Research Study Guide

Chapter 1 Evidence Based Practice Evidence based practice Is the collection, interpretation, and integration of valid research evidence,
combined with clinical expertise, and an understanding of patient and family values and preferences to inform clinical decision making. Research studies are gathered from the literature and assessed so that decisions about clinical practice can be made. Evidence Hierarchy - Rating sys. for the level of evidence a research article provides (judges the strength of the design) Systematic Review: Summation and Assessment of a group of quantitative studies w/o statistical analysis (No Stats) Meta Analysis: Systematic review that uses statistical analysis It takes multiple studies and puts into one Only one that uses statistics Integrative Review: Review and synthesis of a group of studies No statistical analysis Meta Synthesis: Synthesis of a number of qualitative studies using qualitative methods Research: The systematic, logical, and empirical inquiry into the possible relationships among particular phenomena to produce verifiable knowledge. Provides a scientific knowledge base for nurses that is reliable and useful in practice. Qualitative Research The study of research questions about human experiences (grief, hope etc.), conducted in natural environments, data is in words rather than numerical Quantitative Research Process of testing relationships, differences, and cause and effect interactions among variables, used with hypothesis or research questions, Numeric data are summarized and analyzed using statistics.

***Main difference between quantitative and qualitative research is qualitative seeks to interpret meaning and phenomena whereas quantitative seeks to test a hypothesis or answer research questions using statistical methods***

Chapter 2 Research Questions, Hypotheses, and Clinical Questions

Research: I. Question (aka problem statement) presents the idea that is to be examined in the study and is the foundation of the research study a. Relevant and of interest to the researcher b. Must be measurable (testability) c. Can be declarative (statement) or interrogative (question)

II. Hypothesis attempts to answer the research question III. Question/hypothesis should indicate that practical experience, critical appraisal of the scientific literature, or interest in an untested theory was the basis for the generation of the research idea Variable (anything that varies or properties that differ from each other ex. age, gender, med dosage) 2 types: Independent variable: Has the presumed effect on the DV (changes the dependent variable/outcome) Dependent variable: The consequence or presumed effect that varies with a change in the IV (outcome) Hypothesis (a prediction, intelligent hunch or best guess that help researchers seek a solution or answer a question): 1) Statistical hypothesis (null hypothesis): no relationship between independent and dependent variables 2) 3) Complex hypothesis: when contains more than one independent or dependent variables Research Hypothesis: Directional/Non directional (statement about expected relationship or variables) I. Directional: Specifies expected direction of a relationship (ex. increase or decrease etc.) II. Non directional: indicates a relationship exists but does not specify the direction. Population a well defined set of certain properties Purpose (research question) encompasses the aims or objectives the investigator hopes to achieve with the research, NOT the question to be answered. Theory - Set of interrelated concepts, definitions that present a systematic view of phenomena for the purpose of explaining and making predictions about those phenomena. Clinical Question The first step in development of an evidence based practice project. Purpose: keep practice up to date by searching for, retrieving, and critiquing research articles that apply to practice issues encountered in clinical settings then using the evidence from the research to make the best clinical/health care decisions. (4 components-PICO): Population individual patient or group of pts. with a particular problem Intervention particular aspect of care that is of interest Comparison a comparison of 2 treatments or no treatment Outcome effective outcome (inc./dec.) Through the selection of verbs the purpose statement suggests the manner in which the researcher planned to study the question and level of evidence: Verbs such as discover, explore or describe suggest an investigation of a research question Verbs such as effectiveness or comparison suggests hypothesis in nature (level of evidence has more strength and rigor)

Chapter 3 Literature Review

Literature Review: 1) A systematic review and critical appraisal of the most important literature on the topic, a key step in the research process that provides the basis of a study. 2) The purpose of the literature review in a research study is to present a strong knowledge base to carry out a research study or EBP project, the purpose for the consumer is to review studies to answer a clinical question or to or to solve a clinical problem using the EBP approach. 3) Provides a rationale for the variables and explains concepts, definitions, and relationships between the independent and dependent variables used in the theoretical framework of the study. Concept: An image or symbolic representation of an abstract idea, a major component of theory, conveys the idea within a theory, builds foundation of a study. Theory: Set of interrelated concepts, definitions that present a systematic view of phenomena for the purpose of explaining and making predictions about those phenomena. Conceptual/Theoretical Framework of a research report: A structure of concepts and/or theories pulled together as a map for the study that provides a rationale for the development of a research question or hypothesis.

