Research FINAL EXAM Flashcards
Examples of quantitative and qualitative data
Definitions of important concepts: e.g., research, primary source, generalization, transferability,
Agencies in the USA that support nursing research.
Types of study: prospective, retrospective, cross-sectional, experimental, empirical literature, EBP importance, systematic reviews, survey,
A priori, sample size, primary investigator, independent variable, dependent variable, difference between uni/bi/multivariate variables extraneous, null hypothesis, alpha level, different types of triangulation e.g. data, theory.
Grounded theory ethnography, phenomenological, quasi-experimental, case study
How is Cohen’s kappa related to inter-rater and inter-coder reliability?
Bracketing, maturation, history, Power, immersion/crystallization, integrative reviews
Practice guidelines, translating research to practice – using models.
Difference between research, EBP and quality improvement/process improvement
Standard normal deviation, bell curve, mode/median/mean
p-value significance
Indicates that the probability the results were due to chance is also very small —> test is said to have a statistical significance
Cohen’s Kappa r/t dependability of analysis in QUANTitative analysis
A measure of inter-rater or inter-coder reliability between two raters or coders. The test yields the percentage of agreement and the probability of error
— Generates a p-value for probability that random error was responsible for the agreement
— Agreement of at least 80% = acceptable for qualitative coding, with an associated p-value <5% that the agreement was due to chance
Quantitative study
A traditional approach to research where variables are identified and measured in a reliable and valid way
—Generalized and determines whether an outcome is caused by chance; is the result clinically significant?
— Based on reliability and validity = consistency
— Validity = instrument you are using in quantitative study tests what it was designed to test
— SPSS = program to analyze data using #s
Qualitative study
A natural approach to research where the focus is understanding the meaning of an experience from the individual’s perspective
— Transferability; provide holistic view; uses words, languages, concepts rather than #s to produce evidence; NO hypothesis, objectives, aims
— ID meaning of a phenomenon, event, or experience for an individual
— NVIVO = program to analyze data using words, themes, codes
— e.g. What are your thoughts of the shooting at Ariana Grande concert? Will you ever attend a concert again?
The strongest evidence is
Well-designed clinical trials
Randomized experimental designs
Multiple studies reporting replicable findings
Meta-analysis or meta-synthesis
Power r/t sample size in QUANTitative studies
An analysis that indicates how large a sample is needed to adequately detect a difference in the outcome variable
— There are enough subjects to detect a difference in the outcome variable
— Mathematical process done either prospectively (to determine how many subjects are needed) OR retrospectively (to determine how much power a sample possessed)
— 3 factors for ultimate sample size: significance level needed, power, magnitude of any differences found (e.g. effect size)
Sample size in QUANTitative studies
– Need it to be large so that study is more credible and detect difference in outcome variable
– Power analysis = G-Power (80% = safe); make sure to mention in paper (“We used G-power”)
– Choose methodology/design
– Go to previous studies/authors to determine the sample size + document
(E.g. Hypothesis: Smoking will increase lung cancer (directional hypothesis b/c placing a key word))
QUALitative studies
— think: redundancy + saturation
— When is the point at which no new information is being generated?
NOTE: When you’ve hit redundancy, you can stop interviewing people because you’ve hit data saturation
Define research
— A systematic process of inquiry that uses rigorous guidelines to produce unbiased, trustworthy answers to questions about nursing practice.
New information gathered, more information to validate, must be original (for PhD students)*
Define evidence-based practice
— The use of the best scientific evidence, integrated with clinical experience and incorporating patient values and preferences in the practice of professional nursing care
— Translating research to implement
Define quality improvement
Process improvement
— The systematic, databased monitoring and evaluation of organizational processes with the end goal of continuous improvement. The goal of data collection is internal application rather than external generalization
— Intent is to improve processes for the benefit of patients/customers w/in an organizational context
— Studies often undertaken to determine if appropriate and existing standards of care are practiced in a specific clinical setting
— Management tool to ensure continuous improvement and a focus on quality
What is a sample?
Selection of objects/observations taken from a population of interest
— e.g. All apples at an orchard at a given time; wish to know how big all apples at the orchard are, but cannot measure all of them, so we take some from the population
What are we looking for in a QUALitative analysis?
