Midterm Review Flashcards
What are the 5 Ways of Knowing in Nursing?
- Tradition
- Authority
- Trial & Error
- Experience intuition
- Logical reasoning/scientific method research
From a Historical Perspective, Scientific Approach to Development of Knowledge is characterized by?
- ORDER: inquiry conducted following a logical series of steps, according to a pre-specified plan
- CONTROL: some aspect of what we are studying to minimize error/bias, which threaten our conclusion/validity.
- EMPIRICISM: Facts are grounded to objected reality.
- GENERALIZATION: Gain knowledge that is transportable from a specific situation to a general.
Assumptions:
- objective reality
- nature is orderly & regular
- events proceded & cause others (“ determinism”)
What is qualitative research?
- Concerened primarly with process (HOW), rather than outcomes or products.
- interested in meaning & meaning-making-how people make sense of there lives and experiences.
Advent assumptions:
- Reality/ knowledge is constructed by the human mind or social interactions
- Events not neccesarily casual & predetermined
What are the 2 philosophies of research/paradigms
- Quantitative-empirical analytical/positivist/received
2. Qualitative-naturalistic, recieved
In the qualitative vs. quantitative paradigm what is the ontological assumption?
Questions: what is the nature of reality?
Qualitative: tangible reality, controllable, predictable, testable
Quantitative: constructed, mulitple, context dependent.
In the qualitative vs. quantitative paradigm what is the epistemological assumption?
Questions: what is the relationship of the researcher to that researched?
Qualitative: constructed, multiple, context dependant.
Quantitative: highly, interactive
In the qualitative vs. quantitative paradigm what is the axiological assumption?
Questions: what is the role of values?
Qualitative: value-free
Quantitative: value-laden
In the qualitative vs. quantitative paradigm what is the Rhetorical assumption?
Questions: what is the language of research?
Qualitative: formal, based on set definitions, impersonal voice
Quantitative: informal, evolving decisions, personal voice
In the qualitative vs. quantitative paradigm what is the methodological assumption?
Questions: what is the process of research?
Qualitative: deductive process, cause & effect, static design-categories isolated before study, context free, generilations leading to prediction, explanation & understanding, accurate & reliable through validity & realiability.
Quantitative: inductive process, mutual simultaneous shaping of factors, emerging design-categories identified during research process, context bound, petterns, theories deveolped for understanding, accurate & reliable through verification.
What are the 9 philosophical orgins with in the Quantitative & Qualitative Research Characteristics ?
- FOCUS: Quantitative: concise, objective, reductionistic. Qualitative: broad, subjective, holistic.
- REASONING: Quantitative: logistic, deductive. Qualitative: dialectic, inductive
- BASIS OF KNOWING: Quantitative: cause & effect relationships. Qualitative: meaning, discovery, understanding
- THEORETICAL FOCUS: Quantitative: tests theory. Qualitative: develops theory.
- RESEARCH INVOLVEMENT:Quantitative: control Qualitative: shared interpretation
- METHODS OF MEASUREMENT:Quantitative: Structured interviews, questionnaires, observations, scales, or physiological instruments. Qualitative: Semi- or unstructured interviews & observations
- DATA: Quantitative: numbers Qualitative: words
- ANALYSIS: Quantitative: statistical analysis Qualitative: individual interpretation
- FINDINGS: Quantitative: generalization accept or reject theoretical proposition. Qualitative: uniqueness dynamic understanding of phenomena & new theory
- Qualitative (naturalistic, interpative, humanistic)
- Quantitative (logical positvism)
Define nursing research?
Research: systematic, logical, and empirical inquiry into a phenomenon to produce verifiable knowledge
(qualitative & quantitative)
Purpose: to improve practice & health outcomes of patients
Define Evidence- Informed Decision Making
“A continuous interactive process involving the explicit, conscientious and judicious consideration of the best available evidence to provide care” [CNA]
Research use/utilization requires nurses to:
- Value research as one way of developing knowledge for nursing
- Have the ability to find relevant research
Have knowledge of sound research practices
Have the ability to critical evaluate research findings
What are the roles of a nurse in research?
- consumer/decision maker
- change champion
- participate/subject
- investigators/producers
CNO: review research in nursing and health related disciplines, critically evaluate research findings, and use findings to inform practice
CNA:) All nurses will …participate in research, read, and apply research findings
What are the directions of nursing research?
