research final 2
Terms
undefined, object
copy deck
- Views on quality depend on ___________of the patients who use treatments
- perspective
-
Qual Res gives us a variety of methods to help us
1)identify patient and provider _________,
2) identify _________to changing practice,
3) Offers ___________to the development of “ contextually grounded, culturally sensitive†res pr -
preferences
obstacles
“unique†contributions -
Qualitative
Historically, qual methods have been views as a way to enhance the quality of __________
Now, qual methods are seen as ends in themselves, providing info to ______________.
Qual res philosophy diff than Quant (_____________)†-
Quant projects
impact treatment process
single objective reality -
________philosophy is one that supports the idea that:
_________meaning and interpretations are what decisions are based upon
It is generative⬦meant to offer __________and explanation -
Qual res
subjective
description -
Indications for Qual Research
*The level of knowledge uncovered in your lit search often establish ________for your study design
*____________for the background of your study may be indicative of the need for qual res
*Qual methods are oft -
rationale
Lack of literature
first steps
exper design
augment or enhance study -
Qual Research Techniques
Three data collection techniques -
Observation
Interviews
Document Review -
Qualitative Res Techniques
Observation is central to _____________
Observe what they do⬦describe and interpret what has been observed
Often ____________ responses are diff than what people actually do⬦ -
understanding behavior
questionnaire or interview -
Observational Methods Vary in distinct ways
1) __________- Participant Observer
2) based on the ____________the researcher is involved
3) conducted with or w/o subj awareness/permission..________
4) may be limited to specific area of -
Classic Fieldwork
length of time
hawthorne eff
inquiry -
Interview
Different interview strategies are avail
__________- Highly structured and directed vs unstructured and non directed
__________, probes for content, recall strategy will effect quality and quantity of information received.
U -
Indiv
Active listening
exploratory
Focus groups
variables -
Qual Research Techniques
_________
Involves organizing and evaluation of a body of existing information for combination with other data; or as a stand alone data source.
____________can range from formal to informal
_________- object -
Document Review
Documents
Formal
Informal -
Qualitative Research
_____________
Qual Research requires constant __________..Field notes and trigger notes are used,
Recording on subjective experiences during data collection also impt
___________means to capture interview or obser -
Data Management
recording
Electronic
Nonverbal and verbal
Transcription -
Qualitative Research
____________
Do not have to have all data collection completed prior to beginning
___________..coding for initial categories and themes
Develop concepts/categories
Sort and re categorize, will have themes ev -
Data Analysis
Segment data
Contextualizing process
Inductive theory -
Qualitative Research
_________is subject of debate in qual research
Strategies:
___________is a safeguard- Multistrategy approach
(Ex. Open ended interviewing WITH observation)
Need to work out issues of logistics and resources< -
Validity
Triangulation
Validity Check
Researchers’ critical appraisal skills
colleagues
Qualitative -
Community Based Participatory Research (CBPR)
An approach to RESEARCH designed to “___________â€.
How? Through the establishment (*and ________) of community partnerships
Not the “___________†clinician researcher coming into the c -
promote community
maintenance
all knowing -
Why does this WORK?
The __________approach creates a well needed “________†between communities and researchers
Incorporates local knowledge and local theory
Culturally relevant measurement design and instrumentation
Partnerships -
partnership
BRIDGE
quality of data
VALIDITY -
CBPR
CBPR is
Designed to be
-____________
-emphasize co-learning/reciprocal transfer of ___________, and ownership of process and product
