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NURS8006 Research Midterm 2025 Exam
Questions with Verified Answers 100% Rated
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What are the components of a PICOt question? P patient population, I intervention, issue of interest, C comparison, O outcome, t time Understand the EBP process of appraising articles to address a PICOt question (ex: assessing quality of study, examining the level of the study) Assessing the quality of the study You do not just take studies at their face value. Evidence should be appraised before clinical action is taken. Critical appraisal may involve several types of assessments, but often focusses mostly on evidence quality. Evidence quality Are findings valid? Study methods sufficiently rigorous that the evidence can be believed? Draw conclusions about body of evidence taken as a whole
Magnitude of effects Are findings clinically important? How powerful are effects? Precision of estimates relevant when evidence is quantitative, how precise the estimate of effect is. Research results provide only an estimate of effects and it may be useful to understand not only the exact estimate but also the range within which the actual effect probably lies. Peripheral effects even is valid, peripheral benefits and cost may guide decisions Financial costs costs of applying evidence; cost of not taking action is equally important Clinical relevance It is important to appraise the evidence in terms of its relevance for the clinical situation at hand. Best practice evidence can most readily be applied to an individual patient in your care if similar to study under review.
Does daily baths with CHG compared to daily baths with soap and water affect rates of CLABSIs? IV: type of bath- CHG or soap & water DV: rates of CLABSIs What are examples of pre-appraised evidence? Pre-appraised evidence- (pre-processed) is evidence that has been selected from primary studies and evaluated together for use by clinicians- more than a literature review- pooling all literature Systematic reviews merges and synthesizes findings from multiple research studies meta-analysis- technique for integrating quantitative research findings statistically metasynthesis similar to meta-analysis but uses qualitative data Clinical practice guidelines distill a body of evidence into a usable form; often based on systematic reviews; statements of specific recommendations based on the best EBP research available- appraises all evidence but doesn't factor in clinical expertise, pt preference and clinical setting. Primary studies
2nd type of evidence- Not already complied into pre-appraised statements or evidence- articles describing primary studies. Heirarchy of Evidence What is the role of the IRB and what types of studies require IRB review? IRB (Institutional Review Board) established formal committees for reviewing research plans; before undertaking a study, researchers must submit a research plan to the IRB, and must also undergo formal IRB training. An IRB can approve the proposed plans, require modifications, or disapprove them. Any study that includes any interaction or intervention with human subjects or involves access to identifiable private information requires IRB approval and review. Describe the informed consent process. What are required components of informed consent? Informed consent- important procedure for safeguarding participants involves obtaining their informed consent. Informed consent means that participants have adequate information about the study, comprehend the information, and have the power of free choice, enabling them to consent to or decline participation voluntarily. It is usually documented by having participants sign a consent form. The form includes information about the study purpose, specific expectations regarding participations (how much time will be required), the voluntary nature of participation, and potential cost and benefits. Implied consent
questions and to withdraw from study; includes freedom from coercion - right to full disclosure- researcher has fully described the study, the person's right to refuse participation, and possible risks and benefits; can have biases Justice
- right to fair treatment- selection of participants should be based on research requirements not on people's vulnerabilities; obligations to those who can't protect their own interests; not to discriminate against those who may benefit from advances in research; must honor all agreements made with participants; must show respect for beliefs and lifestyles of people from different backgrounds; must treat participants courteously and tactfully at all times - right to privacy- research must not be more intrusive than it needs to be and privacy should be maintained; data provided should be confidential (HIPAA) What are vulnerable populations? Vulnerable populations- incapable of giving fully informed consent or may be at high risk of unintended side effects. Children legally and ethically do not have the competence to give informed consent so consent of parent/guardians should be obtained; if child is at least 7 should obtain child's assent as well. Assent- child's affirmative agreement to participate.