Conceptual (theoretical literature): includes books about theory, integrative reviews or clinical article. Data based (research literature): empirical, includes both qualitative and quantitative research reports. Primary Sources (essential in lit. review): Research or data based, presentation/development of an original theory, autobiography, author conducts the research his self, articles and books by original author Secondary Sources: Summary of material, critique, analysis of a theory, topic, practice, biography, written by a person other than the individual who developed the theory or research study. Conceptual: Comparable to a dictionary definition Ex. Ambulate - to walk from place to place Operational: Specifies exactly how the concept will be measured Specifies procedures and operations necessary to measure a concept Ex. Ambulate taking 4 steps without assistance

Chapter 4 Qualitative Research

***The study of research questions about human experiences (grief, hope etc.), conducted in natural environments (home, school, etc.) data is in words rather than numerical *** Purposive sample (qualitative studies) researchers are looking for a particular kind of person who can illuminate the phenomenon they want to study. Inclusion criteria - eligibility, attributes of subjects that will represent the variable of interest, characteristics that restricts the population to a homogeneous group Exclusion criteria - delimitations, subjects who do not possess the criteria to participate, characteristics that restricts the population to a homogeneous group of subjects Data Saturation is the point in a qualitative study when the information being shared with the researcher from subjects becomes repetitive (basically no new ideas emerge) Steps in a Qualitative Research Process: 1) 2) 3) 4) 5) 6) 7) 8) Literature Review Review of relevant literature Design Descriptive or naturalistic Sample Purposive sampling using inclusion/exclusion criteria Setting Where recruitment/data collection took place Data collection Data in words (interview, focus group, observation) Data Analysis How raw data was handled and analyzed Findings Break down of results Conclusions Summarization of the results and comparison of findings against existing literature

Chapter 5 Qualitative approaches to Research ***Qualitative research combines the science and art of nursing to enhance the understanding of human health experience*** Phenomenological Method a process of learning and constructing the meaning of human experience through intensive dialogue with persons who are living the experience, goal is to understand the meaning of the experience as it is lived by the participant (the lived experience). Case Study Method Is studying the peculiarities and the commonalities of a specific case includes; quantitative and qualitative data but its focus is on uncovering an individual case. Historical Method A systematic approach for understanding the past through collection, organization, and critical appraisal of facts. Goal is to shed light on the past so it can guide the present and the future. Meta synthesis A type of systematic review applied to qualitative research. It integrates qualitative research findings on a topic and is based on comparative analysis and interpretive synthesis of qualitative research findings that seeks to retain the essence and unique contribution of each study. (Basically provides a way for researchers to build up a critical mass of qualitative research evidence that is relevant to clinical practice. Community-Based Participatory Research is a method that systematically accesses the voice of a community to plan context-appropriate action. CBPR provides an alternative to traditional research approaches that assume a phenomenon may be separated from its context for purposes of study, recognizes importance of involving members of a study population as active and equal participants, in all phases of the research project. Chapter 7 Quantitative Research Design: 1) The framework a researcher creates; research question, purpose, literature review, theoretical framework, and hypothesis, allows the researcher to provide different levels of control, and to avoid bias

2)

Research design purpose in quantitative research provides a. The plan or blue print of a study b. Is the vehicle for testing research questions and hypotheses c. Involves structure and strategy

