exam 1 new

• Factors Affecting Health
• Research


  Process that uses observable and verifiable information (data), collected in a systemic manner, to describe, explain, or predict events
• Goals of research

  • Develop explanations (in theories)
  • Find solutions to problems
• Goals of Nursing Research

  • Improve care of people in clinical setting
  • Study people and the nursing process
  • Education
  • Policy development
  • Ethics
  • Nursing history
  • Develop greater autonomy and strength as a profession
  • Provide evidence-based nursing practice
• National Institute of Nursing Research Goals of Research

  • Build the scientific foundation for clinical practice
  • Prevent disease and disability
  • Manage and eliminate symptoms caused by illness
  • Enhance end-of-life and palliative care
• Quantitative research


  Involves concepts of basic and applied research
• Qualitative research


  • Conducted to gain insight by discovering meanings
  • Based on belief that reality is based on perceptions that differ for each person and change over time
• Basic research


  Designed to generate and refine theory; findings are often not directly useful in practice
• Applied research


  Designed to directly influence or improve clinical practice
• Terms in Quantitative Research

  • Variable
  • Dependent variable
  • Independent variable
  • Hypothesis
  • Data
  • Instruments
• Types of Quantitative Research

  • Descriptive
  • Correlational
  • Quasi-experimental
  • Experimental
• Steps of Quantitative Research

  1. State the research problem

  2. Define purpose of the study

  3. Review related literature

  4. Formulate hypotheses and variables

  5. Select research design

  6. Select population and sample

  7. Collect data

  8. Analyze data

  9. Communicate findings and conclusions
• Qualitative Research Methods


  • Phenomenology
  • Grounded theory
  • Ethnography
  • Historical
• Evaluating the Ethics of Clinical Research Studies

  • Value
  • Scientific validity
  • Fair subject selection
  • Favorable risk–benefit ratio
  • Independent review
  • Informed consent
  • Respect for enrolled subjects
• The basis of phenomenology is the discovery of how people describe their own reality and how their beliefs are related to their actions in a social scene.
• The basis of grounded theory is the discovery of how people describe their own reality and how their beliefs are related to their actions in a social scene.
• Evidence-Based Practice


  • Problem-solving approach to making clinical decisions using the best evidence available
  • Blends both the science and the art of nursing so that the best patient outcomes are achieved
  • May consist of specific nursing interventions or may use guidelines established for the care of patients with certain illnesses, treatments, or surgical procedures
  • The use of EBP mandates the analysis and systematic review of research findings
• Reading and Critiquing a Research Article


  1. Review the elements of the article

  2. Determine the level and quality of the evidence using a scale

  3. Decide if the study is applicable to your practice
• PICOT format


  • P = patient, population, or problem of interest
  • I = intervention of interest
  • C = comparison of interest
  • O = outcome of interest
  • T = time
• Steps in Implementing EBP

  1. Formulate the burning clinical questions

  2. Search for and collect the best evidence

  3. Critically appraise the evidence (validity, reliability, applicability)

  4. Integrate the evidence with clinical expertise and patient/family to make the best clinical decision

  5. Evaluate the outcomes of the practice decision or change based on evidence

  6. Disseminate the outcomes of the EBP decision or change
• Quality Improvement


  • Systematic and continuous actions that lead to measurable improvement in health care services and the health status of targeted patient groups
  • Systems that affect patient access
  • Care provision that is evidence based
  • Support for patient engagement
  • Coordination of care
  • Cultural competence and patient-centered communication
• Health


  A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity
• How the health of the public is measured globally

  • Morbidity—how frequently a disease occurs
  • Mortality—number of deaths resulting from a disease
• Wellness


  An active state of being healthy by living a lifestyle promoting good physical, mental, and emotional health
• Disease


  Medical term, referring to pathologic changes in the structure or function of the body or mind
• Illness


  The unique response of a person to a disease; an abnormal process involving changed level of functioning
• Classifications of Illness

  • Acute Illness
  • Chronic Illness
• Acute Illness


  Generally has a rapid onset of symptoms and lasts only a relatively short time
• Acute Illness


  • appendicitis, pneumonia, diarrhea, common cold
• Chronic Illness


  • Slow onset, sometimes with periods of remission and exacerbation
  • Permanent change or is caused by irreversible alterations in normal state
  • Requires long period of support
• Stages of Illness Behavior

  • Experiencing symptoms
  • Assuming the sick role
  • Assuming a dependent role
  • Achieving recovery and rehabilitation
• A person who defines oneself as sick and self-medicates or visits a doctor is said to be in stage 2 of illness behavior: assuming the sick role.
• Health equity


  Attainment of the highest level of health for all people
• Health disparity


  Particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage
• Factors influencing health disparities

  • Race and ethnicity
  • Poverty
  • Sex
  • Age
  • Mental health
  • Educational level
  • Disabilities
  • Sexual orientation
  • Health insurance
  • Access to health care
• Social determinants of health


  Conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality of life outcomes and risks
• Diversity


  Welcoming individuals of different race, religion, nationality, culture, age, sexual orientation, and identity
• Inclusion


  Giving everyone a sense of purpose and belonging
• Equity


  Ensuring that everyone has access to the conditions they need to thrive
• Vulnerable populations


  Groups that experience health disparities