Mentally or emotionally detached people disability makes it impossible for them to make informed decisions (cognitive impairment, coma); cannot legally provide informed consent; written consent must be obtained from legal guardians Severely ill or physically disabled people very ill or undergoing certain treatments (mechanical ventilation); may be necessary to assess ability to make reasoned decisions; for certain disabilities special consent procedures may be required (can't read or write) The terminally ill can seldom expect to benefit personally from research; risk/benefit ratio needs to be carefully assessed Institutionalized people- hospitalized/institutionalized people may feel like their care would be jeopardized by failure to cooperate; inmates fall into this category; researchers should emphasize the voluntary nature of participation Pregnant women reflect desire to safeguard both the pregnant woman, who may be at heightened physical or psychological risk, and the fetus, who cannot give informed consent. The regulations stipulate that a pregnant woman cannot be involved in a study unless risks are minimal.
What is the difference between a directional and a non-directional research hypothesis? Directional research hypothesis specifies not only the existence but the expected direction of the relationship between variables Non-directional research hypothesis does not stipulate the direction of the relationship Define the levels of measurement (nominal, ordinal, interval/ratio) and if you are given a study be able to identify which level of measurement each of the variables are. Nominal lowest level, involves using numbers simply to categorize attributes; gender and blood types; numbers used do not have quantitative meaning; provides information only about categorical equivalence; numbers cannot be treated mathematically Ordinal
ranks people based on relative standing on an attribute (completely dependent, needs another person's assistance, needs mechanical assistance, completely independent); does not tell how much greater one level is than another; do not know if being completely independent is twice as good as needing mechanical assistance Interval/ratio interval- occurs when researchers can rank people on an attribute and specify the distance between them; IQ test (score of 140 is higher than 120; ratio- is the highest level; have meaningful zero and provides information about the absolute magnitude of the attribute; temperature, weight Compare and contrast qualitative and quantitative methods. Qualitative descriptive research; narrative; experience; what does it feel like? - Grounded theory- describe and understand the key social and psychological processes - Phenomenology- approach to thinking about life experiences - Ethnography- framework for studying the patterns, lifeways, and experiences of a defined cultural group in a holistic fashion Quantitative Experimental (actively introduce an intervention or treatment; clinical trials) and Non- experimental; numeric; weight, patient satisfaction; measure scores; scale - Experimental research - Non-experimental research - Clinical trials - Observational studies
Experimental design - Control group (experimental or control) - Describing experimental design: R=randomization, X=intervention, O=measure outcome - Posttest- only- randomizing people to different groups and measuring the outcome; no pre-test; don't know for sure if groups were equal in the beginning - Pretest only- more common; randomized into groups 1st; interventions given/not given to groups; measure outcomes - Solomon four group- randomized into 4 groups- pretest on 2 groups and not on 2 groups and measure outcomes of all 4 - Crossover design- randomized into 1 or 2 schemes; get intervention then outcome measured; then alternative intervention; and opposite on other group - Advantages- randomized; optimal design for testing cause and effect relationships - Disadvantages- control vs. practical in life; generalizability; need for randomization of subjects (feasibility, ethically) Be able to describe types of studies using the following terms: correlational vs descriptive; longitudinal vs cross-sectional; retrospective vs prospective Correlational study relationships between variables that cannot be manipulated; correlation does not prove causation - cohort design- higher on pyramid; prospective study; prognosis or etiology; start with cause or exposure and then follow over time to see if outcome is present - case control design- down pyramid a little further; start with outcome and look back at time and see what exposures they had Descriptive observe, describe, and document a phenomenon; don't look at relationship but just describe the phenomenon and why they make up base
