Tag Archives: quantitative data

Data, Evidence based nursing, reading research

Does Data Drive you Dotty? Then watch this!

Leave a comment

Does the very idea of looking at data make your eyes cross and set your teeth on edge?EyesCrossed

If so, I have the solution for you!!   And you DO need a solution because Data–>Information–>Best Practices.

You might be surprised that in less than 10 minutes John Hicks at https://www.youtube.com/watch?v=–r9_R60Jws will have you able to describe the basic approach to data.   He gives you 4 key steps & builds from there.HappyFaces

I promise: No eyes glazing over. No getting lost in numbers and calculations. No problem. Don’t worry; be happy.

LearningI can feel it.  Your research reading skills have gone up a notch!  (And for those of you who are masters of data & analysis, enjoy this link for teaching others.)

For more Info: Watch his great follow-up, short, & sweet videos for more on statistics.

CRITICAL THINKING: First watch the video above—click here if you didn’t yet do that. Second outline the 4 steps using the abstract below. Third, answer these questions: Are the data quantitative or qualitative? Are the data are continuous or discrete? Are the data are primary or secondary?

Anjdersson, E.K., Willman, A., Sjostrom-Strand, A. & Borglin, G. (2015). Registered nurses’ descriptions of caring: A phenomenographic interview study. BMC Nursing. doi: 10.1186/s12912-015-0067-9

“Background: Nursing has come a long way since the days of Florence Nightingale and even though no consensus exists it would seem reasonable to assume that caring still remains the inner core, the essence of nursing. In the light of the societal, contextual and political changes that have taken place during the 21st century, it is important to explore whether these might have influenced the essence of nursing. The aim of this study was to describe registered nurses’ conceptions of caring. Methods: A qualitative design with a phenomenographic approach was used. The interviews with twenty-one nurses took place between March and May 2013 and the transcripts were analysed inspired by Marton and Booth’s description of phenomenography. Results: The analysis mirrored four qualitatively different ways of understanding caring from the nurses’ perspective: caring as person-centredness, caring as safeguarding the patient’s best interests, caring as nursing interventions and caring as contextually intertwined.  Conclusion: The most comprehensive feature of the nurses’ collective understanding of caring was their recognition and acknowledgment of the person behind the patient, i.e. person-centredness. However, caring was described as being part of an intricate interplay in the care context, which has impacted on all the described conceptions of caring. Greater emphasis on the care context, i.e. the environment in which caring takes place, are warranted as this could mitigate the possibility that essential care is left unaddressed, thus contributing to better quality of care and safer patient care.” [quoted from http://www.ncbi.nlm.nih.gov/pubmed/25834478]

 

 

experiment, Literature review, quantitative research, RCT, reading research

What’s an RCT anyway?

3 Comments
  • Question: What is a randomized controlled trial (RCT)? And why should I care?
  • Answer: An RCT is one of the strongest types of studies in showing that a drug or a treatment actually improves a symptom or disease. If I have strep throat, I want to know what antibiotic works best in killing the bacteria, & RCTs are one of the best ways to find that answer.

In the simplest kind of RCT, subjects are randomly assigned to 2 groups.  One group gets the treatment in which we are interested, & it is called the experimental group.   The other group gets either no treatment or standard treatment, & it is called the control group.  

Here’s an example from a study to determine whether chewing gum prevents postoperative ileus after laparotomy for benign gynecologic surgery:  A total of 109 patients were randomly assigned to receive chewing gum (n=51) or routine postoperative care (n=58).  Fewer participants assigned to receive chewing gum … experienced postoperative nausea (16 [31.4%] versus 29 [50.0%]; P=0.049) and postoperative ileus (0 vs. 5 [8.6%]; P=0.032).* There were no differences in the need for postoperative antiemetics, episodes of postoperative vomiting, readmissions, repeat surgeries, time to first hunger, time to toleration of clear liquids, time to regular diet, time to first flatus, or time to discharge. Conclusion?  Postop gum chewing is safe & lowers the incidence of nausea and ileus! (Jernigan, Chen, & Sewell, 2014. Retrieve from PubMed abstract)

Do you see the elements of an RCT in above?

Let’s break it down.

  • Randomized means that 109 subjects were randomly divided into 2 or more groups. In above case, 51 subjects ended up in a gum chewing group & 58 were assigned to a routine care, no gum group.  Randomization increases the chance that the groups will be similar in characteristics such as age, gender, etc.   This allows us to assume that different outcomes between groups are caused by gum-chewing, not by differences in group characteristics.
  • Controlled means that 1 of the groups is used as a control group. It is a comparison group, like the no-gum , standard care group above
  • Trial means that it was a study. The researchers were testing (trying) an intervention and measuring the outcomes to see if it worked.  In this case the intervention was gum chewing and the measure outcomes were nausea and ileus.

