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NSG3301 Midterm Exam, Exams of Nursing

NSG3301 Midterm Exam NSG3301 Midterm Exam

Typology: Exams

2024/2025

Available from 07/02/2025

Prof.Lorraine-Dixon
Prof.Lorraine-Dixon šŸ‡¬šŸ‡§

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NSG3301 Midterm Exam
Research - Solution the systematic , rigorous, investigation with the aim of
answering Qs about nursing phenomenon
Phenomenon - Solution occurrence, circumstances, or facts that are
perceptible by the senses
Significance of Research - Solution - expands scientific knowledge
- foundation for evidence-informed nursing
- allows practice to advance and adapt to current issues and environment
- maintain professional relevance
evidence-based practice - Solution nursing care provided that is supported
by sound scientific rationale
Evidence-informed practice - Solution The incorporation of evidence from
research, clinical expertise, client preferences, and other sources to make
decisions about client care.
- includes ways of knowing, indigenous knowledge, cultural and religious
norms and clinical judgement
Evidence-informed practice - Solution making a continuous, interactive
process involving the explicit, conscientious, and and judicious
consideration of the best available evidence
Research trends - Solution - community based care
- reduce disparities
- health promotion and risk reduction,
- reduce nosocomial diseases
- reduce comorbid conditions
Research trends - Solution - emphasis on provider accountability on
quality and cost outcomes,
- aging population,
- interdisciplinary collaboration
- technology to serve humans
- needs of indigenous people
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NSG3301 Midterm Exam

Research - Solution the systematic , rigorous, investigation with the aim of answering Qs about nursing phenomenon Phenomenon - Solution occurrence, circumstances, or facts that are perceptible by the senses Significance of Research - Solution - expands scientific knowledge

  • foundation for evidence-informed nursing
  • allows practice to advance and adapt to current issues and environment
  • maintain professional relevance evidence-based practice - Solution nursing care provided that is supported by sound scientific rationale Evidence-informed practice - Solution The incorporation of evidence from research, clinical expertise, client preferences, and other sources to make decisions about client care.
  • includes ways of knowing, indigenous knowledge, cultural and religious norms and clinical judgement Evidence-informed practice - Solution making a continuous, interactive process involving the explicit, conscientious, and and judicious consideration of the best available evidence Research trends - Solution - community based care
  • reduce disparities
  • health promotion and risk reduction,
  • reduce nosocomial diseases
  • reduce comorbid conditions Research trends - Solution - emphasis on provider accountability on quality and cost outcomes,
  • aging population,
  • interdisciplinary collaboration
  • technology to serve humans
  • needs of indigenous people

consumer of research - Solution appraise research evidence & use existing standards to determine merit & readiness for use in clinical practice nurses role in research - Solution - consumer: engage in research & activities that promote safe, competent, & compassionate ethical care

  • generator of clinical questions (MD/PHD)
  • protector of research participants - unethical practice Florence Nightingale - Solution 19th Century
  • 1860 publishes notes in nursing - a systematic collection and exploration of data to support health promotion and disease prevention = decreased mortality rate
  • emphasis on education not research
  • American Nursing Association publishes 'Nursing Research'
  • First masters program at UWesternOntario
  • development of nursing theories and practice guides - Solution 20th century nursing 1900- 20th century nurisng - Solution - first fed grants for nursing research
  • McGill opens 1st nursing research center (1971)
  • Doctoral programs at UofA (91), EBC, McGill, UofT,
  • Canadian Health Services Research Foundation (CHSRF) gives nursing $25million 21st century nursing 2000-2012 - Solution - CHSRF & CIHR give 5 grants for nursing
  • Canadian Association Schools of Nursing develop PhD programs Depth in Nursing Research - Solution - repetition/replication of studies provides depth and promotes generalizability of findings
  • repeats in geographical areas
  • Nancy Edwards, Ottawa, Elderly fall prevention International Council of Nursing - Solution uses networks, databases, websites, funding, and respect for cultural perspectives to do global cross- cultural and cross-national studies

Novice -> competent > expert > practitioner (fully engaged and able to respond) Ethical knowledge - Solution knowledge of the morals of nursing - principles, codes, judgement of right & responsible, including conflict resolution Paradigm - Solution a set of beliefs and practices shared by a community of researchers and guides the knowledge development process Ontology - Solution The study of being - what it means to say something exists or is real Epistemology - Solution the study of knowledge, "How do we know what we know?" methodology - Solution discipline-specific principles, rules, and procedures that guide the research process context - Solution The personal, social, and political environment in which a phenomenon of interest occurs aim of inquiry - Solution goals or specific objectives of the research Post-Positivist Paradigm Ontology - what exists - Solution - a material world exists but not all things can be understood, sensed, or explained by cause and effect

