Major Themes For Midterm
Major Themes and Concepts for Midterm Exam Spring 2013 Intro to Research
Although any material from the assigned reading chapters is fair game for the exam, here are the major areas to review: * Scientific research versus nursing research- * Scientific Research is concerned with ability to generalize research results. * Nursing Research- Generating knowledge that can be used in the near future. * Clinical nursing research- Nursing research studies involving clients or that have the potential for affecting clients * Goals of Nursing Research: * Promotes EBP * Increases credibility of nursing profession * Accountability of nursing practice * Cost effectiveness …show more content…
of nursing care * Applied versus basic research- * Applied - Research that is conducted to find a solution to an immediate practical problem. * Utilizes knowledge to solve immediate problems * Seeks solutions * Immediate/direct application of results * Basic research (pure research)- Research that is conducted to generate knowledge rather than to solve immediate problems. * Generates new knowledge * Develops, tests and refines theories * Delayed application of results * Various research populations * Vulnerable populations: Additional safeguards are required to conduct research on these subjects besides the already stringent guidelines. Researchers must consider the risks to subjects, adequacy of protection against risks, potential benefit to subjects/others, importance of knowledge to be gained, and purpose of inclusion * Pregnant women * Human fetus * Prisoners * Neonates * Children * IRB’s- The creation of an institutional review board (IRB) helped to alleviate many unethical issues such as the Tuskegee Syphilis experiment. You have already discovered that an IRB is an integral part of the research process. Without an IRB, researchers risk losing federal funding which can prohibit many research studies. * Informed consent- A subject voluntarily agrees to participate in a research study in which he or she has full understanding of the study before the study begins. * Informed Consent is one of the best ways to protect subjects’ rights in research. Participants should be given complete information on these elements: * Subject selection process * Purpose of study * Study procedures * Potential risks * Potential benefits * Possible compensation * Alternative procedures disclosed * Anonymity/confidentiality * Answer all questions * Offer means of obtaining study results * Avoiding coercion with subjects means not offering excessive rewards for their participation in a research study * Problem statements, independent variables, dependent variables * Components of adequate research questions/problem statements/purpose statements * Research questions should be stated in interrogative form (problem and purpose statements are in declarative form) * Must include a specific population i.e. instead of “students” use “post-baccalaureate senior nursing students” * Includes the variable(s): Independent variable are what is controlled by the researcher while the dependent variable is affected by the independent variable. * Empirically testable: are the variables measurable? Is empirical data (data gathered through the sense organs) (Nieswiadomy, 2012) available about the variables being tested? * Avoid asking ethical and value issues that require the author to answer ethical decisions. Avoid words like “should” and “better” which indicate value. Avoid trying to determine causal relationships as they are challenging to establish. * Replication studies- involve repeating a study with all the essential elements of the original study held intact. Different samples and setting may be used. Benefits: a body of knowledge that is developed on a sound foundation of research findings. * Replication studies (studies that repeat a study with all important factors of the original study staying the same) should be high on the list of important studies to conduct in nursing because they help to validate nursing theories. They also help to allow for generalization of findings and bring validity to nursing research. * Univariate, bivariate, multivariate studies * Univariate- A study that contains only one variable. Often used as a foundation for other studies. * Bivariate- A study that contains two variables (independent and dependent). Often used to study relationships. * Multivariate- A study that contains more than two variables.
