Hospital-Acquired Pressure damages

Qualitative Annotated Bibliography

For this assignment you will continue to review current research and provide a critical evaluation on that research through an annotated bibliography. An annotated bibliography is a brief summary and analysis of the journal article reviewed. For more information on annotated bibliographies please visit Purdue’s OWL: Purdue Online Writing Lab

A total of two annotated bibliographies are to be submitted (not to exceed one page each). The articles must come from nursing scholarly literature and may not be older than 5 years since publication. Please note that the articles must be research based and reflect a qualitative methodology (review our reading assignments). Web pages, magazines, textbooks, and other books are not acceptable.

Each annotation must address the following critical elements:

Explanation of the main purpose and scope of the cited work

Brief description of the research conducted

Value and significance of the work (e.g., study’s findings, scope of the research project) as a contribution to the subject under consideration

Possible shortcomings or bias in the work

Conclusions or observations reached by the author

Summary as to why this research lends evidence to support the potential problem identified specific to your role specialization.

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Is Healthcare A Right Or A Privilege?

Imagine that it is late at night and you wake up suddenly, struggling to breathe. You discover immediately that your symptoms are severe—this is not a common cold. Unsure of what to do, you call a loved one who insists on driving you to a hospital emergency room. Assume, for the purposes of this example, that you are a U.S. citizen. While you are registering for emergency services, you notice a sign prominently displayed, declaring that you have the right to medical screening and stabilization in the case of emergency or labor, even if you do not have health insurance. This is a provision of the Emergency Medical Treatment and Active Labor Act (EMTALA), which you explore in more detail in this week’s reading.

You may be surprised to learn that Americans have no legal right to health care, as established through extensive legal precedent. In fact, EMTALA represents the only health care rights guaranteed to Americans.

The United States is one of the only high-income nations that does not guarantee health care as a fundamental right, and it is the only developed nation that has not implemented a system for insuring at least all but the wealthiest segment of its population against healthcare costs. . . . In terms of national constitutions, a 2004 survey reported that some two-thirds of constitutions address health or health care, and that almost all of these do so in universal terms. (Teitelbaum and Wilensky, 2013, p. 108)

However, according to the U.S. Census Bureau (2013), 15% of the U.S. population was uninsured in the years immediately preceding the Patient Protection and Affordable Care Act (PPACA). Therefore, except in specific situations (such as those regulated by EMTALA), 48 million people did not have access to health care. Furthermore, according to the same report, family income was strongly correlated to a family’s access to health care. Whereas 75.1% of families with an annual income less than $25,000 were insured, 92.1% of families earning $75,000 or more per year were insured.

These figures may trouble you from a social perspective, but remember that there are many stakeholders in public health. A patient’s perspective is but one of the many you must consider as a public health professional. In this Discussion, you explore whether health care is a right or a privilege.

Student Tips for Discussions

Academic discussions provide a forum to share insights with your colleagues as you encounter new content. Discussion supports a discovery learning experience that facilitates a deeper understanding of content from multiple viewpoints. To ensure that your contributions to the Discussion posts and responses are timely, relevant, insightful, and engaging, keep the following in mind as you post:

Be sure to review and follow the rubric for Discussion assignments.

Engage in the Discussion as early as possible and continue to post throughout the week.

Design your posts to elicit multiple points of view from your colleagues.

Validate your assertions with references to credible sources.

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Conduct a hypothesis test to examine whether there is a relationship between parent education and child alcohol and tobacco use.

Data for

Exercise

Data Set Description

Monitoring

the future

2013 grade

10.sav

This data set contains variables from the 2013 Monitoring the

Future (MTF) study. These data cover a national sample of 10th

graders with a focus on monitoring substance use and abuse.

Variables for

Exercise

Variable

Name

Description

V1070 A student’s race where 1 = Black, 2 = White, and 3 = Hispanic.

SchoolSkip A count of the number of days a student has skipped school or

classes.

V7253 An ordinal measure asking whether the student has any friends who

have dropped out of school, where 1 = none, 2 = a few, 3 = some,

and 4 = most if not all.

LowParentEdu

c

A three-category summary of both parents’ education where 0 =

both parents have high school diplomas, 1 = one parent has less

than a high school education, 2 = both parents have less than a high

school education.

V7214 An ordinal measure asking students the number of hours they are

home alone after school on a typical day. Responses range from 1 =

0 hours to 6 = 5 or more hours.

SmokeDrink A continuous index measuring the quantity and frequency of

smoking and drinking self- reported by respondents.

1. Are students of different races more likely to skip out on school? Criminologists are interested in this question because school acts as a form of social control; if you’re at school, you won’t have as many chances to engage in crime or interact with the justice system! We can test this question using a one-way ANOVA in SPSS with the variables “SchoolSkip” and “V1070”:

a. First, state the null and research hypotheses for this ANOVA.

b. Second, determine the critical value of F you will need for your results to be significant at p < .01. You will need to calculate your within-group and between-groups degrees of freedom in this case; in this case, n = 10,216 and k = 3.

c. Estimating an ANOVA model in SPSS: Doing this by hand would take weeks, but SPSS does it in seconds. To do this, select analyze->compare means->one-way ANOVA. Place the variable “V1070” in the “factor” slot and “SchoolSkip” in the dependent list:

i. Output provided gives the sum of squares within and between groups, your degrees of freedom, and F statistics. It also provides the p value for your specific F statistic.

d. What is your F statistic? What do you conclude about the null hypothesis in this case?

