Study Guide for Nursing Research: Methods and Critical Appraisal

174 Pages·2013·2.44 MB·English

Study Guide for
Nursing Research:
Methods and Critical Appraisal for
Evidence-Based Practice
8th Edition
Geri LoBiondo-Wood, PhD, RN, FAAN
Professor and Coordinator, PhD in Nursing Program
University of Texas Health Science Center at Houston
School of Nursing
Houston, Texas
Judith Haber, PhD, APRN, BC, FAAN
The Ursula Springer Leadership Professor in Nursing
Associate Dean for Graduate Programs
New York University
College of Nursing
New York, New York
Study Guide prepared by:
Carey A. Berry, MS, BSN, RN
Formerly, Clinical Nurse
Gastrointestinal Surgical Oncology
M.D. Anderson Cancer Center
The University of Texas
Denver, Colorado
Jennifer Yost, PhD, RN
Assistant Professor
School of Nursing, Faculty of Health Sciences
McMaster University
Hamilton, Ontario
Canada

3251 Riverport Lane
St. Louis, Missouri 63043
Study Guide for Nursing Research: Methods and Critical Appraisal for
Evidence-Based Practice, Eighth Edition 978-0-323-22643-1
Copyright © 2014 by Mosby, Inc., an imprint of Elsevier Inc.
Copyright © 2010, 2006, 2003, 1998 by Mosby, Inc., an affiliate of Elsevier Inc.
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Notices
Knowledge and best practice in this field are constantly changing. As new research and experience broaden
our knowledge, changes in practice, treatment and drug therapy may become necessary or appropriate.
Readers are advised to check the most current information provided (i) on procedures featured or (ii) by the
manufacturer of each product to be administered, to verify the recommended dose or formula, the method
and duration of administration, and contraindications. It is the responsibility of the practitioner, relying on
their own experience and knowledge of the patient, to make diagnoses, to determine dosages and the best
treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of
the law, neither the Publisher nor the authors assume any liability for any injury and/or damage to persons
or property arising out of or related to any use of the material contained in this book.
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Introduction
Information bombards us! The student lament used to be, “I can’t find any information on X.” Now the cry
is, “What do I do with all of the information on X?” The focus shifts from finding information to thinking
about how to use and filter information. What information is worth keeping? What should be discarded?
What is useful to clinical practice? What is fluff? Where are the gaps?
Thinking about the links between information and practice is critical to the improvement of the nursing
care we deliver. As each of us strengthens our individual understanding of the links between interventions
and outcomes, we move nursing’s collective practice closer to being truly evidence-based. We can “know”
what intervention works best in what situation.
“Helping people get better safely and efficiently” begins with thinking. Our intent is that the activities in
the Study Guide will help you strengthen your skills in thinking about information found in the literature.
The activities are designed to assist you in evaluating the research you read so you are prepared to under-
take the critical analysis of research studies. As you practice the appraisal skills addressed in this Study
Guide, you will be strengthening your ability to make evidence-based practice decisions grounded in
theory and research.
What an incredible time to be a nurse!
GENERAL DIRECTIONS
1. We recommend that you read the textbook chapter first, then complete the Study Guide activities for
that chapter.
2. Complete each Study Guide chapter in order. The Study Guide is designed so that you build on the
knowledge gained in Chapter 1 to complete the activities in Chapter 2, and so forth. The activities are
designed to give you the opportunity to apply the knowledge learned in the textbook and actually use
this knowledge to solve problems, thereby gaining increased confidence that comes only from working
through each chapter.
3. Follow the specific directions that precede each activity. Be certain that you have the resources needed
to complete the activity before you begin.
4. Take the posttest in each Study Guide chapter after you have completed all of the chapter’s activities.
The answers for the posttest items can be found in the answer key. If you answer 85% of the questions
correctly, be confident that you have grasped the essential material presented in the chapter.
