Tag Archives: reading research

Introduction to Introductions!

In a couple of recent blog entries I noted what you can and cannot learn from research 1) titles & 2) abstracts. Now, let me introduce you to the next part of research article:  Introduction (or sometimes called Background or no title at all!).   Introduction immediately follows the abstract.Start

The introduction/background  “[a] outlines the background of the problem or issue being examined, [b] summarizes the existing literature on the subject, and [c] states the research questions, objectives, and possibly hypothesis” (p. 6, Davies & Logan, 2012)

This section follows the abstract. It may or may not have a heading(s) of “Introduction” or “Background” or both.  Like the abstract, the Introduction describes the problem in which the researcher is interested & sometimes the specific research question or hypothesis that will be measured.

In the Intro/Background you will get a more full description of why the problem is a priority for research and what is already known about the problem (i.e., literature writing-handreview).

Key point #1: Articles & research that are reviewed in theIntro/Background should be mostly within the past 5-7 years.  Sometimes included are classic works that may be much older OR sometimes no recent research exists.   If recent articles aren’t used, this should raise some questions in your mind.   You know well that healthcare changes all the time!!  If old studies are used the author should explain.

Key point #2:  The last sentence or two in theIntro/Background is usually the research question or hypothesis (unless the author awards it its own section).  If you need to know the research question/hypothesis right away, you can skip straight to the end of the Intro/background—and there it is!

Critical Thinking: 1) Read the abstract then 2) Read the 1st section of this 2015 free full-text article by Marie Flem Sørbø et al.:  Past and recent abuse is associated with early cessation of breast feeding: results from a large prospective cohort in Norway

  • Is it called Introduction/Background or both?
  • What literature is already available on the problem or issue being examined?
  • What are the research questions/hypotheses?  (After reading above you should know exactly where to look for these now.)

For More Info:  Check out especially Steps #1, #2, & #3 of How to read a research article.

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33,000 foot view isn’t enough! Get down on the Ground To See What’s Really Happening!

My last blog post listed the usual sections of a research report (title, abstract, introduction, methods, results, & discussion/conclusion); and I illustrated the amazing things you can learn from only an article title!Its not enough

This week? Abstracts.   Abstracts are great; abstracts are not enough!

An abstract gives us only enough info to INaccurately apply the study findings to practice.

An abstract typically summarizes all the other sections of the article, such as  the question the researcher wanted to answer, how the researcher collected data to answer it, and what that data showed.  This is great when you are trying to get the general picture, but you should Never assume that the abstract tells you what you need to know.

Wrong WayAbstracts can mislead you IF you do not read the rest of the article.  They are only a short 100-200 words and so they leave out key information.   You may misunderstand study results if you read only the abstract.   An abstract’s 33,000 foot level description of a study, cannot reveal the same things that can be revealed in the up-close & personal description of the full article.

So…what is the takeaway?  Definitely read the abstract to get the general idea.  Then read the full article beginning to end to get the full & beautiful picture of the study.  Davies & Logan (2012) Butterflyencourage us,  Don’t give up reading the full article just because some parts of the study may be hard to understand.  Just read and get what you can, then re-read the difficult-to-understand parts.  Get some help with those PRN.

 

Critical thinking:   What info is missing from the below abstract that you might want to know?

J Nurses Prof Dev. 2016 May-Jun;32(3):130-6. doi: 10.1097/NND.0000000000000227.    Partnering to Promote Evidence-Based Practice in a Community Hospital: Implications for Nursing Professional Development Specialists. Highfield ME1, Collier A, Collins M, Crowley M.

ABSTRACT: Nursing professional development specialists working in community hospitals face significant barriers to evidence-based practice that academic medical centers do not. This article describes 7 years of a multifaceted, service academic partnership in a large, urban, community hospital. The partnership has strengthened the nursing professional development role in promoting evidence-based practice across the scope of practice and serves as a model for others.

More info on abstracts & other components of research articles?  Check out Davies & Logan (2012) Reading Research published by Elsevier.

It was the best of evidence; it was the worst of evidence.

evidencebased practiceEvidence-based practice = best available evidence + expert clinical judgment + patient & family values/preferences.

When clinicians diagnose & treat based on outdated or inadequate knowledge, then outcomes are at best uncertain.  The internet itself is a poor information source; & colleagues may be no more up-to-date that you.

Good sources are the world-wide Cochrane Collaboration and the specific evidence-based Homepractice journals that are beginning to grow–these take best information from the research report all the way through clinical recommendations.   For research reports per se, PubMed is a comprehensive, U.S. tax-supported Findingsdatabase; & there when you find information that fits using your key search terms, you can also look for related articles & get full-text through interlibrary loan or online.  Another strategy is take the article that fits your clinical issue to your librarian, and ask for help in finding more research on the identical clinical issue.

While no one can read everything in the literature, everyone can read something. You can do a focused review on any particular problem.