  • the senses provide us with an imperfect understanding of the external/ material world QUANTITATIVE research values - Solution personal beliefs of the researcher RN licencing and research competencies - Solution research competencies required for RNs:
  • critically evaluate EBP guides to support professional practice
  • nurse/client relationship (inform pt of rights to refuse and participate)
  • read, critique, seek research opportunities & incorporate Critical Theory Paradigm -

Ontology - Solution - reality created by those in history with the most power

  • reality is plastic, imperfect, and shaped by social, political, economic, and cultural forces QUAL & QUANT Constructive paradigm Ontology - Solution reality is constructed by individual perception. No absolute truth; it is relative to perception QUALITATIVE Post-Positivist Paradigm (Quantitative) - Epistemology (truth; how do we know what we know) - Solution - believe that researchers are naturally biased
  • triangulation is encouraged and goal is to be objective QUANTITATIVE Critical theory paradigm - Epistemology - Solution - belief that research is influenced by values, perception and context of what researcher or pts believe to be true QUAL & QUANT Constructive paradigm Epistemology - Solution - belief that values and perception influence the researcher knowledge with emphasis on the human experience QUALITATIVE Post-Positivism Methodology - Solution - research Qs and hypothesis are subjected to testing
  • using a series of logical steps and experimental & non-experimental approaches under careful control Critical theory Methodology - Solution - dialogue between researcher and participant is transformative; discuss historical context - experiences, suffering, conflicts - brings awareness to incite change Constructive paradigm

concepts - Solution - an image or symbolic representation of an abstract idea (pain)

  • the major components of theory that convey the idea theory - Solution A blueprint or set of interrelated concepts or hypothesis that explain phenomena that has been tested with a significant amount of data supported by concepts and how they are related Hypothesis - Solution - a tentative statement of expected relationship between 2 or more variables that can be empirically tested (verified by observation)
  • a best guess or prediction to answer the research Q conceptual framework - Solution this framework describes "constructing" a study map of concepts and/or theories that explain why a phenomenon exists. From a QUALITATIVE research project theoretical framework - Solution This framework is a study map of concepts and/or theories "based" on a philosophical belief or understanding of why the phenomenon exists ladder of abstraction - Solution Abstract > Concrete:
  • worldview
  • framework
  • theories / hypotheses
  • concepts (conceptual definition and operational definition)
  • variables (observable elements through the senses) Concepts - Solution Conceptual/ dictionary definition: hospital stay
  • time a pt is registered in hosp Operational/measurable definition:
  • sum of days from admission to discharge Effective framework guides - Solution effective frameworks:
  • guides researcher -selects methods of measuring variables,
  • is framework present and can it be used as a baseline for other research? Research Process Steps Qual - Solution QUALITATIVE
  • Identify the phenomenon, purpose and literature review in abstract/ intro
  • design and sample in methods/ participants
  • legal-ethical issues, data collection and analysis in procedures/ data
  • results / discussion
  • references Steps of the research process Quant - Solution QUANTITATIVE
  • research problem and purpose in abst/ intro
  • lit review
  • theoretical / conceptual framework (or list concepts)
  • hypothesis / research questions in intro or results
  • research design, sample (type & size), legal-ethical issues, instruments, and data-collection & analysis in "procedures/ methods"
  • results, discussion, findings, recommendations
  • references
  • communicating research results Critical reading - Solution reading while actively engaging in the point of view of the writer Critical reading process / steps - Solution reading process where you
  • identify concepts
  • clarify unfamiliar terms
  • question assumptions
  • assess the study for validity
  • preliminary understanding (skim)
  • comprehensive underst (authors intent, terms and context)
  • analysis undrst. (parts)
  • synthesis undrst. (make sense of it) Levels of Evidence 1-4: Positivist & Quant - Solution 1. Meta-analysis, a systematic review of several randomized control trials
  1. At least one randomized control trial
  2. Quasiexperimental study
  3. Nonexperimental study Levels of evidence 5-7 - Solution 5. Evidence from descriptive or qualitative studies
  4. Evidence from a single descriptive or qualitative study