Used to understand the interaction between variables. * Nursing theories and research * Definitions: * Theory: A set of related statements that describes or explains phenomena in a systematic way. Includes a propositional statement that connects ideas. Ex: Roy’s Adaptation Model, Neuman’s Systems Model * Concept: They are the building block of theories that help to symbolize an idea. Ex: Most of you are in Concepts class now. What concepts are you learning? Patient safety, ethics, nursing process…. * Construct: term used to indicate a phenomenon that cannot be directly observed but inferred by other concrete indicators. Examples: wellness, mental health, self-esteem. * Conceptual framework- A background or foundation for a study; a less well-developed structure than a theoretical framework; concepts are related in a logical manner by the researcher * Middle-range theories- Theories that have a narrow focus; they are concerned with only a small area of the environment or of human experiences. * Grand theories- Theories that are concerned with a broad range of phenomena in the environment or in the experiences of …show more content…
humans. * Model- A symbolic representation of some phenomenon or phenomena. * Proposition- A statement or assertion of the relationship between concepts. * Theoretical framework- A study framework based on propositional statements from a theory. * Types of thinking * Inductive- This type of reasoning starts with something specific and ends with something general. Ex: Empirical data is collected on a concept and the researcher attempts to create a theory or statement that describes the data. * Deductive- This type of reasoning starts with a general concept and whittles itself down to something specific. The researcher would start with a theory and develop a hypothesis which then leads to their specific data. * Nursing Theories/Theorists: Rogers, Roy, Stetler, Orem * Roy’s Adaptation Model: focuses on the whole being versus the medical model that focuses on the disease process (Nieswiadomy, 2012). How does the person adapt to and interact with the changes in their environment? * Neuman’s Systems Model: Each client is unique with various stressors that effect their Line of Defense (LOD). Primary, secondary, and tertiary prevention strategies help to manage the client as they cycle in their wellness system. (“Betty Neuman’s System Model,” 2012) * Rogers’s Science of Unitary Human Beings: Humans interact with their environment through energy fields and are viewed as a whole person, not in divided parts or systems. A true holistic nursing theory (Nieswiadomy, 2012). * Orem’s Self-Care Model: It is a theory of self-care, self-care deficit and a nursing system that promotes nursing to utilize interventions that help the client become as independent as possible (“Orem’s Self-Care Model,” 2012). * Hypothesis * Complex hypothesis- A hypothesis that concerns a relationship where two or more independent variables, two or more dependent variables, or both are being examined. * Directional research hypothesis- type of hypothesis in which a prediction is made of the type of relationship that exists between variables. * Interaction effect- The result of two variables acting in conjunction with each other. * Nondirectional research hypothesis- A type of research hypothesis in which a prediction is made that a relationship exists between variables, but the type of relationship is not specified. * Null hypothesis (Ho)- A statistical hypothesis that predicts there is no relationship between variables; the hypothesis that is subjected to statistical analysis. * Research hypothesis (H1)- An alternative hypothesis to the statistical null hypothesis; predicts the researcher's actual expectations about the outcome of a study; also called scientific, substantive, and theoretical. * Simple hypothesis- A hypothesis that predicts the relationship between one independent and one dependent variable. * Research utilization and evidence-based practice * Research Utilization (RU): Taking research results and applying it directly to a clinical or practice setting. Nurses are often hesitant to utilize research because they do not know if it is safe to implement changes or if the research is even legitimate. * Evidence-Based Practice (EBP): Most of you have probably heard of them term before.
