Using Minitab, health and medicine homework help

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Nursing Research Methods

Description

Using Minitab

This week, you learned about the statistical software applications used to analyze data for research analysis. For this week's discussion, you will use Minitab to run descriptive statistics, create graphs and respond to the following:

  • How could you use Minitab descriptive statistics for data analysis research?
  • What are your plans for learning more about Minitab and how will the information you learned about this software be of benefit in your future analysis of research data?

Refer to this week’s readings and video tutorials before starting this two part discussion question assignment. You will also have access to the Assignment Resources Step-by-Step Guide, accessed through the Assignment Resources Icon located to the right of the grading criteria above.

Step 1: Entering Data

Open Minitab

You will now use Minitab to enter a sample dataset by following the steps below and referring to the examples in the Assignment Step-by-Step guide. Begin by opening Minitab. Once open, you will see two windows. The Session Window is in the top half of the screen and the Worksheet is below. Only one window is active at a time.

Dataset Options

In many cases, researchers may have the data from their study in another software package like Microsoft Excel. However, if the data is not available in a software spreadsheet you can manually enter the data. You may now choose to populate your Minitab worksheet using the provided Excel worksheet in Option 1 or try Manual Data Entry by following the instructions in Option 2.

Option 1: Using Excel to populate Minitab

To access the Excel worksheet populated with data, go to the Data Set Icon located to the right of the grading criteria above. You can copy and paste the data set directly from Excel into Minitab.

Or

Option 2: Manual Data Entry

In the Worksheet window, type “Age” in C1. Enter the numbers as shown in the dataset below. Enter the remaining data as shown below (set up your column labels i.e., variable). The measure reflects math anxiety and the study variables (cringe, uneasy, afraid, worried, understand) the math anxiety range is from 1–5 with low being the least and 5 the highest.

Age

Cringe

Uneasy

Afraid

Worried

Understand

28

5

3

4

4

3

34

2

5

3

2

1

25

4

4

4

2

5

56

3

4

3

1

2

23

5

4

3

3

4

29

1

5

3

2

3

30

3

3

5

2

5

59

2

5

5

1

2

45

4

2

5

3

3

38

1

2

4

1

1

33

3

2

4

3

2

47

4

2

3

4

5

24

1

5

3

4

4

29

5

4

2

1

3

53

3

1

5

2

1

48

4

4

1

5

3

27

2

5

4

3

4

34

4

4

3

2

5

26

4

5

2

3

2

36

5

5

5

4

3

Step 2: Run Descriptive Statistics

Now that your data is in Minitab, you will look at the descriptive statistics for this dataset. Select the Ribbon at the top titled “Statistics,” and then select “Descriptive Statistics”. Under the “Data tab” select a variable, under the “Statistics tab” check all the boxes, then click “OK”.

Discussion Question Part 1

How could you use Minitab descriptive statistics for data analysis research? Write about your experience running descriptive statistics. Use the results in the Session Window to support your response. Then add to your discussion with the information you learn when completing Step 3.

Step 3: Minitab and Graphs

You will now look at graphing. Select the Ribbon at the top titled “Graph,” then select “Histogram,” and then select “Simple.” Choose one of the variables and select "Ok". You can create other Histogram graphs by choosing different variables. You can also choose from the other ten graph choices shown on the Graph ribbon. Remember you can use the left navigation column to access your work.

Discussion Question Part 2

What are your plans for learning more about Minitab and how will the information you learned about this software be of benefit in your future analysis of research data? Copy and paste your graph(s) in a Word document and attach to your discussion response.