Data-based research literature - Solution studies found in journals; aka empirical, scientific Conceptual / theoretical literature - Solution reports of theories or reviews; "how-to" types of articles primary source of research - Solution a source that is data-based, theory, research written by the original person who did it

  • published research study Secondary source of research - Solution a source that is a summary of other material, critique, analysis of a theory, topic, or practice PICOT format to generate clinical Qs in evidence based practice - Solution P - problem/patient population; specifically defined group I - intervention; what intervention or event will be studied C - comparison intervention; with what? O - outcome; effect of the intervention T - time frame systematic review - Solution literature review that uses rigorous methods to identify, critically appraise, and synthesize primary studies.
  • aka evidence studies that provide the best available objective / consumer lens Meta-analysis (Quantitative) - Solution when the treatment effect of effect size is consistent from one study to the next, meta-analysis can be used to identify this common effect Meta-synthesis (QUALITATIVE) - Solution - process allows researchers to identify research Qs, select, appraise, "summarize and combine" (synthesize) qualitative evidence across multiple studies Attentively embracing story - Solution theory that proposes intentional nurse/pt dialogue that engages the human story and enabling self-reflection create ease in pts and are intricately related (kate & alison; ccu) Conducting "a" lit review - Solution - determine research topic/Q
  • find key variables/terms
  • search data bases & review abstracts for relevance & download
  • preliminary reading (skim, keep/ discard)
  • critically read & summarize
  • decide how to present what you've learned Critiquing "the" lit review - Solution when skimming paper
  • is it complete?
  • too old? significant? missing significant?
  • biased?
  • organized?
  • summarized without analysis?
  • conclusion with study purpose? The X Factor IV - Solution the variable that has the presumed effect on the DV; can be manipulated The Y factor DV - Solution the presumed effect that varies with a change from the IV; not manipulated but can be affected by extraneous/ confounding variables Population - Solution a well-defined set that has certain properties;
  • researcher implies in research question and reader gets an idea of who is involved based on study outset Developing a research Q - Solution - consumer (RN) learns from practice and forms clinical Qs
  • search literature for supporting evidence
  • critique and find significance to Q Framing a Clinical Q - Solution framing elements include P - patient / population / situation I - intervention / event C - Control (quantitative) O - outcome (effect of treatment) Components of a hypothesis - Solution Variables to be tested population to be tested design to be used outcomes predicted

Basis for Canadian ethics guidelines - Solution Respect for persons - Treat people with autonomy /do not use people as a means to an end; informed consent Beneficence - doing good / do not harm; sound research design; risk/benefit ratio; privacy Justice - treat people fairly; equitable selection of pop; respect for vulnerable pop Elements of Informed Consent - Solution statement and descriptions of:

  • the study and purpose of research
  • procedures & experiments
  • risks & benefits
  • alternatives
  • extent of confidentiality and records
  • rights & contact info
  • voluntary participation and refusal accepted at any time without penalty Informed consent process does NOT equal informed consent form - Solution - ongoing process of communication & mutual understanding
  • NOT a piece of paper, moment in time, or legal contract Research Ethics Board - Solution REB Role:
  • assess fair recruitment, inclusion & exclusion
  • investigator / subject relationship
  • consent / maximize autonomy
  • assess risk:benefit ratio
  • assess consent process & forms Special considerations / Vulnerable populations - Solution children prisoners mentally disabled persons economically / educationally disadvantaged even subtle: language, culture, pregnancy, students, employees, substance abuse, health status CNA's Code of Ethics, 2008 - Solution -Promoting safe, compassionate, competent, and ethical care -Promoting health and well-being -Promoting and respecting informed decision making

-Preserving dignity -Maintaining privacy and confidentiality -Promoting justice -Being accountable Scientific fraud and misconduct - Solution - nurses obligated to report

