Elementos nucleares para la elaboración de un proyecto de investigación con metodología cuantitativa / Nuclear elements for drafting a research project with quantitative methodology

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Protocolo de enfermagem no implante de valva aórtica transcateter: um direcionamento para o cuidado / Nursing protocol in transcatheter aortic valve implantation: care guideline

Objective: To validate a nursing care protocol by specialist nurses, contributing to the care delivered to patients undergoing percutaneous valve replacement. Methods: This cross-sectional, prospective, quantitative study adopted the Content Validity Index (CVI) to verify level of agreement regarding this protocol's total set of items. Results: The CVI obtained for each item of the protocol, verified using a validation instrument, was greater than the minimum required that is 0.80, on average. Conclusion: The development of a protocol intended to guide care provided to patients who have undergone TAVI, improves patient safety and minimizes health problems, so that the implementation of specific strategies for the development of actions performed by nurses is essential.

Objetivo: Validar un protocolo de cuidados de enfermería por enfermeros especialistas, contribuyendo para la práctica asistencial del paciente sometido al cambio de válvula percutánea. Métodos: Se trata de un estudio metodológico, transversal y prospectivo, con abordaje cuantitativo, que empleó el Índice de Validez de Contenido (CVI) para verificar el nivel de concordancia en el conjunto total de ítems del instrumento del protocolo. Resultados: Después de la verificación con el CVI para cada ítem del instrumento de validación del protocolo, los valores obtenidos en relación a todos los ítems del protocolo, quedaron con los valores, en media, mayores que el mínimo para el CVI, que es arriba de 0,80. Conclusión: El desarrollo de un protocolo de cuidados dirigido para los pacientes sometidos a TAVI, posibilita el aumento de la seguridad del paciente minimiza los daños a la salud, siendo un factor esencial en la implementación de estrategias específicas para el desarrollo de acciones desempeñadas por el enfermero.

Objetivo: Validar um protocolo de cuidados de enfermagem realizado por enfermeiros especialistas, contribuindo para a prática assistencial do paciente submetido à troca valvar percutânea. Métodos: Trata-se de um estudo metodológico, transversal e prospectivo, com abordagem quantitativa, que empregou o Índice de Validade de Conteúdo (IVC) para verificar o nível de concordância no conjunto total de itens do instrumento do protocolo. Resultados: Após a verificação com o IVC, para cada item do instrumento de validação do protocolo, os valores obtidos em relação a todos os itens ficaram, em média, maiores que o mínimo para o IVC, que é acima de 0,80. Conclusão: O desenvolvimento de um protocolo de cuidados, voltado para os pacientes submetidos ao TAVI, possibilita o aumento da segurança destes e minimização dos agravos à saúde, sendo um fator essencial na implementação de estratégias específicas nas ações desempenhadas pelo enfermeiro.

Investigación colombiana en enfermería. Un análisis bibliométrico de su visibilidad en ISI WoS (2001-2013) / Colombian nursing research. A bibliometric analysis of the visibility in ISI WoS (2001-2013)

Objetivo: Evaluar el comportamiento de la actividad científica colombiana en enfermería visible en ISI WoS en el período 2001-2013 para conocer tendencias y regularidades. Métodos: Se emplea el método descriptivo, transversal y retrospectivo de utilidad en los análisis bibliométricos. La búsqueda se realizó utilizando los descriptores Nursing y Colombia con lo cual se obtienen 133 registros. Luego de un proceso de normalización, se examinaron 118 documentos publicados por 526 autores para estudiar la productividad de variables como autores, instituciones, descriptores y revistas, así como la distribución temporal y las redes de colaboración de autores, descriptores y la co-citación de autores y documentos. Resultados: Se visualiza un decrecimiento en la producción anual de documentos, similar a las citas recibidas por año. El español como principal idioma de publicación de las contribuciones, donde el 40% de la producción científica está publicada en la Revista Aquichán y un 62.4% en universidades del país con enfoque a publicar sobre temas de cuidados en enfermería. Por medio del método de análisis de Redes Sociales se obtienen matrices de colaboración y co-citación las cuales permiten concluir la existencia de pocos autores altamente citados, la no presencia de relaciones fuertes de colaboración y diversidad de términos relacionados con áreas clínicas, administrativas y sociales de la enfermería. Conclusiones: La actividad científica presenta un aumento en la cantidad de documentos y citas anuales, aspecto que ha llevado a ganar en visibilidad y reconocimiento en la comunidad científica internacional, aspecto que se percibe en los indicadores obtenidos en la investigación (AU)