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Running head: RESEARCH PROJECT PROPOSAL Research Project Proposal Janice Ferrari South University Online Professor: Marcia Kessack July 10, 2017 1 RESEARCH PROJECT PROPOSAL 2 Research Project Proposal The role that palliative care and palliative care education plays in the well-being of any individual suffering a chronic illness is undisputed in the medical field, by both medical practitioners and those receiving the care. However, there is a need to understand the impact that its timing has on the patient, regarding enhanced quality of life and increased satisfaction of the patient. Indeed, it would be highly beneficial to understand whether the provision of palliative care education early or at the onset of the patient’s illness will yield better results as opposed to its provision in later stages of the disease. This should be done or accomplished with the background that palliative care, traditionally known as the end of- life care, is perceived to offer final comforts for a person whose illness is not only terminal, but there is little to no hope of recovery. Further, with the underlying idea that palliative care and its education can be too costly to implement; it is important to scrutinize if prolonged periods of palliative care education, started early will add any value to the patient’s quality of life. Previous approaches to palliative care education may have been satisfactory where a patient is made comfortable as they approach the end of their with preparation of his or her demise. However, this might not be enough as this study seeks to verify. The idea is that these patients do not need to be simply take care of as they approach the ends of their lives, and kept comfortable with their symptoms. Rather, if they would receive the palliative care early, or at the onset of their illnesses, they would lead better lives, even as they continue to manage the disease. They would suffer fewer symptoms, and thus, live comfortably and higher-quality lives. Indeed, it would even be possible to change the trajectory of their RESEARCH PROJECT PROPOSAL 3 illness if the patient receives the right type, intensity, and approach to early palliative care. This study is central to the role of any medical practitioner for various reasons, the first of which is that it can be the first point of reference in cases that have been diagnosed with a chronic illness. Indeed, if it is found out that early palliative care will increase the quality of life, comfort and decrease the symptoms of the disease significantly, practitioners in the medical field will provide this as the basic approach towards achieving their objectives. The research, therefore, seeks to verify that in patients diagnosed with chronic or life-limiting disease, early palliative care education by a nurse will have a positive impact on patient’s management, measured in improved quality of life, decreased symptoms and improved patient satisfaction, as compared to no or late palliative education over 12 months? Background and Significance of the Problem The role that palliative care education plays in the treatment of patients with chronic diseases is so significant that it cannot be ignored. Palliative care education is easily the most extensive part of the treatment of such illnesses, and as such, its influence should be studied and analyzed. It is important to note that there is a myriad of reasons that explain why people might prefer to undertake palliative care education and even the actual care towards the end of the student life as opposed to earlier stages. Some of these reasons include lack of appropriate resources and lack of information about the condition that the patient is suffering from (Venkatesan et al., 2012). However, the worst approach is one that undertakes to show or bring in palliative care education towards the end of person’s life simply because of the idea that it is understood to be the end of life care and RESEARCH PROJECT PROPOSAL 4 thus, it loses value as early care education. Indeed, the problem is having a population that introduces palliative care education towards the end of life instead of at the beginning of the diagnosis of the illness. This difference is important because it will result in higher rates of survival and receding of chronic diseases. In instances where palliative care education is provided early, there are higher cases of survival as opposed to the cases where palliative care education is provided as the end of life care. This research seeks to find out the lengthening of such care and its education as soon as a patient realizes that he is suffering a chronic illness. Statement of the Problem and Purpose of the Study Palliative care education has been traditionally reserved for the later stages of a patient’s life where he and his family are prepared for his end of life care. It has been conventionally employed as a means to ensure that the patient lives a comfortable life as he prepares for his end of life. The problem is that in instances where a patient is suffering from a life-threatening disease (or a chronic illness), palliative care education should be provided early in the trajectory of the disease as opposed to it being an end of life issue to enhance the quality of their lives. The purpose of this study is to demonstrate that early palliative care education is better than no or later palliative care education as far as enhancement of patient life is concerned, and thus, the achievement of the objectives of medical practice. Literature Review Article 1 Eriksson, G., Bergstedt Wahlström, T., & Melin-Johansson, C. (2014). The need for RESEARCH PROJECT PROPOSAL 5 palliative care education, support, and reflection among rural nurses and other staff: A quantitative study. Palliative & Supportive Care, 13(2), 1–10. https://doi.org/10.1017/S1478951513001272 Main purpose and scope: The main purpose of this article is to systematically evaluate the evidence around the presence of palliative caregivers in rural Sweden, and shed light on the support that they need in various areas of their operation. Brief Description: The authors described the roles and positions available for the