NR 400 Research Exam 2 Notes PDF

Preview

Summary

nursing research exam 2 notes ...

Description

NR 400 Research Exam 2 Notes Chapter 3: Key Concepts and Steps in Qualitative and Quantitative Research The Building Blocks of Research Faces and Places of Research ● A study or investigation is when researchers answer a question through disciplined research. ● Study subject or participant is people being studied or cooperating in study. In either quantitative or qualitative, studies with humans involve two sets of people: ● Those who do the research ● Those who provide the information QUANTITATIVE TERM

QUALITATIVE TERM

Person contributing information

Subject of the study participant

Study participant, informant, key informants

Person undertaking the study

Researcher or investigator

Research or investigator

That which is being investigated

Concepts, constructs, variables

Phenomena, concepts

Information gathered

Data (numeric values)

Data (narrative description)

Connections between concepts

Relationships (cause & effect, associative)

Patterns of association

Logical reasoning processes

Deductive reasoning

Inductive reasoning

Research settings: ● Study site is the overall location; it can be an a hospital, home, or community. ● Multisite studies tend to yield more diverse group of study participants, potentially enhancing generalizability of findings Concepts, Constructs, and Theories ● Concepts are phenomena of particular aspects of human behavior or characteristics (e.g., pain, resilience, fatigue, obesity) ● Constructs are slightly more complex abstractions (e.g. self- care) ● Theories are an explanation of some aspect of reality; concepts are knitted into a coherent system which is intended to explain phenomena Variables ● A variable is any quality of a person, group, or situation that varies or takes on different values ● Examples of variables include: blood type; weight; length of stay in hospital ● The term variable is used almost exclusively in quantitative research ● Types of variables are: - Some variables take on a wide range of values (e.g., height, weight) while others are categorical (e.g., marital status, gender) - Independent variable—the presumed cause (of a dependent variable) - Dependent variable —the presumed effect (of an independent variable) - Often referred to as the or outcome variable or outcome in PIO - Example: smoking (IV); lung cancer (DV)

Conceptual and Operational Definitions

● ●

Conceptual definition: the abstract or theoretical meaning of a concept being studied Operational definition: the operations (measurements) a researcher must perform to measure the concept and collect the desired information

Data ● -

Data (singular = datum): the pieces of information researchers collect in a study Quantitative researchers collect numerical data Example of Quantitative Data: - Question: Thinking about the past week, how depressed would you say you have been on a scale from 0 to 10, where 0 means “not at all” and 10 meaning “the most possible”? - Data: 9 (subject 1) 0 (subject 2) 4 (subject 3) ● Qualitative researchers collect narrative or verbal data ● Example of Qualitative Data: - Question: Tell me about how you’ve been feeling lately—have you felt sad or depressed at all, or have you generally been in good spirits? - Data: Well, actually, I’ve been pretty depressed lately. I wake up each morning and I can’t seem to think of anything to look forward to. I just can’t seem to shake the blues. Relationships ● A relationship is a bond or connection between variables. ● Cause-and-effect (causal) relationship (e.g. we might speculate that there is a causal relationship between caloric intake and weight)) ● Associative (functional) relationship (e.g., between person’s pulmonary artery & tympanic temperatures: People w/ high readings on one tend to have high readings on the other) ● Patterns – qualitative researchers may seek patterns of association to understand the whole Major Classes of Quantitative and Qualitative Research ● Quantitative Research: experimental and non experimental studies - Experimental research - Researchers actively introduce an intervention or treatment - Called clinical trials in medical research - Nonexperimental research - Researchers collect data without intervening and observe. - Called observational research in medical research Qualitative Research: Disciplinary Traditions ● Grounded theory research - Seeks to understand key social psychological processes. - Major component is the discovery of a core variable that is explaining what is going on in the social scene. - Strive to generate explanations of phenomena that are grounded in reality. ● Phenomenological research - Focuses on the lived experiences of humans ● Ethnographic research - Focuses on the patterns and life ways in a holistic fashion - Ethnographers engage in extensive fieldwork. - Primary research tradition in anthropology