- community research
- programs of research
- international perspective
- intervention studies
What are the steps involved in critical reading of nursing research?
- Preliminary reading
- Comprehensive understanding
- Analysis understanding
- Synthesis
What are the steps involved in comprehension/understanding?
- Preliminary understanding: Skim abstract and article. Might decide to stop reading.
- Comprehensive understanding: Understand author’s intent, review unfamiliar terms, terms in relation to context
- Analysis understanding: Understand parts, critique soundness
- Synthesis understanding: Put together and make sense
Critical appraisal ultimately helps you to answer 3 questions. What are they?
- What are the study results?
- Are they valid, i.e., were they obtained by sound scientific methods? (big part of this course)
- Will the results help me in my practice, i.e., clinical significant & useful, generalizable to my patient population?
Goal: begin to determine the value of a research study for your purpose & start critiquing study for its scientific merit, application to practice. You begin to critique!
List the research process/steps
- Research problem and problem statement
- Purpose Statement (Quantitative/Qualitative).
- Hypothesis or Hypotheses in quantitative studies
- Types of hypotheses
- Variables in quantitative research
- Title /abstract
- Critique of problem and purpose statement
What is the purpose of creating a research problem/ problem statement ?
Conduct a research study b/c have:
a problem or situation in need of a solution
A problem/situation arises when we are uncertain about a phenomenon, ie. we don’t have adequate information about it or enough understanding to know what to do
Always indicate a lack of knowledge of some sort or a gap in knowledge
Significance to nursing practice, health care & target population is highlighted – the “so what”?
What is the Contribution?! GAP!!!
Whats the point of having a purpose statement ( quantitative & qualitative) ?
- Tells you the focus of the study (aims, goals, or objectives)
- The purpose (aka aim, objective goal) of this study is …
- Tells the reader what to expect:
- Evaluate …. sounds like an experiment/quasi-experiment
- Explore lived experience … sounds like phenomenology
- Indicates the sample & what the general variable/concepts of interest
- Should contain concepts/variables, population, and possibly setting
- Usually located in the introductory paragraph of the end of the literature review section (therefore, the purpose of this study was ….)
- Sometimes no purpose statement. Researcher goes straight to research questions/hypotheses.
Restatement & clarification of the purpose statement is done through the following…
They make comparisions between 2 or more groups & examine the relationship of 2 or more indepedant variables and dependant variables:
- Questions
- Objectives
- Hypotheses ( only in quantitative)
What is a hypothesis or hypotheses?
- Statement about the relationship between 2 or more variables that suggests an answer to the research question or addresses the study purpose
- Derived from the research problem, literature review, and conceptual framework
- Theory based
- It is a prediction linking theory to research
- Written in declarative format (a statement,NOT a question) and predicts a relationship between 2 or more variables
- May be more than 1 hypothesis in a research study – each is subunit or subset of the research problem/addresses part of study purpose
- Testable=observable, measurable (not value-laden)
What the the different type of Hypotheses?
- Research hypotheses
- Directional
- Non-directional
- Null hypotheses
- No relationship/ difference
What are the variables used in Quantitative Research?
Main types used in quant. research as basis of writing hypotheses & questions for correlational, experimental & quasi-exp studies:
Dependent (Y)
Independent (X)
Think back to high school math
if X then Y
Y=mX + b
Neither dependent or independent
Just a relationship exists
What does the title/abstract tell the reader?
“The title keys the reader to the main variables of the study”
“An abstract keys the reader to the main components of the study”.
“An abstract is a short comprehensive synopsis or summary of a study at the beginning of an article. An abstract quickly focuses the reader on the main points of a study. A well-presented abstract is accurate, self-contained, concise, specific, non-evaluative, coherent, and readable.”
Does the abstract tell you the main components/phenomena of the study? What are the key variables/phenomena?
Does the abstract focus you to the main findings of the study? What are the main findings?
What questions are posed in the Critique of the problem and purpose statement?
- Has the problem been substantiated – how well?
- Has the significance of the problem been identified?
- Does the purpose/aim match/respond to the problem statement?
- Does the question imply the possibility of empirical testing? Can it be answered?