Control The measures that the researcher uses to hold the conditions of the study uniform and avoid possible impingement of bias on the dependent variable or outcome variable Bias threats to the internal validity of the study Intervention Fidelity (aka Constancy) means that the researcher actively standardized the intervention and planned how to administer intervention to each subject in the same manner under the same conditions Pilot study- small sample study conducted as a prelude to a larger scale study Feasibility: (Must have) Time, Availability of subjects, equipment, money, experience and ethical consideration Intervening, extraneous, or mediating variable: A variable that occurs during a study that affects the dependent variable Constancy (Intervention Fidelity): collection of data from subjects in same way/ sameness of data collection Homogenous (internal consistency): similarity in sample subjects Randomization: Manner in which each subject in the population has an equal chance of being selected Manipulation: A treatment, program or intervention provided to 1st group is different than that of the 2nd group Generalizability The inferences that the data are representative of similar phenomena in a population beyond the studied sample Experimental Group receives the intervention Control Group the variables under study are held at a constant or comparison level, NO manipulation Internal validity: **(Asks is the independent variable or something else that caused a change in the dependent variable)** History- event outside study that affects the subjects/results (ex. Lance Armstrong) Selection- if not random or representative (smoking cessation self selects) Maturation- developmental/bio/social/psych processes that occurs with subjects Testing- effect of taking a pretest on the post test score sensitizes subject to information Mortality- loss of subjects (total or within groups) Instrumentation- change in the instruments or change in data collection

External validity: o **Generalizability of the study (need multiple studies before it can become generalized)** o o Selection effects- subject availability, ability to generalize subjects to other populations Reactive effects- Defined as the subjects responses to knowing their being studied (Hawthorne Effect)

Measurement effects admin. of a pretest affects the generalizability of the findings to other pops.

Chapter 8 Experimental and Quasi Experimental Designs

Design 1) Differs from non experimental in one important way; the researcher actively intervenes to bring about the desired effect and does not passively observe behaviors or actions. 2) Purpose: Determine cause and effect relationships, in nursing practice the concern is with identifying and developing interventions to maintain or improve patient outcomes and base practice on evidence. Experimental: 1) Level 2 evidence 2) Experimental/RCTs test true cause & effect relationships 3) Characteristics of a True Experimental Study: a. Manipulation intervention for at least 1 group b. Control using a control group w/ constants c. Randomization- subjects chosen on random basis 4) Types: I. II. III. Internal threats are most controlled in experimental True- 2 groups, pretest, 1 intervention, both post test After-Only (controls testing)- 2 groups, No pretest, 1 intervention, both post test Solomon-four (controls for multiple issues)- 4 groups, 2 pretest, 2 interventions, all post test

Quasi Experimental: 1) Level 3 evidence 2) Has experimental treatment but is not randomized 3) Cons: not clear on cause and effect threats to internal validity, selection bias, NOT randomized Types: I. Non equivalent- (similar to true design except subjects not chosen randomly) 2 groups, pretest, 1 intervention, both post test (threats to IV are selection, maturation, testing and mortality) II. After-only- 2 groups, No pretest, 1 intervention, both post test (similar to after only true except random subjects) III. One-group only when only one group is available for study, data collected before and after experimental treatment on one group of subjects, there is NO control group and No randomization IV. Time series- studies one group over a long period of time, data is collected multiple times before the introduction of the treatment to establish a baseline point of reference on outcomes. Rules out history effects RCT A research study that uses a true experimental design (aka clinical trial)

Chapter 9 Non Experimental Designs

Non Experimental: 1) Explores relationships or differences among the variables, WITHOUT manipulation of them 2) No control group, No randomization, No manipulation 3) Level IV evidence 4) No causal relationship 5) Examines through: surveys, correlational studies between variables, developmental studies, methodological/psychometric studies 6) Uses secondary analysis, systematic review, meta analysis, and integrative review Uses: When cant manipulate internal validity Looking for associations, differences and relationships

Cons: No intervention cant manipulate not practical

Survey Studies Classified as descriptive, exploratory and comparative, they collect detailed descriptions of existing variables and use the data to justify and assess current conditions and practices or to make plans for improving health care practices. Variables of interest can be opinions, attitudes or facts. Correlational Study An investigator examines the relationship between two or more variables. Tests to see if one variable changes, does a related change occur in the other variable. Tests for positive/negative relationships. Development Study Use a time perspective are concerned with not only existing data but also with changes that result from elapsed time. 3 types: I) Cross sectional Data is collected on only one occasion with the same subjects rather than with the same subjects at several time points. Explores potential relationships between and among variables that are related. II) Longitudinal Data is collected from the same subjects at different points in time. Explores the differences and relationships among variables. (aka: Prospective or Cohort studies) Cons: costly in time, effort and money. III) Retrospective The dependent variable has already been affected by the independent variable and the investigator attempts to link present events to events that occurred in the past. Has a higher level of control (Aka. Ex Post Facto which means after the fact) Methodological Research Is the development and evaluation of data-collection instruments, scales, or techniques Psychometrics Deals with the measurement of a concept/theory (anxiety, QOL)with reliable/valid instruments