– Trends and themes
– Saturation of information/data
– Trustworthiness
– Transferability to a similar situation/population
Goals of Qualitative analysis
– Used to organize, provide structure, and draw meaning from the data
– The data collection an analysis must be trustworthy
Challenges of QUALitative analysis
– No single standard or any stipulated guidelines for the analytical process
– Looking for keywords when it comes to your themes and codes
Qualitative research analysis
Collecting data and analyzing is done simultaneously and continuous comparison is done when going from the 1st participant to the 10th
What are the common QUALitative analytic styles?
has either a structure or lack of structure
– Template analysis
– Editing analysis
– Immersion/crystallization
Qualitative researcher
QUAL – heavily imbedded and involved (listening, observing, etc) into the data; really depends on their intuition (what they’re thinking, how they’re thinking, etc)
QUAN – not as involved; very objective
Phases of QUALitative analysis
– Comprehending
– Synthesizing (find meanings; interpreting)
– Theorizing (researcher looks at data, believes/doesn’t believe in the data); e.g. “Ooh, I hit the nail on the head;” “This is not working”
– Recontextualizing (applying findings you obtained from your analysis different groups/setting); finding meaning that can lead to theory.
Possible Types of Codes for QUALitative results
– Setting + context codes
– Perspective codes (viewpoints of…
– Subjects way of thinking
– Process codes
– Activity codes
– Strategy codes
– Relationship codes
– Social structure codes
Techniques to support credibility in QUALitative trustworthiness
– Prolonged engagement
– Triangulation
– External checks
QUALitative trustworthiness
– Credibility
– Dependability
– Confirmability
– Transferability
Techniques to support dependability in QUALitative trustworthiness
– Inter-rater and inter-coder reliability
– Inquiry audit: review relevant data and documents, procedures, and results of an external reviewer
Instrument reliability
Internal reliability: Stability within the instrument
Item-total correlation: Stability among individuals
Inter-rater reliability: Stability between raters
Test-retest: Stability over time
Techniques to support confirmability in QUALitative trustworthiness
– Inquiry audit
– Audit trail
– Decision trail
Techniques to support transferability in QUALitative trustworthiness
– Thick description
– Context of the data
– Deep level of detail
Specific processes of phenomenology
– Reflection on the data
– Explication of themes
– Discernment of patterns that form the ‘essence of the experience’
Specific processes of ethnography
– Triangulation of multiple sources of information
– Use of thick description to draw conclusions to make sure that its correct
Specific processes of grounded theory
● Generate categories of meaning from the ground up (why you’re accepting vs. not accepting)
● Position each category in a theoretical model
demonstrating relationships
● Create a story from the interconnectedness of the
categories
● Add informants as the theory unfolds to illuminate
and/or refute specific conclusions
Examples of QUANTitative research
QUANTitative research: A traditional approach to research in which variables are identified and measured in a reliable and valid way
— To use measurement to determine the effectiveness of interventions.
— Involves measuring objective characteristics or responses of subjects, and is reported using numbers
Examples of QUALitative research
A naturalistic approach to research in which the focus is on understanding the meaning of an experience from the individual’s perspective
Definition of nursing research
Is a systematic process of inquiry that uses rigorous guidelines to produce unbiased, trustworthy answers to questions about nursing practice
Definition of Primary vs. Secondary data + examples
Primary: original data derived from your research endeavors
— e.g. taking surveys about hospital food
2ndary: data derived/obtained from your primary data
– e.g. reviewing surveys from former patients about hospital food
Generalization vs. Transferability
Generalizability = QUANTitative
Transferability = QUALitative
Agencies in the USA that support nursing research
— National Research Act —> enacted by Congress, signed into law to protect human subjects
— The Belmont Report —> deals with beneficence, justice, respect
— National Institute for Nursing (NINI) —> establish national research agenda
Retrospective study
A study that compares two groups of people: those with the disease or condition under study (cases) and a very similar group of people who do not have the disease or condition (controls).
— use 2ndary data that have already been collected about events that have already happened
– e.g. a group of 100 people with AIDS might be asked about their lifestyle choices and medical history in order to study the origins of the disease.
Retrospective = taking data from something that already happened (the data was there)
– e.g. were the patient in the last 3 months satisfied with their meals?