5. Clarify any questions, confusion, or concerns you may have with your instructor.
ACTIVITY ANSWERS ARE IN THE BACK OF THIS BOOK
Answers in a workbook such as this do not follow a formula like answers in a math book. Many times
you are asked to make a judgment about a particular problem. If your judgment differs from that of the
authors, review the criteria that you used to make your decision. Determine if you followed a logical pro-
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iv Introduction
gression of steps to reach your conclusion. If not, rework the activity. If the process you followed appears
logical, and your answer remains different, remember that even experts may disagree on many of the judg-
ment calls in nursing research. There will continue to be many “gray areas.” If you average an 85% agree-
ment with the authors, you can be sure that you are on the right track and should feel very confident about
your level of expertise.
Carey A. Berry, MS, BSN, RN
Jennifer Yost, PhD, RN
Copyright © 2014, 2010, 2003, 1998 by Mosby Inc., an imprint of Elsevier Inc. All rights reserved.
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Contents
PART I OVERVIEW OF RESEARCH AND EVIDENCE-BASED PRACTICE
Chapter 1 Integrating Research, Evidence-Based Practice, and
Quality Improvement Processes..................................................1
Jennifer Yost
Chapter 2 Research Questions, Hypotheses, and Clinical Questions ............................6
Jennifer Yost
Chapter 3 Gathering and Appraising the Literature .........................................14
Jennifer Yost
Chapter 4 Theoretical Frameworks for Research............................................20
Jennifer Yost
PART II PROCESSES AND EVIDENCE RELATED TO QUALITATIVE
RESEARCH
Chapter 5 Introduction to Qualitative Research ............................................24
Jennifer Yost
Chapter 6 Qualitative Approaches to Research .............................................28
Jennifer Yost
Chapter 7 Appraising Qualitative Research ................................................35
Jennifer Yost
PART III PROCESSES AND EVIDENCE RELATED TO QUANTITATIVE
RESEARCH
Chapter 8 Introduction to Quantitative Research ...........................................39
Carey A. Berry
Chapter 9 Experimental and Quasi-Experimental Designs ...................................46
Carey A. Berry
Chapter 10 Nonexperimental Designs......................................................52
Carey A. Berry
Chapter 11 Systematic Reviews and Clinical Practice Guidelines...............................60
Carey A. Berry
Chapter 12 Sampling ....................................................................65
Carey A. Berry
Chapter 13 Legal and Ethical Issues........................................................73
Carey A. Berry
Chapter 14 Data Collection Methods ......................................................80
Carey A. Berry
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vi Contents
Chapter 15 Reliability and Validity.........................................................89
Carey A. Berry
Chapter 16 Data Analysis: Descriptive and Inferential Statistics................................96
Carey A. Berry
Chapter 17 Understanding Research Findings..............................................108
Jennifer Yost
Chapter 18 Appraising Quantitative Research ..............................................111
Jennifer Yost
PART IV APPLICATION OF RESEARCH: EVIDENCE-BASED PRACTICE
Chapter 19 Strategies and Tools for Developing an
Evidence-Based Practice ......................................................115
Jennifer Yost
Chapter 20 Developing an Evidence-Based Practice.........................................123
Jennifer Yost
Chapter 21 Quality Improvement.........................................................129
Carey A. Berry
Answer Key ...........................................................................134
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CHAPTER 1 Integrating Research, Evidence-Based Practice, and Quality Improvement Processes 1
1
Integrating Research, Evidence-Based Practice,
and Quality Improvement Processes
INTRODUCTION
One goal of this chapter is to assist you in reviewing the material presented in Chapter 1 of the
text written by LoBiondo-Wood and Haber. A second and more fundamental goal is to pro-
vide you with an opportunity to begin practicing the role of a critical consumer of research.
Succeeding chapters in this study guide fine-tune your ability to evaluate research studies
critically.
