Exam 1

systematic inquiry using disciplined methods to solve problems or answer questions

systematic inquiry to develop knowledge about issues of importance to the nursing profession

• tradition
• authority
• clinical experience; trial and error; intuition
• Logical reasoning
• Assembled information (e.g. quality improvement data)
• Disciplined research

a world view; a general perspective on the complexities of the real world, with certain assumptions about reality

• Reality exists
• There is a real world driven by natural causes
• Positive assumption
• "the subjects"
• quantitative data

the inquirer is independent from those being studied

• Reality is multiple and subjective
• Constructed by individuals
• Naturalist assumption
• "The participants"
• qualitative data

the inquirer interacts with those being studied; findings reflect this interaction

the tecniques used to structure a study and to gather, analyze, and interpret information

• description
• explanation
• prediction
• control

• Identifying and understanding the nature of nursing phenomena (pain, breathing, ect) and the relationships among the phemonema to:
• Describe what exists
• Discover new info
• Promote understanding of situations
• Classify info for use int he discipline

identifying the reasons why certain events occur

estimating and anticipating the outcomes in a particular situation

manipulating a situation in order to achieve a particular outcome

consumer of research

truthfulness

group we are interested in studying

a type of consistence

• We do not put our weight in just one study
•     
• One study application can create problems
•   
• If multiple studies, taken place in various
• settings, are conducted and find similar results, it is more reliable
•   
• Individual studies – Research Summary – E-B
• Guideline – Agency Protocol

• traditions
• authority 
• borrowing
• trail and error
• personal experience
• role modeling
• intuition
• reasoning

• based on customs and trends 
• can also narrow and limit knowledge

Example: cardiovascular pts being required to take basin baths because thats the way it has always been done

• people with expertise and power influence opininons and behavior 
• knowledge is obtained from the authority

• using knowledge from other disciplines to guide nursing practice:
• medicine, sociology, psychology, physiology, education

Example: using technology in nursing practice

• Trying to see what will work without certainty 
• knowledge is gained from experience
• Very time consuming
• Contains many failures

Being personally involved in an event and learning from it

imitating the behavior of an expert

also called mentorship when the role model is a sponsor or guide

using an insight or understanding without logical basis

organizing ideas to reach conclusions

a statment of the proposed relationship between two or more concepts

moves from specific to the general 

a headache is an altered level of health that is stressful. A terminal illness is stressful. So, all altered levels of health are stressful

Qualitative

general to specific

Humans experience loss. Adolescents are humans. Therefore, all adolescents experience loss

Quantitative

Arguements are given to reach a conclusion

• • The client as a person
• • The client’s environment
• • Nursing practice
• • The nurse-patient relationship and communication
• • The healthcare system

Different purposes require different methods

research question

how you word your purpose which affects how you word your methods

• • Understand a health, illness, or healthcare experience
• • Develop a theory
• • Describe a health-related happening
• • Measure the strength of relationships between several health-related events or states
• • Test a hypothesis about the effectiveness of an intervention

• phenomenologic research 
• ground theory research 
• ethnographic research 
• historical research

• • Philosophical origin: naturalistic, interpretive, humanistic
• • Focus: broad, subjective, holistic
• • Reasoning; dialectic, inductive
• • Basis of knowing: meaning, discovery, understanding
• • Theoretical focus: theory development

• • Descriptive research
• • Correlational research
• • Quasi-experimental research
• • Experimental research

• • Philosophical origin: logical positivism
• • Focus: concise, objective, reductionistic
• • Reasoning: logistic, deductive
• • Basis of knowing: cause-and-effect relationships
• • Theoretical focus: tests theory

research findings

• pt and families
• providers 
• health care systems

A systematic and comprehensive identification, analysis, summarization of all research related to a specific topic or practice problem

develops empirical knowledge base

• • Conscientious integration of best research evidence with clinical expertise and patient values and needs in the delivery of high-quality, cost-effective health care
• • Synthesis of knowledge for development of guidelines, standards, protocols or polies to direct nursing interventions and practice

• Gets beyond:
• Personal opinion
• Power plays
• Tradtion/routine
• Nursing staff convenience

• Using the nursing science that exists
• Produces the best pt outcomes

a set of specific care actions for a pt population that has been endorsed by the hospital, agency, primary care clinic, or healthcare facility

• • identify a clinical question/issue/goal
• • Locate and summarize the science
• • Translate the science into a clinical protocol that works for the agency

• • Existing e-b guideline (shortcut; best for practice)
• • Science summary (medium path)
• • Individual studies (long trek; best for learning)

road map displaying why the study was done, how it was done, and what was found

• credibility- was it conducted well
• Relevancy- usable for my pt population

starting point: Is this a report of an original research study?