caregivers in Sweden, and the commensurate gaps that these people experienced. This provides information on the best resources to provide the to ensure that palliative care provided is efficient. Numbers of Participants: The research had 1686 palliative healthcare staff involved in various institutions of palliative care. These include those in nursing homes, home care, group residences, registered nurses, assistance nurses, managers, and paramedics. Methodology Use: The researchers used a sampling method to secure the test subjects, and used a 20 item questionnaire to collect data. Value and Significance: The value in this study is to show how various service providers, especially those in rural settings can enhance their palliative care service provision. Possible Bias: Possible biases identified are that the case in the rural region in Sweden was not compared to other rural areas in the same country or other countries. Observations: From the research, it is evident that many caregivers of palliative care do not have palliative training, and many of them needed to further their education. There are also various shortcomings in terms of education and other abilities to ensure efficiency. Summary: The main points of this study were that palliative care is not where it should be, and it can always be enhanced. This is best RESEARCH PROJECT PROPOSAL 6 achieved through the inclusion of aspects such as informatics, education, further training and interactions with other professionals. Article 2 Venkatesan, P., Harikesavan, K., Kumar, S., Karthikbabu, S., Syed, N., Sisodia, V., & Jaykumar, S. (2012). Study of Nurses’ Knowledge about Palliative Care: A Quantitative Cross-sectional Survey. Indian Journal of Palliative Care, 18(2), 122– 127. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3477365/ Main purpose and scope: The main purpose of this article is to investigate the information and knowledge held by nurses as far as palliative care services and analyzing the challenges experienced is concerned. The authors seek to verify the fact that in the past nurses, and doctors are not well prepared to deliver effective palliative care in all the necessary changes and developments in conventional services that provide care for a high proportion of advanced and terminally ill patients. Brief Description: The authors described the role that nurse and doctors play in palliative care plays and present the fact that in most countries, enhancing knowledge and information about palliative care would be important to enhance life. Numbers of Participants: The number of human subjects in this study was 363 nurses who are also primary care professionals in a multispecialty hospital. Methodology Use: The researchers used a self-report questionnaire with 20 items to respond to. Value and Significance: The value in this study is to analyze the role of changes in the palliative care in the world and the impact it could have. It also sheds light on the fact that palliative care service providers are usually not well-equipped with information that will help them make better decisions. Possible Bias: Possible biases identified are that the researcher interviewed nurses alone as opposed to the wide RESEARCH PROJECT PROPOSAL 7 of professionals who are involved in palliative care. Observations: From the analysis or research undertaken, it is evident that many nurses are not aware of may developments in the palliative care field and other related areas, including pain, philosophy, and psychiatry. All of these are essential to track all aspects of palliative care in all chronic diseases. Summary: The main points of this study were the emphasis on the importance of knowledge and information in palliative care. This is enhanced by the increasing needs and demands of patients with advanced chronic diseases and their families. Article 3 King, J. D., Eickhoff, J., Traynor, A., & Campbell, T. C. (2016). Integrated oncopalliative care associated with prolonged survival compared to standard care for patients with advanced lung cancer: A retrospective review. Journal of Pain and Symptom Management, 51(6), 1027–1032. https://doi.org/10.1016/j.jpainsymman.2016.01.003 Main purpose and scope: The main purpose of this article is to perform a retrospective analysis of partially integrated onco-palliative care lung cancer clinic to evaluate overall survival and resource utilization. Brief Description: The authors described lung cancer as the leading cause of cancer-related death in the U.S. Further, they describe a large randomized controlled trial in advanced lung cancer found a survival advantage with an early palliative care (EPC) intervention compared to standard oncologic care. Numbers of Participants: The number of human subjects in this study was two hundred seven patients with advanced lung cancer. Methodology Use: The researchers used clinical trial participation, hospice enrollment and length of stay, and chemotherapy utilization for collecting and analyzing data. Value and Significance: The value in this study is to RESEARCH PROJECT PROPOSAL 8 paint an image of the role that palliative care plays in enhancing survival rates of patients with lung cancer. Possible Bias: Possible biases identified are the provision of care in the selected facility. This does not mean that the same impact will be felt in a different facility. Observations: From the topic and issues written in this study it emerges that EPC patients had a survival advantage, were more likely to participate in clinical trials and had a longer median hospice length of stay. Summary: The main points of this study were that palliative care is not only necessary, but when implemented early, it can have a bigger impact. Early palliative care or EPC can also be enhanced through information and informatics. Article 4 Kwon, J. H., Hui, D., Chisholm, G., Ha, C., Yennurajalingam, S., Kang, J. H., & Bruera, E. (2013). Clinical characteristics of cancer patients referred early to supportive and palliative care. Journal of Palliative Medicine, 16(2), 148–155. https://doi.org/10.1089/jpm.2012.0344 Main purpose and scope: The main purpose of this article is to compare the impact of the palliative care between early