The Literature Review

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The Literature Review

• Primary Sources
• Secondary Sources
• Theoretical literature
• Empirical literature
• Integrative reviews
• www.best4health.com/
• www.cochrane.org/
• www.guideline.gov
• www.stti.iupui.edu/library/ojksn/
• www.ahcpr.gov/clinic/

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Definition of a Literature Review

• A systematic and explicit approach to the
  identification, retrieval, and bibliographical
  management of independent studies locating
  information synthesizing developing
  guidelines

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Purposes of the Lit. Review

• Facilitate development of the Conceptual
  Framework by summarizing knowledge
• Clarify the research topic
• Clarify the research problem
• Verify the significance of the research problem
• Specify the purpose of the study
• Describe relevant studies or theories
• Develop definitions of major variables
• Select a research design, data measurement, data
  collection analysis, interpret findings

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Ethics and Research

• Starts with the study purpose, design, methods of
  measurement, and subjects
• Guidelines for all of these
• It is still a concern today
• More recent ethical issues are
• Fabrication of a study
• Falsification or forging of data
• Dishonest manipulation of the design or methods
• Plagiarism
• 50 of the top 50 research institutions in US
  have been investigated for research fraud

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Ethical Problems in Historyhttp//helix.nih.gov8
001/ohsr/mpa/45cfr46.php3

• Nazi medical experiments (1933-1945)
• Tuskegee syphilis study by the USPHS (1932-1972)
• Willowbrook study (1950-1970) Hepatitis study
• Jewish Chronic Disease Hospital study with live
  CA cells in 1960s

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Ethical Problems in History

• University Atomic Energy Government Exp.
• 18 men and women injected with plutonium to
  determine body distribution (at the time said to
  be terminal) 1945-47
• 20 subjects ages 63-83 given doses of radioactive
  radium and thorium inj. or oral. 1961-65
• 64 male inmates at Washington St. Prison had
  testicular radiation to determine the smallest
  does to makes someone sterile. 1963-70
• 125 retarded residents were fed radioactive ir9n
  and calcium to see if a diet rich in cereal would
  block the digestion of those two minerals.
  1946-56

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Nuremberg Code-1949

• Voluntary consent
• Must yield fruitful results for society
• Anticipated results justify the type of
  experiment
• Avoids all unnecessary physical-mental injury
• Cannot do studies that have a known injury or
  death unless the exp. Physician is a subject
• Risk does not out weight humanitarian benefit
• Proper precautions to prevent injury, dis., death
• Conducted by qualified persons
• Subjects can always stop the study
• Researcher must always be ready to stop the study
  (risk)

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Declaration of Helsinki-1964-84

• Differentiated therapeutic vs. non-therapeutic
  research
• Clinical vs. Basic
• Greater care to protect subjects in
  non-therapeutic research
• There must be a strong, independent justification
  for exposing a healthy vol. to substantial risk
• The investigator is to protect the health and
  life of research subjects

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The Belmont ReportThree Ethical Principles

• Principle of respect for persons
• Right to self determination and freedom to
  participate or not
• Principle of Beneficence
• Do no harm to others
• Principle of Justice
• Treat everyone fairly without discrimination
• Led to USDHHS Code on Ethics
• Title 45, Part 46 (45 CFR 46)
• Office of Human Subjects Research (OHSR) within
  NIH
• http//helix.nih.gov8001/ohsr

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Generally Called Subject Rights

• Right to self-determination (can stop the
  research)
• Right to privacy-anonymity-confidentiality
• Right to fair treatment
• Right to protection from discomfort and harm

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Institutional Review Board

• IRB review process 4-6 weeks
• Consent forms (voluntary subjects)
• Disclosure forms
• Confidentiality
• Compensation disclosure
• Ethics documented in the research
• Accountability to rules, regulations, and legal
  entities

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Research Problem

• The research problem dictates the method of
  inquiry (research method, or research design)

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Problem ClarificationgtMethod

• What are the mothers ages, education level, and
  marital status for those who have a child with a
  birth defect from low folic acid intake in Denver
  County?
• There is a significant difference between mothers
  ages 15-19 having babies with birth defects when
  placed on supplemental folic acid versus those
  without the supplements.

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Problem ClarificationgtMethod

• What is the relationship between mothers ages
  15-19 who have effective dietary habits and folic
  supplement use versus those that do not in
  relation to the number of birth defects in Denver
  county.
• There is no statistical difference between women
  ages 15-19 having babies with birth defects from
  low folic acid intake when randomly comparing
  Denver to Jefferson Counties

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Problem ClarificationgtMethod

• How did M. Jones (a 15 y.o.) mother have good
  nutrition with Folic Acid supplements, still have
  a baby with neural-spinal tube closure defect?
• What is the experience of Jefferson County teen
  mothers (ages 15-19) caring for babies with
  spinal cord defect associated with poor
  nutrition?

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Problem ClarificationgtMethod

• What keeps teen mothers (ages 15-19) from being
  nutritionally prepared for pregnancy when they
  know being sexually active is logically and
  directly related to becoming pregnant?

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Problems

• Hypotheses
• Predicts a relationship between variables
• More precise than a problem statement
• Must be written before collecting the data
• Testing the hypothesis is the heart of empirical
  research
• They are never proven, they are accepted or
  rejected

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Problems

• Hypotheses
• Identify the population, specify the variables,
  indicate the type of research, indicate variable
  measurement techniques, suggest an appropriate
  sampling method, and guide the interpretation of
  results
• Help link theory to reality and back to theory
• Encourage logical thinking to reduce
  misinterpretation

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Types of Hypotheses

• Simple predicts a relationship between 1
  independent and 1 dependent variable
• Null (or statistical) predicts no relationship
• Complex predicts a relationship with 2 or more
  independent and dependent variables
• Directional predicts the relationship between
  the variables (simple or complex)
• Nondirectional no relationship predicted
• Research most commonly used for clarity, is
  directional and in relational form.

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Research Question

• Used when knowledge is insufficient or in
  qualitative studies (exploratory, descriptive)
• Written as interrogative sentences-present tense
• Identifies the problem
• Contains one of more variables
• Reflects the problem statement
• May or may not be empirical
• Focuses on variables and their possible
  relationships