Major Steps in a Quantitative Study ● Phase 1: Conceptual Phase

-

● ● ● ● -

Step 1: Formulating & Delimiting the Problem: identify interesting research problem & formulating research questions (identifies study variables) Step 2: Reviewing the Related Literature: quantitative researchers strive to understand what is already known about a topic by undertaking a thorough literature review before any data are collected. Step 3: Undertaking Clinical Fieldwork: discussing topic w/ clinicians and observing current practices to provide perspectives on clinicians and clients’ viewpoints. Step 4: Defining the Framework & Developing Conceptual Definitions: researchers should have a conceptual rationale & clear vision of the concepts under study. Step 5: Formulating hypotheses: state researchers’ expectations about relationships between study variables. Predictions of the relationships researchers expect to observe in the study data. Phase 2: Design and Planning Phase Step 6: Selecting a Research Design: overall plan for obtaining answers to the research questions. Step 7: Developing Protocols for the Intervention: specify exactly what the intervention will entail and what the alternative condition will be. Unnecessary in non experimental research. Step 8: Identifying the Population: All the individuals or objects w/ common, defining characteristics. Step 9: Designing the Sampling Plan: specifies how the sample will be selected and how many subjects there will be to have a sample that adequately reflects the population’s traits. Step 10: Specifying Methods to Measure Variables: data collection methods such as selfreports, observations (task of measuring research variables & developing data collection plan) Step 11: Developing Methods to Safeguard Human/ Animal Rights: Study adheres to ethical principles. Step 12: Finalizing the Research Plan: Evaluate readability of written material & ensure procedures will work smoothly. Phase 3: Empirical Phase Step 13: Collecting the Data: often proceeds according to a pre established plan. Step 14: Preparing data for Analysis (e.g., coding the data; translating verbal data into numeric form) Phase 4: Analytic Phase Step 15: Analyzing the Data (through statistical analysis) Step 16: Interpreting Results: making sense of study results & examining their implications. Phase 5: Dissemination Phase Step 17: Communicating the Findings: in a research report (e.g., in a journal article); Step 18: Putting the Evidence into Practice: develop recommendations on how evidence could be used in practice.

Activities in a Qualitative Study ● Continually examining and interpreting data and making decisions about how to proceed based on what has already been discovered ● Flexible approach to collecting and analyzing data

● ● ● ● -

Flow varies from one study to another Some major activities in a Qualitative study include: Conceptualizing and planning the study Identifying the research problem Doing a literature review Selecting sites and gaining entrée with gatekeepers who have the authority to permit entry into their world. Developing an overall approach Addressing ethical issues Conducting the study: undertaking iterative activities through emergent design Making sampling decisions Deciding what questions to ask Collecting data until finalizing their research design. Evaluating integrity and quality Analyzing and interpreting data Making new decisions

Chapter 5: Ethics in Research Historical Background ● 1930s and 1940s: Nazi medical experiments - Subjects exposed to harm and forced to participate ● 1932–1972: Tuskegee Syphilis Study - Withheld medical treatment ● 1940s: U.S. radiation experiments ● 1960s: Willowbrook Codes of Ethics ● Nuremberg Code was one of the first ________ set of ethical standards in response to the Nazi atrocities. ● Declaration of Helsinki was adopted by the World Medical Association. ● Nurses have developed ethical guidelines , such as the American Nurses Association’s Code of Ethics. ● Ethical guidelines in the conduct, dissemination, and implementation of nursing research and code of ethics for nurses with interpretive statements ● In 2015 - ANA declares year of ethics: Revised Code of Ethics for Nurses with Interpretive Statements Government Regulations for Protecting Study Participants ● Governments throughout the world fund research and establish rules for adhering to ethical principles. ● In the U.S., an important code of ethics was adopted by the National Commission for the Protection of human subjects of biomedical & behavioral research. ● The Belmont Report provided a model for many guidelines adopted by disciplinary organizations in the U.S. as well as research sponsored by the U.S. federal government ● The Belmont Report includes studies supported by the National Institute of Nursing Research (NINR) Ethical Dilemmas ● An ethical dilemma in research is a situation in which the rights of participants are in direct conflict with requirements of a study ● Research questions: - Does a new medication prolong life in patients with AIDS?