Longitudinal good for looking at things that change over time Cross-sectional all at one-time point; easier or less time; don't have to worry about attrition Retrospective (case-control design) an effect (outcome) observed in the present is linked to a potential cause occurring in the past Prospective (cohort design)- start with a presumed cause and then go forward to the presumed effect Describe the types of validity. If you are given a scenario, be able to identify which threat to validity you'd be most concerned about. Be able to provide examples about techniques to control for potential threats to validity. Define Evidence-based Practice Evidence-based practice is the use of the best evidence in making patient care decisions, and such evidence typically comes from research conducted by nurses and other health care professionals- applying new knowledge- problem solving approach. The integration of best evidence, clinical expertise, patient values/preferences and clinical setting. (Not just what does the research say I'm suppose to do)
Diagnosis/assessment What test or assessment procedure will yield accurate diagnoses or assessments of critical patient conditions and outcomes? - For ___ (Population), does ___ (Identifying tool/procedure) yield accurate and appropriate diagnostic/assessment information about ____ (outcome)? - For ___ (Population), does ___ (Identifying tool/procedure) yield more accurate or more appropriate diagnostic/assessment information than ___ (comparative tool/procedure) about ___ (Outcome)? Prognosis Does exposure to a disease or health problem increase the risk of subsequent adverse consequences?-For ____ (Population), does ___ (Exposure to disease or condition) increase the risk of ____ (Outcome)?-For ____ (Population), does ____ (Exposure to disease or condition), relative to ____ (Comparative disease or condition) increase the risk of ____ (Outcome)? Etiology/harm What factors cause or contribute to the risk of a health problem or disease? - In ____ (Population), does ___ (Influence, exposure or characteristic) increase the risk of _____ (Outcome)?-Does ___ (Influence, exposure, or characteristic) increase the risk of (Outcome) compared to ___ (Comparative influence, exposure or condition) in (Population)? Description (prevalence/incidence)
- In ___ (Population), how prevalent is ___ (Outcome)?-Explicit comparisons are not typical, except to compare different populations
Meaning or process What is the meaning of life experiences, and what is the process by which they unfold?-What is it like for ___ (Population) to experience ___ (condition, illness, circumstance)? ) OR What is the process by which ____ (Population) cope with, adapt to, or live with _____(condition, illness, circumstance)? Validity concerns the soundness of the study's evidence; important criterion for evaluating methods to measure variables; the validity question is whether the methods are really measuring the concepts that they purport to measure; another aspect of validity concerns the quality of evidence about the relationship between the independent variable and the dependent variable. Statistical conclusion validity: can statistical tests actually detect true relationships? Statistical power- the capacity to detect true relationships; (can be achieved by having a large enough sample) Attrition- loss of participants over time Internal validity
Nonprobability sampling select elements by nonrandom methods in which every element usually does not have a chance to be included; less likely than probability sampling to produce representative samples; most research samples are nonprobability Convenience sampling selecting most conveniently available people as samples; problem is that people that are readily available might be atypical of the population so it is a risk of bias; weakest form of sampling; most commonly used in many disciplines Quota sampling researches identify population strata and figure out how many people are needed from each stratum; similar to convenience sampling; participants are a convenience sample from each stratum; shares some of the weaknesses of the convenience sample Consecutive sampling involves recruiting all people from an accessible population over a specific time interval, for a specified sample size; all eligible patients admitted over a 6-month period; if sampling period is long it helps with biases Purposive sampling based on the belief that researchers' knowledge about the population can be used to hand-pick sample members; can lead to bias but can be useful when researcher wants a sample of experts.
Probability sampling- involves random selection of elements from a population. Random sampling each element in a population has an equal independent chance of being selected Simple random sampling most basic probability sampling; researchers establish a sampling frame (technical name for the list of population elements); elements in a sampling frame are numbered and then a table of random numbers or an online random sample generator is used to draw a random sample of desired size; samples selected are not subjected to researcher bias; no guarantee of a representative sample but does guarantee that differences between the sample and the population are purely a function of chance. The probability of selecting a markedly atypical sample through random sampling random sampling is low, this probability decreases as the sample size increases. Stratified random sampling the population is first divided into two or more strata, from which elements are randomly selected.; aim is to enhance representativeness; often based on demographic attributes such as age or gender; may not be possible if info on the stratifying variable is unavailable Systematic sampling