LEARNING OUTCOMES
On completion of this chapter, you should be able to do the following:
(cid:114)(cid:1) (cid:52)(cid:85)(cid:66)(cid:85)(cid:70)(cid:1)(cid:85)(cid:73)(cid:70)(cid:1)(cid:84)(cid:74)(cid:72)(cid:79)(cid:74)(cid:272)(cid:68)(cid:66)(cid:79)(cid:68)(cid:70)(cid:1)(cid:80)(cid:71)(cid:1)(cid:83)(cid:70)(cid:84)(cid:70)(cid:66)(cid:83)(cid:68)(cid:73)(cid:1)(cid:85)(cid:80)(cid:1)(cid:70)(cid:87)(cid:74)(cid:69)(cid:70)(cid:79)(cid:68)(cid:70)(cid:14)(cid:67)(cid:66)(cid:84)(cid:70)(cid:69)(cid:1)(cid:79)(cid:86)(cid:83)(cid:84)(cid:74)(cid:79)(cid:72)(cid:1)(cid:81)(cid:83)(cid:66)(cid:68)(cid:85)(cid:74)(cid:68)(cid:70)(cid:15)
(cid:114)(cid:1) (cid:42)(cid:69)(cid:70)(cid:79)(cid:85)(cid:74)(cid:71)(cid:90)(cid:1)(cid:85)(cid:73)(cid:70)(cid:1)(cid:83)(cid:80)(cid:77)(cid:70)(cid:1)(cid:80)(cid:71)(cid:1)(cid:85)(cid:73)(cid:70)(cid:1)(cid:68)(cid:80)(cid:79)(cid:84)(cid:86)(cid:78)(cid:70)(cid:83)(cid:1)(cid:80)(cid:71)(cid:1)(cid:79)(cid:86)(cid:83)(cid:84)(cid:74)(cid:79)(cid:72)(cid:1)(cid:83)(cid:70)(cid:84)(cid:70)(cid:66)(cid:83)(cid:68)(cid:73)(cid:15)
(cid:114)(cid:1) (cid:37)(cid:70)(cid:272)(cid:79)(cid:70)(cid:1)evidence-based practice.
(cid:114)(cid:1) (cid:37)(cid:74)(cid:84)(cid:68)(cid:86)(cid:84)(cid:84)(cid:1)(cid:70)(cid:87)(cid:74)(cid:69)(cid:70)(cid:79)(cid:68)(cid:70)(cid:14)(cid:67)(cid:66)(cid:84)(cid:70)(cid:69)(cid:1)(cid:69)(cid:70)(cid:68)(cid:74)(cid:84)(cid:74)(cid:80)(cid:79)(cid:1)(cid:78)(cid:66)(cid:76)(cid:74)(cid:79)(cid:72)(cid:15)
(cid:114)(cid:1) (cid:38)(cid:89)(cid:81)(cid:77)(cid:66)(cid:74)(cid:79)(cid:1)(cid:85)(cid:73)(cid:70)(cid:1)(cid:69)(cid:74)(cid:263)(cid:70)(cid:83)(cid:70)(cid:79)(cid:68)(cid:70)(cid:1)(cid:67)(cid:70)(cid:85)(cid:88)(cid:70)(cid:70)(cid:79)(cid:1)(cid:82)(cid:86)(cid:66)(cid:79)(cid:85)(cid:74)(cid:85)(cid:66)(cid:85)(cid:74)(cid:87)(cid:70)(cid:1)(cid:66)(cid:79)(cid:69)(cid:1)(cid:82)(cid:86)(cid:66)(cid:77)(cid:74)(cid:85)(cid:66)(cid:85)(cid:74)(cid:87)(cid:70)(cid:1)(cid:83)(cid:70)(cid:84)(cid:70)(cid:66)(cid:83)(cid:68)(cid:73)(cid:15)
(cid:114)(cid:1) (cid:38)(cid:89)(cid:81)(cid:77)(cid:66)(cid:74)(cid:79)(cid:1)(cid:85)(cid:73)(cid:70)(cid:1)(cid:69)(cid:74)(cid:263)(cid:70)(cid:83)(cid:70)(cid:79)(cid:68)(cid:70)(cid:1)(cid:66)(cid:78)(cid:80)(cid:79)(cid:72)(cid:1)(cid:85)(cid:90)(cid:81)(cid:70)(cid:84)(cid:1)(cid:80)(cid:71)(cid:1)(cid:84)(cid:90)(cid:84)(cid:85)(cid:70)(cid:78)(cid:66)(cid:85)(cid:74)(cid:68)(cid:1)(cid:83)(cid:70)(cid:87)(cid:74)(cid:70)(cid:88)(cid:84)(cid:27)(cid:1)(cid:74)(cid:79)(cid:85)(cid:70)(cid:72)(cid:83)(cid:66)(cid:85)(cid:74)(cid:87)(cid:70)(cid:1)(cid:83)(cid:70)(cid:87)(cid:74)(cid:70)(cid:88)(cid:13)(cid:1)(cid:78)(cid:70)(cid:85)(cid:66)(cid:14)(cid:66)(cid:79)(cid:66)(cid:77)(cid:90)(cid:84)(cid:74)(cid:84)(cid:13)(cid:1)
and meta-synthesis.
