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Module 1 Discussion
Building an Evidence-Based Study
Questions 1-9.  Below is a description of a study’s conceptual framework.  Read the description and then answer the following questions 1-9. 
            There is abundant evidence that adolescents are at especially high risk of pregnancy complications and that their infants have a higher-than-average rate of low birth weight and neonatal death. Few studies, however, have examined the health status of children of adolescent mothers after the first few weeks of life, but findings suggest that these children continue to be at a health disadvantage throughout their childhood. The purpose of this study was to further explore factors that might lead to greater health problems and less appropriate use of health care among children born to adolescent mothers.
            The theoretical framework for this study was the Health Belief Model (HBM). This model postulates that health-seeking behavior is influenced by the perceived threat posed by a health problem and the perceived value of actions designed to reduce the threat (Becker, 1978). Within the HBM, perceived susceptibility refers to a person’s perception that a health problem is personally relevant. It is hypothesized that young mothers, compared to older mothers, are developmentally unable to perceive their own (or their infant’s) susceptibility to health risk accurately. Furthermore, adolescent mothers are hypothesized to be less likely, because of their developmental immaturity, to perceive accurately the severity of their infants’ health problems and less likely to assess accurately the benefit of appropriate interventions than older mothers. Finally, teenaged mothers are expected to evaluate less accurately the costs (which, in the HBM, include the complexity, duration, accessibility, and financial costs) of securing treatment. Thus, because it is expected that adolescent mothers perceive lower threat and less susceptibility to health problems than older mothers, their children are at higher risk to health problems. In summary, the HBM provides an excellent vehicle for testing the mechanisms through which children of young mothers are at higher-than-average risk of severe health problems and are less likely to receive appropriate health care.
Is the framework for this study based on a conceptual model of nursing?  Explain.
Would the HBM be described as a shared theory?  Explain.
Is the HBM a grand theory? Explain.
Was the HBM used as a basis for developing hypotheses in this study?  Explain.
Is the study qualitative or quantitative?  Explain.
In the second paragraph, second sentence, the key “outcome” of the model is specified. What is it?  Explain.
In this study, the HBM will be tested with two groups. What are they?  Explain.
If the researcher’s hypotheses are not supported, would this study disprove the HBM?  Explain.
Given the problem statement, what other theory or conceptual model could be used to guide the study?  Explain why you chose the other theory.
This question does not refer to the above items 1-9.  As part of your assigned readings you were to read the AACN MSN Essentials.  What is the purpose of the AACN Masters Essentials? 
List each of the nine Essentials and provide a statement in your own words about the value of the each individual Essential to advanced nursing practice.
Module 2 Discussion
Nursing Conceptual Models and Borrowed Theories
Choose one of the conceptual models in your assigned reading in your Alligood text and answer the following questions:  a.  Name of the conceptual model;  b.  Core concepts of the model;  c.  Describe a nursing situation in which the model could be applied; and d.  Describe how you would apply  your chosen model to the nursing situation to facilitate a process improvement.
Choose a borrowed theory from either your Polit and Beck text or the llterature which could be applied to a nursing research article.  Answer the following items:  a.  Name the theory and the non-nursing discipline from which it comes;  b.  Identify 3-4 of the core concepts of the theory; and c.  Explain why this theory might be a good fit from which to develop a nursing research study.
Your assigned readings this week introduces you to the ways of knowing in nursing written by Barbara Carper.  This is a seminal work in nursing.    Answer the following items:   a.  List the 4 patterns of knowing according to Barbara Carper;  b.  Provide an example from your practice for each of the 4 patterns;  and c.  What are your thoughts about the pertinence of these patterns in nursing today?
There are multiple learning theories as you read in the Zhou & Brown chapter. Answer the following items:  a.  Choose and identify the name of one of the learning theories from the assigned reading of Zhou & Brown   and  b.  Develop a step-by-step program to decrease the frequency of medical mistakes in a healthcare practice setting.  Cite the principles or key concepts from your chosen learning theory that back each step of the program you develop. 