Clinical Practice Guidelines Are systematically developed statements or recommendations that serve as a guide for practitioners and assist in linking practice and research.

Secondary Analysis Also is not a design but rather a research method in which the researcher takes a previously collected and analyzed data from one study and reanalyzes the data or a subset of data for a secondary purpose. The original study maybe experimental or non experimental design, and allows for further in depth exploration.

Chapter 10 Sampling **Process of selecting a portion or set of the designated population to represent the entire population in a study** Concepts: Can never test whole population, only tests sample Must have a well defined set of properties (people, objects, events, animals)
Samples: Set of elements that make up the population(element- most basic unit about which info is collected) Characteristics of the population and sample should be congruent Must be representative of the target population Population is a well defined set that has certain specified properties a researcher is interested in Representative Sample -One whose key characteristics closely approximate those of the population Goal: generalizability, bias, representativeness, homogeneity, and balance cost vs. accuracy Target: entire population of interest that researchers would like to make generalizations about (not used) Matching 2 similar comparison sample groups Accessible Population: Portion of population available that meets target population criteria (usually used) Inclusion criteria: (eligibility criteria) attributes of subjects that will represent the variable of interest Exclusion criteria: (delimitations) subjects who do not possess the criteria to participate Snowballing: locates samples that are difficult to locate Probability: Sample chosen using random methods, strongest type of sampling, is representative of population (3 types) Simple random Controlled process, 1) researcher defines the population 2) list all of the units of the pop 3) selects sample. Pros: know all elements from sample, select elements from sample frame, bias, cons: time consuming, dont always know elements Stratified random Requires the pop to be divided into strata or subgroups, pop is homogenous, appropriate number of elements from each subset are randomly selected on the basis of proportion in the pop, Pros: representativeness, helps make group comparisons, Cons: time consuming, costly (contains %) Multistage (clustered) involves random sample of units (clusters) that progress from large to small and meet sample eligibility criteria, Pros- saves time and money, Cons- more errors than simple and stratified sampling Pilot study- small sample study conducted as a prelude to a larger scale study Non probability: elements chosen by non random methods (3 types) Convenience (greatest bias because self selection) subjects are convenient and accessible to researcher, subjects include; volunteers, all people enrolled in program x in Sept., students enrolled in biology at a particular university, Pros: easy to obtain subjects, Cons: bias, generalizability, Quota Sampling sampling in which knowledge about the population of interest is used to build some representativeness into the sample, Identifies the strata of the pop and proportionately

represents the strata in the sample, Quota is NOT random once proportion strata has been identified the researcher enrolls subjects until quota for each stratum is filled Pros: fairly easy, some representativeness, bias (contains %) Purposive (purposely picks) researchers knowledge of the pop is used to hand pick the cases to be included in the sample (Ex. people with a certain genetic disease). Pros: easy, Cons: bias, limited generalizability

Probability Sampling Uses random selection Most likely to provide a representative sample Enables researcher to estimate probability

Non Probability Sampling Elements chosen NOT random No way of estimating probability of being included in sample Produce less representative sample