1. You may have noticed that an ANOVA test on its own isn’t a very precise assessment of our research question. Let’s follow this up by estimating the difference between pairs of means and the strength of the association:

a. Post Hoc Tests in ANOVA: In the one-way ANOVA menu, you will notice an option to “post- hoc” tests. Click that button and select “Tukey,” which will give you an estimation of Tukey’s honest significant difference:

i. The output provided compares one racial category with all the others, providing the statistical significance of each difference. So, for instance, the first row compares Blacks against Whites and shows that the differ- ence between the means for Blacks and Whites is .449 days skipped.

ii. Interpret the remaining differences between racial groups. Are all groups significantly different from one another? Which group means are closest/furthest from one another?

iii. What new information does this test add to our ANOVA interpretation?

b. By using the ANOVA sum of squares output, calculate η2 by hand:

i. What new information does this statistic tell us?

ii. Consider the difference between statistical and substantive significance. Do we have both in this

case?

1. Do students who hangout with individuals who dropout of school also tend to skip out on school themselves? Run a one- way ANOVA test with pairwise comparisons and estimate

η2 (by hand) usingthevariables “V7253” and “SchoolSkip”:

a. Conduct the hypothesis test fully, stating your null hypotheses and identifying test statistics (n = 12,449 and k = 4 in this case). What do you conclude about the null hypothesis?

b. What do the pairwise comparisons in this case tell you? What groups are most prone to

skipping school?

c. What does η2 tell us in this case? What proportion of the variability in school skipping can be explained by one’s peer network?

d. By thinking substantively, what does this tell us about the role of peer networks? Do you think it might relate to other areas of deviant behavior as well?

1. Are kids who have lots of unsupervised time more likely to use alcohol or drugs than other kids? Use the variables “SmokeDrink” and “V7214” to test this hypothesis. Also estimate

pairwise comparisons and η2: a. Conduct the hypothesis test fully, stating your null hypotheses and identifying test statistics

(n = 12,169 and k = 6 in this case). What do you conclude about the relationship?

b. What do the pairwise comparisons in this case tell you? Use an alpha of .001 for this test. Are any groups not statistically different? It may help to visually rank each group against one another in a diagram.

c. What does η2 tell us in this case?

d. Given your results, what are your policy recommendations?

1. Often researchers talk about the importance of socioeconomic status in producing heightened risk for criminal and delinquent activity. The education of a student’s parents is one way to look at this difference. Let’s see whether the variable “LowParentEduc” is associated with higher levels of student smoking and drinking:

a. Conduct a hypothesis test to examine whether there is a relationship between parent education and child alcohol and tobacco use. Fully state your null hypotheses and

identifying test statistics (n = 10,726 and k = 3 in this case). What do you conclude about the relationship?

b. What do the pairwise comparisons in this case tell you? Use an alpha of .001 for this test. Are any groups not statistically different from one another?

c. What does η2 tell us in this case?

d. Take a moment to consider the “why” part of this result; what mechanisms might explain why the results you have found might lead to delinquent behaviors?

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DB Response APA Format To Marie With At Least 2 References

In a perfect world, research studies would be flawless however, that is not typically the case. Inherently, flaws exist related to study design, how the study is conducted, and also the manner in which research is reported. “Given that research is not perfect, users of research must learn to carefully evaluate research reports to determine their worth to practice through critical appraisal” (Melnyk & Fineout-Overholt, 2015, p. 92-93). Factors that need to be assessed when critically appraising quantitative studies include validity, reliability and applicability (Melnyk & Fineout-Overholt, 2015).

  The validity of a study relates to obtaining results from utilizing sound methods which are scientific.  Bias and confounding variables can compromise validity of a study.  Bias can occur at any stage of the process but while assessing the reliability of the results one must look at if the study was systematic, grounded in theory, and criteria was followed for all of the processes.  If so, then the study, more than likely, is valid and reliable.  Clinicians need the ability to interpret the results so they can implement EBP into their practice (LoBiondo-Wood & Haber, 2014).  “Whether we are interpreting the research studies of others, or designing our own, we need a good understanding of research design and an ability to recognize weaknesses in intervention studies which may reduce the reliability of study findings” (Ebbels, 2017, p. 229).      Although each factor is important to quality research, I feel the most important factor is the applicability to practice.  Having the ability to appraise research, which is evidence-based, and implement EBP interventions with our patients is essential in promoting optimal patient outcomes.   

References

Ebbels, S. H. (2017). Intervention research: Appraising study designs, interpreting findings and creating research in clinical practice. International Journal of Speech-Language Pathology, 19(3), 218-231. https://doi.org/https://doi-org.arbor.idm.oclc.org/10.1080/17549507.2016.1276215

LoBiondo-Wood, G., & Haber, J. (2014). Nursing research: Methods and critical appraisal for evidence-based practice (8th ed.). St. Louis, MO: Mosby Elsevier.

Melnyk, B. M., & Fineout-Overholt, E. (2015). Evidence-based practice in nursing & healthcare: A guide to best practice (3rd ed.). Retrieved from Amazon Kindle App

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