-

Ethical dilemma: what if side effects are dangerous? Are nurses equally empathic in their treatment of male and female patients in the ICU? Ethical dilemma: nurse may behave differently How do parents cope when their children have a terminal illness? Ethical dilemma: may be looking at their psychiatric health or have maladaptive coping mechanisms. - What is the process by which adult children adapt to the day-to-day stresses of caring for a parent with Alzheimer’s disease? - Ethical dilemma: Ethical Principles for Protecting Study Participants ● The Belmont Report articulated 3 primary ethical principles - Beneficence: imposes a duty on researchers to minimize harm & maximize benefits. - The Right to Freedom from Harm and Discomfort: researchers have obligation to prevent or minimize harm in studies w/ humans. - Principle of beneficence is to minimize harm; to do good. Above all, do no harm. - Beneficence—maximize good - Non-maleficence—minimize harm - The Right to Protection from Exploitation - Participants should not be placed at a disadvantage - This special relationship should not be exploited ● Principle of respect for human dignity: - Right to self-determination (absence of coercion) - Deciding voluntarily whether to participate in a study, without risking prejudicial treatment - Having the right to ask questions, refuse answering questions, and drop out of the study - Right to full disclosure (absence of deception or concealment) - Receiving a description of the study, the person’s right to refuse participation, and potential risks and benefits ● Justice - The Right to Fair Treatment: selection of participants should be based on research requirements & not on people’s vulnerabilities. - Concerns the equitable distribution of benefits and burdens of research ● The Right to Privacy - Ensures that the research is not more intrusive than it needs to be and that privacy is maintained Procedures for Protecting Study Participants ● Risk–benefit assessments - Potential Benefits and Risks to Study Participants - Minimal risk is a risk which is expected to be no greater than those ordinarily encountered in daily life or during routine tests/procedures ● Informed consent means that participants: - Have adequate information about the research - Can comprehend that information - Have free choice in deciding whether to participate in or withdraw from the study - Typical documentation: consent form - Implied consent (e.g., returned questionnaire) - Process consent (renegotiated over time, qualitative studies) ● Confidentiality Procedures - Anonymity—even researchers are unable to link participants to their data - Confidentiality in the Absence of Anonymity - Confidentiality procedures— developed by researchers to ensure confidentiality of research

● ● -

● ● ● -

subjects - Certificate of confidentiality—a certificate obtained to prevent forced disclosure of confidential information to authorities Debriefings and referrals Respect participants Debriefing sessions follow data collection to allow participants to ask questions or air complaints. Make referrals appropriate to health, social, or psychological services Treatment of Vulnerable Groups Vulnerable subjects are study participants who require special protection. - Some cannot make a truly informed decision about voluntary participation - Others are at higher-than-average risk (e.g. children, mentally/emotionally disabled people, severely ill or physically disabled people, terminally ill people, institutionalized people, pregnant women) External Review and Protection of Human Rights Ethical aspects of a study are increasingly likely to be reviewed before permission is granted to conduct a study Human subjects committees review research plans Institutional Review Boards (IRBs): cannot deviate from research plan Ethical issues in using animals in research Proper care and treatment of animals Research misconduct (for the protection of public interest) Plagiarism Fabrication of results Falsification of data

Chapter 8: Theoretical & Conceptual Frameworks Theories, Models, and Frameworks ● Theories are an abstraction or idea whose purpose is to account for or explain phenomenon. ● NR 351 definition: A group of concepts that describe a pattern of reality. ● Theories are powerful because they articulate the nature of relationships among phenomenon. ● Theories are created; they are built inductively from observations. ● Theories can be:

-

Classical—an abstract generalization that systematically explains relationships among phenomena - Descriptive—a theory that thoroughly a phenomenon, based on rich observations - Grand (or macro-theories)—a theory that attempts to explain large aspects of human experiences; Parse’s Theory of Human Becoming has also been called a nursing grand theory - Middle-range—a theory that focuses on a specific aspect of human experience (e.g., stress, comfort, health promotion) ● Models (or conceptual models) - Deal with abstractions that are assembled because of their relevance to a common theme - Represent a more loosely structured attempt to explain phenomena than theories - Broadly presents an understanding of the phenomenon of interest and reflects the assumptions and philosophical views of the model’s designers - Can serve as springboards for generating hypotheses - Types of models that are used in research context are: - Schematic models (or conceptual maps) – an example is Pender’s Health Promotion Model on page 124 –visually represent relationships of phenomenon in quantitative and qualitative research; appealing visual summaries of complex ideas Framework ● The overall conceptual of a study ● Not every study is based on a theory or conceptual model, but every study has a framework ● Researchers who clarify information of key variables provide important information about the study’s framework ● Quantitative researchers are less likely to identify their frameworks than qualitative researchers ● Types of framework: - Theoretical framework (based on a theory) - Conceptual framework (based on concepts) ● Commonalities of Theories and Conceptual Models - Use concepts as building blocks of theories. - Require conceptual definitions of key concepts. - Can be represented in a schematic model - Theories, conceptual frameworks, and models are created, not discovered - Are developed inductively - A theory cannot be proved – they are supported - A theory represents a theorists best efforts to describe and explain phenomena - Theory guides and generates ideas for research - Research assesses the worth of the theory and provides a foundation for new theories

Conceptual Models and Theories Used in Nursing Research ● Formal explanations of what nursing practice is ● Four concepts central to models of nursing: - Nursing - Health - Individual - Environment ● Various conceptual models define these concepts differently while keeping them central to

● -

● ● -

-

-

-

nursing Conceptual models of nursing that have been used in nursing research include: Roy’s Adaptation Model – humans are viewed as biopsychosocial adaptive systems who cope w/ environmental change through process of adaptation - Within human system, there are 4 subsystems: physiologic/ physical; self- concept/ group identity; role function; interdependence Middle-range theories – developed by nurses - focuses on more clinical adaptation phenomena or aspect of the human experience Beck’s Theory of Postpartum Depression (2012) Mishel’s Uncertainty in Illness Theory (Mishel, 1990): focuses on the concept of uncertaintyinability of a person to determine the meaning of illness-related events. Pender’s Health Promotion Model (2006): focuses on explaining health promoting behaviors using a wellness orientation. Shared theories – a theory that is tested and found to be empirically adequate in health-relevant situations of interest to nurses; borrowed theory Bandura’s Social Cognitive Theory: aka self- efficacy theory; offers explanation of human behavior using concepts of self-efficacy, outcome expectations & incentives. (example of key constructs: self- efficacy) Prochaska’s Transtheoretical Model: core construct is stages of change, which conceptualizes a continuum of motivational readiness to change problem behavior. (example of key constructs: stages of change) 1) Precontemplation 2) Contemplation 3) Preparation 4) Action 5) Maintenance Health Belief Model: explain people’s health-related behavior, such as compliance w/ medical regimen. Influenced by a person’s perception of a threat posed by a health problem & value associated w/ actions aimed at reducing threat. (example of key constructs: threat perception) Ajzen’s Theory of Planned Behavior (TPB): extension of Theory of Reasoned Action, offers framework for understanding people’s behavior and its psychological determinants. Behavior that is volitional is determined by people’s intention to perform that behavior. (example of key constructs: understanding behavior intentions)

Theories in Qualitative Research ● Theories are almost always present in studies that are embedded in qualitative research ● Substantive theory—conceptualizations of the target phenomena under study ● Theory embedded in a research tradition: - Grounded theory: - Humans act toward things based on the meanings that that the things have for them - The meaning of things is derived from the interaction humans have with fellow humans - Meanings are handled in and modified through an interpretive process - Ethnography:

- Cultural perspectives – ideational or materialistic Phenomenology: - The phenomenological philosophy of human experience The Use of Theories or Models in Quantitative Research ● Testing hypotheses deduced from and existing theory ● Hypotheses are predictions about the manner in which variables would be interrelated if the theory were correct ● Key variables are measured, data collected, and hypotheses t...