Prospective study
—Collecting data now to use in the future (don’t know when/how/where); followed over time as characteristics/circumstances change
— uses primary data to be implemented in the future
– e.g. birth cohort studies
Cross-sectional
— Can evaluate people of different ages, ethnicity, geographical locations, social backgrounds
— Studies conducted by looking at a single phenomenon across multiple populations at a single point in time
Experimental study
GOLD standard = experimental design/Level 1
— They provide convincing support. For the value of a treatment for EBP
Empirical literature
— Reports tests of relationships and actual outcomes
— Tests arguments for effectiveness
— Research studies focused on the question posed
— Need to report literature that supports as well as literature that does not
_________________
this type of literature is based on experiences or observations and displays
how theories apply to individual behavior or observation. E.g. if a medication is going to reduce
BP, then you hypothesize that because the medication reduces BP in will lower the risks for
heart attacks. This notion is based on observation rather than theory
Importance of evidenced-based practice (EBP)
— Randomized controlled trials, clinical trials
— Highly structured studies of cause and effect applied to determine the effectiveness of an intervention
Primary vs. Secondary sources + examples
Primary:
— Provide a first-hand account of an event or time period and are considered to be authoritative.
— They represent original thinking, reports on discoveries or events, or they can share new information.
Secondary:
— Secondary sources involve analysis, synthesis, interpretation, or evaluation of primary sources.
— They often attempt to describe or explain primary sources.
_________________
Primary: gathering data from person directly; looking for the original author
– “I did this study. These are my outcomes.”
Secondary: data already collected
– e.g. going through medical records to go through BPs and blood sugars
– taking information and quoting me on MY study; got it from somebody else’s article
Systematic reviews
— To deliver a meticulous summary of al the available primary research in response to a research question
— Highly structured and controlled search for available literature on a topic, Reduces bias and produces a recommendation
— Identify, evaluate, summarize
E.g. secondary research
Define systemic review
The person writing the review did the literature review
Survey design
targets instruments or procedures that ask > 1 question that may/may not be answered
A priori means
The researcher has to lay out EVERYTHING in front before conducting the study (everything they’re doing, methodology, design, sample sizes, location of sample sizes, laid out) —> IRB and come back —> CANNOT change b/c jeopardize subject (even if they thought of something better that can impact the study)
Sample size: QUANTitative vs. QUALitative
Primary investigator
also known as primary researcher
The main person asking questions/performing the study
— The individual who is primarily responsible for a research study. The principal investigator is responsible for all elements of the study and is the first author listed on publications or presentations
— has an idea about an issue or problem
Dependent variable + example
Deals with the outcomes of the study
Independent variable + example
— Controlled by researcher
— Introduced into the experiment
— Manipulated by the researcher
— e.g. Athletes performing high intensity exercises to build lean muscle…HIIT = IV
Univariate variables
Analysis of a single variable in descriptive statistics or a single dependent variable in inferential analysis
— primary focus of descriptive and summary statistics
— may also be applied when only one group is included or involves a single DVariable
— e.g. differentiating whether BP is affected more by exercise in the AM or in the PM; even though 2 groups (AM & PM) are included in the study, the analysis focuses on a single dependent variable….BP
Bivariate variables
Analysis of 2 variables at a time
— Most common = correlation studies
— Relationship-checking for correlation
— e.g. determining if BP is associated w/ Na intake; 2 variables = BP + Na, are analyzed to determine any relationship b/w them
Multivariate variables
The simultaneous analysis of multiple variables
— >2 variables; simultaneously analysis
— e.g. determining if BP is different in the AM or PM, and is associated w/ Na intake, weight, and stress level
Extraneous variables
also known as confounding variables
— Rival explanations for an outcome: threats to internal/external validity
— Ways to deal with: eliminate, control them, own up to them (account for the threat/write-up)
Null hypothesis
1) Null hypothesis: one to be tested; want to test if that is correct; null is true until rejected (innocent until proven guilty)
(E.g. “The mean data scientist salary in the US is $113k”)
— Accept if: Null is close enough to the true mean
— Reject if: Null is too far from the true mean
Alpha level
Different types of QUANTitative vs. QUALitative research design
QUANTITATIVE = external validity, effectiveness
— Descriptive
— Survey
— Correlational
— Quasi-experimental
— Experiment
__________________________________________
QUALITATIVE = saturated data, transferability,
— Ethnography = customs, culture; study of the features and interactions within a culture
— Narrative = interviews ,documents over a period of time (chronology based)
— Phenomenology = used to study an event/activity as it happens, from various angles; investigation of the meaning of a phenomenon among a group who have experienced it
