Data Analysis
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© Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION Chapter 13 Data Analysis James Eldridge © VLADGRIN/iStock/Thinkstock Chapter Objectives At the conclusion of this chapter, the learner will be able to: 1. Identify the types of statistics available for analyses in evidence-based practice. 2. Define quantitative analysis, qualitative analysis, and quality assurance. 3. Discuss how research questions define the type of statistics to be used in evidence-based practice research. 4. Choose a data analysis plan and the proper statistics for different research questions raised in evidence-based practice. 5. Interpret data analyses and conclusions from the data analyses. 6. Discuss how quality assurance affects evidence-based practice. Key Terms Analysis of variance (ANOVA) Magnitude Central tendency Mean Chi-square Median Interval scale Mode 9781284108958_CH13_Pass03.indd 375 10/17/15 10:16 AM © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION 376 | Chapter 13 Data Analysis Nominal scale Quantitative analysis Ordinal scale Ratio scale Qualitative analysis Statistical Package for the Social Quality assurance Sciences (SPSS) Quality improvement t-test nnIntroduction This text methodically explains how to move from the formulation of the hypothesis to the data collection stage of a research project. Data collection in evidence-based practice (EBP) might be considered the easiest part of the whole research experience. The researcher has already formed the hypothesis, developed the data collection methods and instruments, and determined the subject pool characteristics. Once the EBP researcher has completed data collection, it is time for the researcher to compile and interpret the data so as to explain them in a meaningful context. This compilation and interpretation phase is completed using either quantitative data analysis or qualitative data anal- ysis techniques. Quantitative analysis is defined as the numeric representation and manipulation of observations using statistical tech- niques for the express purpose of describing and explaining the outcomes of research as they pertain to the hypothesis. In other words, quantitative analysis uses numerical values to explain the outcomes of a research project. In contrast, qualitative analysis techniques use logical deduc- tions to decipher gathered data dealing with the human element and do not rely on numerical values or mathematical models to explain the results. In other words, qualitative analysis uses words and phrases to explain the outcomes of a research project. Do not confuse qualitative analysis with quality improvement, which is a measure of change over time and may use both quantitative and qualitative analyses to develop results and conclusions. An example of the contrast between quantitative and qualitative analyses would be a research project involving the study of a specific treatment for the reduction of pressure-induced bedsores during conva- lescent care. To determine if the treatment was effective, data would be collected to compare two groups of individuals who were bedridden. One group would receive the treatment, while the other group would not receive the treatment. Using a scale, such as the Braden Scale, that quantified the number and size of bedsores, the researcher would collect numerical data to determine if differences were apparent between the treatment group and the no treatment group. This custom is a classic example of quantitative analysis. Using the same group of subjects, the researcher could also observe the patients’ movement 9781284108958_CH13_Pass03.indd 376 10/17/15 10:16 AM © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION Quantitative Analysis | 377 characteristics, attitude, and facial expressions during pre-treatment and post-treatment phases. The nursing staff could chronicle their improvement through the use of a written journal. This process would be an example of qualitative analysis. In the example using quantitative analysis techniques, the researcher could report significant differences between the end treatment values of the treatment and no treatment groups. For example, a significant differ- ence between the mean post-treatment occurrences of pressure ulcers of the treatment group compared to those of the no treatment group might be the result from the treatment. In the qualitative analysis example, the researcher would state the results in a different way. For example, the treatment group exhibited more positional changes during bed rest, with an observed decline in localized long-term pressure points in a single area of the body, skin blood flow changes, rashes, and blisters; further- more, the patients had a better attitude and were less likely to complain to the nurse while undergoing the post-test procedures. Notice that in the qualitative analysis example, no mention of statis- tical differences occurs. Only a description of the observed differences and changes is included. The only time a researcher can report a signifi- cant difference is when he or she has used quantitative analysis techniques