-ensure and structure ___________ by those being affected
-increase the _______ of -
collaborative
expertise
participation
value
community
methods
SHARE
PHASES -
CBPR PHASES
*Identifying ________
*Assessing _________ strengths, assets and challenges
*Defining __________
*Developing research and _________
*______________data
*______________findings
(Disseminating of findings
-
research questions
community
priorities
data collection methodologies
Collecting and analyzing
Interpreting
community concerns
Transformation of findings into action
community members -
RESEARCH PARADIGMS
____________- Set of basic beliefs about the nature of reality which can be studied and understood.
______________- A single reality on how things work exists to be studied and understood
_______________- single reality -
Paradigm
Positivist and Postpositivist
Positivist
Postpositivist
Objective detachment -
Research Paradogms
CBPR is aligned with ______________(multiple realities, intangible construction and rooted in everyday experience)
_______________– indiv constructions of reality “informed rather than true†and are alterable…
Re -
constructivist research paradigms
Consensus construction
linked -
Common Research Methods
There are basic partnership principles and values that CBPR rely on
*Form and informal __________and structures
*Build and maintain _______
*Agree on values, ________and obj of research
*Balancing _______a -
partnership networks
trust
goals
power
credit -
Clinician is armed with ___________but can’t forget that community members and reps from CBO’s have perspectives that are also useful for inclusion during the research process
CBPR can be infused into any __________. Your text demonstrates its -
intellectual resources
research methodology -
Common Research Methods
AOCD- ____________
It’s purpose-To understand the health status, dynamics and relationships with the community.
To understand the interaction between community members and “_____________†which impede or prom -
Action Oriented Community Diagnosis
broader structures
needs assessment
strengths-based -
CBPR within AOCD
Like ALL methods that adhere to CBPR, AOCD begins with a working collaborative relationship with _________
*Community data review and windshield tour of community
*After tour (and throughout AOCD), researchers document exp -
community members
field notes
fish bowl scenario
action or intervention -
CBPR with in AOCD
More about AOCD
AOCD will rely on a community forum to present to “_________†the findings of a research process
*__________is meant to encourage dialogue
Often emic and etic perspectives are explored and done s -
influential advocates
Forum
qualitative methods
Focus Group
ethnograph -
CBPR
How to get started?
To be able to establish partnerships, values and principals⬦you must ____________first
Networking is essential. Identify _________, investigate issues from various perspectives, build trust
Stakeholders are -
NETWORK
stakeholders
gatekeepers
entry -
How do start a CBPR?
Build _______
They have been “________†before as living laboratories
You, the researcher, may want to put in some volunteer time
Serving on local health coalitions are good ideas too
You build community -
Trust
burnt
association
Relationships
Partnerships -
Things you need to know about Data Analysis
You must make decisions about data analysis ________to data collection
Data analysis planning is part of ____________
Pay careful attention to the type of research being conducted and the type of -
PRIOR
research methodology
understanding data analysis -
Objectives when evaluating data analysis of a research study
Be familiar with the ___________ in the study
Be familiar with the most common __________
Understand the rationale behind the selection of _________
Understand how specific -
types of data produced
statistics
statistical analyses -
What test do I use
The first step in deciding on the type of statistical analysis is determining the ___________
The higher the level of measurement, the ________info that can be ascertained from the data
See figure 9-1 page 121 AND see ha -
level of measurement
more
Nominal
Ordinal
Interval/ratio -
What test do I use?
The second step- Is your data _______________?
* parametric(normal) and non parametric describe the distribution of the ________ or variables. _________ data are always considered to have a normal distribution.
Th -
parametric or non parametric
subjects
Continuous
relationship
number
Relationship -
Statistics
___________- measures of central tendency, measures of variability (range, std dev and std error of the mean)
_____________-Start with the basic, “What is the hypothesis? 1) A relationship or 2) a difference between variables
-
Descriptive
Inferential statistics -
What do we remember about Inferential statistics?
Tools we use to draw ________ about the results (the test of hypothesis)
It is based on the testing of a _____________
___________ testing is key
All the steps of hyp testing are impor -
inferences
null hypothesis
Hypothesis
(est hyp, alpha, test, conclusion, p values)
Chi Square
Epidemiological -
Measures of Association
Can only be used to determine relationship between two continuous (interval or ratio) variables
__________, interpret it and test of significance
____________ techniques also allow for relationships among variables -
Pearson R
Multivariate Regression
prediction -
What do you do next?
