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Questions and Answers
What is the highest level of evidence in the ranking of evidence?
What differentiates meta-analysis from meta-synthesis?
Who was Florence Nightingale?
The first epidemiological nurse and a pioneer in nursing research.
What is the Nuremberg Code?
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Which of the following is NOT one of the three basic ethical principles in the Belmont Report?
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What occurred during the Tuskegee Experiment?
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What is assent in the context of informed consent?
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What is the role of Institutional Review Boards (IRBs)?
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Which type of theory in nursing research is focused on a limited aspect of reality?
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Which of these options represents the highest level of evidence?
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Meta analysis uses a _____ method to synthesize findings.
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What is the primary focus of meta synthesis?
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The Tuskegee Experiment was conducted with the aim of treating syphilis.
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What are the three basic ethical principles outlined in the Belmont Report?
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What does assent refer to in the context of informed consent?
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Institutional Review Boards (IRBs) are responsible for ensuring ethical standards are met in research.
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What was Florence Nightingale known for in the context of nursing research?
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Match the types of nursing theories with their descriptions:
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What is the main purpose of informed consent?
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Study Notes
Levels of Evidence
- The strongest level of evidence is a meta-analysis of randomized control trials (RCTs)
- The weakest level of evidence is expert opinions.
- The acronym "Most Random Questions Need More Quality Evidence" helps remember the ranking of levels of evidence:
- Meta-analysis of RCTs
- Randomized control trials
- Quasi-experimental
- Non experimental/observational study
- Meta synthesis of qualitative studies
- Qualitative study/descriptive study
- Expert options
Meta-analysis vs. meta-synthesis
- Meta-analysis uses statistical methods to synthesize findings from quantitative research studies on a single topic.
- Meta-synthesis is a synthesis of several qualitative research studies.
Florence Nightingale's Contributions to Nursing Research
- Florence Nightingale was a pioneer in nursing research.
- She was the first nurse to use statistics to support her hypotheses and is known as the first epidemiological nurse.
- She set a standard for optimal patient outcomes.
Nuremberg Code
- The Nuremberg Code defines voluntary consent, legal capacity, sufficient understanding, and enlightened decision-making.
- The code established ethical standards for research following unethical experiments conducted by Nazi Germany on concentration camp members.
Belmont Report
- The Belmont Report outlines three fundamental ethical principles for research involving human subjects:
- Respect for persons: Individuals should be treated autonomously with the freedom to participate or not, and those with reduced autonomy should be protected.
- Beneficence: Research should maximize benefits and minimize harm to participants.
- Justice: The costs and benefits of research should be distributed fairly.
Tuskegee Experiment
- The Tuskegee Experiment, a syphilis study conducted by the US Public Health Service in Alabama from 1932 to 1973, involved two groups of poor Black male sharecroppers.
- One group was left untreated for syphilis, while the other was free of the disease.
- The researchers withheld treatment from the individuals with syphilis to study the untreated disease process.
Principles of Informed Consent
- Informed consent is built on 16 ethical principles of respect and related to self-determination.
Basic Ethical Principles
- Respect for persons: Individuals should be treated autonomously with the freedom to participate or not, and those with reduced autonomy should be protected.
- Beneficence: Research should maximize benefits and minimize harm to participants.
- Justice: The costs and benefits of research should be distributed fairly.
Informed Consent vs. Assent
- Informed consent is provided by an individual who is legally capable of making decisions.
- Assent is given by children between 7 and 18 years old.
- Assent is required in addition to parental permission and should include:
- Information about what the child will be expected to do and what will be done during the research.
- A basic understanding of the research's purpose.
- The ability for the child to express their preference about participation.
Protecting Basic Human Rights: Vulnerable Groups
- Vulnerable groups, those with diminished autonomy, may require extra precautions to protect their rights.
- Consult agencies like the Institutional Review Board (IRB) for the latest federal and state regulations and guidelines regarding research involving vulnerable groups.
Institutional Review Boards (IRBs)
- IRBs review studies to ensure ethical standards are met and the rights of human subjects are protected.