(cid:114)(cid:1) (cid:42)(cid:69)(cid:70)(cid:79)(cid:85)(cid:74)(cid:71)(cid:90)(cid:1)(cid:85)(cid:73)(cid:70)(cid:1)(cid:74)(cid:78)(cid:81)(cid:80)(cid:83)(cid:85)(cid:66)(cid:79)(cid:68)(cid:70)(cid:1)(cid:80)(cid:71)(cid:1)(cid:68)(cid:83)(cid:74)(cid:85)(cid:74)(cid:68)(cid:66)(cid:77)(cid:1)(cid:85)(cid:73)(cid:74)(cid:79)(cid:76)(cid:74)(cid:79)(cid:72)(cid:1)(cid:66)(cid:79)(cid:69)(cid:1)(cid:68)(cid:83)(cid:74)(cid:85)(cid:74)(cid:68)(cid:66)(cid:77)(cid:1)(cid:83)(cid:70)(cid:66)(cid:69)(cid:74)(cid:79)(cid:72)(cid:1)(cid:84)(cid:76)(cid:74)(cid:77)(cid:77)(cid:84)(cid:1)(cid:71)(cid:80)(cid:83)(cid:1)(cid:68)(cid:83)(cid:74)(cid:85)(cid:74)(cid:68)(cid:66)(cid:77)(cid:1)(cid:66)(cid:81)(cid:81)(cid:83)(cid:66)(cid:74)(cid:84)(cid:66)(cid:77)(cid:1)(cid:80)(cid:71)(cid:1)
research studies.
(cid:114)(cid:1) (cid:37)(cid:74)(cid:84)(cid:68)(cid:86)(cid:84)(cid:84)(cid:1)(cid:85)(cid:73)(cid:70)(cid:1)(cid:71)(cid:80)(cid:83)(cid:78)(cid:66)(cid:85)(cid:1)(cid:66)(cid:79)(cid:69)(cid:1)(cid:84)(cid:85)(cid:90)(cid:77)(cid:70)(cid:1)(cid:80)(cid:71)(cid:1)(cid:83)(cid:70)(cid:84)(cid:70)(cid:66)(cid:83)(cid:68)(cid:73)(cid:1)(cid:83)(cid:70)(cid:81)(cid:80)(cid:83)(cid:85)(cid:84)(cid:16)(cid:66)(cid:83)(cid:85)(cid:74)(cid:68)(cid:77)(cid:70)(cid:84)(cid:15)
(cid:114)(cid:1) (cid:37)(cid:74)(cid:84)(cid:68)(cid:86)(cid:84)(cid:84)(cid:1)(cid:73)(cid:80)(cid:88)(cid:1)(cid:85)(cid:80)(cid:1)(cid:86)(cid:84)(cid:70)(cid:1)(cid:66)(cid:1)(cid:82)(cid:86)(cid:66)(cid:79)(cid:85)(cid:74)(cid:85)(cid:66)(cid:85)(cid:74)(cid:87)(cid:70)(cid:1)(cid:70)(cid:87)(cid:74)(cid:69)(cid:70)(cid:79)(cid:68)(cid:70)(cid:1)(cid:73)(cid:74)(cid:70)(cid:83)(cid:66)(cid:83)(cid:68)(cid:73)(cid:90)(cid:1)(cid:88)(cid:73)(cid:70)(cid:79)(cid:1)(cid:68)(cid:83)(cid:74)(cid:85)(cid:74)(cid:68)(cid:66)(cid:77)(cid:77)(cid:90)(cid:1)(cid:66)(cid:81)(cid:81)(cid:83)(cid:66)(cid:74)(cid:84)(cid:74)(cid:79)(cid:72)(cid:1)(cid:83)(cid:70)(cid:84)(cid:70)(cid:66)(cid:83)(cid:68)(cid:73)(cid:1)
studies.