Chapter 11 Legal and Ethical Issues Ethics: I) The theory or discipline dealing with principles of moral values and moral conduct II) Code of Ethics- To protect patients from harm, has rules and regulations regarding human research subjects to ensure the research is conducted legally and ethically III) Researchers and caregivers of research subjects must take every precaution to protect people being studied from physical or mental harm or discomfort IV) The design of the experiment must be as sound as possible given any ethical constraints V) Benefits must be maximized in magnitude and probability of occurrence VI) The risk of the subjects must be reasonable in relation to the anticipated benefits
Respect for Persons People have the right to self determination and to treatment as autonomous agents, they have the freedom to participate or not participate in research Beneficence Is an obligation to do no harm and maximize possible benefits. Efforts are made to secure their well being Justice Human subjects should be treated fairly and not be denied of benefits Human Rights 1) Right to self-determination respect for persons, freedom of choice, autonomy 2) Right to privacy and dignity respect, person determines time/extent in which private info is shared 3) Right to anonymity and confidentiality subjects identity cannot be linked 4) Right to fair treatment subjects cannot be linked to the info they provide and not be publicly divulged 5) Right to protection from discomfort and harm Promotes good and prevents harm around them Informed Consent Is the legal principle that governs the patients ability to accept or reject individual medical interventions designed to diagnose or treat an illness. A doctrine that determines/ regulates participation in research. I) Title of protocol, Invitation to participate, Basis for subject selection, overall purpose of the study, explanation of procedures, Description of risks and discomforts II) Potential Benefits, Alternatives to participation, Financial obligation, Financial Compensation, Assurance of confidentiality, In case of injury compensation III) Subject withdrawal, Offer to answer questions, Concluding consent statement, Identification of investigators

Risk A potential harm that a reasonable person, in what the investigator knows or should know to be in the subjects position, would be likely to consider injurious (something that can cause injury) a) Physical (ex. venipuncture- pain, infection/ drugs- adverse side effects) b) Psychological (ex. drugs behavior problems/ sensitive survey painful memory) c) Social ( Drug abuse survey social stigmatization) d) Economic (ex. additional diagnostic testing- Increased hospital bill) e) Legal (Criminal activity survey prosecution) Risks must be minimized in magnitude and probability of occurrence, Risk Minimization: Investigator skill- Conducted by qualified investigator that has the highest degree of skill and care g) Prescreening selection of subjects should be equitable h) Subject Compliance subjects can comply (competent) i) Monitoring j) Termination of Protocol The inclusion of vulnerable subjects must be strongly justified; pregnant women, children etc. In therapeutic research risks should be outweighed or balanced by benefits to the subject In Non therapeutic risks should be outweighed or balanced by benefits to the subject or society Chapter 12 Data Collection Methods ***Data collection methods rely on the ability of the researcher to standardize procedures to increase accuracy and reduce measurement error*** Objective Data collected free from personal bias, beliefs, values or attitudes Systematic Data collected in a uniform, consistent standard way from each subject Operational Definition How the researcher will measure each variable Debriefing Informing subjects after being observed allowing the opportunity to refuse to have their data used Existing Data (secondary analysis) can be collected for research purposes/examining a problem by extracting data from medical records or databases using standardized procedures Consistency/Intervention Fidelity data is collected from each subject in exactly the same manner with the same method by carefully trained data collectors Measurement Error Is the difference between what really exists and what is measured by a given study (every study has some amount of measurement error) a) Random Error: Scores vary in a random way, occurs when data collectors do not collect data consistently b) Systematic Error: Scores are incorrect but incorrect in the same direction (ex. scale not calibrated correctly) Observational Methods: (best used to study human behavior) I. Scientific observation Important method for collecting data on how people behave under certain conditions, can take place in different settings a. Unstructured collects descriptive information about the topic of interest 3 types: f)

i. participant observation (researcher participates as part of the group while keeping notes, recording activities, they are also the observers interpretations) ii. field notes (summary of observations, narrative notes intended to paint a picture of situation) iii. anecdotes (summaries of particular observation that focuses on the behavior of interest) b. Structured specify in advance what behaviors or events are to be observed i. Concealment (whether or not subjects know they are being studied) ii. Intervention (whether the observer provokes action from those being observed) Cons: observer biases, ethical issues subjects dont know their being studied, reactivity effect