— Ground theory = construction of hypothesis and theories through collecting and analyzing data; research aimed at developing a theory of process, action, and interaction
Triangulation
A means of enhancing credibility by cross-checking information and conclusions using multiple data sources using multiple methods or researching to ensure credibility
— The study, phenomenon using multiple theories/perspectives to help with data
NOTE: improve validity of QUALitative research And ensure trustworthiness
Method triangulation
Multiple data collection methods are used
— e.g. interviews, observations, document review
TRIANGULATION TYPES
Triangulation cross-checking all the data
Data source triangulation - multiple data sources are used such as e.g. interview multiple informants about a place or time to corroborate the information
Investigator triangulation - more than one investigator is used to collect, analyze or interpret the data
Theory triangulation - use multiple perspectives, may use different theories to examine the situation, or use variety of published literature
Method triangulation - use more than one method for data collection e.g. interviews, field notes, observations
Theory triangulation
Use multiple perspectives, may use different theories to examine the situation, or use variety of published literature
— Multiple perspectives are obtained from other researchers or published literature
Investigator triangulation
More than one investigator is used to collect, analyze or interpret the data
Data source triangulation
Multiple data sources are used in a study
— e.g. interview multiple informants about a place or time to corroborate the information
— e.g. interviewing diverse key informants to give credence to the findings
Grounded theory
Construction of hypothesis and theories through collecting and analyzing data
Ethnography
Observes cultures, customs
Phenomenological
— Uses research to understand phenomenon’s universal nature by exploring views of those who have experienced it
— Examining a meaning of an experience or phenomena (e.g. How did the victims of a bomb threat feel in school? “What was your first rxn of a bomb threat?”)
Quasi-experimental
Attempts to establish cause-effect relationships among variables
Attempts to establish cause-effect relationships among groups of variables that make up a study
— QUANTitative research method
— # data collection an statistical analysis
e.g. You hypothesize a new after-school program will lead to higher grades
— choose 2 similar groups of children who attend different schools
—> implements new program
—> not implementation
What is a case study?
An in-depth, detailed examination of a particular case w/in a real-world context
How is Cohen’s kappa related to inter-rater and inter-coder reliability?
Bracketing
— A researcher separates own perspectives/experiences/assumptions from what is being observed in the study (the participants information), to reduce bias
— A method of limiting the effects of researcher bias and setting them aside by demonstrating awareness of potential suppression of research
—
NOTE: improve validity of QUALitative research
Maturation
- r/t internal validity*
— Too much time has passed with long study
Changes in the research subjects not due to the intervention, because time has passed
— e.g. deterioration of physical characteristics: vision, hearing, taste, memory
— e.g. pain relief w/ cancer patient disease is maturing (stage I —> stage III)
History/Historical threat
— subjects behave in a certain manner because of their exposure to events outside the experiment
– e.g. the occurrence of an actual earthquake during a field study of the effects of training in earthquake preparedness
Factors of Power r/t QUANTitative samples
Biggest effect: sample size
Level of accuracy required
Number of variables to be studied
Variability in the population
Magnitude of effect
Independence of the data
Immersion/Crystallization
A style of analysis that uses total immersion in and reflection on the text, usually in personal case reports, especially during case research and ethnography
— Researcher is the true analytic tool; investigator be immersed in the data and rely heavily on intuition to arrive at conclusions
— Insight might arise during/after data collection —> constant comparison
— As analysis is being carried out and conclusions are “crystallizing,” the researcher can better decide how to proceed in further data gathering
— Least structured approach for qualitative analysis
— Not found often in RN research literature, but still useful in healthcare research
— CONS: time-consuming nature, researcher must constantly hold his/her biases at bay
Criteria for evaluating clinical practice guidelines
— Must be rigorous and peer-reviewed
— Recommendations are clear and easily identified
— Patient education must appear in the final guidelines
— Implementation considerations
— Cost and patient acceptance
— Sponsors must have no financial interest in the outcome
Translating research to practice — using models
Methods
IOWA Model
The John Hopkins Model
Integrating EBP in Magnet
Outcomes Focused Knowledge Translation to the Bedside
Collaborative Model for Knowledge Translation
Community-Based Research Translation Models
Community-based research translation model
— Phase one: focus on expert analysis of critical health issues within a community. Address the issue
— Phase two: Nurses analyze the cause of morbidity and mortality, appraise and choose EB interventions and adapt interventions to the community and develop measures
Outcomes-focused knowledge translation at the bedside has 4 elements influencing nursing-sensitive outcomes. What are they?
