HNN 108 seminar note PDF

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HNN 108 seminar notes from week 1 to week 9...

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HNN108 Week 1 ILO 1. Define health research & evidence based practice Health research Clinical research involves in human subjects in health and illness, done in response to a health research question in order to inform health practice through the implication of pathophysiological, population-based, behavioural, or qualitative research methods, as well as include Observational and interventional. Evidence based practice Practice that is informed by the careful consideration and evaluation of relevant information, and client/patient and practiorer experience and preference. Research Systematic process of enquiry undertaken with the purpose of new knowledge that can be generalised to settings and subjects other that those studied. 2. Describe the contribution of health research to the disciple of nursing The result of health research are published in scholarly journals. Such published studies contribute to the body of evidence that ultimately informs clinical practice via a process know evidence based practice. 3. Outline and describe the steps in the research a) Define the research problem  Clinicians identified problem  Knowledge or information needed by clinicians. b) Review the literature  Review literature related to the research problem  Provides foundational knowledge about problem area  Educates researchers about what studies have been conducted in the past, how they are conducted, and conclusions in problem area  This step illustrate about learning more about the topic under investigation. c) Formulate the question  Clarify the problem and narrow the scope of study.  Can only be done after the literature has been reviewed.  The knowledge gained through the review of literature guides the researcher in clarifying and narrowing the research project. d) Choosing the research design  Research design is the framework or plan for answering the research problems. It involves a plan structure and strategy.  The research question determines the research design to be used.  The research design must be able to answer the question.

e) Collection the data  A critical step in providing the information needed to answer the research question.  From literature or subjects to answer the research question.  Data can be collected from direct measurement, words on the survey, with questionnaire, through observation or from the literature. f) Analysis data  Researchers analyse the data according to the design.  The results of analyse are reviewed and summarised in a manner directly related to the questions.

g) Report the data  Findings of researches can be disseminated in a number of ways including via journal articles and conference presentations.  It’s important that researches ensure the findings reach appropriate audiences. h) Research utilisation  Findings are applied in clinical practice. Hierarchy of evidence A top-down approach to locating the best available evidence, starting with a systematic review, if that’s not available, then more down to the next level of evidence and so on. Additional information 1. Reason A process of understanding and exploring the relationships between the many events, objects and idea in our world. 2. Smart thinking: how to link things together  Similarity / difference  Commonality/ inconsistency  Necessity and sufficiency 3. Forms of reasoning  Arguing * exploring issues  Explaining * finding answers  Making decisions *justifying actions  Predicting the future 4. Smart thinking is about reasoning Reasoning is also about people way of thinking about idea. It’s always a social act. 5. One key ingredient of successful thinking is our attitude. Our knowledge consists of both the basic information or facts we know, and a framework or structure of broader idea with which we interpret these facts. Smart thinking constantly assess their structure and framework. 6. Question

Is the key analytical skill that enables as to develop complex knowledge about the world in the form of structures of related ideas, so as to communicate with other people, questions are fundamental to reasoning. 7. The purpose of conducting research Is to generate new knowledge or to validate existing knowledge based on a theory. Research studies involve systematic scientific inquiry to answer specific research questions or test hypotheses disciplined, rigous, methods. 8. The ‘5 as’ – the step of EBP I. Ask a question II. Access the information III. Appraise the articles found- critiquing evidence IV. Apply the information V. Audit impact 9. Background question A broad, basic knowledge question that can usually best be answered by information found in textbooks/general clinical resources or by the patient themselves. e.g How long have you had these symptoms? Foreground question 10. A very specific question that, when answered, provides evidence to inform a clinical decision. A foreground question is usually answered by investigating the research. e.g Does handwashing among healthcare workers reduce hospitalacquired infection? 11. PICO question  A well-structured PICO question up the chances of finding the best available evidence to inform clinical decision-making.  P- patient, population, problem  I – intervention (therapy, treatment), indicator  C – comparison, control  O – outcome e.g in patients aged 65 years and over (P) how does the use of influenze vaccine (I )compared to not receiving the vaccine ( C ) influenze their risk of developing pneumonia ( O ) during the flu season? 12. the interplay of research evidence and practice ensures that advancing knowledge contributes to the delivery of services and ultimately to enhancing outcomes for service users. 13. Quantitative evidence: ( numbers and statistics) Information collected through rigorously conducted research processes with an emphasis on the quantity of data. Qualitative evidence (stories and narrative) Information collected through a rigorous research process that emphasised the quality and richness of data. 14. Paradigm shift A changes in the theoretical framework or perspective from which information and knowledge has been viewed.

15. Ethics Moral values that are identified by any group of people, such as health professionals. 16. In Australia the National Health and Medical Research Council (NHMRC) Is a federal government organisation that fund research and promotes the development and maintenance of public and individual health standards for research practice. 17. Research principle ( treaty of Waitangi) Protection, participation, partnership

Week 2 1. Outline and describe the difference between a research problem and research question.  Components of a research question ( may can use PICO) - Depends on research design - Population - Variables - Intervention - Comparison - Outcome - Timeframe - Hypothesis 2.    