intervention and end of life care. They compared clinical characteristics between patients referred late in the course of their disease Brief Description: The authors described palliative care in its changing or evolving forms. They argue that Palliative care is evolving from end-of-life care to care provided earlier in the disease trajectory. Numbers of Participants: The number of human subjects in this study was 695, of which 100 were early referrals. Methodology Use: The researchers used comparative research method for analyzing the data collected. Value and Significance: The value in this study is that it tackles an aspect that has been RESEARCH PROJECT PROPOSAL 9 ignored for a long time. The authors argue that there are no studies on the characteristics, clinical problems, and outcomes of patients referred early to palliative care. Possible Bias: Possible biases identified are the use of cancer patients and the absence of other chronic diseases. Observations: From the topic and issues written in this study it emerges that early referrals were younger and shorter disease duration until first palliative care consultation. Summary: The main points of this study were that early referrals had better chances at recovering and changing a disease trajectory as opposed using palliative care as an end of live care. Article 5 Back, A. L., Park, E. R., Greer, J. A., Jackson, V. A., Jacobsen, J. C., Gallagher, E. R., & Temel, J. S. (2014). Clinician Roles in early integrated palliative care for patients with advanced cancer: A Qualitative Study. Journal of Palliative Medicine, 17(11), 1244–1248. https://doi.org/10.1089/jpm.2014.0146 Main purpose and scope: The main purpose of this article is to show how an elaborate integrated care model ensures that a patient who needs palliative care is well taken care of. Brief Description: The authors described the idea that palliative care is necessary to ensure that the patient receives better quality of life and increased awareness of his health state. This is supported by the need of the patient to survive and improve their lives even in cases where they have advanced cancer. Numbers of Participants: The number of human subjects in this study included two qualitative group interviews and one qualitative individual interview with eight palliative care clinicians. Methodology Use: The researchers used an interview approach or method for collecting data. In analyzing the data collected the researchers simply reviewed and identified the major themes and RESEARCH PROJECT PROPOSAL 10 developed a content-based coding scheme. Value and Significance: The value in this study is the description of the roles of clinicians and possible roles that can be changed to ensure effective achievement of objectives. Possible Bias: Possible biases identified are the fact that the researchers are also doctors and can sympathize (or empathize) with their position, or assume its significance to the study in general. Observations: From the topic and issues written in this study it is evident that the clinician has many roles even into the palliative care of patients. Summary: The main points of this study include the idea that clinicians should have a continuing role in the palliative care, and they have roles that should be integrated into the early palliative care. Article 6 Dahlhaus, A., Vanneman, N., Siebenhofer, A., Brosche, M., & Guethlin, C. (2013). Involvement of general practitioners in palliative cancer care: A qualitative study. Supportive Care in Cancer, 21(12), 3293–3300. https://doi.org/10.1007/s00520-0131904-6 Main purpose and scope: The main purpose of this article is to explore general practitioners' perceptions of their involvement in palliative cancer care and the constraints they confront. Brief Description: The authors described the role that practitioners play in palliative care in cancer patients and how these roles should be maintained. Numbers of Participants: The number of human subjects in this study was 13, all of which were German general practitioners and selected after purposeful sampling. Methodology Use: The researchers used a sampling method to secure the test subjects, and used electronic recordings and transcription to analyze the data collected. Value and Significance: The value in this study is to show how general practitioners are involved in the provision of RESEARCH PROJECT PROPOSAL 11 palliative care of their cancer patients, and how these roles should be taken, or advanced. Possible Bias: Possible biases identified could be in the sampling methods and the small sample size, which could limit the perspectives in the general practitioners’ field. Observations: From the topic and issues written in this study it is evident that doctors are not only intensely involved in the final phase of their patients' lives, but they are also aware of the limitations in their medical skills and knowledge and their ability to provide round-the-clock care. Summary: The main points of this study were that doctors are currently involved in the palliative care of their patients and that they are not well prepared for this role. Article 7 Maloney, C., Lyons, K. D., Li, Z., Hegel, M., Ahles, T. A., & Bakitas, M. (2013). Patient perspectives on participation in the ENABLE II randomized controlled trial of a concurrent oncology palliative care intervention: Benefits and burdens. Palliative Medicine, 27(4), 375–383. https://doi.org/10.1177/0269216312445188 Main purpose and scope: The main purpose of this article is to understand how patients feel about ENABLE II (Educate, Nurture, Advise Before Life Ends) which was aimed at enhancing a patient’s quality of life and mood in cancer patients. Brief Description: The authors described the program which required that the patients evaluate and relay their perspective of the palliative care they received before and after the program. Numbers of Participants: The number of human subjects in this study was 72, of which only 53 agreed to engage in an in- depth interview. Methodology Use: The researchers used a semi- structured interview to collect data and coded the responses into themes for analyzing the data collected. Value and Significance: The value in this study is to