Test 1 (Ch.1 &2) Flashcards
What is research?
Research is the systematic, rigorous, critical investigation that aims to answer questions about nursing phenomena
Research vs. evidence based practice. What is research?
Research is the systematic, rigorous, logical investigation that aims to answer questions about nursing phenomena
Research vs. evidence based practice. What is EVP?
EVP is the collection, and integration of valid research evidence, combined with clinical expertise and an understanding of patient and family values and preferences to inform clinical decision making
Quality Improvement
Systematic use of data to monitor the outcomes of care processes as well as the use of improvement methods to design and test changes in practice, the aim of which is to continuously improve the quality and safety of health care systems
Nurse as “knowledgeable consumer”
Nurses must ne knowledgeable consumers of research and should be able to appraise research evidence and use existing standards to determine the merit and readiness of research for use in clinical practice
Qualitative research
Seeks to understand the meaning of the human experience, is usually conducted in natural settings, seeks to DESCRIBE experiences, takes a subjective approach, and is theory generating
Quantitative research
Seeks to test relationships or answer a question, explains cause and effect relationships, seeks to DESCRIBE phenomena, objectivity is important, theory testing
Critical Reading
Actively looking for assumptions, key concepts and ideas, reasons, justifications, supporting examples, implications and consequences, and any other structural features of the written text, to interpret and assess it accurately and fairly
What is a research technique?
The process of critical appraisal that objectively and critically evaluates a research reports content for scientific merit and application to practice. Requires some knowledge of the subject matter and knowledge of how to critically read and use critiquing criteria
Evidence Based Practice and Research
EVP allows one to systematically use the best available evidence from research w/the integration of individual clinical expertise, as well as the patients values and preferences, to make clinical decisions
Grading the Strength of a Body of Evidence: Quality
The extent to which a studys design, implementation, and analysis minimizes bias
Grading the Strength of a Body of Evidence: Quantity
The number of studies that have evaluated the research question, including overall sample size across studies, as well as the strength of the findings from data analysis
Grading the Strength of a Body of Evidence: Consistency
The degree to which other studies, w/similar or different designs, investigating the same research question report similar findings
Types of Journal Articles: Research
qualitative, quantitative, or mixed
Types of Journal Articles: Systematic Review
Summation and assessment of a group of research studies that test a similar research question. if statistical techniques are used to summarize and assess the studies, the systemic review is labled meta-analysis
Types of Journal Articles: Meta-Analysis
Summary of a number of studies focused on a question/topic using a specific statistical methodology to synthesize the findings in order to draw conclusions about the area of focus
Types of Journal articles: Integrative Review
A focused review and synthesis of either research or theoretical literature on a particular area that follows specific steps of literature integration and synthesis without statistical analysis and can include both quantitative and qualitative articles
Types of Journal Articles: Meta Synthesis and Meta Summary
Synthesis of a number of qualitative research studies on a focused topic using specific qualitative methodology
Clinical Guidelines
Consensus or expert based guidelines are developed by expert panels, evidence based guidelines are those developed using research findings
Quality Improvement
Conducting an assessment, setting specific goals for improvement, identifying ideas for changing current practice, deciding how improvements in care will be measured, rapidly testing practice changes, measuring improvements in care, adopting the practice change as a new standard of care
Critical Reading Steps
Preliminary understanding (skimming), Comprehensive understanding, analysis understanding, Synthesis understanding
Research questions should…
Define specific question area, reflect a review of the literature, identify the potential significance to nursing, reflect the feasibility of studying the research question
Independent variable X
Variable that has presumed effect on dependent variable. Manipulated
Dependent variable Y
Varies with a change in the independent variable. Not manipulated but observed, the variable we are interested in testing
The research question
Presents the idea that will be studied, also called the problem statement, focuses on: describing variables, specifying the population being studied, examining testable relationships among variables. The hypothesis attempts to answer the research question must be testable
Steps in defining the research question
idea emerges, brainstorming, literature review, identify variables, research question formulated
Literature Review
Critical examination of individual studies and systemic reviews to refine and focus the research question. Important variables can be identified
Significance of the research question
Will the findings lend support to untested theoretical assumptions, extend or challenge an existing theory, fill a gap, or clarify a conflict in the literature? Will they potentially provide evidence that supports developing, retaining, or revising nursing practices or policies? Will they be beneficial, applicable, and theoretically relevant>
Feasibility of the Research Question
Time, population of interest availability, adequate facilities, equipment, and money, researcher experience, ethical difficulties?