Define the Philosophical Terms: Ontology, Epistemology, Methodology
ONTOLOGY
The science or study of “being.”
Questions: What can be said to exist? Into what categories can existing things be sorted?
EPISTEMOLOGY
Epistemology addresses the issue of “truth.”
Questions: What is knowledge? How do we know what we know? What is the scope of knowledge?
METHODOLOGY
Methodology refers to discipline-specific principles, rules, and procedures that guide the research process.
Questions: How can we answer our research question? What approache(s) are most relevant/suitable?
What are the 3 nursing paradigms?
- Post-Positivism
- Critical Social
- Constuctivist
Describe the Paradigms for Ontology.
post-positivism, critical theory, constructive
POST-POSITIVISM - a material world exisits, not all things can be understood, sensed or placed into a cause and effect relationship. The senses provide us with imperfect understanding of the external material world.
CRITICAL THEORY- reality is constructed by those with the most power at particular points in history, reality is palstic at all times imperfectly understood, overtime relaity is shaped by numerous political/social/economical & cultural forces.
CONTRUCTIVE- reality in constructed by individual perception, not absolute truth or validity, truth is realitive and subjective and based on perception or some particular frame of reference.
Describe the Paradigms for Epistemology.
post-positivism, critical theory, constructive
POST-POSITIVISM- researchers are naturally biased, objectivity is the ultimate goal, encourages traingulation & replication findings, encourages intense scrutiny of research and rejectin of poorly conducted research.
CRITICAL THEORY- research is a transaction b/w the researcher and participant, perceptions naturally influence knowledge generation/creation, contextual awareness & its relationship to the participants-understanding of reality is the focus of the research, objectivity as outlined by past positivist is not a desired goal.
CONSTUCTIVE- research is a transaction b/w researcher & participant, perceptions naturally influence knowledge generalization/creation, emphasizes the meaning ascribed to human experience, context is considered but not emphasized, objectivity as outlined by the post-positivist is not a desired goal.
Describe the Paradigms for Methodology.
post-positivism, critical theory, constructive
POST-POSITIVISM-research is a series of lodgical steps, includes experimental & non-experimental approaches, research questions/hypotheses are proposed and subject to testing.
CRITICAL THEORY- inquiry requires dialogue b/w the investigator and researcher participant, dialogue is transformative and brings to the forefront the historical context behind experiences of suffering, conflict and collective struggles, dialogue increases participates awareness of actions required to incite change.
CONSTRUCTIVE-inquiry requires dialogue b/w the researcher and participant, focus on intrepretation of written texts, art pictures and videos, findings bring to the forefront the various ways in which people construct meaning and understanding.
Describe the Paradigms for Aim.
post-positivism, critical theory, constructive
POST-POSITIVISM - explanation, predication, control
CRITICAL THEORY- critique, change, reconstruction of what we know to be true, emanicpation
CONSTRUCTIVE- understanding, reconstructive of what we know to be true.
Desribe the 2 approaches to research?
- INDUCTIVE REASONING: Start with details of experience and move to a general picture; from specific observations to broader generalizations and theories. More open-ended and exploratory, especially during the early stages of research. Example: Delirium is a newer concept that has been gaining a new definition in practice or notice cloudy catheter bags in patients with infections, helps you think they are connected.
- DEDUCTIVE REASONING: Works from the more general information to the more specific. Sometimes this is called the “top-down” approach because the researcher starts at the top with a very broad spectrum of information and they work their way down to a specific conclusion. More narrow and is generally used to test or confirm hypotheses. Example: All dogs are mammals, all mammals have kidneys, therefore all dogs have kidneys.
Define concepts?
Explain why concepts helpful?
- An image or symbolic representation of an abstract idea (e.g., pain).
- The major components (building blocks) of theory and convey the abstract ideas within a theory.
Helpful beacause….
- Categorize & organize environmental stimuli
- Classify our experiences in meaningful way
- Help us to understand our world
Define Theory
A set of interrelated concepts that serve the purpose of explaining or predicting phenomena.
A blueprint or a written or diagrammatic depiction of both the concepts that compose a theory and how they are related
Define Quantitative Theory
Organize concepts into meaningful relationships to explain an event/ situation.
Conceptual/theoretical framework.
Test the relationships btw concepts with operationalized variables that measure your concepts (deductive).