show RESEARCH PROJECT PROPOSAL 12 that while research can be done on the care providers, it is also important to consider the patients and the home- based caregivers to share their perspectives on the care received from doctors. Possible Bias: Possible biases identified are exaggerations of the homebased caregivers pertaining to the help they receive from doctors. Observations: From the topic and issues written in this study it emerges that patients assign various aspects of values to physicians, which include enhanced problem-solving skills, better coping, feeling empowered, and feeling supported or reassured. Summary: The main points of this study were that doctors have a major role to play in providing and enhancing palliative care and that the roles of doctors and home-based caregivers should be merged and or at least, complementary. Article 8 Rhondali, W., Burt, S., Wittenberg-Lyles, E., Bruera, E., & Dalal, S. (2013). Medical oncologists’ perception of palliative care programs and the impact of name change to supportive care on communication with patients during the referral process. A qualitative study. Palliative and Supportive Care, 11(5), 397–404. https://doi.org/10.1017/S1478951512000685 Main purpose and scope: The main purpose of this article is to understand how oncologists perceive or understand palliative care and how they feel the changing of the name from palliative care to supportive care will impact the reception and communication with patients. Brief Description: The authors described palliative care and in the context of oncology, how it helps to support the patients in the later stages of cancer. Numbers of Participants: The number of human subjects in this study was 17, all of whom were oncologists. Methodology Use: The researchers used semi- directed RESEARCH PROJECT PROPOSAL 13 interviews to collect data from the participants, and used grounded theory and qualitative methods to analyze the data collected. Value and Significance: The value in this study is that it depicts palliative care as not only a basic need or care, but as an essential timesaving application, and symptom control, transitioning to end-of-life care, family counseling, and improving patients’ ability to tolerate cancer therapies. Possible Bias: Possible biases identified are that the research interviewed only oncologists, who are specialists. To overcome this bias, the researcher should have included perspectives from other professionals who are in the same field or who serve patients treated by oncologists. Observations: From the topic and issues written in this study it appears that the provision of palliative care is not only important to the patients and the oncologists, but it is also unchanged by the changes in the terminology and title. Further, these changes in terminology did not make it easier to interact with the patients. Summary: The main points of this study were the emphasis on the importance of palliative care, and the fact that it should be incorporated into the cancer treatment schedule. Research Questions, Hypothesis, and Variables The relationship between various variables will be tackled through an analysis of research questions, which will culminate to the description of the differences between early and late palliative care education provision. The research question is: In patients diagnosed with chronic or life-limiting disease, how does early palliative care education by a nurse, as compared to no or late palliative education impact a patient’s management (improve quality of life, decrease in symptoms, improve patient satisfaction) over 12 months? RESEARCH PROJECT PROPOSAL 14 The research hypothesis is that in patients diagnosed with chronic or life-limiting disease early palliative care education by a nurse will have a positive impact on patient’s management, measured in improved quality of life, decreased symptoms and improved patient satisfaction, as compared to no or late palliative education over 12 months. The null hypothesis is that in patients diagnosed with chronic or life-limiting disease early palliative care education by a nurse will not have a positive impact on patient’s management, measured in improved quality of life, decreased symptoms and improved patient satisfaction, as compared to no or late palliative education over 12 months. The independent variable presentation of early or late palliative care education that will determine the enhanced life of the patient. The dependent variable is the health of the patients, which is determined by the palliative care and measure by enhancing quality of life, and decreased symptoms. The operationalizing variables of variable will be done through the qualitative information and quantitative data received from research materials and secondary sources. Theoretical Framework Overview and Guiding Propositions The theory of self-actualization provided the theoretical foundation of this research proposal. Abraham Maslow created this theory from his broad theory of the hierarchy of needs. According to him, self-actualized individuals are the ones who are psychologically healthy and are therefore at a higher level of the hierarchy of needs. Also, he contends the notion that self-actualizing people are creative and highly RESEARCH PROJECT PROPOSAL 15 demonstrate an ability to resolve contradictions characterized by ultimate contraries such as life and death. Under self-actualization theory, Maslow he argues that an individual does not need to transcend the self-actualization needs in a linear, direct and subsequent stage. He postulates that creative individuals are capable of being self-actualized, free from their mental health or the lack of it. Maslow describes self-actualization as the ability surpass the levels of physiological, social and psychological needs and obtaining personal needs fulfillment regarding the meaning of life (Maslow, 1950). Self-actualization is said to occur when an individual can exploit his or her advantages and as well be aware of the limitations. According to Maslow, selfactualization the desire that drives people to realize their full potential and also realize their biggest limitations or disadvantages and be able to live with them