Continuation of Data Collection Self Report Methods: Requires subjects to respond to interviews or questionnaires useful for collecting data that cannot be observed or measured. I. Interview A data collector asks subjects to respond to a set of open ended or close ended questions. Both quantitative or qualitative used; best used for personal information, may take place; face to face, by phone, or online II. Questionnaires (Scale) Paper and pencil instruments designed to gather data from individuals about knowledge, attitudes, beliefs, and feelings, May be open ended or closed ended, most useful with finite set of questions Cons: a. Social Desirability No way of knowing if subjects are telling the truth b. Respondent Burden Length of questionnaire or interview are too lengthy or difficult, may result in incomplete or flawed answers jeopardizing validity of study Open ended questions Used when the researcher wants the subjects to respond in their own words Close ended questions Structured fixed response items with a fixed number of responses Likert Scale Type Statements in which subjects indicate strongly agree agree disagree / true or false etc. Physiological Measurement The use of specialized equipment to determine the physical and biological status of subjects Used to test intervention effect, improve performance Pros: precision, objectivity Cons: requires specialized knowledge, variable changes (white coat syn)

Physical (weight, temperature)

Chemical (blood glucose level) Microbiological (cultures)

Demographic Data I) Includes information that describes important characteristics about the subjects in a study II) Includes age, gender, race, ethnicity, education, marital status III) This information is important to collect in order for researchers to describe and compare data of the samples

Chapter 13 Reliability and Validity Measurement: 1) Purpose to increase accuracy and decrease error Measurement Error instruments are not foolproof and therefore contain some degree of error. Error variance the extent of variability in test scores that is attributable to error rather than a true measure of the behaviors (Xo = Xt + Xe, o=observed, t= true, e=error) Types of Error Chance/Transient (not consistent) errors that are difficult to control, unsystematic in nature, are the result of a transient state in the subject, instrument, environment (ex. car accident can increase stress in a subject, occurred randomly not consistent) 2) Systematic/Consistent error that is attributable to stable characteristics of the study population that my bias their behavior or cause incorrect instrumentation calibration; includes the subject, instrument, environmental (scale not calibrated/ level of education, SES etc.) Reliability Is the ability of an instrument to measure the attributes of a concept (aka construct) consistently Should provide precision, accuracy, stability, homogeneity over repeated measures. Reliability Coefficient 0-1 the higher the error the lower the score, preferable score of at least .70 Chance/Random Error - Is the extent to which an instrument measures the attributes of a concept accurately Measures of Reliability: I. Stability same results are obtained with repeated measures over a period of time, measures concept consistently over time used with; test/retest, parallel or alternate form II. Homogeneity internally consistent measures the same concept used with; item to total, split half, Kuder-Richardson dichotomous response format yes or no true or false, Chronbach Alpha/Likert

III. Equivalence degree to which different instruments yield the same result, degree to which different investigators with same instrument obtain the same result used with; parallel or alternate form, interrater reliability expressed as % Test retest- is the administration of the same instrument to the same subjects under similar conditions on two or more occasions Parallel or Alternate Form existence of two comparable forms of the same instrument, contains the same type of items based on the same concept but the wording is different (test A/test B) Item to Total measure the relationship between each of the items and the total scale. Cronbachs Alpha measures psychosocial variables and attitudes Split half Reliability involves dividing a scale into two halves and making a comparison Interrator Reliability type of measurement for observed behaviors, 2 or more individuals make an observation or one observer observes behavior on several occasions. Reliability and Validity continued Validity Is the extent to which an instrument measures the attributes of a concept accurately When an instrument is valid, it truly reflects the concept it measures If a tool is not reliable it cannot be valid

Measures of Validity 1) Content Validity Ability of instrument to adequately represent the domain of the concept being tested, provides the framework and basis for developing the items that will adequately represent the content; reviewed by Expert Panel 2) Criterion-Related Validity Extent to which an instrument corresponds to some other observation (the criterion) that accurately measures the concept or phenomenon of interest (2 Types): Concurrent (measures against another valid tool) degree of correlation of one test with scores of another more established instrument of the same concept when both are administered at the same time Predictive degree of correlation between the measure of the concept and some future measure of the same concept (prognosis/outcomes). Ex. tool used on current clinical condition predict future/outcome of pt. 3) Construct Validity extent to which a test measures a theoretical construct (concept) or trait. Validates underlying theory of measurement. Hypothesis testing approach Convergent, Divergent, and Multi trait multi method

