Additional Synthesis Abstracts and Exercises

Radford University School of Nursing NURS 362 – Nursing Research Dr. Kim Carter

Using the abstracts cited, consider the following questions. You may not be able to answer every single question, depending on the degree of descriptiveness of the abstract. You may also want to use these questions to help you analyze particular research articles.

1. Is this basic or applied research? 2. Does it employ inductive or deductive reasoning? 3. What is the research problem? Purpose? 4. What are the research objectives, questions or hypotheses? 5. If there are hypotheses, identify the characteristics of the hypothesis. 6. What is the theoretical framework? 7. What are the variables: independent, dependent, demographic? What do you think the conceptual and operational definitions for the independent and dependent variables might be? 8. What are potential extraneous variables, and how have these been controlled? 9. What study design was used in this piece of research? Draw a model of it. What are the strengths and limitations of this type of design. 10. What threats might you suspect exist to internal validity? External validity? 11. Who is the target population? Accessible population? What sampling technique was employed? What are the strengths/limitations of this sampling? Are the findings generalizable? 12. What types of measures were used? What are the reliability and validity issues associated with these measures? 13. What data analysis techniques were employed? What were the findings? What issues are relevant to statistical and clinical significance? 14. What are the limitations of this study? What are the major contributions it makes to the science? How can this information be useful to nursing practice? 15. What measures were taken for the protection of human subjects? If not described, what are relevant human subjects protection issues for this study? Abstract #1

Martinelli, A. (1999). Testing a Model of Avoiding Environmental Tobacco Smoke in Young Adults. Image: Journal of Nursing Scholarship, 31(3), 237-242.

Purpose: To test an explanatory model of gender, self-efficacy, situational influences, and other health-promoting behaviors on the avoidance of environmental tobacco smoke (ETS) in young adults. ETS is a cause of lung cancer, pulmonary disease, and cardiovascular disease. Although young adults are at increased risk for ETS exposure, there are few behavioral studies of ETS exposure and no reported studies of ETS exposure in young adults. Although college students are often exposed to ETS, the college environment offers a setting in which the opportunities for change are substantial. Design: Model-testing. Data are reported on a convenience sample of 136 nonsmoking 18- to 25 year old students in one mid-Atlantic U.S. university. This sample of nonsmokers was drawn from a larger sample of 241 smokers and nonsmokers in 1995. Model constructs were based on Pender’s health promotion model (HPM). Methods: The General Self-efficacy Scale, Health Promotion Lifestyle Profile, and ETS Avoidance Scale were used along with items measuring ETS-avoidance efficacy and Living with Smoke. Path analysis was used to test the model. Findings: The trimmed explanatory model showed that 26% of the variance in avoiding ETS was accounted for by gender, having self-efficacy, and ETS-avoidance efficacy, not living with people who smoke, and performing other healthy behaviors. Being female and general self-efficacy indirectly influenced ETS avoidance through their effects on related health promoting behaviors. Conclusions: The explanatory model of ETS avoidance can provide useful information for the development of interventions to prevent exposure to passive smoke. Given the occurrence of ETS exposure in young adults, longitudinal research using this explanatory model is yielding promising results. Enhancing the self-efficacy of young adults and encouraging healthy lifestyle behaviors may be an important factor in their avoidance of ETS.

Abstract #2

Landis, C. & Whitney, J. (1997). Effects of 72 Hours Sleep Deprivation on Wound Healing in the Rat. Research in Nursing & Health, 20, 259-267.

The purpose of this study was to examine effects of sleep deprivation on cellular and biochemical markers of wound healing. Expanded polytetrafluoroethylene tubing inserted in subcutaneous tissue created miniature wounds in the dorsal skin of 12 rats. Seven days later, 6 rats were deprived of sleep by the platform method for 72 hr; control rats remained on usual sleep/wake routines. Numbers of macrophages, granulocytes, fibroblasts, and extent of connective tissue present and total amounts of protein, DNA, and hydroxyproline in the implants were not different between sleep-deprived and control rats. There is no evidence from this study that sleep deprivation impairs cellular and biochemical indicators of tissue repair. Abstract #3

Girgis, A., Sanson-Fisher, R., and Watson, A. (1994). A Workplace Intervention for Increasing Outdoor Workers’ Use of Solar Protection. American Journal of Public Health, 84(1), 77-81.