- Sources of evidence
- Patient preferences
- Context of care
- Facilitation
Standard normal deviation
Standard normal distribution: mean = 0 and std. deviation = 1
Standard score — Describe the relative position of an observation within a distribution
– z-score depicts the number of standard deviations above or below the mean an observation falls
–Positive z-score: Above the mean
–Negative z-score: Below the mean
What is the 1st step in analyzing quantitative research data?
Summarize descriptive data
True/False. Aggregating evidence in many forms provides the strongest evidence for translating research into practice.
TRUE
Research question to design
If you see these words..
— Cause = experimental design
— Change
— Measure an effect
— Test a relationship
— Predict an outcome
— Quantify an occurrence
— Describe a phenomenon
— Develop theory
..it will lead to this design:
— Experimental design
— Correlation
— Regression study
— Prevalence/Incidence
— Qualitative
—Qualitative or quantitative
___________ __________ are the bridge between research and practice.
Practice guidelines
Bell curve
Nominal & Ordinal data vs. Internal & Ratio data
N-O Data
Frequency table
Bar graph
Pie chart
Relative frequency
I-R Data
Measures of Central Tendency
Histograms
Variability
Position
Difference b/w: Mode, Median, Mean
Mean: the average of the #s; interval and ratio levels
Median: the middle #; applied to ordinal, interval, or ratio level data
Mode: division of the highest # subtracted by the lowest #; applied to nominal data
Integrative review
— Broader reviews that allow for the simultaneous inclusion of experimental, non experimental, and comparative studies/research to more fully understand a phenomenon of concern
— can be quantitative, qualitative, and comparative studies
— Provide a comprehensive understanding of human response to health and illness
Anatomy of abstract
Introduction —> Objective —> Methods —> Results —> Conclusions —> Acknowledgments —> References
What are the six (6) primary methods for aggregating the results of research studies for translation into practice?
- Scoping review
- Systematic review
- Integrative review
- Meta-analysis
- Meta-synthesis
- Practice guidelines
Scoping review is based on a six-stage framework. What are they?
- ID the research ?
- Search for relevant studies
- Select studies
- Chart the data, collate data, and summarize results
- Report results
- Consult w/ stakeholders to validate study findings
Systematic review
cornerstone of EBP
A highly structured and controlled search of the available literature that minimizes the potential for bias and produces a practice recommendation as an outcome
— Reduces bias and produces a recommendation
— e.g. focus on patient concerns, prevalence of problems, effectiveness of Dx’c procedures
Meta-analysis
— Statistical aggregate of results from QUANTitative studies so an overall effect size can be evaluated
— Sums up the findings of different studies on the same population
— Complicated to run and yield complex output
— Challenge: to find a sufficient # of studies that used similar populations, measures, and statistics
— Able to sum up the interventions on the outcomes
— Draw inferences from a sample of studies
Meta-synthesis
— Sums up results from multiple QUALitative studies on a specific/similar phenomenon
— The inclusion of multiple sites and samples, and replication of qualitative studies enhances trustworthiness, and therefore, confidence w/ which one can generalize the results
— Develops overarching themes about the meaning of human events based on synthesis
What are the steps of review
What is the background for the review
State the review question
Develop inclusion and exclusion criteria for the populations, conditions, and settings
Devise a search strategy
Develop study selection criteria
Conduct the review
Practice guidelines
Research-based recommendations for practices that are graded as mandatory, optional, or supplemental and that may be stated as standards of practice, procedures, or decision algorithms
— developed by group of clinical experts who are convened by a professional or academic body
Characteristics of reviews
Use of objective criteria reduces bias
Multiple studies enhance the credibility of recommendations
Structured approach to the selection and evaluation of studies
Produces a practice recommendation as an outcome
_______ing ___________ into practice is the final and most important step in the research process!!
Translating research
Define evidence-based practice
Translating research to implement