3 characteristics of fully developed research question
Variables considered are clearly identified, population being studied is clearly identified, possibility of empirical testing is implied
Variables
Something that varies (age, weight, height). Differences in one variable relate to differences in the other. The variables could be the independent variable in one study and the dependent variable in another study
Population
Must be clearly specified. Setting must be clearly described.
Testability
Can the research question be tested by measuring the relationship between the independent variable and the dependent variables? The variables can be observed, measured, and analyzed.
Study purpose, aims, or objectives
What the investigator hopes to achieve, suggests the level of evidence to be obtained
Research Hypothesis
Flows from the research question, literature review, and theoretical framework. Predicts the expected outcome, formulated before the study is started bc it determines how data are collected, analyzed and interpreted
Directional Hypothesis
Expected direction of the relationship between the independent and dependent variables
Non Directional Hypothesis
Indicates the existence of a relationship between the variables, but doesn’t specify the anticipated direction of the relationship
What is a “good” hypothesis?
A declarative statement that identifies a predicted relationship between X and Y. The nature of the relationship is implied. It should be testable and consistent with an existing theory and research findings
What are the variables involved in wording the hypothesis?
The population being studied, the predicted outcome of the hypothesis
Research Hypothesis vs Statistical Hypothesis- RH
Also known as scientific hypothesis, predicts the expected outcome, may be directional or non directional
Research Hypothesis vs Statistical Hypothesis-SH
Also known as null hypothesis, states there is no relationship between X and Y
Hypotheses. What is most common?
Most hypotheses are RESEARCH hypotheses and DIRECTIONAL bc they PREDICT the DIRECTION of the outcome. They state in what way and what direction X will influence Y
Two Tailed Hypothesis
Predict that there will be a difference between the groups, but not the direction of the difference
4 components of clinical questions (PICO)
population, intervention, comparison, outcome
Critiquing the research question
Is there an implied relationship b/t two or more variables? Is the population being studied described? Can the implied relationship be tested?
Critiquing the hypothesis
The hypothesis might not be explicitly stated; it may be inferred. Even when stated, it should be reexamined in the results or discussion section, data analysis should answer the hypothesis, hypothesis should logically follow the literature review and theoretical framework. Hypothesis are NEVER proven. Findings either support or don’t support the hypothesis
Literature Review
A systemic and critical appraisal, provides the development and foundation of a research study, provides the development and foundation of the theoretical framework, ESSENTIAL to evidence based nursing practice
Theoretical or conceptual framework
The basis for the development of research questions or hypotheses. Can be viewed as a map for understanding the relationships between or among the variables in quantitative studies, presents the context for studying the problem, often illustrated using a diagram, integral to practice and research
Sources for Literature Review
Primary: Research articles and books by the original author, Secondary: Published articles or books thatre written by persons other than the individual who conducted the research study or developed the theory
Literature Review: Components of the Research Process
research question and hypothesis, design and method, outcome of the analysis
Goal of the literature review- researcher and consumer
Researcher: develop the knowledge foundation necessary to design a sound study, generate research questions and hypothesis. Consumer- Answer a clinical question or solve a problem to improve patient outcome
Literature Review: Researchers Perspective
Facilitates understanding of the problem by identifying a theoretical or conceptual framework to provide a context. Discover what is known and not known to refine the research question and hypothesis. Assists in the design and methods to be used. Allows interpretation and discussion of the outcome of the analysis by comparison w/previous studies
Literature Review: Consumers Perspective
Identifying and gathering evidence, critically appraising and synthesizing evidence, assessing the usefulness of the evidence in changing practice, changing practice to improve outcomes or justify current interventions, developing evidence based practice projects
Literature Review: Consumers Perspective- 3 steps in EVP process
Asking clinical questions, identifying and gathering evidence, critically appraising and synthesizing the evidence or literature
Computerized Decision Support System
Integrates EVP clinical info into electronic medical record. Specific pt data can be entered and matched against a knowledge base to generate pt-specific recommendations or assessments
Summaries
Clinical practice guidelines and electronic EVP textbooks. EVP guidelines that provide recommendations based on high quality evidence
Synopsis of synthesis
Provides a preappraised summary of systemic review. Synopses provide a synthesis of the review; some include commentary related to strength of the evidence and applicability to a patient population
Synthesis
Systemic reviews are a synthesis of research on a clinical topic conducted by multiple experts. Include quantitative summaries, metaanlysis. Synopsis of single studies: Keep in mind that a synopsis of a single study, while critically preappraised, still remains a single study. Most often, significant practice changes are not based on the results of a single study.
What is a referred or peer reviewed journal?
Panel of expert scholars. Usually reviews are “blind” to promote objectivity, name of the authors isn’t included. Reviewers use a set of scholarly criteria to judge whether it meets criteria to be published
