Statistical significance refers to the likelihood that the results of a study are not due to chance, while clinical significance refers to the practical i

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The Role of Confounding Variables in Causal Inference

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The Role of Confounding Variables in Causal Inference

In research, independent variables are the ones that are controlled or varied in order to establish their correlation to the dependent variable. The dependent variable is the variable that is being observed in order to determine the effects of the independent variables. On the other hand, there are extraneous variables that refer to any variable that is not of interest to the study but which has the capability of affecting the dependent variable.

There are two common strategies used to address extraneous variables: randomization and matching. Randomization helps in the allocation of the participants to groups in a random manner to eliminate bias. Matching: the subjects are matched in such a way that other extraneous variables are grouped together to avoid confounding. Another type is statistical control, in which the researcher employs statistical means for controlling for extraneous variables, such as through regression analyses (Byrnes and Dee, 2025).

For instance, in the paper by Egami and Tchetgen (2024), the authors employed negative control variables (auxiliary variables) to control unmeasured network confounding in causal peer effect estimation. By including outcome and exposure variables with no relation to the treatment of interest, they couldn’t be influenced by confounding and determine accurate causal peer effects with dependence in the network (Egami and Tchetgen, 2024).

Reference

Egami, N., & Tchetgen Tchetgen, E. J. (2024). Identification and estimation of causal peer effects using double negative controls for unmeasured network confounding. Journal of the Royal Statistical Society: Series B (Statistical Methodology), 86(2), 487-511. https://doi.org/10.48550/arXiv.2109.01933

Byrnes, J. E., & Dee, L. E. (2025). Causal inference with observational data and unobserved confounding variables.  Ecology Letters,  28(1), e70023. https://onlinelibrary.wiley.com/doi/abs/10.1111/ele.70023

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Critical Appraisal Using CASP Checklist:

To the best of my knowledge, this study used a method of prospective, two-site randomized control trial that comes out positive when comparing open vs. closed PIVC systems. For this research, the objective was defined concisely and straightforwardly: it had to identify which catheter system is most favorable for patients, staff, and the healthcare system if considering quality, safety, and costs. The authors were fair in the randomization method applied and inclusion criteria, hence making the results more valid. The measures used, such as the rates of complications and satisfaction of the clinicians, were relevant and good (Galang et al., 2020). 

However, there is no detail about blinding that may potentially create bias in the study. This follow-up period of 3 days seems reasonable for the acute results, such as catheter failure or discomfort.

Benefits vs. Harms: 

The study failed to demonstrate different levels of complications but indicated that the open-system catheter had more risks than benefits since it was associated with increased blood leakage and reduced clinician satisfaction. The closed-system catheter is safer and more cost-effective than the other type and is more preferred by patients as well as clinicians (Long et al., 2020).

Ethical Consideration:

One of the ethical concerns is to gain participants’ consent; these persons need to understand the risks associated with various types of catheter systems.

References

Galang, H., Hubbard-Wright, C., Hahn, D. S., Yost, G., Yoder, L., Maduro, R. S., Morgan, M. K., & Zimbro, K. S. (2020). A randomized trial comparing outcomes of 3 types of peripheral intravenous catheters. Journal of Nursing Care Quality, 35(1), 6-12. https://doi.org/10.1097/NCQ.0000000000000421

Long, H. A., French, D. P., & Brooks, J. M. (2020). Optimising the value of the critical appraisal skills programme (CASP) tool for quality appraisal in qualitative evidence synthesis.  Research Methods in Medicine & Health Sciences,  1(1), 31-42. https://journals.sagepub.com/doi/abs/10.1177/2632084320947559

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The Impact of COVID-19 on Nursing Motivation and Skills Development: A Qualitative Study

Study Design: This is a qualitative study based on the fact that the research is shedding light on the social experience of nurses employed at COVID Centers. Interviewing is a good technique of data gathering as it yields high-quality data, especially when it comes to aspects such as the motivation, skills enhancement, and feelings of an individual (Singh et al., 2021). The study uses inductive content analysis since the goal is to derive themes that are implicit and involved in participants’ narratives, and therefore the study as a whole is phenomenological in nature since it aims at capturing the very nature of the participants’ experiences (De Benedictis et al., 2022). 

Critical Appraisal: Based on the application of the CASP Qualitative Checklist, this study is well done in terms of the methodology that has been used. The objectives of the study were properly defined and included the overall effects on nursing practice due to the COVID-19 pandemic. It made more sense to use focus groups as data collection methods and purposive sampling aimed at identifying participants of interest. An aspect of ethical consideration that was well observed was obtaining consent and keeping the client’s identity secret. Reasoning was methodical with the conduct of open coding and categorization done via themes that provided a clear focus. The results are described in detail and provide useful information about the issues and concerns of the nurses during the period of a worldwide health crisis. The current study is therefore useful in shedding light on nursing practice, especially in regards to how best the staff can prepare for an emergency (De Benedictis et al., 2022).