Objective: Evaluate the performance of the Colombian scientific activity in nursing, visible at ISI WoS in the period 2001-2013 for know trends and regularities. Methods: A descriptive, cross-sectional and retrospective utility method is used in bibliometric analysis. The search was performed using Nursing and Colombia as descriptors, with which were obtained 133 records. After a normalization process, 118 documents published by 526 authors were reviewed to study the productivity variables as authors, institutions, descriptors and magazines as well as the timing distribución and collaborative networks of authors, descriptors and co-citation of authors and documents. Results: Displays a decrease in the annual production of documents, similar to the citations received per year. Spanish, as their primary language of publication of contributions, where 40% of the scientific production is published in the Journal Aquichán and 62.4% in universities of the country focusing on publishing issues in nursing care. Through the method of analysis of social networks are obtained matrices of collaboration and co-citation which allow us to conclude the existence of few highly cited authors, non-presence of strong collaborative relationships and diversity of terms related to clinical, administrative and social areas of nursing. Conclusions: The scientific activity has increased the amount of documents and annual quotes, aspect that has been gaining visibility and recognition in the international scientific community, aspect perceived at the indicators obtained in the investigation (AU)

The concept of research utilization as understood by Swedish nurses: demarcations of instrumental, conceptual, and persuasive research utilization.

BACKGROUND AND AIMS: The literature implies research utilization (RU) to be a multifaceted and complex phenomenon, difficult to trace in clinical practice. A deeper understanding of the concept of RU in a nursing context is needed, in particular, for the development of instruments for measuring nurses' RU, which could facilitate the evaluation of interventions to support the implementation of evidence-based practice. In this paper, we explored nurses' demarcation of instrumental RU (IRU), conceptual RU (CRU), and persuasive RU (PRU) using an item pool proposed to measure IRU, CRU, and PRU. METHODS: The item pool (12 items) was presented to two samples: one of practicing registered nurses (n = 890) in Sweden 4 years after graduating and one of recognized content experts (n = 7). Correlation analyses and content validity index (CVI) calculations were used together with qualitative content analysis, in a mixed methods design. FINDINGS: According to the item and factor analyses, CRU and PRU could not be distinguished, whereas IRU could. Analyses also revealed problems in linking the CRU items to the external criteria. The CVIs, however, showed excellent or good results for the IRU, CRU, and PRU items as well as at the scale level. The qualitative data indicated that IRU was the least problematic for the experts to categorize, whereas CRU and PRU were harder to demarcate. CONCLUSIONS: Our findings illustrate a difficulty in explicitly demarcating between CRU and PRU in clinical nursing. We suggest this overlap is related to conceptual incoherence, indicating a need for further studies. The findings constitute new knowledge about the RU concepts in a clinical nursing context, and highlight differences in how the concepts can be understood by RNs in clinical practice and experts within the field. We suggest that the findings are useful for defining RU in nursing and further development of measures of RU.

[How to quantify the qualitative aspects of nursing outcomes classification scales with psychosociocultural indicators]. / Cómo cuantificar los aspectos cualitativos en escalas de clasificación de resultados NOC para etiquetas psico-socioculturales.

Working necessarily with Likert scales to measure Nursing Outcomes Classification (NOC) outcomes has the advantage of unification, but also presents difficulty in reducing the rating from 1 to 5, especially when the research is qualitative and thus includes the use of words and expressions, as well as observations and perceptions. What exactly does a score of 2 or 3 mean with regard to the NOC Health beliefs? In this paper, we make a number of different proposals for operationalizing concepts and transforming them to numbers; however, it should be noted that such proposals always end in a quantitative analysis. Thus, we propose the use of emic/etic qualitative observations for psychosocial and cultural indicators, following ethnographic principles. Basic and applied research on nursing languages must have correct methodological foundations and seek to satisfy the same criteria of methodological suitability as any other research.