Module 3 & 4 Discussion
Quantitative Design
Read this fictitious study and then answer the questions that follow:
Brusser and Joansy wanted to test the effectiveness of a new relaxation/biofeedback intervention on menopausal symptoms.  They invited women who presented themselves in an outpatient clinic with complaints of severe hot flashes to participate in the study of the experimental treatment.  These 50 women were asked to record, every day for 3 weeks before the intervention, the frequency and duration of their hot flashes.  The intervention involved five 1-hour sessions over a period of 1 week.  Then for 3 weeks after the treatment the women were asked to record their hot flashes again every day.   At the end of the study, Brusser and Joansy found that both the frequency and average duration of the hot flashes had been significantly reduced in this sample of 50 women.  They concluded that their intervention was an effective therapy in treating menopausal hot flashes.  
What is the independent variable in this study?
What are the dependent variables in this study?
Was there random assignment in this study?
Is the design experimental, quasi-experimental, pre-experimental, or nonexperimental?
What is the specific name of the design used in this study?
Is the study design within subjects or between subjects?
Was there blinding in this study?
Provide at least one way in which this study could have been improved based on your chapter readings.
Here is a brief summary of the data collection plan of a fictitious study.  Read the summary and then respond to the questions that follow.
Traina conducted a study to investigate the relationship between adults’ blood pressure and their suppression of anger.  Data were gathered from a sample of 347 healthy men and women aged 22 to 60 who were members of a gym in Washington DC.  Subjects completed two paper and pencil scales:  The Feeling of Anger Scale and the Expression of Anger Scale.  The scales used a 9 point rating scales.  Responses to each scale were summed to yield a total score for each variable.  The subjects’ BP was measured by nurses using zero calibrated aneroid sphygmomanometers.  Weight was measured with subjects wearing only gym shorts and a t-shirt on an upright scale to the nearest 10th of a pound.  Heights was measured without shoes, feet together.  All instruments were assessed at being below the eighth grade level.  The results indicated for both men and women higher diastolic and systolic BP was associated with higher levels of suppressed anger even when various variables were statistically controlled.
Which of the following types of data were collected in this study (self-report, observation, biophysiologic, records)?
Were the data collection methods structured or unstructured?
For which variables did Traina NOT derive numeric information?
Which of the following specific methods were used (likert-type scale, semantic differential scale, event history calendar, rank-order questions, Q-sort)?
Which type of data collection was used: telephone interview, personal interview, web-based interview, or self-administered questionnaire?
Was readability assessed?  At what level?
Provide at least one way that data collection and measurement effort be improved in this study based on your readings.
Module 5 Discussion
Clinical Questions
Choose a problem or issue that you anticipate within your future advanced nursing role.  Describe this problem in 5 sentences or less.
Formulate a clinical question using the PICOT format. This question will drive the literature search for your issue.  
To support and assist in choosing and writing your PICOT in question 1 of this discussion board, you should have reviewed a minimum of 6-10 articles with at least one being a quantitative design.  List the 6-10 articles here as a response to this #3 question.  The articles should be in alphabetical order and each article should be listed as a full citation using the APA format.
Choose one of those articles cited in #3 above that is a quantitative article and use the guide in Box 4.3  of Polit and Beck text to critique the research problem, research question, and hypothesis in the article (page 84).   Answer each of the 8 questions and discuss the relationship of this article to your PICOT.
Module 7 Discussion
The Future of Nursing Theory
Describe what the following quote means to you.  “Theory without practice is empty and practice without theory is blind” (*Cross, 1981, p. 110).
Explore the Sigma  website.  Based on your exploration of the Sigma Theta Tau International website, provide 3  specific examples of the globalization of nursing.  At least one example must include an example of an internationally written article from the most recent issue of the Journal of Nursing Scholarship.  You can access this journal from the Sigma website.
Share the three most important concepts that you learned this 7 week term.
What were the two most challenging activities for you confronted in this course?  What suggestions do you have related to addressing those challenges?

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