Basically, our practices (the way we insert a Foley, start an IV, change a wound, etc.) should be established or modified based on current, reliable and valid research. * Research resource organizations i.e. NINR, AHRQ, Cochrane, NGC, USPSTF, NIH, DHHS * The National Institute for Nursing Research (NINR), a division of the National Institute of Health (NIH), enable nursing research to progress by leaps and bound by greatly increasing funding and available resources for nurse researchers. The NINR wants nursing researchers to focus on promoting health and preventing disease, improving the quality of life and eliminating health disparities (Nieswiadomy, 2012). * The Agency for Healthcare Research and Quality (AHQR) understands the need for outcomes research which focuses on the results of various health care interventions or practices. Everyone who participates or influences healthcare in any ways is very interested in this type of research because it can greatly effect the cost and efficiency of healthcare. * Literature
Sources: * Primary- A description of a research study written by the original researchers. Ex: I can quote directly from your Nieswiadomy text anything that the Ms. Nieswiadomy has written herself and it would be a primary source for Ms. Nieswiadomy’s ideas. * Secondary- A summary of description of a research study written by someone other than the primary researchers. Ex: If I were to quote or paraphrase another author’s work that is contained inside your Nieswiadomy text, I would be utilizing it as a second source since I am finding that information in the Nieswiadomy text and not in that author’s original work. * PICOT * Population/ Patient Problem: Who is your patient? (Disease or Health status, age, race, sex) * Intervention: What do you plan to do for the patient? (Specific tests, therapies, medications) * Comparison: What is the alternative to your plan? (ie. No treatment, different type of treatment, etc.) * Outcome: What outcome do you seek? (Less symptoms, no symptoms, full health, etc.) * Time: What is the time frame? (This element is not always included.) * Nursing, professionalism and value? * Most valid means of developing a unique body of knowledge that would allow nursing to be clearly identified as a distinct profession is through scientific research. They can determine what it is that they do and how they do it that distinguishes them from other groups in the health care field. * Outcomes research * The research that focuses on measurable outcomes of interventions with certain patient populations. The types of designs, methods and sampling procedures used in these studies may be somewhat different from those used in the traditional quantitative or qualitative studies. * Nursing’s role in research * Principal investigator * Member of a research team * Identifier of researchable problems * Evaluator of research findings * User of research findings * Patient/client advocate during studies * Subject/participant in studies * Ethics: nursing’s role in ethics, unethical studies, Belmont Report * Nurses role: Patient advocate- protect the privacy and the dignity of people involved in the research and to protect them form harm. * Unethical studies * WWII * Germany- wound infection, skeletal size, freezing flesh studies. * Japan- Infecting women with syphilis, impregnating them and dissecting babies; draining blood and substituting horse blood, exploding gas gangrene bombs, endurance of pain. * USA- 1932- syphilis study with black men (Tuskegee); 1960s deliberately expose child to smallpox to try out vaccine; 1963 injected live cancer cells in elderly pts.; 1989 experimental measles vaccine in LA; 1991, American Indian children given Hep A vaccine without parents consent. * Belmont Report (1979) * Respect for Persons- research subjects should have autonomy and self-determination. * Beneficence- research subjects should be protected from harm * Justice- research subjects should receive fair treatment.
Although any material from the assigned reading chapters is fair game for the exam, here are the major areas to review: * Scientific research versus nursing research- * Scientific Research is concerned with ability to generalize research results. * Nursing Research- Generating knowledge that can be used in the near future. * Clinical nursing research- Nursing research studies involving clients or that have the potential for affecting clients * Goals of Nursing Research: * Promotes EBP * Increases credibility of nursing profession * Accountability of nursing practice * Cost effectiveness …show more content…
of nursing care * Applied versus basic research- * Applied - Research that is conducted to find a solution to an immediate practical problem. * Utilizes knowledge to solve immediate problems * Seeks solutions * Immediate/direct application of results * Basic research (pure research)- Research that is conducted to generate knowledge rather than to solve immediate problems. * Generates new knowledge * Develops, tests and refines theories * Delayed application of results * Various research populations * Vulnerable populations: Additional safeguards are required to conduct research on these subjects besides the already stringent guidelines. Researchers must consider the risks to subjects, adequacy of protection against risks, potential benefit to subjects/others, importance of knowledge to be gained, and purpose of inclusion * Pregnant women * Human fetus * Prisoners * Neonates * Children * IRB’s- The creation of an institutional review board (IRB) helped to alleviate many unethical issues such as the Tuskegee Syphilis experiment. You have already discovered that an IRB is an integral part of the research process. Without an IRB, researchers risk losing federal funding which can prohibit many research studies. * Informed consent- A subject voluntarily agrees to participate in a research study in which he or she has full understanding of the study before the study begins. * Informed Consent is one of the best ways to protect subjects’ rights in research. Participants should be given complete information on these elements: * Subject selection process * Purpose of study * Study procedures * Potential risks * Potential benefits * Possible compensation * Alternative procedures disclosed * Anonymity/confidentiality * Answer all questions * Offer means of obtaining study results * Avoiding coercion with subjects means not offering excessive rewards for their participation in a research study * Problem statements, independent variables, dependent variables * Components of adequate research questions/problem statements/purpose statements * Research questions should be stated in interrogative form (problem and purpose statements are in declarative form) * Must include a specific population i.e. instead of “students” use “post-baccalaureate senior nursing students” * Includes the variable(s): Independent variable are what is controlled by the researcher while the dependent variable is affected by the independent variable. * Empirically testable: are the variables measurable? Is empirical data (data gathered through the sense organs) (Nieswiadomy, 2012) available about the variables being tested? * Avoid asking ethical and value issues that require the author to answer ethical decisions. Avoid words like “should” and “better” which indicate value. Avoid trying to determine causal relationships as they are challenging to establish. * Replication studies- involve repeating a study with all the essential elements of the original study held intact. Different samples and setting may be used. Benefits: a body of knowledge that is developed on a sound foundation of research findings. * Replication studies (studies that repeat a study with all important factors of the original study staying the same) should be high on the list of important studies to conduct in nursing because they help to validate nursing theories. They also help to allow for generalization of findings and bring validity to nursing research. * Univariate, bivariate, multivariate studies * Univariate- A study that contains only one variable. Often used as a foundation for other studies. * Bivariate- A study that contains two variables (independent and dependent). Often used to study relationships. * Multivariate- A study that contains more than two variables.
Used to understand the interaction between variables. * Nursing theories and research * Definitions: * Theory: A set of related statements that describes or explains phenomena in a systematic way. Includes a propositional statement that connects ideas. Ex: Roy’s Adaptation Model, Neuman’s Systems Model * Concept: They are the building block of theories that help to symbolize an idea. Ex: Most of you are in Concepts class now. What concepts are you learning? Patient safety, ethics, nursing process…. * Construct: term used to indicate a phenomenon that cannot be directly observed but inferred by other concrete indicators. Examples: wellness, mental health, self-esteem. * Conceptual framework- A background or foundation for a study; a less well-developed structure than a theoretical framework; concepts are related in a logical manner by the researcher * Middle-range theories- Theories that have a narrow focus; they are concerned with only a small area of the environment or of human experiences. * Grand theories- Theories that are concerned with a broad range of phenomena in the environment or in the experiences of …show more content…
humans. * Model- A symbolic representation of some phenomenon or phenomena. * Proposition- A statement or assertion of the relationship between concepts. * Theoretical framework- A study framework based on propositional statements from a theory. * Types of thinking * Inductive- This type of reasoning starts with something specific and ends with something general. Ex: Empirical data is collected on a concept and the researcher attempts to create a theory or statement that describes the data. * Deductive- This type of reasoning starts with a general concept and whittles itself down to something specific. The researcher would start with a theory and develop a hypothesis which then leads to their specific data. * Nursing Theories/Theorists: Rogers, Roy, Stetler, Orem * Roy’s Adaptation Model: focuses on the whole being versus the medical model that focuses on the disease process (Nieswiadomy, 2012). How does the person adapt to and interact with the changes in their environment? * Neuman’s Systems Model: Each client is unique with various stressors that effect their Line of Defense (LOD). Primary, secondary, and tertiary prevention strategies help to manage the client as they cycle in their wellness system. (“Betty Neuman’s System Model,” 2012) * Rogers’s Science of Unitary Human Beings: Humans interact with their environment through energy fields and are viewed as a whole person, not in divided parts or systems. A true holistic nursing theory (Nieswiadomy, 2012). * Orem’s Self-Care Model: It is a theory of self-care, self-care deficit and a nursing system that promotes nursing to utilize interventions that help the client become as independent as possible (“Orem’s Self-Care Model,” 2012). * Hypothesis * Complex hypothesis- A hypothesis that concerns a relationship where two or more independent variables, two or more dependent variables, or both are being examined. * Directional research hypothesis- type of hypothesis in which a prediction is made of the type of relationship that exists between variables. * Interaction effect- The result of two variables acting in conjunction with each other. * Nondirectional research hypothesis- A type of research hypothesis in which a prediction is made that a relationship exists between variables, but the type of relationship is not specified. * Null hypothesis (Ho)- A statistical hypothesis that predicts there is no relationship between variables; the hypothesis that is subjected to statistical analysis. * Research hypothesis (H1)- An alternative hypothesis to the statistical null hypothesis; predicts the researcher's actual expectations about the outcome of a study; also called scientific, substantive, and theoretical. * Simple hypothesis- A hypothesis that predicts the relationship between one independent and one dependent variable. * Research utilization and evidence-based practice * Research Utilization (RU): Taking research results and applying it directly to a clinical or practice setting. Nurses are often hesitant to utilize research because they do not know if it is safe to implement changes or if the research is even legitimate. * Evidence-Based Practice (EBP): Most of you have probably heard of them term before.