Define Qualitative Theory
Explore concept/phenomena’.
Develop theory about the relationships btw variables/ phenomena (inductive).
May have theoretical perspectives guiding you but not in the sense of a linear/causal framework that you are testing (ex. Feminist theory).
Used to focus the research inquiry…
Explain Conceptual Frameworks
-A structure of concepts, theories, or both that is used to construct a map for a study.
Presents a theory that explains why the phenomenon being studied exists.
Constructed from a review of the literature or is developed as part of a qualitative research project
Explain Theoretical Frameworks
Also defined as a structure of concepts, theories, or both that is used to construct a map for the study.
Based on a philosophical or theorized belief or understanding of why the phenomenon under study exists.
Explain Function of Framework?
- Clarifies context
- identifies & states underlying assumptions of a study
- Speifies the relationship among and b/w concepts
- A conceptual of theoretical model is a visual symbolic represention of the concepts in a framewrk
Evaluating Framework questions what?
Is the framework…
- clearly identified?
- consistent with a nursing perspective?
- appropriate for the topic?
- Are the concepts and variables clearly and appropriately defined?
- Did the study present sufficient literature to support the selected concepts and hypotheses?
- Is there a logical, consistent link between the framework, the concepts being studied, and the methods of measurement?
What is a variable?
A property, quality or characteristic of a person, thing, or situation that can change or vary
List and describe the different types of variables?
Independent (X) and Dependent (Y)
Demographic variables: contain background info about sample like age, gender
Extraneous variables: rival hypotheses or may be alternate reasons for findings because they cloud/obscure the relationship between the independent & dependent variables
- DECIDED BY RESEARCHER
- VARIABLES ON THEIR OWN ARE NOT INHERENTLY DEFINED AS INDEPENDENT, DEPENDENT, DEMOGRAPHIC OR EXOGENOUS
What are the variables in quantitative research both conceptually and operationally?
Conceptually:
- Abstract
- Theoretical definition
- Mental image/ idea about something
- Provide the general meaning
Operationally:
- Concrete
- Defines exactly how concept/ construct will be measured
What is a literature review?
“An objective, thorough summary and critical analysis of the relevant available research and non-research literature on the topic being studied”.
Gathers information from many sources on what is “known”/“not known” about a subject (“current state of knowledge”).
- Can be a written report, section of a research article or part of a book. May or may not be explicitly called “lit review”.
Why conduct a literature review?
Lays the foundation for a study/highlights its significance to nursing.
Helps with identifying, developing and refining research problem/questions
Identifies key sources that are important for understanding a particular phenomenon or issue.
What is the purpose of a literature review?
Increase our knowledge/ understanding of a particular topic to:
1. Support practice.
2. Make decisions related to policy, education (develop and revise nursing curricula) etc.
3. Develop BPGs, protocols, etc.
4. Identify gaps in knowledge/need for new research/need for - replication of a study with a different population (background for research proposals).
5. Identify potential theoretical/conceptual frameworks and develop hypotheses to be tested.
6. Identify potential designs & data collection methods.
7. Interpretation of study
findings/implications/recommendations
“scope” of literature review is shaped by?
Shaped by:
The depth and breadth required
The time frame for conducting the review
The types of sources available
Define Depth and Breadth
Depth: the amount & quality of the sources that are examined
Breadth: the number of different topics/sub-topics examined
Define Time frame
How long researchers have to conduct the review.
Time period covered in the review.
Influenced by the problem studied, sources available, and the goals of the researcher (not set).
List the types of sources in a literature review
Theoretical vs. empirical literature
Primary studies
Secondary studies
Synthesized knowledge & Systematic reviews
Clinical practice guidelines
Patient decision aides
Popular / “Grey” literature (e.g. newspapers, personal websites, blogs, etc.)
Modes of communicating: printed and electronic
What are 3 types or reviews support in evidence-based practice?
- Traditional Narrative Reviews
- Meta-analysis
- Qualitative Metasynthesis
Synthesized knowledge/systematic reviews do what?
Ask a researchable question.
Select primary research studies that have tried to answer the question(s) – Problem & purpose statements, design, sample etc.
Puts them all together – synthesize them.
Some analyze results in a meta-analyses.
Come up with a bottom line statement that answers the question.