After selecting design and data analysis method⬦you run the test
Then you need to report and interpret your results
Results of a study are presented in the _______ of the text, tables, figures and charts
Extensi -
body
graphical
Tables -
Results
One of the more impt parts of the research report.The “_______†of the report
Key ________ must be presented clearly in logical fashion
Author indicates whether the _________ was supported or rejected
Previous sections of -
meat
findings
hypothesis
Facts -
Interpretations and conclusions need to go elsewhere
Opinions need to go elsewhere- Discussion section
_______ section should be neutral in every aspect, free from conclusions
The use of _________ is advised
The ______ part of the res -
Results
Graphs and Charts
shortest
past
present -
Results
For ethical purposes, all _________ should be reported, not just those supporting the hypothesis
Information or description of what was done go in Materials and Methods section and NOT in the Results Section
Do not make the mistak -
key findings
raw
meaning -
Results
How do you start
Begins with description or profile of subjects..include _________
Use #s % and central tendency measures to describe the study sample
After you describe the sample used in study, you need to report the results -
demographics
detail
Descriptive
Experimental (or Quasi) -
Results
Be careful using the word _________.
Significant can mean statistically significant or clinically significant
Only significant if statistics support that judgment
Include ________ for why you chose the statistical procedure, -
significant
rationale
methodology
discussion -
Results
Tables and figures as essential for ________ and brevity..exp when numerical data needs to be presented.
Software programs are great, excel and spss
Don’t start off with topic sentence “Tables 1 presents…â€
Tables usefu -
clarity
correlations
tables and figures -
Results
Variety of choices, line graphs, scatter graphs, histograms, pie charts
_______graphs to show relationships (between to quan variables)
_______and histograms, used to plot freq distributions
Remember the difference in bar grap -
Line
Freq polygons -
Discussion
This is where you state your:
__________
You can have subsections in the discussion paper for _______, conclusions, implications, interpretations, _________ and a closing -
interpretations,
Conclusions and
Opinions
summary
recommendations -
The discussion should center on the importance of the results AND their _________ to patient care, as well as society, education or the profession
The _________ discussion section of a research report covers the following area:
Implications, __ -
APPLICATION
TRADITIONAL
limitations
bias considerations -
Discussion
__________
This is where you explore the meaning of research results
Think critically about the research results and draw/make ____________
Remember, even with out statistical significant findings, there is still meaning to -
Implications
inferences -
Discussion
Implications in a study may point out the ________ values of a finding or the need for replication of the study or ________
Your arguments should be ________ if you are contradicting accepted dogma or theory
Be __________in list -
potential
modifications
rational
conservative
practice and clinical -
Discussion
_____________
Impt bec it gives a picture of the study’s defects or weaknesses
Limitations should be considered in light of the overall ________of the study.
________ in the methodology..such as the sample size limited by -
Limitations
worth
Flaws -
Discussion
Limitations⬦other things to discuss
Discuss the _________ if the sample selection
Can the data be generalized to the entire population
Discussion of errors in data _______
The level of data quality
Any interveni -
randomness
entry
hawthorne effect -
Discussion
___________
To avoid bias, make sure you write out your hyp before hand
Maintain your ___________
Concentrate on the process and methodology of the study
If the process is sound, results will be sound
Be careful -
Bias Consideration
objectivity
attention
double blind -
Discussion
_________
States your ideas on what future research is needed based on the outcomes of the current study
New data collection technique? New instrument, larger sample, etc
Purpose is to alert the reader that more?s need to b -
Recommendations
obscure
****
1.relevance,
2.clarity and
3.brevity -
__________
Last section of the paper
It is brief
Begins with brief restatement of the aim of the study and major res ?s
Then state the major ________ of the study (bullets or numbers to separate each)
Point out same findings as o -
Conclusions
findings
closing abstract -
Bibli and Ref
Most places have a technical style manual requirement for papers
Publishers require manuscripts that follow a style, found under “________â€
APA, MLA and CHI (Chicago Manual of Style)
Differences between these styles -
information for authors
AMA
APA
MLA
Chicago -
Bibli and Ref
Buy the manual or an abridged handbook
The ______ Handbook
The ______ Writers Handbook
Adv are compact and handy
Disadv limited _____ and amount of info limited
There are lots of different writing style manual -
Brief Holt
Thesis
scope -
Documenting Sources Using Ref and Bibli
Since much of the info gleaned in a lit search uses backgrd materials representing other people’s work, you must ________
Whether direct quote or paraphrased, you must ______
If it is not ________ -
cite it and give credit.