comfortably. A self-actualized person has reached human existence's apex not physical achievements but psychological well-being. Self-actualized people display a strong sense of fulfillment irrespective of their physiological condition or physical health. Abraham Maslow, therefore, identified some characteristics of self-actualized individuals. They include selfacceptance and acceptance of others, find humor in their mistakes, have a perception of reality for themselves and others, have a sense of purpose, experience regular moments of profound joy and happiness, (peak experiences), show compassion and empathy for themselves and others as well as appreciating the goodness of life. Self-actualization in person-centered therapy is associated with human potential, defines human nature and motivates human behavior. Person-centered therapy involves choosing the direction of motivating a person and individuals who have a negative attitude about themselves or who are facing difficulties to come to terms with reality are RESEARCH PROJECT PROPOSAL 16 assisted to become self-actualized. Self-actualization focuses on individual strengths as opposed to failings. Application of Theory to Study Focus In this project proposal self-actualization will be used to support the research from the perspective that palliative care education, when offered to chronically ill or diagnosed patients assists them and their relatives to become self-actualized about their situation hence play a critical role in determining the quality of patient management and reduction of symptoms as well as improved their satisfaction. Self-actualization in this research is directly related to patient satisfaction through palliative care, and the lack of palliative care is related to a lack of self-actualization. About this research and self-actualization death is part of living and both death and life provide opportunities for self-actualization and personal growth. From the characteristics of self-actualized individuals, the project will identify palliative care as key in instilling these characters or qualities in chronically ill patients which improve their psychological and physiological condition. This study will also anticipate that palliative care education provides person-centered therapy to patients and focuses on identifying their strengths rather than weaknesses which improve the patients' physical and psychological well-being. Methodology Sample/Setting The research will involve sampling from a pool of people who have interacted with either form of palliative care education and who can honestly share their experiences about these approaches to palliative care. The idea is to show that the impact of the early or late (or no) palliative care education is felt by the people who are in the community, RESEARCH PROJECT PROPOSAL 17 and the patients can easily attest to this. Further, previous articles or secondary data that will be used will need to be sampled to find the sources that directly relate to quantitative data sources. The samples will be representative samples thus they will be selected in a manner that represents the population of study. This type of sample was select because it provides credible or valid results that reflect on the traits within the population selected. Sampling Strategy The sample will be chosen randomly. According to Cormack (2016 ), the method of randomly selecting the sample is the best, because it represents the population of interest and also eliminates sampling bias. The sampling frame for this study is the cancer patients admitted to the oncology unit where this author works, and a hospice care agency in the area. The patients and nurses within the unit and the agency will be included in this study at random, as data will be collected to determine if early palliative education makes a difference in patients with chronic or life-limiting disease’s quality of life. All the participants will be of any race, religion, or ethnic background along with education of level. Education will not be a factor as the feedback expected will be based on observation. However, the researcher will perform a random sampling strategy that will be aimed at a pool of participants of religious, gender and racial diversity. Research Design The design of this research is quantitative quasi-experimental design to show the relationship between the variables (Grove, Burns, & Gray, 2013).). According to Cormack (2016), qualitative researchers are required to use a small, selected sample centered in-depth nature of the study and the necessary data analysis. As per, Grove et al. (2013) when using two variables, it is advised that the researcher a use at least 60 RESEARCH PROJECT PROPOSAL 18 participants. Therefore, a minimum of 50 participants and a maximum of 100 will be surveyed in this study. This study will use a survey method. The survey method is preferred because it has a standard measurement approach. However, this method has its shortcomings, which are centered around inflexibility, validity and reliability threats. Secondary data will also be used by incorporating research by other scholars and researchers to complement ideas generated by the researcher. The survey approach attempts to collect data from members of a large population on one or more variables. This research design was found to be appropriate because it provided detailed data directly from the field to meet the research objectives. The survey design is accurate and has greater efficiency. It was more relevant for the purpose of finding the experiences and perceived benefits of introducing palliative care education at the early stages of an illness. Extraneous Variables In a study, extraneous variables are factors that confound the capability of a researcher to demonstrate causation. There are two kinds of extraneous variable; external variables and intrinsic variables that included age, gender, and diagnosis. On the other hand, external factors arise from the research itself. In this research proposal, the researcher has managed to handle all the intrinsic variables because all the participants will be of any religion, race or ethnic background along with the level of education. The educational