to interpret the data. In this chapter, the learner will discover when and how to use these two techniques in the reporting and explanation of a project’s results. nnQuantitative Analysis Measurement Scales As described previously, quantitative analysis requires the use of numeric data to describe and interpret the results. It is often referred to as statisti- cal analysis; in reality, however, statistical analysis is a subunit of quan- titative analyses. Before a researcher can understand the nuances of quantitative analysis, he or she must first understand the types of numeric data that are available for analysis. Numeric data are classified into four measurement scales: (1) nominal, (2) ordinal, (3) interval, and (4) ratio. These four scales are listed here in hierarchical order, with the nominal scale being the least precise measurement scale and the ratio scale being the most precise measurement scale in describing results. The nominal scale is the simplest of the measurement scales, because it is used for identification or categorization purposes only. This level of measurement lacks numeric order, magnitude, or size. Examples of nominal scales include race, gender, and patient identification number. A scale for race might collect data in the following way: Anglo equals 1, African American equals 2, Hispanic equals 3, and other race equals 4. In this scale, 9781284108958_CH13_Pass03.indd 377 10/17/15 10:16 AM © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION 378 | Chapter 13 Data Analysis the number assigned to each race is indicative of group identification only, with no other assumption of magnitude, order, or size. The reason that we use the numerical scale rather than the word terms for race is because most statistical analysis packages have a difficult time interpreting word terms, especially when capitalization and misspellings occur. The second measurement scale in the hierarchy is the ordinal scale. This scale is more precise in measuring items as compared to the nominal scale. It incorporates order or ranking, yet lacks magnitude and size. A researcher using an ordinal scale is unable to make direct comparisons between ranks, because he or she does not know whether the difference between a ranking of 1 and 2 is very small or very large. The only known aspect is that a ranking of 1 is greater or better than a ranking of 2. A medical example of an ordinal scale is the transplant recipient list for a donor heart. A transplant recipient is given a number that identifies his or her order on the list based on symptoms, severity, cross-matching/typing, and time of request. When a donor heart becomes available, the person ranked highest on the list who meets the criteria of proper cross-matching/typing, being symptomatic, with the highest level of illness severity, and the longest time on the donor list receives the heart. Potentially, two patients with the same symptoms, severity, and cross-matching/typing might be separated in the order only by the time (sometimes a few seconds) at which they were placed on the list. Thus, the different aspects have no magnitude or set units of measure between each numeric value. This example illustrates how an ordinal scale represents order but lacks magnitude and size. For both nominal and ordinal scales, mathematical calculations have no meaning, because the scales are unable to represent the magnitude and size of the variable. The final two scales of measurement in the hierarchy are considered continuous scales, because each incorporates order and magnitude within its description. Continuous scales allow for mathematical calculations to give the results meaning. Researchers can truly describe significant differences because each number in the scale represents a unique place of order within the scale, and there is equal distance between it and the number directly above and below it in the order. The third scale of measurement is the interval scale. This scale is more precise than the nominal and ordinal scales because it incorporates both order and magnitude within the description; at the same time, it lacks a defined size or, for want of a better term, an “absolute” zero point. An example of the interval scale is the Fahrenheit temperature scale. The degrees in the Fahrenheit scale are ordered from high to low. Each degree within the scale has an equal distance from the next degree; however, the point taken as zero in the scale is arbitrary. Using the term “arbitrary zero” in a scale means that the zero point is not defining a complete lack of quantity, but rather just serves as a starting point for the measurement. In 9781284108958_CH13_Pass03.indd 378 10/17/15 10:16 AM © Jones & Bartlett Learning, LLC. NOT FOR SALE OR DISTRIBUTION Quantitative Analysis | 379 the Fahrenheit scale, the point chosen as zero is arbitrary, because you can actually have a score that is below zero. This same consideration also applies when using the Celsius scale for temperature. The final and most precise scale in the hierarchy is the ratio scale. This scale combines the attributes of the interval scale with the addition of an absolute zero point.