Summarise online health information and literature Year Author Title Topic summery – problem question

Key term Research problem A statement about an area of concern, a condition to be improved upon, a difficulty to be eliminated, or a troubling question that exists in scholarly. Literature, in theory, or in practice that points to the need for meaningful understanding and deliberate investigation. A research problem does not state how to do sth, offer a vague or broad a situation needs proposition, or present a value question a solution. Research question An answerable inquiry into a specific concern or issue. A set of words posing for an answer/a statement that identifies the phenomenon to be studied.

Week 3 1. Define research design Research design Is the framework or plan for answering research questions. In involves a plan, structure and strategy. Research design  Done by way of completing a research proposal - Title of the project - Summary of the project (usually no more than 75-10 words) - Brief description of the project Statement of the research question to be answered or hypotheses to be tested by proposed research program Clear statement of objectives - Rational (supported by literature review) State why the project is important or significant. Show what the potential / useful application of knowledge. - Methodology includes Brief outline of research design setting and participants Sequence of steps for collecting data Time frame - Budget/justification of budget - References supporting literature 2. Identify different research designs  Exploratory descriptive designs Aim: observe & describe - Descriptive research - Exploratory research  Correlational / non- experimental design Aim: predict relationship not causality - Case control study - Observational study - Cohort study - Cross-sectional study - Longitudinal study  Experimental design

Aim: determine causes where random assignment of participants can occur. - Randomised controlled trial - Quasi- Experimental research (pre test post test)  Secondary research design (where primary studies are synthesised to process primary studies) Aim: explain - Literature view - Meta-analysis - Systematic review 3. Link type of research design to levels of evidence See ‘ John Hopkins nursing EBP tools Hierarchy of Evidence’ Level 1  Experimental research  Randomised controlled trails  Systematic review of randomised control trails(with or without meta-analysis) Leve2  Quasi experimental designs, systematic reviews of a combination of RCTs AND Quasi- experimental or quasi experimental studies only (with or without meta-analysis) Level 3  Non experimental studies, systematic reviews of RCT,Quasi experimental non experimental or non experimental studies only(with or without meta-analysis)  Qualitative studies or systematic review (with or without metaanalysis). Leve 4  Opinion of respected authorities and /or nationally recognised expert committees/consensus panels based scientific evidence are included. And these include: clinical practice guidelines & consensus panels. Level 5  Based on experimental and non-research evidence. - Literature reviews - Quality improvement - Program or financial evaluation - Case reports - Opinion of nationally recognised experts based on experiential evidence. Key term 1. Quantitative research Research strategies that emphasise numbers in data collection and analysis. The focus of quantitative research is on the testing of theories. 2. Qualitative research Research strategies that emphasise words rather than numbers in data collection and analysis to gain an understanding of underlying

reasons, opinions, and motivation. The focus of qualitative research is on the generation of theories. Additional information 1. Goal of literature review  Determine what research has been conducted on the topic of interest  How has it been conducted.  What are the geos in the knowledge. [ to find out what is known and unknown about topic] 2. Factors influences the choosing of research design  The specific research question being investigated.  The nurture of the topic  The characteristics of the individual or groups being researched. 3. Hypothesis Prediction a researcher makes about the relationship between variable. 4. Foreground questions tend to be about either.  Intervention or treatment  Progrosis of a disease  Experiences and attitude concerning healthcare.

Week 4 ILT 1. Describe the role of ethics committees in health research  Protect the welfare and the rights of participants in research  Evaluate the merits of research and determine whether it is justifiable in term of its potential contribution to knowledge(Do the benefits of conducting the research outweigh the risks??)  Monitor all approved research projects to ensure that they are being carried out according to the provisions under which they were approved. Ethics committee A group of people that includes researchers, health and social care professionals, a lawyer, lay members, and a balance of men and women. 2. Identify key principle for ethical conduct of research in humans  Beneficence: the likely benefit of the research, maybe to the participants, to the wider community or the both.  Justice: fairness, the concept that benefits, risks and costs are equitably distributed.  Respect : respect for human beings in a recognition of their intrinsic, value.  Research merit and integrity  Research that has merit is a) Justifiable by its potential benefit b) Designed or developed using methods appropriate for achieving the aims of the proposal. c) Based on a thorough(彻底的) study of the current literature, as well as previous studies. d) Designed to ensure that respect for the participants is now compromised by the aims of the research, by the way it is carried out, or by the results. e) Conducted or supervised by persons or teams with experience, qualifications and competence that are appropriate for the research.

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Conducted using facilities and resources appropriate for the research.  Research that is conducted with integrity is carried out by researchers with a commitment to a) Searching for knowledge and understanding b) Following recognised principles of research conduct. c) Conducting research honestly d) Disseminating and communicating results, whether favourable; or unfavourable, in ways that permit scrutiny(详 细审查) and contribute to public knowledge and understanding. Privacy and confidentiality Concerns the true identify of participants to protect them from any negative. Dignity and respect Non-maleficence Avoiding bad intention or the causing of harm or discomfort disproportionate to the benefits of the research. Respecting autonomy The person making an informed decision about being involved.