barrier will not hinder the feedback from the participants as it will be based on observation. RESEARCH PROJECT PROPOSAL 19 Extraneous variables arise from the research itself, and in this research, they are selection bias and confounding that contribute to overestimate and underestimate of the real influence of the treatment (Spruyt, 2016). Selection bias is problematic in this observation research of intervention because of the characteristics of the clinicians, patients, system, and the context as it will affect the choice of who receives the treatment. Another kind of selection bias is the healthier volunteer bias that happens when some of the participants are generally healthier than others. Selection bias results into confounding that occurs when the independent variable (presentation of early or late palliative care education that will determine the enhanced life of the patient), and dependent variable (the patient’s health) predisposes selections into the treatment that correlate with outcome. The correlation of these variables with the outcome and the treatment will result in type 1 errors whereby the outcomes of the treatment will be falsely accredited to the intervention rather than the confounding treatment. Alternatively, confounding can also lead to type II error whereby the research will falsely conclude that there are no treatment effects. For instance, patients in palliative care services are likely to have high comorbid conditions and organ systems needing treatment. This group is likely to receive early treatment for cancer conditions unless they are contrasted to other patients who received early palliative care. Therefore, without accounting for the baseline symptoms and severity of the condition, then early palliative care could be the source of discomforts. Before the execution of the research, the Evidence-based Practices Model states that modifications to the contemporary palliative care practices should be piloted. With early interventions in palliative and palliative care education there, instrumental variables RESEARCH PROJECT PROPOSAL 20 approach will be used to control extraneous variables (Spruyt, 2016). The researcher will use instrumental variables that will have to meet two conditions. The first condition is that the variables should be relevant while the second requirement is that they should not be able to influence the outcome directly on through the effect of the treatment. In this palliative care research, this will mean that the researcher will be looking for variables that will predict the choice of the patients in the setting but do not impact the succeeding outcomes, apart from the onset palliative care versus late palliative care. Description of the Intervention PQLI (Palliative Care Quality of Life Instrument) is a type of instrument used to evaluate the psychometric characteristics of the value of life instrument on terminally ill patients getting palliative care (Spruyt, 2016). It was viewed to be succinct, quantitative and simply applicable; more so, it is designed for use by users in palliative care themselves and based on the current literature. The instrument has items that regarded to be important to what is perceived as end-of-life care. During the research, as evidenced from the qualitative evaluation on the description of the patients on the QoL, there is a necessity to partake in the intervention process because this will provide them with sense of control over their severe condition. Normally, patients require recognition in the palliative care and involvement in the intervention choices incorporates the psychosocial results that they might possess in their lives. When assessing the quality of life in critically sick cancer patients, the treatment choice is the palliative one, and hence we regard the significance of the addition of a new measurement when assessing the quality of life. Lack of a questionnaire in the end-of-life setting and the availability of the unique needs of the patients was the driving force for such a measurement to be used. RESEARCH PROJECT PROPOSAL 21 Test-retest reliability of the participants (N= No. of patients) will be assessed by relating the tallies documented on two occasions, an average of one week apart (Spearman rho test). The clinical phase of the patients did no vary between the first and second completion. Additionally, the state of the patients was steady between the examination and re-examination. Because of its hierarchical condition, interest reliability of the rank reports (Selection of Intervention) was determined by applying the Kendall’sW test (Mohanti, 2011). Two indirect methods will be applied in the evaluating the validity. By assessing the statistical variance of the questionnaire prior and during the intervention in terms of Wilcoxon rank test amid the scale of similar subjects. The second method was the Exploratory factor analysis (Mohanti, 2011). The fundamental principle with direct oblivion rotation was applied to evaluate the validity of the PQLI. The purpose of intervention in this research proposal is to bring a change into the feeling, behaviors, and thoughts of the participants. In this palliative and end-of-life care, complex intervention will be used (Mohanti, 2011). This is because mixed method approaches work well within the multiphase model of the intervention evaluation and development. However, the guidance of generic mixed method will be helpful, but it presents challenges in the quantitative quasi-experimental design and its use in the endof-life-care have an influence on the application of the mixed methods. A one-day workshop will be carried out where the nurses in the palliative care hospital participated in the facilitated groups. After getting the consent of the patients to carry out the research, instructions will be given on the intervention day and they will be selected based on program adherence and other physiological factors. The intervention group will ensure RESEARCH PROJECT PROPOSAL 22 that the research studies the impact of early and late palliative care on the health of cancer patients. Data Collection Procedures The data-collection tool will be TELEform whereby the assessment will be carried