Can be stronger level of support on which to base clinical practice decisions than on one study alone
What are the Steps in Searching & Reviewing the Literature?
- Identify a researchable problem
- Identify terms related to concepts/phenomena/variables
- Identify appropriate electronic database i.e. Joanna Briggs, * DARE (database of abstracts of reviews of effects), Cochrane, CINAHL, Medline…
- Enter the terms into the database and conduct the search
- Initial - review the retrieved resources: title, abstract, journal…
- Retrieve key papers (electronic full text, print)
- Critically read each source
- Synthesize review if individual papers
- Identify consistencies & gaps/ inconsistencie
What are the Characteristics of a Good Literature Review?
Relevant literature (both seminal + current)
Comprehensive
Critique of reviewed articles
Adequate information concerning reviewed resources for reader
Summarize, identify gaps, consistencies and inconsistencies
Make a case for policy or practice change…
What do you look for when Critiquing Literature Reviews
- Is the coverage of the literature thorough?
- Does it include all or most of the major studies that have been conducted on the topic of interest? Are recent research reports cited?
- Does the review rely on appropriate materials? (use of primary sources or secondary?)
- Is the review organized and the development of ideas is clear?
If the review is part of a new research study, does the review support the need for the new study? If the review is designed to guide clinical practice , does the review of the evidence support the need for practice change?
what are the 3 types of knowledge involved with “Knowledge Translation”?
SYNTHESIS OF KNOWLEDGE: involves searching the lit then putting it together to formulate an overall understanding
DISSEMATION OF KNOWLEDGE: Involves identifying the audience and tailoring the message to enhance understanding
EXCHANGE OF KNOWLEDGE: Interaction with people who will use the knowledge for their mutual understanding & benefit
- People – Patients, Families, Communities
- Nurses and other clinicians
- Policy makers
- Researchers
Research design involves:
- Plan (directions/ blueprint)
- Structure of the investigation/study
- Strategy
Purpose of research design is to “aid in the solution of research problems and to maintain control”.
- In other words, to give an answer to research question and to control variance/differences which may confuse the results
When choosing a design it must be….
Consistent with the research problem and purpose, i.e., questions/ hypotheses
Based on the review of the literature and conceptual/ theoretical framework to establish what is known about a topic and relationship between concepts
If little is known (i.e., limited empirical & theoretical evidence), might decide to do preliminary descriptive or exploratory study
What are some practical things to consider in choosing a design?
- Time and timing
- Availability of participants
- Facility and availability of equipment/facilities
- Scope and breadth of the study
- Funding/$
- Researcher experience
- Ethics
What is control?
Why do we need it?
When is it needed?
What is control?
Holding the conditions of the study constant (text)
In other words, putting rules/ regulations/ protocols/ controls in place.
Why do we need it?
In order to make statements about causality, i.e., X →Y and not some extraneous variable →Y
Consumers can trust the findings
The findings are an accurate/ true reflection of reality
X →Y, not an extraneous variable →Y
When is it needed?
when examining causal relationships between variables
How do we get control?
What limits our ability to control?
How do we get control?
- Homogeneous sample (keeping sample relatively same on certain criteria that may influence Y; sampling criteria/ eligibility criteria)
- Consistent data collection procedures
- Randomization, i.e., random assignment
- Manipulation of independent variable in exp/quasi exp studies
- Including a control/ comparative group (usual care group or no intervention/ untreated group)
What limits our ability to control?
- Ethics/practical considerations
What are the 3 levels of design?
Non-Experimental
Level I Descriptive/exploratory studies
Only describe a phenomenon (e.g. surveys on voting tendency)
Level II Interrelational studies
Considered “higher” because do more than describe
Examine the relationships among variables (e.g. surveys on voting tendency that also aim to make a correlational statement about level of education, type of education, profession, SES, income, region etc)
Experimental
Level III quasi-experimental / experimental
Highest level of design = experimental. Most control and therefore ability to make causal statements X →Y
What are Non-Experimental Designs used for?
Used to identify and explore events, people or situations as they occur naturally
Used to test relationships or difference among variables (NOT identify/test direct causality)
No independent variable manipulation
What are the types of Non-Experimental Designs organized by there purpose?