Critical thinking:  Is there a clinical issue that you think could use a better solution?  Plug related words into PubMed & see what you can learn.question

For more information see fulltext at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC226388/

Strong nursing leadership is essential to evidence-based practice

priority“The Institute of Medicine (IOM) set a goal that, by 2020, the majority of healthcare practices and decisions would be evidence-based.Yet…only three percent of the executive-level nurse leaders surveyed ranked EBNP as a top priority at their own organizations. What’s worse, more than half said EBNP is practiced at their organizations only “somewhat” or “not at all.”  Posted on July 19, 2016HTimothy  at American Sentinel.   

For full text see the source link: http://www.americansentinel.edu/blog/2016/07/19/strong-nursing-leadership-is-essential-to-evidence-based-practice/

Critical Thinking: Given all the demands of the healthcare questionenvironment, how can we make this goal happen.   

Afraid to Relieve Pain? You may have Opiophobia

fear5In pain management are you afraid to give comfort to your patients with appropriate medications?   Are you afraid to be comforted when in pain?  Have you encountered families or care partners, who are afraid to comfort their loved one in pain by giving pain medications?

In a classic 2002 qualitative study, “Fearing to Comfort,” Zerwekh, Riddell, & Richard identified that RNs, physicians, patients, families, and health systems were afraid to relieve pain with appropriate use of pain medications.  They were Not doing evidence-based practice, but fear-based practice. barrier

Fear barriers include, but are not limited to 1) patients’ fear of addiction, fear of distracting the MD from the main treatment plan, and loss of control; 2) MDs’ avoiding the needs of the dying, fear of rewarding drug-seekers, or equating pain management with euthanasia; 3) RNs’ avoiding pain, failing to switch to palliative goals at end of life,  and fear of killing the patient; 4) families’ fears of addiction, side effects, & killing their loved one; and 5) health facilities’ not giving unique consideration to those at end of life, inadequate staffing, & time constraints (Zerwekh et al., 2002).

This is an issue because irrational problems cannot be simply solved by giving rational Pain fistinformation.   We have to find evidence-based practices that can create a change of heart, if you will.  As Zerwekh et al wrote: “Because fear is so influential in decisions to keep pain under control, palliative educational approaches must go beyond providing information to fill deficits in palliative knowledge.”
We must learn evidence-based ways to overcome fear and control pain.  Why?  Because pain interferes with living life.  Who are we protecting when we fear appropriate pain medications?  Not the patient.

FearRemedy?  Palliative care education must confront the fears and remove them through cognitive restructuring that includes learning to question beliefs about addiction etc.  Role playing, role modeling, and an expert walking through this with the provider or family who is afraid.  Beyond this helping people to recognize their own fears of pain & death, and providing the very best available information on pain management (Zerwekh et al).

CRITICAL THINKING:  Have you been afraid?  Or seen others afraid?  How can you solve this problem using evidence-based practice that = BEST available evidence + Clinical judgment + Patient/family preferences & values? Be specific because if you haven’t yet encountered the problem of fearing to comfort, be assured that you will.fear4

FOR MORE INFORMATION:   Read full text Zerwekh et al (2002) online.   It could change your life & the life of those for whom you care!!

Google’s Beauty is Only Skin Deep: Go for the Database!

maxresdefaultGoogle–not to mention yahoo, bing & other web search engines–are mere popularity contests of literature.   Google Scholar is a step up, but it is still a search engine.  It can miss important articles entirely.

If you want to be sure that you are getting the BEST, you gotta look in the right place if you want to find the right articles on the right topic at the right time!Beauty contest winner

You need a Database!

Don’t believe me?  Watch “What are databases and why you need them?”(youtube 2:34)

Reputable publishers give away very few articles for free, so when you want the best literature out there you need a Database that will systematically help you to find quality articles that fit your topic.

PubMed.gov is a tax funded database that is highly comprehensive.  CINAHL is strong on nursing literature.  If you are enrolled in a university, you have access to lots of full-text articles at no added cost.  Check with your librarian if your database search is not turning up what you need–with a few hints, you could get the best.

Needle in haystackFor more info:  Look for that needle in the haystack.

True or False: Experiment or Not

Experiments are the way that we confirm that one thing causes another.   If the study is not an experiment (or combined experiments in a meta-analysis), then the research does not show cause and effect. imagesCALQ0QK9

Experiments are one of the strongest types of research.

So…how can you tell a true experiment from other studies?   Hazel B can tell you in 4:04 and simple language at https://www.youtube.com/watch?v=x2i-MrwdTqI&index=1&list=PL7A7F67C6B94EB97E

Go for it!

[After watching video:  Note that the variable that is controlled by the researcher is call the Independent variable or Cause variable because it creates a change in something else. That something else that changes is the Dependent variable or Outcome variable.]Learning

CRITICAL THINKING:  

  1. Based on the video, can you explain why true experiments are often called randomized controlled trial (RCT)?
  2. Take a look at The Effect of the Physical and Mental Exercises During Hemodialysis on Fatigue: A Controlled Clinical Trial, that is free in full-text via PubMed. How does it meet the criteria of a true experiment as described by Hazel B in the video?

FOR MORE INFORMATION:   Go to “What’s an RCT Anyway?” (https://discoveringyourinnerscientist.wordpress.com/2015/01/23/whats-a-randomized-controlled-trial/ )