• • A specific research question, hypothesis, or purpose
• • Systematic methods of data collection and analysis
• • Results
• • Findings

• • Title
• • Abstract- less than 300 words
• • Intro- Research question, purpose, and hypotheses
• • Methods
• • Results
• • Discussion/Conclusion
• • References

• A concise, interrogative statement written in the present tense and including one or more variables/concepts

• describing variables
• specifying the pop being studied
• examining testabel relationships among variables

• o Define specific question area
• o Reflect a review of the literature
• o Identify the potential significance to nursing
• o Reflect the feasibility of studying the research question

an atribute or property in which organisms vary (people, events, objects)

the variable that has the presumed effect on the dependent variable (DV)

It is maniuplated or not manipulated

the presumed effect that varies with a change in the independent variables (IV)

o Not manipulated

• • Patient/Population/ Problem (among ________)
• • Intervention/ Exposure (does _________)
• • Comparison (versus _______)
• • Outcome (affect _____________)
• • P- Infants at increased risk for ICI
• • I- how well clinical features predict
• • C- not using clinical features
• • O- predicting ICI

• • Aim or goal the researcher hopes to achieve
• • Suggests the type of design to be used
• • Implies the level of evidence to be obtained (discover, explore, or describe vs. compare, test the effectiveness of…)
• • Purpose statement examples: 
• o The purpose of this study was to examine outcomes of the existing brief psychiatric treatment program
• o The aim of this study was to describe the scientific basis…

formal statement of the expected relationships between two or more variables in a specified population that suggests an answer to the research question 

Statement that predicts the outcomes of a study 

Directional or non-directional

• Theory
• Hypothesis
• Observation
• Confirmation

RESEARCH

Theoretical propositions

broader, higher level of abstraction 

lay workers --- health promotion opportunity ----adoption of healthy behavior

Research hypotheses

more specific than theoretical propositions

trained volunteers at lunch ---- opportunity to task health living questions--- performance of healthy behaviors

how your going to measure it

broad

• • 1. Protecting human rights
• • 2. Understanding informed consent
• • 3. Understanding institutional review of research
• • 4. Balancing benefits and risks in a study

a situation in which the rights of study participants are in direct conflict with requirments for a rigorous study

ethical studies protect subjects are carried out using scientific principles

• o Scientific misconduct
• o Fraud, research protocol violations
• o Fabrication, falsification, forging of data
• o Plagiarism
• o Putting subjects at risk without consent

• • 1. Principle of Beneficence: Above all, do no harm
• o Right to protection from harm and discomfort
• • Beneficence- Maximize good
• • Non maleficence- minimize harm
• o Right to protection from exploitation

• • 2. Principle of Respect for Human Dignity o Right to self-determination (absence of coercion)
• o Right to full disclosure (absence of deception or concealment)

• 3. Principle of Justice o Right to fair treatment o Right to privacy (confidentiality, anonymity)

• • Risk benefit assessments
• • Informed consent
• • Confidentiality procedures
• • Debriefings and referrals
• • Treatment of vulnerable groups
• • Institutional Review Boards and external reviews

• have adequate info about the research
• can comprehend that info
• have free choice in deciding whether to participate in or withdraw from the the study

• a consent form
• implied consent (e.g. self-administered questionairs)
• process consent (qualitative studies)

• • Children
• • Mentally or emotionally disabled
• • Severely ill or physically disabled
• • Terminally ill
• • Institutionalized people
• • Pregnant women

selecting a group of poeple events behaviors, or other elements with which to conduct a study

the subjects or particpants

the entire set of individuals (or elements) who (that) meet sampling criteria

the portion of target population to which the researcher has reasonable access

an individual unit of a population

people that can be in the study

people that cannot be in the study

• Extending the findings from the sample under
• study to the larger population

• The extent is influenced by the quality of the
• study and consistency of the study’s findings

the sample, the accessible population, and the target population area are alice in as many ways as possible

• setting
• characteristics of subjects ( age, gender, ethnicity, income, education)
• distribution of values on variables measured in the study

difference between the population mean and the mean of the sample

happens by random chancer, or if we bias the study in any way

percentage of subjects that declined to participate in the study

withdrawal or loss of subjects from a study 

this rate should be reported in published study

increases the representativeness of the sample based on the target poulation

used in studies with random sampling

not randomly determined

used in random sampling

a listing of every member of the population, suing the sampling criteria to define membership in the population

outlines strategies used to obtain a sample for a study 

• Probability sampling plans
• Nonprobability sampling plans