out in 12 months. Data sources like summary notes and emails will be collected through discussions and meetings with the caregivers, staff, and patients. For resource utilization and data quality, descriptive statistics will be used. This tool of data collection is based on optical recognition, and it will be able to respond to the requirements of contemporary data processing. Additionally, it is helpful in terms of data quality, work practice and resource utilization. Data Analysis Plans The data to be analyzed will be obtained from the survey results. The dataset will contain a sample of 100 patients undergoing the palliative care. The analysis of the dataset will seek to evaluate the difference between the early palliative care education and the late palliative care education and their impact on improving the quality of patient’s life as well as reducing the underlying symptoms of the patient’s diagnosis. Demographic variables Demographic data variables describe the attributes of the population including the age, gender, the income level, ethnicity, the size of the population, as well as the education level (Ott & Longnecker, 2015). The study will seek to evaluate the measures of central tendency; mean, mode, and median, and the measures of dispersion; the standard deviation, variance, and range, of the demographic variable. For instance, it will seek to establish the typical age of the data sample, the average income, the gender as RESEARCH PROJECT PROPOSAL 23 well as the education level of the patients. However, by evaluating the five number summaries, the study will seek to establish any outliers in the data set as well the skewness of the data variables. Additionally, graphs and tables will be used in order to give a clear analysis of the various data variables. Study variables The analysis of the study variable seeks to answer the critical questions of the study. These variables include the palliative care services provided, the time at which the palliative care education was initiated, the benefits obtained regarding reduction of symptoms and the improvement of the quality of life of the patients. Since some data variables will be qualitative in nature, they will be assigned codes for better analysis. The descriptive tests that will be employed include; the five number summary, the measures of dispersion and center. The data will, however, be grouped into two portions; early palliative care education and late palliative care education in order to employ the ANOVA test and the T-test to evaluate the difference in between the means and the variances of the two portions. Additionally, confidence intervals will be employed in order to better analysis and understanding the research variables. Ethical Issues Discuss here. Limitations of Proposed Study Discuss here. Implications for Practice Discuss here. RESEARCH PROJECT PROPOSAL 24 References Bliss, J., & While, A. (2007). District nursing and social work: palliative and continuing care delivery. British Journal of Community Nursing, 12(6), 268–72. https://doi.org/10.12968/bjcn.2007.12.6.23775 Cormack, D. (2016). The research process in nursing. Oxford [u.s.]: Blackwell Science. Eriksson, G., Bergstedt Wahlström, T., & Melin-Johansson, C. (2014). The need for palliative care education, support, and reflection among rural nurses and other staff: A quantitative study. Palliative & Supportive Care, 13(2), 1–10. https://doi.org/10.1017/S1478951513001272 Grove, Susan, Nancy Burns, Jennifer Gray. The practice of nursing research: appraisal, synthesis, and generation of evidence, 7th Edition. W.B. Saunders Company, 2013. [South University]. King, J. D., Eickhoff, J., Traynor, A., & Campbell, T. C. (2016). Integrated oncopalliative care associated with prolonged survival compared to standard care for patients with advanced lung cancer: A retrospective review. Journal of Pain and Symptom Management, 51(6), 1027–1032. https://doi.org/10.1016/j.jpainsymman.2016.01.003 Kwon, J. H., Hui, D., Chisholm, G., Ha, C., Yennurajalingam, S., Kang, J. H., & Bruera, E. (2013). Clinical characteristics of cancer patients referred early to supportive and palliative care. Journal of Palliative Medicine, 16(2), 148–155. https://doi.org/10.1089/jpm.2012.0344 Maslow, A. H. (1950). Self-actualizing people: a study of psychological health. RESEARCH PROJECT PROPOSAL 25 Personality. Mohanti, B. (2011). Research focus in palliative care. Indian Journal of Palliative Care, 17(4), 8. http://dx.doi.org/10.4103/0973-1075.76231 Murray, M. (2007). Crossing over: transforming palliative care nursing services for the 21st century. International Journal Of Palliative Nursing, 13(8), 366-376. Ott, R. L., & Longnecker, M. T. (2015). An introduction to statistical methods and data analysis. Nelson Education. Shima, Y. (2010). Introduction to palliative care for the oncologist-history and basic principles of palliative care. Cancer & Chemotherapy, 37(10), 1849–1853. Spruyt, O. (2016). Qualitative research in palliative care. Indian Journal of Palliative Care, 22(4), 367. http://dx.doi.org/10.4103/0973-1075.191739 Venkatesan, P., Harikesavan, K., Kumar, S., Karthikbabu, S., Syed, N., Sisodia, V., & Jaykumar, S. (2012). Study of nurses’ knowledge about palliative care: a quantitative cross-sectional survey. Indian Journal of Palliative Care, 18(2), 122– 127. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3477365/ RESEARCH PROJECT PROPOSAL 26 Appendices
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Minitab descriptive statistics can be deployed in summarizing a large set of data
into few explainable values such as the typical value, and the spread of data values from
the mean. Additionally, the median value obtained from the Minitab is a good indicator
of center in cases where the data is skewed. Minitab descriptive statistics also gives the
idea about the spread of the data set by giving out the standard deviation, the five number
summary as well as skewness of the data variables (Cramer). For instance, the Minitab
descriptive statistics gave a summary of the Math Anxiety data set as shown below. From
the summary, we can deduce the spread of the data varia...


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