document
general
footnote or endnotes
end -
________
End notes and footnotes seem to be giving way to the bibliographic format in many scientific writings
All works used as ________ material in the construction of the paper need to be properly documented
The bibliography (also refer -
Bibliographies
reference
alphabetically -
Text mentions two variations of bibli 1) _______(authors comments to be appended to any of the entries in the list) and 2_ ______entries by source, primary, secondary, published and unpublished ..
Remember, ________ sources are those which are origi -
Annotated
Grouping
Primary
critical
article,case studies or books -
General bibliographies are available, such as ________- can be a starting place to locate other sources of info. Not a good tool for graduate work and above (too generic written for layman)
_________ direct reader to more in-depth sources in particu -
Books in Print and the Bibliographic Index
Index Medicus -
Material in _______ domain can be used without permission, but should be acknowledged as a source..PD- Material that has not been copyrighted or for which the copy right has expired.
Public Domain works are those “Creative works that are _________ -
public
not protected by copyright and may be freely used by anyone
fair use -
The __________ Act is a comprehensive law that deals with the legalities of using copyrighted material. Material may be used without permission of the holder for certain specific uses. These uses are referred to collectively as fair use. ⬦
$______ -
1976 Copyright
$150,000 -
Evaluating Sources
Remember, its not quantity but _______
Is your source authorative? Credible author
Current trends or theories? Don’t forget _________
Where and when was article published? Peer reviewed?
Prestigious Journals? -
quality
classic works
original -
________– a discipline which seeks to understand the moral duties and obligations that associate with any action
Ethics in medicine a factor- _____ medical experiments
Do no Harm
Respect Human Rights
Have you thought about what it m -
Ethics
WW II
affective dimension
intellectual rigor
moral -
The values that surface as impt to researchers are: ________, ________, ________, altruism, respect, prudence, justice, equality, and fidelity⬦intra or interpersonal aspects of personal functioning..
Other good values that shape good practice, pag -
Honesty
beneficence
intergrity
Affective -
Research Ethics
Ultimately, the goal of ethics in research is to ensure that no one is _________ from research activities.
As research is designed, several ethical considerations must be balanced:
Protect the ______ of the participant or -
harmed or suffers adverse consequences
rights
sponsor -
Ethical Principles
Three Ethical Principles Guide Research with Human Participants
There are MORE we will discuss, p 177 -
1) Respect for Persons
2) Beneficence
3) Justice -
Respect for Persons
Requires investigators to obtain _________ from research participants, to protect participants with impaired decision making capacity, and to maintain confidentiality
Research participants are not passive sources of data, bu - informed consent
-
___________
Requires that the research design be scientifically sound and that the risks of research be acceptable in relation to the likely benefits
Risks to participants include (not only physical harm from tests or treatments) but also _____ -
Beneficence
psychosocial
confidentiality -
____________
Requires that the benefits and burdens of research be distributed fairly
Requires equitable access to the benefits of research
_________ populations, such as people with poor access to health care, those with impaired decision -
Justice
Vulnerable -
So what is the problem?
Historically, Clinical Research has been thought of as ________and potential subjects have been thought of as “_________†needing protection…
Now, it is regarded as providing access to potentially life saving new t -
risky
guniea pigs
PROTECTION -
Obligations of the Client
Protect rights of ____________ of the subjects
Follow medical ethics in their relationship with the researcher
Provide full information to the researcher about the objectives or problems to be studied
Encour -
confidentiality
truth
misrepresent -
Affect vs Cognition
Science demands affect and cognition from its ________⬦often in equal measures.
Examples of situations that may involve value conflicts are endless.