Descriptive/exploratory studies
Purpose = get more info about a phenomenon/ variable(s)
Includes surveys, case studies, and comparative studies
Correlational studies
Purpose = to examine the relationships btw 2 or more variables
Can be further differentiated by a Cohort
Purpose = show a relationship btw an outcome (dep variable) and an event (ind. variable) using cohorts/ groups
That has occurred or is occurring in the natural course of events
Used when it would be unethical to use experimental study (eg. smoking, bedrest)
What are the types of Non-Experimental Designs organized by there time?
Cross-sectional: data collected at 1 point in time (“snapshot”)
Longitudinal: data collected at > 1 point in time
Prospective: in the future
Retrospective/ ex-post facto: in the past
What are the 2 types of Designs for Establishing/Testing Cause and Effect Relationships
- EXPERIMENTAL DESIGNS: For testing cause and effect relationships or the effect of the independent variable on the dependent variables
- QUASI-EXPERIMENTAL:Full experimental control not possible and/or not feasible /or unethical
Less control than true experiment
typically from lack of randomization to a control group /or lack of control group
extraneous variables could explain/ account for the results
- Both manipulate the independant variable and apply interventions
What are the 3 Properties of Experimental Research Designs?
- Manipulation of the independent variable
- Randomization or random assignment to groups
- Control or maintaining constants (intervention, sample and study groups)
What are the Advantages/Disadvantages of Experimental Designs/Randomize controlled trials?
Advantages: Gold standard, Its main characteristic Its main characteristic (control from randomization) high internal validity, ie, crucial for establishing cause & effect.
Disadvantage: Ethics & feasibility of randomization, Difficult to implement in field setting
List the 4 components of validity?
- Internal validity
- External validity
- Contruct validity
- Statistical Conclusion
Explain Internal validity.
What are the 6 threats to the internal validity?
X →Y, not an extraneous variable →Y
Can something else explain the results (whether significant or non-significant)?
6 Threats to internal validity: 1. History 2. Maturation 3. Testing 4. Instrumentation 5. Mortality 6. Selection Bias
Explain Internal Validity - history
Another event may have an effect on the dependent variable. May occur inside or outside the experimental setting. The event is external to the person.
concurrent life events
media, health initiatives…
Happen over the duration of the investigation
Explain internal validity - Maturation
“Refers to the developmental, biological, or psychological processes that operate within an individual as a function of time” and are external to the events of the investigation/unrelated to the investigation.
It is internal to the person:
- changes that would occur naturally over time without the study intervention
- Get tired, bored, hungry, lose
- Losing Interest, change in health - consider the time interval
Explain internal validity - Testing
Experience of pre-test may affect post-test scores even without an intervention
Explain Internal Validity - Instrumentation
- Something about the way in which data were collected may account for changes in outcomes/dependent variables rather than the independent variable
- Measurement error
- Inconsistent measurement practices
- Observation inconsistency
Explain Internal Validity - Mortality
- Loss of study participants from the first data collection point (pretest) to next future data collection point (post test)
- Lost/dead to the researcher as no longer in the study
Explain Internal Validity – Selection Bias
- Way in which sample was selected results in experimental & control group differ on a characteristic/variable that influences findings
- Way in which sample was assigned to groups.
- Lack of random assignment to groups.
- Self-selection to groups.
Explain External Validity
List 3 external threatsto External Validity
Refers to the applicability of findings The extent to which findings of the study are generalizable to other - Populations - Settings - Conditions
Consider what factors may limit or affect generalizability. 3 Threats to external validity: 1. Selection effects 2. Reactive effects 3. Measurement effects
Explain External Validity – Selection Effects
Focus on the population to whom the findings are generalizable
Consider
* How sample obtained
* Who ended up in the study
- Who refused to participate
- Who dropped out
- Did a certain characteristic or trait predispose entry into the study or into a research group
Explain External Validity – Reactive Effects
Focus on participants’ reaction to being studied & if findings only generalizable to study conditions
Consider
- Did subjects want to please the Researchers?
- Was there something in the study conditions that the subjects reacted to? (novelty, Hawthorne effect)
Explain External Validity – Measurement
Effect of pretest on findings on outcomes
- Consider how data collection at baseline (pretest) may influence responses later in the study
Study results may not be generalizable to those who had only the intervention but not the pre-test