Towards better measures of research utilization: a collaborative study in Canada and Sweden.

AIMS: This paper is a report of a study examining research utilization in nursing. The specific aims were to (1) clarify the construct of research utilization, and (2) identify observable indicators of research utilization. BACKGROUND: Robust measures of research utilization do not exist despite steadily increasing numbers of studies in the field. One reason for this is theoretical confusion surrounding the central concepts in the field. METHOD: A qualitative (focus group) design was used to explore the construct of research utilization in two countries: Canada and Sweden. A systematic and sequential (three phases) approach to expert sampling framed the study. Phase 1 consisted of initial construct clarification by the research team (2005). In Phase 2, a face-to-face meeting with a panel of international research utilization nursing experts was held (2005). Phase 3 consisted of a series of focus groups with nursing care (direct and non-direct) providers (2005-2007). Data were analysed using content analysis. FINDINGS: The nursing care providers did not commonly use the term 'research utilization'. Several examples of research utilization were provided; a majority of these examples related to instrumental research utilization and became increasingly concrete as one moved from non-direct to direct care participants. Participants identified several indicators of research utilization (instrumental and conceptual). From these indicators, a measurement schematic was derived. CONCLUSIONS: The construct of research utilization is multi-faceted. Several indicators of research utilization were identified, which can be used to augment existing or develop a new and improved measure that taps both instrumental and conceptual use.

La enfermera asistencial y la investigación / The welfare nurses and the research work

Objetivos: averiguar el nivel de conocimientos básicos sobre investigacióny grado de interés e implicación de las enfermeras en nuestro centro.• Metodología: estudio descriptivo transversal en una muestra de enfermerasasistenciales, mediante cuestionario autoadministrado en elque se consignaron: datos personales, conocimientos sobre investigaciónen el ámbito laboral, participación y grado de implicación en proyectose interés formativo en investigación.• Resultados: se cumplimentaron 110 de 240 encuestas, siendo56,6% mujeres y 43,4% hombres. Se declaró un pequeño porcentajecon conocimiento sobre metodología de investigación (12,5%), perohubo un alto acuerdo (más del 86%) sobre la necesidad, utilidad e interésde la investigación enfermera. Se conocía en general cómo obtenerasesoramiento para investigar. El 91,6% investigaría en un proyectoque le interesara. Entre los temas propuestos para formarse destacaronla búsqueda bibliográfica y cómo publicar. Como temas interesantespara investigar resaltaron la formación en Enfermería,panificación de cuidados y registros y documentación enfermera.• Conclusiones: una gran mayoría reconoce la importancia de la investigaciónenfermera, lo que mantiene la esperanza en progresar en estavía de desarrollo profesional. Conocer el estado actual del “espíritu investigador”de nuestro centro permitirá elaborar estrategias que mejorensu proceso y aumente la calidad de los trabajos que ya se realizan,proponiéndose un liderazgo mixto como sistema más apropiado

Development of cultural belief scales for mammography screening.

PURPOSE/OBJECTIVES: To develop instruments to measure culturally related variables that may influence mammography screening behaviors in African American women. DESIGN: Instrumentation methodology. SETTING: Community organizations and public housing in the Indianapolis, IN, area. SAMPLE: 111 African American women with a mean age of 60.2 years and 64 Caucasian women with a mean age of 60 years. METHODS: After item development, scales were administered. Data were analyzed by factor analysis, item analysis via internal consistency reliability using Cronbach's alpha, and independent t tests and logistic regression analysis to test theoretical relationships. MAIN RESEARCH VARIABLES: Personal space preferences, health temporal orientation, and perceived personal control. FINDINGS: Space items were factored into interpersonal and physical scales. Temporal orientation items were loaded on one factor, creating a one-dimensional scale. Control items were factored into internal and external control scales. Cronbach's alpha coefficients for the scales ranged from 0.76-0.88. Interpersonal space preference, health temporal orientation, and perceived internal control scales each were predictive of mammography screening adherence. CONCLUSIONS: The three tested scales were reliable and valid. Scales, on average, did not differ between African American and Caucasian populations. IMPLICATIONS FOR NURSING: These scales may be useful in future investigations aimed at increasing mammography screening in African American and Caucasian women.

