinal design to gather data from different samples across time
nonexperimental
are risky behaviors tested q2yrs in teens increasing, decreasing, or staying the same
trend
a longitudinal design used to follow subjects into the future
experimental or nonexperimental
breatfeeding impacts on future health
follow up
experimental design using two or more treatments (relaxation or exercise to reduce BP) in random order to determine which intervention has a greater impact on reducing BP
crossover: limited by carryover effect. subject may be asked to stop doing intervention A, but may actually continue using it during the implementation of the second intervention
which three features must be present in an experimental desgn?
randomization, control, and manipulation
what is the purpose of Solomon Four Group Design?
to decrease the threat of testing
allow researchers to manipulate more than one intervention during the same experiment
Factorial Designs (experimental quantitative)
lack randomization or control group, but maintain manipulation of IV
quasi-experimental designs
most commonly seen quasi-experimental design
time series design: one group is measured prior to administering IV, then multiple times afterwards
preexperimental
posttest only designs
lacks control from extraneous variables
a research design that lacks manipulation of the IV and random assignment
nonexperimental design: descriptive in nature and can be used todescribe phenomena in detail, explain differences among variables in detail, and predict relationship and differences among variables
two general categories of nonexperimental designs
descriptive and correlational
provide a pict of the situation as it is naturally happening w/out manipulation of an of the variables
descriptive design
exploratory, comparative, or survey
nonexperimental design used when little is known about a phenomenon
exploratory design
design that compares two or more groups or variables
comparative design
disign involving data obtained through subject’s self-report
survey design
used to study reltionships between two of more variables
correlational design: correlation does not prove causality
used to answer questions r/t the hows and whys of behavior, investigate topics about which little is known, or generate theory
qualitative designs: using words to provide evidence
what sampling method is used in qualitative research?
purposive, not random
sampling method to recruit specific persons who could provide inside information
or snowball sampling: accumulation of participants based on word of mouth or referrals from other participants
what drives sample size in quantitative research?
number of variables
what drives sample size in qualitative design?
determined by info being provided by participants
data collection stops when no new info is being obtained and repetition of information is consistently heard.-data saturation
three main sources of data for qualitative research
interviews
direct observation
written docs, photos, and physical obj
what is the hallmark of a sample?
representativeness–generalize to population