- They are responsible for:
- Protecting subjects from undue risk and loss of personal rights and dignity.
- Assessing the risk/benefit ratio of research.
- Approving, modifying, or disapproving research studies.
Types of Theories in Nursing Research
- Grand nursing theories are also known as conceptual models.
- These theories aim to describe the broader discipline of nursing as a whole.
- An example is Jean Watson's Theory of Caring.
- Middle range theories focus on a limited aspect of reality and contain a limited number of concepts.
- An example is the Theory of Unpleasant Symptoms.
- Situation-specific nursing theories are developed for a specific situation or context.
Levels of Evidence
- A hierarchy of evidence categories, ranked from strongest (level 1) to weakest (level 7) evidence
- Level 1 - Meta-analysis of randomized controlled trials (RCTs)
- Level 2 - Randomized controlled trials (RCTs)
- Level 3 - Quasi-experimental studies
- Level 4 - Non-experimental/observational studies
- Level 5 - Meta-synthesis of qualitative studies
- Level 6 - Qualitative study/descriptive study
- Level 7 - Expert opinions
Meta-analysis vs. Meta-synthesis
- Meta-analysis focuses on a single topic/question, using quantitative methods and statistical analysis to synthesize findings.
- Meta-synthesis is a synthesis of several qualitative studies, involving qualitative methods.
Florence Nightingale’s Contributions to Nursing Research
- First to utilize statistics to support her hypothesis.
- Groundbreaking nurse known for setting the standard for optimal patient outcomes.
- Her work positioned her as a pioneering epidemiologist.
Nuremberg Code
- A set of ethical research guidelines developed after World War II, in response to Nazi human experimentation atrocities.
- Established principles like voluntary participation, legal capacity, and informed consent, which have shaped ethical standards in research.
Belmont Report
- A document outlining the ethical principles for human subject research.
-
Three fundamental principles:
-
Respect for Persons:
- Recognizing individual autonomy (freedom to participate or not)
- Protecting individuals with reduced autonomy
-
Beneficence:
- Maximizing benefits and minimizing harm to participants
-
Justice:
- Ensuring equitable distribution of research benefits and costs.
-
Respect for Persons:
Tuskegee Experiment
- A controversial syphilis study conducted in Alabama from 1932 to 1973.
- Involved two groups of poor black male sharecroppers.
- The untreated group was deliberately left without treatment for syphilis, with the aim of observing the disease's progression.
Informed Consent vs. Assent
- Informed consent is a process where individuals voluntarily agree to participate in research after understanding the potential risks and benefits.
- Assent is obtained from children aged 7-18 years old for research participation.
- Assent requires parental permission and includes explanations about the study, its purpose, and the child's role.
Protecting Basic Human Rights: Vulnerable Groups
- Research involving vulnerable groups, like children, pregnant women, or prisoners, requires extra precautions to ensure their rights are protected.
- Consult with Institutional Review Boards for the most recent guidelines and federal and state regulations.
Institutional Review Boards (IRBs)
- Committees responsible for ethical review of research involving human subjects
- Assess whether ethical standards are met in terms of subject protection, minimizing risk, and maximizing benefits.
- Have the authority to approve research, require modifications or disapprove the study.
Types of Nursing Theories
-
Grand Nursing Theory:
- Also known as conceptual models.
- Broad, overarching theories encompassing the entirety of the nursing discipline.
- Example: Jean Watson's theory of caring.
-
Middle-range Theory:
- Limited number of concepts focusing on a specific aspect of reality.
- Example: Theory of unpleasant symptoms in healthcare.
-
Situation Specific Nursing Theory:
- Narrowly focused, developed for a particular setting or situation.
- Example: A theory on pain management for elderly patients.
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Description
Test your knowledge on the various levels of evidence in nursing research. Explore the differences between meta-analysis and meta-synthesis, and learn about Florence Nightingale's contributions to the field. This quiz will help you understand critical concepts in evidence-based practice.