Contrasted Groups Factor Analytic Approach

Chapter 14 Data Analysis: Descriptive and Inferential Statistics Descriptive Statistics Organizes, summarizes and describes data by measuring central tendency, variability, and degree of relations.
a. Quantity table, histogram, polygon (frequency of occurrence) b. Central Tendency Mode (most frequent number that occurs in the data) used with all levels, Median (exact middle score)used with interval & ordinal and ratio, Mean (average- add all values then divide by total number of values) used with interval and Ratio Inferential Statistics Procedures that allow researchers to estimate how reliably they can make predictions and generalize findings based on the data. Combines logic and math processes, Tests; Scientific Hypothesis and the Null Hypothesis. Parameter- characteristic of the population, Statistic characteristic of the sample Assesses the probability of the stats found in one group (sample) are the same as the larger group (pop) The use of inferential statistics is based on random sampling Levels of Measurements: 1) Nominal classifies variables or events into categories (are mutually exclusive) used to categorize a sample on gender, marital status, or religion. (allows for the least amount of statistical manipulation) 2) Ordinal shows relative rankings of variables or events (ex. class ranking, level of wellness, edema ranking) 3) Interval shows rankings of events or variables on a scale with equal intervals between the numbers (No absolute zero)ex. temperature where 0 does not indicate the absence of a temperature, test scores 4) Ratio shows rankings of events or variables on scales with equal intervals and absolute zero. The number represents actual amount of the property the object possess. (Highest level of measurement) ex. BP, HR, Wt. etc. Variability Measures asks is the sample similar or different? Range the difference between the highest and lowest scores (simplest but most unstable) Semiquartile Range indicates the range of the middle 50% of the scores (more stable) Percentile represents the percentage of cases a given score exceeds. (median is 50% percentile) Standard Deviation a measure of average deviation of the scores from the mean, based on the concept of the normal curve (most frequently used measure) Scientific Hypothesis is that which the researcher believes will be the outcome of the study. Null Hypothesis which is the hypothesis that actually can be tested by statistical methods, would state that there is no difference between the groups

Probability asks what the chances are of obtaining the same result from a study that can be carried out many times under identical conditions? Statistical probability is based on the concept of sampling error. Type 1 error occurs when a researcher rejects a true null hypothesis or rejects null when they should not Type 2 Error occurs when a researcher accepts null when they should not or accepts a false null hypothesis Variability or dispersion relates to the spread of data to evaluate similarities vs. differences Chi square nonparametric stat. used to determine if frequency in each category differs from what is expectd Non Parametric Statistics are not based on the estimation of population parameter, used with small samples and nominal/ordinal data, does not require assumption or normal distribution. (Used when studies are not made at interval level or variables do not have normal distribution) Parametric Statistics involve estimation of population parameter, require measurement on interval scale, involve assumptions about variables being studied. Assumes a normal distribution, uses Interval / ratio data. Chapter 15 Understanding Research Findings Generalizability - are inferences that the data are representative of similar phenomena in a population beyond the studys sample. Rarely can one study be enough to be generalized.

Chapter 17 Evidence Based Practice Evidence Based Practice Is the conscientious and judicious use of current best evidence in conjunction with clinical expertise and patient values to guide health care decisions Evidence includes; systematic reviews, RCTs, descriptive/qualitative research, case reports, scientific principles Practice should be guided by research evidence in conjunction with clinical expertise and patient values

Chapter 5 Qualitative Research Grounded Theory An inductive approach involving a systematic set of procedures to arrive at a theory about basic social processes Is used to construct theory where no theory exists or in situations where existing theory fails to provide evidence to explain a set of circumstances Appropriate research questions for grounded theory are those that address basic social processes that shape human behavior
Ethnographic Method Focuses on scientific description and interpretation of cultural or social group systems Goal of the ethnographer is to understand the natives view of their world or the emic view o Emic view- insiders view o Etic view outsiders view

Chapter 14 Data Analysis

Level of significance (alpha level) is the probability of making a type 1 error, the probability of rejecting a true null hypothesis. 0.05 signifies the decision to reject the null would be wrong 5 times out of 100 trials. Correlation degree of association between two or more variables

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