Critical Appraisal
BS-EBM Unit 22: Assessment Questions 1 to 10
Answers may vary. Clinical implications may include patient education on the potential risk of weight gain for DMPA users or the potential benefit of exercise in maintaining weight for TCu 380A users. The Centers for Disease Control and Prevention (CDC) has contraception information for consumers and healthcare providers at http://www.cdc.gov/reproductivehealth/UnintendedPregnancy/Contraception.html and obesity, weight, and healthy lifestyle information at http://www.cdc.gov/obesity/index.html. The National Institutes of Health (NIH) has a healthy weight resource that contains family and provider information including BMI calculator at http://www.nhlbi.nih.gov/health/education/lose_wt/index.htm.
The Moore et al. (2018) study result of p = 0.012 for perceptions of teamwork indicated that the clinical simulation intervention was significantly effective in promoting the nursing staff’s perceptions of teamwork. The result was significant because p = 0.012 is less than alpha set a 0.05 for this study.
BS-EBM Unit 21: Assessment Questions 1 to 10
Q5. Was the null hypothesis in Question 4 accepted or rejected? Provide a rationale for your answer.
The clinical importance is that patients with COPD who have either moderate or severe airflow limitations have identified difficulty sleeping as their number one psychological symptom. Management of these patients requires assessment, diagnosis, and management of sleeping disorders. The Global Initiative for Chronic Obstructive Lung Disease website is an excellent resource for evidence-based guidelines at http://www.goldcopd.org/Guidelines/guidelinesresources.html. Cochrane Library in England has a large collection of systematic reviews and evidence-based guidelines and includes several resources on COPD (see http://www.cochrane.org and search for COPD). You might document with other websites, research articles, or textbooks that focus on generation of research evidence for practice (Melnyk & Fineout-Overholt, 2019).
BS-EBM Unit 19: Assessment Questions 1 to 10
The sample size is N = 201 with n = 111 (55%) RAAPS users and n = 90 (45%) RAAPS nonusers as indicated in the narrative results. Answers might vary because the sample size is limited for an online survey with only 35% of the providers responding. However, many of the chi-square values were significant, indicating a decreased potential for a Type II error. In addition, the group sizes were fairly equal, which is a study strength (Gray et al., 2017).
The p = < .00 for the provider type. Yes, the χ2 = 12.7652 for provider type is statistically significant as indicated by the p value presented in Table 2. The specific χ2 value obtained could be compared against the critical value in a χ2 table to determine the significance for the specific degrees of freedom (df), but readers of research reports usually rely on the p value provided by the researcher(s) to determine significance. Many nurse researchers set the level of significance or alpha (α) = 0.05 (Grove & Gray, 2019). Since the p value is less than alpha, the result is statistically significant. The null hypothesis is rejected when study results are statistically significant (Gray et al., 2017; Pett, 2016). You need to note that p values never equal zero as they appear in this study. The p values would not be zero if carried out more decimal places.
Yes, there is a statistically significant difference between RAAPS users and RAAPS nonusers with regard to percentage of adolescent patients. The chi-square value = 7.3780 with a p = .01, which is less than alpha = 0.05. You might expect that nurses caring for more adolescents might have higher RAAPS use as indicated in Table 2. However, nurses need to be knowledgeable of assessment and care needs of populations and subpopulations in their practice even if not frequently encountered. Two valuable sources for adolescent care include the Centers for Disease Control and Prevention (CDC) Adolescent and School Health at http://www.cdc.gov/HealthyYouth/ and the World Health Organization (WHO) adolescent health at http://www.who.int/topics/adolescent_health/en/.
The df = 3 for U.S. practice region is provided in Table 2. The df formula, df = (R − 1) (C − 1) is used (Kim & Mallory, 2017; Pett, 2016). There are four “R” rows, Northeastern United States, Southern United States, Midwestern United States, and Western United States. There are two “C” columns, RAAPS users and RAAPS nonusers. df = (4 − 1)(2 − 1) = (3)(1) = 3.
Q8. State the null hypothesis for the years in practice variable for RAAPS users and RAAPS nonusers.
The null hypothesis: There is no difference between RAAPS users and RAAPS nonusers for providers with ≤5 years of practice and those with >5 years of practice.
The null hypothesis for years in practice stated in Questions 8 should be rejected. The χ2 = 6.2597 for years in practice is statistically significant, p = .01. A statistically significant χ2 indicates a significant difference exists between the users and nonusers of RAAPS for years in practice; therefore the null hypothesis should be rejected (Kim & Mallory, 2017).
The Bhatta et al. (2018) results were statistically significant with female adolescents reporting significantly more sleep problems (χ2 = 9.147, p = 0.002) and tiredness (χ2 = 6.165, p = 0.013) than male adolescents. The results are statistically significant because the p values are less than alpha set at 0.05. The results are clinically important because the sleep and tiredness outcomes vary based on gender and additional screening and interventions are needed to manage these health problems in females.