  • increases risk & causes harm
  • bases clinical practice on false data Research involving human embryos - Solution materials from human reproduction can't be purchased Health Sciences library: searching the literature - Solution - Search+: discovery tool; most resources
  • Key resources: most used data bases & point of care (Medline & PubMed)
  • Research guides: librarians setup access points for disciplines Qualitative research methods - Solution - guides the nursing practice
  • create instruments
  • and develop nursing theory BY...
  • understanding everyday health experience
  • using voice of participants
  • and structuring ideas from experts Steps for qualitative research design - Solution 1. form a question
  1. review literature (has it already been done?)
  2. make research design / choose side Qualitative method: Phenomenological - Solution -understanding the human experience (phenomenon)
  • Q: what is the human experience of ...? Qualitative method: Grounded theory (group) - Solution If a researcher wanted to ...
  • uncover social process
  • Q: how does this social group interact to ...?
  • analyze authenticity Ethnography method (culture) - Solution Qualitative research:
  • this method aims to understand the EMIC view; cultural views, patterns & lifeways
  • used in cultural anthropology
  • population: key informants
  • data: informal interviews & field notes Phenomenology - Solution Qualitative research:
  • this method wants to understand the meaning of a lived experience/ event
  • used in philosophy
  • Q: what is the meaning ... Participatory action - Solution Qualitative research:
  • this method is based on finding solutions for a community problem in partnership with the participants (the experts)
  • explore, reflect, & take action on social & health problems Orientational Qualitative Inquiry - Solution an ideology that directs the research process
  • critical (focus on power & justice issues)
  • feminist & queer (gender issues)
  • post colonial (power over aborigionals issues)
  • disabilities Metasynthesis of Qualitative Research - Solution this process reviews multiple* qualitative studies
  • retains essence and contribution of each study that is relevant and synthesizes* into a new theory triangulation - Solution this process expands the research strategy of one study to strengthen your research
  • enhance diversity
  • enrich understanding (multiple perspectives)
  • accomplish certain goals
  • use different researchers(disciplines), times, settings Issues with Qualitative studies - Solution this research process has a:
  • naturalistic settings (skip consent)
  • design limits rt. of informed participation
  • researcher as measuring instrument (only human ... bias)
  • time consuming research design - Solution - provides plan to aid in solving problems, answering Qs, & testing hypotheses
  • allows the researcher control so they can say the independent variable influence the dependent variable Control - Solution - means less generalizability
  • used in research designs to sway influence of variables
  • to rule out extraneous variables: use homogeneous sample, consistent data collection, manipulation and randomization randomization - Solution a process of randomly assigning subjects to different treatment groups (control vs experimental groups) Internal validity - Solution this validity asks if it's the independent variable (or something else) that caused or resulted in the change in the dependent variable (within the study) threats to internal validity - Solution this validity is impacted by:
  • history: event impacted DV
  • selection: pretreatment differences in groups
  • maturation: developmental, bio & physiological process (babies grow anyway)
  • testing: better score second time around
  • mortality: participants die
  • instrumentation: changes in measuring device or observation techniques External validity - Solution this validity analyses the extent to which we can generalize findings to real-world settings / outside population Threats to external validity - Solution this validity is affected by
  • selection effects: volunteers not representative
  • reactive effects: Hawthorne (know they're being watched)
  • measurement effects: pretests can prime/ influence thoughts purpose of the quantitative research designs:

Quant Exp. design: Solomon 4 - Solution -2 classic & 2 after-only groups

  • helps rule out testing threats to internal validity (higher score on 2nd)
  • evaluate effects of pretest on study groups Quasiexperimental designs - Solution - a research design that attempts to test cause & effect in which the researcher initiates an experimental treatment but lacks full control.
  • might be missing randomization, control group,
  • non-equivalent control group
  • after-only non-equivalent
  • one group
  • time series evaluation reserach - Solution - the use of analytical means are used to document the worth of an intervention / determine effect or outcome of a program
  • formative: program is assessed as it's being implemented (focus on process rather than outcome)
  • summative: outcome of program is assessed after completion of program non-experimental research design *can't give any evidence to cause and effect!! only correlation! (less control)
  • Solution used to construct a picture of a phenomenon at one point or over a period of time
  • explore people, place, events, or situations as they naturally occur
  • tests/ explores relationships & differences among variables
  • IV is not manipulated non-experimental: survey studies - Solution - this group of non-exp designs includes & variables can be classified as perceptions/ opinions/ facts
  • search for accurate info about participants, groups, institutions, situation, freq of phenomenon when little is known about the phenomenon!
  • descriptive
  • exploratory
  • comparative Relationship/ differences studies - Solution this group of non-experimental studies deals with correlation; not cause & effect
  • cross-sectional
  • longitudinal
  • retrospective methodological / psychometrics - Solution the theory and development of measurement instruments (surveys & questionnaires) and measurement techniques secondary analysis - Solution type of analysis when a researcher reanalyzes the data from a study (exp or nonexp) for a completely different purpose epidemiological studies - Solution examine factors affecting the health and illness of populations in relation to their environment
  • investigate the distribution, determinants & dynamics of health & disease