Lets go over some of the scenarios we MIGHT encounter⬦.Page 176 - practioners
-
Federal Regulations for Research on Human Subjects
_________ regulations are intended to ensure that clinical research is conducted in an ethically acceptable manner
Federal regulations provide 2 main protections for human subjects, _________an -
Federal
IRB approval
informed consent -
Federal guidelines distinguish ________(that to contribute to generalizable knowledge) from unproven clinical care that is directed toward benefiting the individual patient and not toward publication
Research is also distinguished from ______ that w -
research
program evaluation -
IRB
Fed regulations require that research on _______subjects be approved by an IRB. IRB systems are decentralized
The IRB mission is to “ensure that the research is _________ and that the welfare and rights of research participants are ______ -
human
ethically acceptable
protected -
Ok, but what does the IRB actually Do?
It has the authority to approve (or deny) research study and the IRB must determine the following for EACH study
1) ______ to participants are minimized
2) Risks are reasonable in relation to anticipa -
Risks
benefits
participants
Informed consent
Confidentiality -
The Cons of IRB
Some criticize them for focusing too much on ________, like consent forms rather tha research design
A common criticism is that the fail to scrutinize the research design and review of scientific merit is usually beyond the expe -
procedure
funding agency
research participants -
Character? Does it have its place in Medicine?
Many feel that it is ultimately about the judgment and character of the _________(researchers) which is the most essential element for ensuring that the research is ethically acceptable.
WHAT DO Y - investigator
-
Exceptions to the IRB Review
What Research is EXEMPT from IRB Review
(See pg 191)
What is __________? There is a list of types of research that are eligible for expedited review (review by a ________ rather then the full committee) p -
expedited review
single reviewer -
Obligations of the Researcher
Protect the ___________of the subjects and client
Provide subjects informed choice to participate (________)
Follow medical ________ in their relationship with the client
Do not appropriate ideas from oth -
rights of confidentiality
INFORMED CONSENT
ethics -
Scientific Misconduct- Other Responsibilities of the Researcher
There are many levels of __________ and many behaviors considered worthy of this labels (ie. Enrolling ineligible patients in clinical trials, making up research data, altering research -
misconduct
fabrication, falsification -
SCIENTIFIC MISCONDUCT
__________- MAKING UP RESULTS AND RECORDING OR REPORTING THEM
_________- MANIPULATING RESSEARCH MATERIALS, EQUIPMENT OR PROCEDURES OR CHANING OR OMITTING DATA OR RESULTS SO THAT THE RESEARCH RECORD MISREPRESENTS THE ACTUAL -
FABRICATION
FALSIFICATION
PLAGIARISM -
Conflicts of interest
RESEARCHERS MAY HAVE CONFLICTING INTERESTS THAT MIGHT IMPAIR THEIR ___________
Some potential types of conflict of interest are:
1) ________for clinician-investigators
2) ________conflicts of interest
Resear -
OBJECTIVITY AND UNDERMINE PUBLIC TRUST IN RESEARCH
Dual roles
Financial -
Deception is sometimes used in research. It is allowed if the information is critical, and there is no other way to gather the necessary data.
If deception is used,
1. The researcher must ensure that _________will result from the deception, an -
no physical danger or psychological harm
concealment or deception -
Informed Consent
Researchers must disclose information that will be relevant to the potential participant’s decision about whether or not to participate
Some crucial questions are?
Why is the research being done?
What will participa - minimal risk
-
Minimal risk?
Plays a key role in _________
Minimal Risk is defined as that “__________†encountered in daily life or during the performance of routine physical or psychological tests.
The ________ and probability of risk must be consi -
federal regulations
ordinarily
magnitude -
Informed Consent
You must address these areas with potential participants
1) The _______ of the research project
2) The ________ of the study
3) The _______and potential benefits of the study⬦and the alternatives to participating in -
nature
procedures
risks
confidentiality
voluntary -
Vulnerable Populations
The following should be subjected to additional scrutiny
1) ________
2) Prisoners
3) _________, fetuses and embryos
4) People with impaired decision making capacity -
Children
Pregnant women - Obligation of the Respondent
- Honesty