The Delta project: increasing breast cancer screening among rural minority and older women by targeting rural healthcare providers.

PURPOSE/OBJECTIVES: To test a multimethod approach designed for rural healthcare providers to increase breast cancer screening among low-income, African American, and older women. DESIGN: Two-year experimental pretest/post-test with random assignment by group. SETTING: Primary healthcare providers' offices. SAMPLE: 224 nurses, physicians, and mammography technicians. METHODS: Standardized patients to observe and record healthcare providers' performances, followed by direct feedback, newsletters, posters, pocket reminder cards, and lay literature about screening to use in clinics. MAIN RESEARCH VARIABLES: Healthcare providers' knowledge and attitudes as measured by survey responses, skills as measured by a checklist, and the provision of breast cancer screening as measured by mammography facilities' data. FINDINGS: Healthcare providers significantly improved in demonstration of breast cancer screening practice after the intervention. Nurses performed significantly better than physicians on the breast examination during the post-test. More women older than 50 received mammograms in the experimental counties than in the comparison counties. Culturally sensitive lay literature is needed for African American women with low literacy. CONCLUSIONS: Successful interventions included use of standardized patients to teach healthcare providers in their office settings, prompts such as posters and pocket reminder cards, and easy-to-read newsletters. IMPLICATIONS FOR NURSING: Physicians and nurses play a powerful role in motivating women to have mammograms and clinical breast examinations and to practice breast self-examination. Interventions that help these providers fulfill that role should be implemented.

A synthesis technique for grounded theory data analysis.

AIMS: The purposes of this paper are to examine the issues surrounding current changes in grounded theory (GT) research methods and to explicate an innovative synthesis technique to GT data analysis. BACKGROUND: In recent years there has been a steady rise in the number of published research reports that use the GT method. However, this growing body of GT literature has been criticized for its lack of adherence to the method as explicated by its originators, Glaser and Strauss. METHODS: Recent and past literature that explicates, describes, and discusses GT methods is reviewed. A synthesis technique for grounded theory data analysis was developed to analyse qualitative data collected for a grounded theory study on caregiving. This synthesis technique was derived from the works of four grounded theorists (Kathy Charmaz, Mark Chesler, Juliet Corbin and Anselm Strauss). RESULTS: The lack of clarity and the inconsistencies surrounding GT analysis, as reported in the literature, resulted in the development of a synthesis technique based on the works of the aforementioned-grounded theorists. The product was a synthesis approach that included analytical steps from each of these authors. CONCLUSIONS: This synthesis approach increased understanding and enhanced clarity of GT data analysis techniques. This paper illustrates how integration of works by noted qualitative scholars is an appropriate and effective means to advance the discourse on data analysis for GT research studies.

[Creating nursing knowledge in Brazil: research topics]. / Produção do conhecimento em enfermagem no Brasil: as temáticas de investigação.

The present article discusses the themes that have orientated knowledge building in nursing in Brazil. The data was collected in post-graduation programs, graduation schools, university hospitals and indexed publications in LILACS and MEDLINE's database (1990-1999). Cardoso categorized the lines and areas of research according to a document created in nursing forums of discussion. The data was analyzed through a qualitative and quantitative approach, and presented in the form of graphics. Results indicate a shift on the lines/areas of research, especially in the case of researches that are indexed. It also demonstrates a special attention of this professional area to methodological references and paradigms that relate to the object of knowledge in nursing.

The analysis of the data for two-way contingency tables.

One of the best ways, if not the best way, to analyze data displayed in a two-way contingency table is to use a method originally due to Williams (1952) and later embellished upon by Guttman (1971) and others. This method applies the principles of canonical correlation analysis to contingency table data and obviates the need for the a priori specification of scale values for the two variables whose relationship is explored. In this article the method is described and compared with other approaches, and several examples of its application are provided.