3. Differentiate between high risk and low risk research and apply to research proposals 4. Critique ethical issues in health research  Pregnant women and fetus(胎儿)  Wellbeing and care of women and fetus  Consent  Conflict of interest ( treating health professionals)  Children and young people  Their capacity to understand what the research entails, and therefore whether their consent to participate is sufficient for their participation.  Their possible coercion by parents, peers, researchers, or others to participate in research.  Conflicting values and interests of parents and children.  People in dependent or unequal relationships  Pre-existing relationships may compromise the voluntary character of participants’ decisions.  People highly dependent on medical care who may be unable to give consent.  Unfair recruitment  Impaired capacity for verbal or written communication(consent)  People with cognitive impairments, on intellectual disability, or a mental illness.  Ability to consent  People who may be involved in illegal activities  Participant’s risks when involving in research

 Use pseadonyms or to remove links between names and data.  Aboriginal and torres strait islander people.  Reciprocity  Respect  Equality  Responsibility  Survival and protection  Spirit and integrity  People in other countries  Value tension  General: consent ability, prtential harm, cultural sensitivity, (exploitation) Key term Informed consent The process where research participants, having been fully informed of the aims and methods of the research, agree to engage in the study; also used in clinical settings to ensure patients are informed and agree to procedures or treatments. Ethical principle

Additional information 1. Ethics committee members  A chairperson  At least 2 members that are lay people  At least 2 people with current research experience  At least 1 person with knowledge / experience in the professional care, counselling and treatment of people  At least 1 member who performs a pastoral care role in the community.  At least 1 member who is a lawyer 2. Important statement The National Statement on Ethical Conduct in Human Research(2007) (updated May 2015) issued by’ the National Health and Medical Research Council’. 3. Anonymity A person being unknown to the researcher and hence to anyone else. 4. vulnerable people individuals who are marginalised or discriminated against because of their class, ethnicity, gender, age, illness, disability or sexual preference. 5. plan language statement a statement that outlines the details of the study in language that is intelligible to particcipants.

Week 5 ILO 1. distinguish different types of qualitative methodologies.  Ethnography The direct description of a group, culture or community, mainly through observation, interviews and examination of documents.  Case studies Study on a specific eatity, with clear confines and boundaries in terms of the questions being asked, and the context and person(s) involved.  Grounded theory The systematic generation of theory from the data collected during the research process.  Phenomenology The study of lived experience and meaning, with the aim of making clear phenomena as presented to human consciousness. Phenomenology presents the essential structure a phenomenon.  Historical An approach aimed at building understanding about present and future and future states through an understanding of the events of the past, including what happened and why it happened in that way. 2. Describe different types of qualitative sampling methods.  Convenience sampling

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A method of drawing representative data be selecting people because of the ease of their volunteering or selecting units because of the availability or easy access. Purposive sampling The selection of a group of people, events, behaviours, or other elements that are representative of the population being studied. Snowballing sampling Where research participants recruit other participants for a test or study. It is used where potential participants are hard to find. Observational sampling Researcher observes behaviour in a systematic manner without influencing or interfering with behaviours. Theoretical sampling The process of fata collection for generating theory whereby the analyst jointly collects, codes and analyses data and decides what data to collect next and in order to develop theory as it emerges.

3. Explain ways of collecting qualitative data.  Direct data: interview, observation, open-ended questionnaire, journaling(diary accourts), think aloud sessions.  Indirect data: systematically searching archives, browsing through the interest

4. Distinguish the differences between experimental, quasi-experimental and non-experimental designs  Experimental Seeks to determine if a particular treatment/intervention influences an outcome and tests the hypothesis when the independent variables is manipulated and the effects are observed  Quasi-experimental Random allocation is difficult and the characteristics of the sample are measured before the treatment/intervention.  Non-experimental When the variables cannot be manipulated and relies on observation and interpretation to come to a conclusion.  Simple sampling Random selection of participants from all units in a target population- tossing a coin, all participants have an equal chance.  Systematic sampling  Stratified random sampling When population is made up of more than one subgroup.  Confidence interval Communicates how accurate our estimates are going to be. Key term  Focus group A small structured group with selected participants that are asked about their experiences, perceptions, opinions, beliefs and attitudes.

Focus group are specialised groups in term of purpose, size, composition and procedures.  Interview Conversations held for the purpose of gathering information  Data saturation Data should be collected until there are fewer surprise in the data and no more patterns or themes are emerging from the data. Additional information 1. Advantages and disadvantages of different types of sampling - Convenience sampling: most common from (+) fast and easy way to achieve the sample size (-) under/over- representation of particular group within the population; unlikely to be representative of population being studied, leading to limitation in generalisation. - Purposive sampling/ judgement sampling Designed to provide information-rich cases for in-depth study a. Quota sampling: the researcher decides th...