References

De Benedictis, A., Gualandi, R., Saccoccia, S., Pensieri, C., Piredda, M., De Micco, F., … & Alloni, R. (2022). Back to the roots of nursing: Qualitative study on the experience of nurses in the front line during the COVID-19 pandemic. Frontiers in Medicine, 9, 903517. https://doi.org/10.3389/fmed.2022.903517

Singh, C., Jackson, D., Munro, I., & Cross, W. (2021). Work experiences of nurse academics: A qualitative study.  Nurse Education Today,  106, 105038. https://www.sciencedirect.com/science/article/pii/S0260691721002951

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Comparing Phenomenological and Ethnographic Research Designs in Qualitative Studies

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Comparing Phenomenological and Ethnographic Research Designs in Qualitative Studies

Phenomenological and ethnographic research designs can be categorized under the qualitative research tradition; therefore, they are very similar, but they have some differences. Phenomenology as a method of study aims at exploring and does actually realize the perspectives of participants regarding a given phenomenon. It seeks to understand the phenomenon in a broad way, especially in terms of how individuals give meaning to them, and is mostly based on the interview method (Lungu, 2022). For instance, about research on the emotions of various patients suffering from chronic diseases, narratives are collected to get at the phenomenology of these chronic illness experiences.

On the other hand, ethnographic sampling is concerned with identifying the cultural groups and their behaviors in a given setting. Participants enroll themselves as quasi-ethnographers in that they document and observe the research participants in real-life settings and for an extensive period (Risku et al., 2022). An example of anthropological research would be exploring the typical work and interpersonal relationships of nurses in a health facility in an effort to capture the ethnography of the health care institution.

Despite the fact that both designs are founded on human experiences, phenomenology deals with the perception of a single person, while ethnographic shift attitudes to the overall behavior of people in a culture.

References

Lungu, M. (2022). The coding manual for qualitative researchers.  American Journal of Qualitative Research,  6(1), 232-237. https://www.ajqr.org/download/the-coding-manual-for-qualitative-researchers-12085.pdf

Risku, H., Hirvonen, M., Rogl, R., & Milošević, J. (2022). Ethnographic research. In  The Routledge handbook of translation and methodology (pp. 324-339). Routledge. https://www.taylorfrancis.com/chapters/edit/10.4324/9781315158945-24/ethnographic-research-hanna-risku-maija-hirvonen-regina-rogl-jelena-milo%C5%A1evi%C4%87

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PICOT Question and Article Selection

PICOT Question:

In veterans hospitalized for heart failure (P), what is the effect of enrollment in a home telehealth program (I) compared to standard care (C) on hospital readmission rates (O) within 10 weeks (T)?

The purpose of this question is to assess an issue of a high readmission rate of heart failure patients, particularly veterans, and if home telehealth can lower the rates.

Articles:

Qualitative Article: Ashby, M. (2024). Ashby, M. (2024). Using Home Telehealth to Reduce Hospital Readmission Rates in Heart Failure Patients in the Emergency Room. University of St. Augustine for Health Sciences. Retrieved from https://soar.usa.edu/scholprojects/176

This qualitative article focuses on how home telehealth affects heart failure patients’ rates of being readmitted to the hospital. By the use of telehealth interventions, it is illustrated how it can enhance the coordination of patient care and the reduction of readmission rates.

Quantitative Article: Krzesiński, P., Jankowska, E. A., Siebert, J., et al. (2022). Effects of an outpatient intervention comprising nurse‐led non‐invasive assessments, telemedicine support, and remote cardiologists' decisions in patients with heart failure (AMULET study): A randomized controlled trial. European Journal of Heart Failure, 24(3), 565-577. https://doi.org/10.1002/ejhf.2358

This increases the understanding that although telecare mainly entails nurse-led and remote cardiology, it is effective at reducing heart failure hospitalizations and cardiovascular deaths compared to conventional treatment protocols.

These articles assist in formulating the PICOT question by presenting the optimum ways of implementing telehealth to curb hospitalization of individuals diagnosed with heart failure.

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The Evolution and Impact of Nursing Research on Evidence-Based Practice

The history of nursing research can be traced back to the Crimean War in 1854, where Nightingale went to assess and later collect data on the poor hygiene standards, hence implying changes that brought down the death rates. Nightingale’s systematic approach to dealing with healthcare indicated the beginning of nursing research. Nursing research in the early part of the century centered on education, and its recommendations were made by the Goldmark Committee in 1923, which recommended university-based nursing education. The latter half of the twentieth century was marked by the onset of the publication of the Nursing Research journal in 1952 and funding for the nursing study that led to the formation of the National Institute of Nursing Research (NINR) in 1993 that made research for nursing a fundamental section (Helbig, 2022).

Nursing research is particularly vital to EBP since it helps to apply scientific evidence in the practice environment. EBP directs patient care to be made based on evidence, professional knowledge, and patient preferences, leading to better results and healthcare (Sharma, 2022). With the help of the qualitative and quantitative approaches, it is possible for nurses to improve patient safety, create new interventions, and implement standards. EBP also includes ways of embracing continued professional development as a manner of enabling the nurse in practice to get prepared for challenging healthcare issues. Evidently, nursing research plays an important role in minimizing the gap between theory and practice and making the proper decision by providing approved current information.

References

Helbig, J. (2022). Nursing research: Understanding methods for best practice (2nd ed.). Grand Canyon University.

Sharma, S. (2022).  Nursing research and statistics-e-book. Elsevier Health Sciences. https://books.google.com/books?hl=en&lr=&id=5H2eEAAAQBAJ&oi=fnd&pg=PP1&dq=+Nursing+research:+Understanding+methods+for+best+practice+(2nd+ed.).&ots=Bd7COCxBqc&sig=hZ5eyxKg9KGDanUsBbR_L_Y1SB0

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