Development and psychometric evaluation of the Demands of Immigration Scale.

The Demands of Immigration Scale (DI) measures demands associated with immigration, including loss, novelty, occupational adjustment, language accommodation, discrimination, and not feeling at home in the resettlement country. The DI scale was evaluated in a sample of 1,647 immigrants from the former Soviet Union who had resided in the United States from a few months to 20 years. Confirmatory factor analysis supported the proposed factor model. The DI subscales were internally consistent and had good test-retest reliability. Support for concurrent validity was demonstrated by correlations in the expected direction between the DI total and subscale scores and measures of depression and somatization. Support for discriminant validity was demonstrated by mean group differences in some or all of the DI dimensions according to age and years in the United States.

Development of a scale to measure information needs in cancer care.

Developing approaches to improve the use of scarce health care resources is of increasing importance in cancer care. Being able to target the provision of information to the primary needs of consumers ensures more productive use of expensive teaching time by health care professionals. Researchers and clinicians have used a variety of measurement techniques to assess the information needs of individuals with cancer at various points in their illness trajectory. The two most common types of scaling techniques used by researchers to measure information needs have been summative and differential. The advantages and disadvantages of using these types of measurements are evaluated. This article describes the development and pilot testing of a measure of the information needs in cancer patients that uses one type of differential scaling technique, Thurstone scaling. This measure was subsequently converted into a patient-friendly computerized program capable of helping consumers identify their information priorities before their medical visits. Individualized teaching may be guided by this new measurement technique in the future.

Methodologic issues in the measurement of oxytocin in human neonates.

Oxytocin's (OT) role in the onset and maintenance of labor and in the letdown reflex is well known. OT also has been recognized as a neurotransmitter having functions in the central nervous system, including an influence on behavior (e.g., initiation of maternal behavior). This research was conducted to (1) evaluate whether human tactile contact in the human newborn would increase urine OT levels and alter infant behavioral state, and (2) determine the reliability of measuring OT in human infant urine. Although the data did not support the hypotheses, it was noted that OT levels significantly decreased in infants who cried during the study period and that there was no correlation between infant's chronologic age and OT levels. The findings illustrate several methodologic and measurement problems in the study of OT in human infants and that urine sampling in the neonate is not the most reliable method to evaluate change in OT levels. Some general issues concerning research with human infants also are discussed. Further research is recommended to document baseline levels of OT in neonates and to explore the use of salivary OT to measure short-term responses to interventions.

[The trap of percentages]. / Il trabocchetto delle percentuali.

It is still controversial which is the correct way to report and to interpret different event rates of clinical trials. Results can be expressed in terms of several measures: absolute risk reduction, relative risk reduction, relative improvement, number needed to be treated. Each measure leads to a different interpretation of study results. In the present article data from a clinical study on serum cholesterol reduction are analyzed and compared with different measures. Investigators, physicians, nurses and patients should be aware that the presentation of trials' results can be misleading even if statistically exact.

[Prospective analysis in nursing: a methodology to be disseminated]. / Análise prospectiva em enfermagem: metodologia a ser difundida.

This paper intends to motivate the nurses in the evaluation of any teaching or health institutions. The authors propose the prospective analysis in nursing as a new methodological option to be used in that evaluation. The conceptual bases, as well as the methods and instruments, of the research are presented.

The concept of integration: a foundation for evaluating outcomes of nursing care.

Changes in the health care environment, an aging population, and an increase in chronic health conditions require consideration of the adequacy of concepts available for demonstrating the effectiveness of nursing care. One concept that has potential utility for nursing in this regard is the concept of integration. Analysis of the concept of integration was conducted to alleviate existing ambiguity and to explore ways in which this concept has been employed in diverse disciplines. The concept of integration is characterized primarily as a process of combination: two or more elements are merged with sufficient interaction so that unity of the newly formed entity is achieved. The attributes of the concept of integration, therefore, include process, combination, interaction, and unity. The concept of integration is useful in evaluation of reconciliation of past and present identities and altered role relationships within the environment.