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2 CHAPTER 1 Integrating Research, Evidence-Based Practice, and Quality Improvement Processes
Activity 1
(cid:46)(cid:66)(cid:85)(cid:68)(cid:73)(cid:1)(cid:85)(cid:73)(cid:70)(cid:1)(cid:85)(cid:70)(cid:83)(cid:78)(cid:1)(cid:74)(cid:79)(cid:1)(cid:36)(cid:80)(cid:77)(cid:86)(cid:78)(cid:79)(cid:1)(cid:35)(cid:1)(cid:88)(cid:74)(cid:85)(cid:73)(cid:1)(cid:85)(cid:73)(cid:70)(cid:1)(cid:66)(cid:81)(cid:81)(cid:83)(cid:80)(cid:81)(cid:83)(cid:74)(cid:66)(cid:85)(cid:70)(cid:1)(cid:81)(cid:73)(cid:83)(cid:66)(cid:84)(cid:70)(cid:1)(cid:74)(cid:79)(cid:1)(cid:36)(cid:80)(cid:77)(cid:86)(cid:78)(cid:79)(cid:1)(cid:34)(cid:15)(cid:1)(cid:38)(cid:66)(cid:68)(cid:73)(cid:1)(cid:85)(cid:70)(cid:83)(cid:78)(cid:1)(cid:88)(cid:74)(cid:77)(cid:77)(cid:1)(cid:67)(cid:70)(cid:1)(cid:86)(cid:84)(cid:70)(cid:69)(cid:1)
(cid:80)(cid:79)(cid:77)(cid:90)(cid:1)(cid:80)(cid:79)(cid:68)(cid:70)(cid:15)(cid:1)(cid:258)(cid:74)(cid:84)(cid:1)(cid:78)(cid:66)(cid:90)(cid:1)(cid:67)(cid:70)(cid:1)(cid:66)(cid:1)(cid:72)(cid:80)(cid:80)(cid:69)(cid:1)(cid:85)(cid:74)(cid:78)(cid:70)(cid:1)(cid:85)(cid:80)(cid:1)(cid:83)(cid:70)(cid:87)(cid:74)(cid:70)(cid:88)(cid:1)(cid:85)(cid:73)(cid:70)(cid:1)(cid:72)(cid:77)(cid:80)(cid:84)(cid:84)(cid:66)(cid:83)(cid:90)(cid:1)(cid:66)(cid:79)(cid:69)(cid:1)(cid:85)(cid:73)(cid:70)(cid:1)(cid:76)(cid:70)(cid:90)(cid:1)(cid:85)(cid:70)(cid:83)(cid:78)(cid:84)(cid:1)(cid:74)(cid:79)(cid:1)(cid:36)(cid:73)(cid:66)(cid:81)(cid:85)(cid:70)(cid:83)(cid:1)(cid:18)(cid:15)
Column A Column B
1. _____ Systematic investigation about phenomena (cid:66)(cid:15)(cid:1) (cid:36)(cid:83)(cid:74)(cid:85)(cid:74)(cid:82)(cid:86)(cid:70)
b. Meta-analysis
2. _____ Studies conducted to understand the meaning
c. Research
of human experience
d. Qualitative
3. _____ (cid:52)(cid:85)(cid:66)(cid:85)(cid:74)(cid:84)(cid:85)(cid:74)(cid:68)(cid:66)(cid:77)(cid:1)(cid:85)(cid:70)(cid:68)(cid:73)(cid:79)(cid:74)(cid:82)(cid:86)(cid:70)(cid:1)(cid:86)(cid:84)(cid:70)(cid:69)(cid:1)(cid:85)(cid:80)(cid:1)(cid:84)(cid:86)(cid:78)(cid:78)(cid:66)(cid:83)(cid:74)(cid:91)(cid:70)(cid:1)(cid:84)(cid:85)(cid:86)(cid:69)(cid:74)(cid:70)(cid:84)(cid:1) e. Systematic review
in a systematic review (cid:71)(cid:15)(cid:1) (cid:38)(cid:87)(cid:74)(cid:69)(cid:70)(cid:79)(cid:68)(cid:70)(cid:14)(cid:67)(cid:66)(cid:84)(cid:70)(cid:69)(cid:1)