Why should you care about RCTs?  Because RCTs are strong evidence that an intervention works (or doesn’t) for your patients

Critical Thinking Exercise:   Go to http://www.ncbi.nlm.nih.gov/pubmed   In the blank box at the very top enter a few key words about the problem in which you are interested + RCT.  For example:  music pain + RCT.   Then read 1 or more of the abstracts looking for random assignment (randomized), control group, and whether it was a study (trial).   You’re on your way!    -Dr.H

*Note: You may remember from other blogs that p<.05 means the difference between groups is probably cause by the intervention—in this case gum chewing.

Uncategorized

“It Takes 2 to Tango” (Or to Answer Research Questions)

Leave a comment

It takes 2 people to dance the tango, and 2 types of data to answer research questions.

Researchers answer hypotheses and research questions by collecting and analyzing data.   The collected data often are numbers (AKA quantitative data) that are analyzed with statistical tests.  

In contrast, some researchers may collect word data to answer the research question. The word data are usually subjects’ descriptive answers to open-ended interview questions.   Researchers analyze the word data (AKA qualitative data) by looking for patterns in subjects’ descriptions.

A researcher may also choose to collect and analyze both numbers (quantitative) data AND word (qualitative) data to answer a research question more completely. This is similar to what an RN might do when the RN asks the patient to rate pain from 0 to 10 (number data) and also to describe the character, location, & severity of the pain (word data). You can see that having both types of data can give a more complete picture clinically. The same is true in research.  (Using both quantitative & qualitative data is called mixed methods.)

Many nurses associate research only with numbers data and statistical analysis. Here is an excerpt of how analysis of numbers/quantitative data may look. “The majority of patients were female (58.5%), the mean age was 59.5 years, 53.1% of the patients had cancer, and 55.5% had undergone surgery….The majority of patients (56.6%) reported pain in the abdominal region. The mean duration of pain in patients with chronic pain was 4.8 years (SD =10.8), and for patients with acute pain 5.9 days (SD =5.9).” (de Rond et al, 2000, p.429) Notice the statistical calculation of percents, means (averages), and standard deviations (SD).*

In contrast, sometimes word data and analysis is the only way to answer a research question!   Here is an example of how such qualitative data analysis was used to answer the question of what social processes were blocking the comforting of hospice patients: “Open coding initially generated five [barriers to appropriate opioid use to manage pain among hospice patients]…: within the patient, within the physician, within the family, within the nurse, and within the healthcare system….Two basic psychosocial processes became apparent as the foundation of these barriers: fear and avoidance behaviors.” (Zerwekh et al, 2002, p.85)  Notice that the researchers identified 5 barriers and 2 processes by analyzing nurses’ descriptions.

At other times researchers may collect and analyze BOTH numbers (quantitative) data and word (qualitative) data, as in this excerpt: “[In response to the question of] ‘Who asked me about my pain and how did they do this?’ Seven of the eight children interviewed indicated they had been asked about their pain. …Some children did provide evidence of areas where they felt improvements could be made. One child indicated she would like nurses: to check on me more often (Case 1). However, another child (Case 3) indicated that nurses asked her about her pain too often and that this was particularly annoying if it meant they woke her up.” (Twycross & Finley, 2013, p.3100)   Notice in this mixed methods case that 70% (7 of 10) said they had been asked about pain, and that several gave descriptions suggesting improvements.

 

CRITICAL THINKING: Read this excerpt and identify whether the researcher collected and analyzed quantitative or quantitative data or used mixed methods:“Approximately 82% of all patients received pain medications in the hospital, doctor’s office, outpatient clinic, or surgery center. The most commonly administered medications were morphine (33%) and meperidine (27%) for inpatients and acetaminophen with codeine (23%) and ibuprofen (15%) for outpatients.   Overall, one third of patients requested their first one to two doses of pain medication while in the surgical setting. Of these, 37% were inpatients and 25% were outpatients. After discharge, 76% of all patients received pain medications.” (Source: Apfelbaum, Chen, Mehta, & Gan, 2003, DOI: 10.1213/01.ANE.0000068822.10113.9E)

 

*Standard deviations (SD) are how the data spread out while means (averages) are how the data clump together.