Basically, our practices (the way we insert a Foley, start an IV, change a wound, etc.) should be established or modified based on current, reliable and valid research. * Research resource organizations i.e. NINR, AHRQ, Cochrane, NGC, USPSTF, NIH, DHHS * The National Institute for Nursing Research (NINR), a division of the National Institute of Health (NIH), enable nursing research to progress by leaps and bound by greatly increasing funding and available resources for nurse researchers. The NINR wants nursing researchers to focus on promoting health and preventing disease, improving the quality of life and eliminating health disparities (Nieswiadomy, 2012). * The Agency for Healthcare Research and Quality (AHQR) understands the need for outcomes research which focuses on the results of various health care interventions or practices. Everyone who participates or influences healthcare in any ways is very interested in this type of research because it can greatly effect the cost and efficiency of healthcare. * Literature
Sources: * Primary- A description of a research study written by the original researchers. Ex: I can quote directly from your Nieswiadomy text anything that the Ms. Nieswiadomy has written herself and it would be a primary source for Ms. Nieswiadomy’s ideas. * Secondary- A summary of description of a research study written by someone other than the primary researchers. Ex: If I were to quote or paraphrase another author’s work that is contained inside your Nieswiadomy text, I would be utilizing it as a second source since I am finding that information in the Nieswiadomy text and not in that author’s original work. * PICOT * Population/ Patient Problem: Who is your patient? (Disease or Health status, age, race, sex) * Intervention: What do you plan to do for the patient? (Specific tests, therapies, medications) * Comparison: What is the alternative to your plan? (ie. No treatment, different type of treatment, etc.) * Outcome: What outcome do you seek? (Less symptoms, no symptoms, full health, etc.) * Time: What is the time frame? (This element is not always included.) * Nursing, professionalism and value? * Most valid means of developing a unique body of knowledge that would allow nursing to be clearly identified as a distinct profession is through scientific research. They can determine what it is that they do and how they do it that distinguishes them from other groups in the health care field. * Outcomes research * The research that focuses on measurable outcomes of interventions with certain patient populations. The types of designs, methods and sampling procedures used in these studies may be somewhat different from those used in the traditional quantitative or qualitative studies. * Nursing’s role in research * Principal investigator * Member of a research team * Identifier of researchable problems * Evaluator of research findings * User of research findings * Patient/client advocate during studies * Subject/participant in studies * Ethics: nursing’s role in ethics, unethical studies, Belmont Report * Nurses role: Patient advocate- protect the privacy and the dignity of people involved in the research and to protect them form harm. * Unethical studies * WWII * Germany- wound infection, skeletal size, freezing flesh studies. * Japan- Infecting women with syphilis, impregnating them and dissecting babies; draining blood and substituting horse blood, exploding gas gangrene bombs, endurance of pain. * USA- 1932- syphilis study with black men (Tuskegee); 1960s deliberately expose child to smallpox to try out vaccine; 1963 injected live cancer cells in elderly pts.; 1989 experimental measles vaccine in LA; 1991, American Indian children given Hep A vaccine without parents consent. * Belmont Report (1979) * Respect for Persons- research subjects should have autonomy and self-determination. * Beneficence- research subjects should be protected from harm * Justice- research subjects should receive fair treatment.