practice
4. _____ Critically evaluates a research report’s content
g. Quantitative
based on a set of criteria to evaluate the
h. Clinical guidelines
scientific merit for application to practice
i. Quality
5. _____ Studies conducted to test relationships, assess improvement
(cid:69)(cid:74)(cid:263)(cid:70)(cid:83)(cid:70)(cid:79)(cid:68)(cid:70)(cid:84)(cid:13)(cid:1)(cid:66)(cid:79)(cid:69)(cid:16)(cid:80)(cid:83)(cid:1)(cid:70)(cid:89)(cid:81)(cid:77)(cid:66)(cid:74)(cid:79)(cid:1)(cid:68)(cid:66)(cid:86)(cid:84)(cid:70)(cid:1)(cid:66)(cid:79)(cid:69)(cid:1)(cid:70)(cid:263)(cid:70)(cid:68)(cid:85)
6. _____ Summary and assessment of a group that
(cid:68)(cid:80)(cid:79)(cid:84)(cid:74)(cid:69)(cid:70)(cid:83)(cid:70)(cid:69)(cid:1)(cid:84)(cid:74)(cid:78)(cid:74)(cid:77)(cid:66)(cid:83)(cid:1)(cid:83)(cid:70)(cid:84)(cid:70)(cid:66)(cid:83)(cid:68)(cid:73)(cid:1)(cid:82)(cid:86)(cid:70)(cid:84)(cid:85)(cid:74)(cid:80)(cid:79)(cid:84)
7. _____ Clinical practice based on the collection,
evaluation, and integration of clinical expertise,
research evidence, and patient preferences
8. _____ Systematically developed statements that
provide recommendations to guide practice
9. _____ Systematic use of data to monitor outcomes of
care
Activity 2
Match the term in Column B with the appropriate phrase in Column A. Terms from Column B
will be used more than once.
Column A Column B
1. _____ Getting a general sense of the material (cid:66)(cid:15)(cid:1) (cid:36)(cid:83)(cid:74)(cid:85)(cid:74)(cid:68)(cid:66)(cid:77)(cid:1)(cid:85)(cid:73)(cid:74)(cid:79)(cid:76)(cid:74)(cid:79)(cid:72)
b. Critical reading
2. _____ Clarifying unfamiliar terms with text
3. _____ (cid:54)(cid:84)(cid:74)(cid:79)(cid:72)(cid:1)(cid:68)(cid:80)(cid:79)(cid:84)(cid:85)(cid:83)(cid:86)(cid:68)(cid:85)(cid:74)(cid:87)(cid:70)(cid:1)(cid:84)(cid:76)(cid:70)(cid:81)(cid:85)(cid:74)(cid:68)(cid:74)(cid:84)(cid:78)
4. _____ Questioning assumptions
5. _____ Rationally examining ideas
6. _____ (cid:258)(cid:74)(cid:79)(cid:76)(cid:74)(cid:79)(cid:72)(cid:1)(cid:66)(cid:67)(cid:80)(cid:86)(cid:85)(cid:1)(cid:90)(cid:80)(cid:86)(cid:83)(cid:1)(cid:80)(cid:88)(cid:79)(cid:1)(cid:85)(cid:73)(cid:74)(cid:79)(cid:76)(cid:74)(cid:79)(cid:72)
7. _____ Allowing assessment of study validity
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