Objectives: Outdoor workers are at high risk of developing skin cancer. Primary prevention in this group can potentially reduce the incidence of skin cancer, and also potentiates the spontaneous remission of existing solar keratoses. A randomized controlled trial was conducted to evaluate a solar protection intervention targeting outdoor workers. Methods: Outdoor workers were randomly allocated to an intervention (n=65) or control group (n=77). The intervention group received individual skin screening by a dermatologist and participated in an education session. Pre- and posttest outcome measures included solar protection behavior (assessed using a validated diary), knowledge, and attitudes. Results: There was a significant increase (16%) in the percentage of outdoor workers who were using a high level of solar protection at posttest compared to pretest in the intervention group, but there was no change in the control group. Although both groups improved in their knowledge score, the intervention group showed a significantly greater improvement at posttest. No changes in attitudes were detected. Conclusions: The findings suggest that changes in solar protection are achievable with outdoor workers.

Abstract #4

Slattery, M., Caan, B., Potter, J., Berry, T., Coates, A., Duncan, D., and Edwards, S. (1997). Dietary Energy Sources and Colon Cancer Risk. American Journal of Epidemiology, 145(3), 199-210.

Because energy-contributing nutrients are highly correlated with total energy, the association with colon cancer from energy versus other components of energy-providing nutrients is often not clear. Dietary data from a population-based case-control study of colon cancer were analyzed in subjects from California, Utah, and Minnesota in 1991- 1994 to assess the colon cancer risk associated with consumption of energy, fat, protein, and carbohydrate. After adjustment for long-term physical activity, total energy intake, increased risk of colon cancer in men (odds ration = 1. 74, 95% confidence interval 1.14- 2.67 for highest vs. lowest quartile) and in women (odds ration = 1.70, 95% confidence interval 1.07-2.70). Various methods of analysis suggested that intakes of individual sources of energy (dietary fat, protein, and carbohydrate) were not associated with colon cancer risk after total energy intake was taken into account. People who consumed a high-calorie diet that was dense in fiber and calcium appeared to be at lower risk than people with the same caloric intake who consumed smaller amounts of dietary fiber and calcium. Individuals with a first-degree relative with colorectal cancer, especially those diagnosed at a younger age, were at a greater risk from a diet high in energy than were individuals without a family history of colorectal cancer. Abstract #5

Schilke, J., Johnson, G., Housh, T., O’Dell, J. (1996). Effects of Muscle-Strength Training on the Functional Status of Patients with Osteoarthritis of the Knee Joint. Nursing Research, 45(2), 68-71.

This study was designed to determine whether an 8-week isokinetic muscle-strength- training program improved the functional health status of patients with osteoarthritis of the knee joint. Twenty volunteers with osteoarthritis of the knee joint were randomly assigned to either an experimental (n=10) or control (n=10) group. The experimental group completed six sets of five maximal contractions three times per week for 8 weeks on a Cybex II dynamometer at 90º per second. Both groups were pre- and posttested for extension and flexion strength of the right and left legs, the 50 foot walk time, range of motion at the knee joint, the Osteoarthritis Screening Index (OASI), and the Arthritis Impact Measurement Scale (AIMS). There was a significant decrease in pain and stiffness, and a significant increase in mobility. There was also a significant decline in arthritis activity in the experimental group as measured by the OASI and AIMS. The experimental group significantly increased in all strength measures, while the control group increased in only right leg flexion and left leg extension across the training period.

Abstract #6

Humphreys, J., Lee, K., Neylan, T., and Marmar, C. (1999). Sleep Patterns of Sheltered Battered Women. Image: Journal of Nursing Scholarship, 31(2), 139-143.

Purpose: To describe sheltered battered women’s sleep patterns and resulting daytime fatigue. The model for symptom management framed this study to describe one component of the model – symptom experience. Beginning evidence suggests that sheltered battered women experience disturbed sleep and fatigue that can interfere with vital activities. Design: Descriptive using a convenience sample of 50 ethnically diverse women residing at least 21 days in battered women’s shelters located in one western U.S. city. The study was done in 1997. Methods: The Pittsburgh Sleep Quality Index (PSQI), the Mini Motionlogger Actigraph, a sleep diary, the Visual Analogue Scale for Fatigue, and an open-ended interview were used to collect data. Descriptive and inferential statistics were used to analyze the quantitative data. Qualitative data were analyzed to determine patterns and themes. Findings: Seventy percent of the women had global PSQI scores of greater than five indicating poor sleep and 17 (34%) had a sleep efficiency index of 80% or less. Fourteen (28%) of the women went to bed very fatigued (>66mm) and 20 (40%) woke up very fatigues (>33mm). Conclusions: The majority of sheltered battered women experienced disturbed sleep and daytime fatigue. Both personal and environmental variables were found to significantly affect sleep patterns. Sheltered battered women can benefit from information about sleep disturbances and sleep enhancing self-care strategies.