Evidence Based Practice Exam #1 Review – Flashcards
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What is Nursing Research?
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The systematic, rigorous, logical investigation that aims to answer questions about nursing phenomena.
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What is Clinical Nursing Research designed to do?
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Generate evidence to guide nursing practice and to improve the quality of care.
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What is Evidence-Based Practice?
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The collection, interpretation, and integration of valid research evidence, combined with clinical expertise and an understanding of patient and family values and preferences to inform clinical decision making.
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What is Clinical Decision Making?
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Nurses using best available evidence, combined with their clinical judgment and patient preferences to influence the nature and direction of health care delivery, and document outcomes related to the quality and cost effectiveness of patient care.
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What is Quality Improvement?
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The systematic use of data to monitor the outcomes of care processes as well as the use of improvement methods to design and test changes in practice, the aim of which is to continuously improve the quality and safety of health care systems.
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What is the role of Nurses in research?
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Evaluate strengths & weaknesses of research evidence & uses existing standards to determine the merit & readiness of research for use in clinical practice.
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What is the difference between Research, Evidence-Based Practice and Quality Improvement Processes?
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RP: Use appropriate design & specific methodology to TEST RESEARCH HYPOTHESES AND ANSWER THE RESEARCH QUESTION EBPP & QIP: Question is used to search literature for ALREADY COMPLETED STUDIES to bring about improvements in care
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What is the difference between Quantitative and Qualitative Research?
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Quantitative: Aims to test cause & effect relationships between variables & effectiveness of interventions, uses numeric data to describe phenomena, data collected from a large number of subjects, uses an objective approach Qualitative: Aims to understand meaning of a human experience, uses words to describe experiences, data collected from a small number of subjects, uses a subjective approach
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What is the Research Process?
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A series of steps of developing any kind of research. Can be qualitative, quantitative, or mixed.
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What is a Systematic Research journal article?
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A summation & assessment of a group of studies that used similar designs based on a focused clinical question.
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What is a Meta-Analysis journal article?
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A summary of a number of studies focused on a topic using a specific statistical methodology to synthesize findings in order to draw conclusions.
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What is an Integrative-Review journal article?
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A focused review & synthesis of literature without statistical analysis. Can include both qualitative & quantitative articles.
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What is a Meta-Synthesis journal article?
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Synthesis of a number of qualitative studies on a focused topic using specific qualitative methodology.
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What is critical reading?
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Refers to a careful, active, reflective, analytic reading.
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What is critical thinking?
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Involves reflecting on the validity of what you have read in light of our prior knowledge and understanding of the world.
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What is a preliminary understanding level of critical reading?
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Familiarize yourself with the study. Skim abstract and article.
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What is a comprehensive understanding level of critical reading?
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Understand research purpose/intent, clarify unfamiliar terms/concepts.
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What is an analysis understanding level of critical reading?
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Understand parts, critique soundness.
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What is a synthesis understanding level of critical reading?
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Understand whole article & each step of Research Process.
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What is a critique?
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Process of objectively & critically evaluating a research report's content for scientific validity or merit & application to practice, theory & education.
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What are critiquing criteria?
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Standards, appraisal guides, or questions used to judge/assess an article.
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Critical reading requires four stages of understanding. What is the last stage?
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Synthesis
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What is an assessment of a group of research studies that test a similar research question?
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Systematic Review
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What is an Evidence Hierarchy Model?
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A model for rating level of evidence, associated with a study's design which helps nurses think about strengths & weaknesses of a study & nature of evidence provided in the findings & conclusions.
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What is the difference between Level I and Level VII of Evidence?
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Level I: (Narrow) Systematic review or meta-analysis of randomized controlled trials. Evidence based clinical practice guidelines based on systematic reviews. Level VII: (Broad- anyone can say anything) Opinion of authorities and/or reports of expert committees.
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What is the first step in research or evidence-based practice?
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Defining a problem and asking a question.
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What is PICO?
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P- patient or problem I- intervention, cause or prognosis C- comparison or control O- outcome or results
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What is the PICO of the following question: "In infants born prematurely, compared to those born at full term, what is the subsequent lifetime prevalence of sensory deafness?"
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P- Infants I- Premature C- Full term O- Sensory deafness
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What is the PICO of the following question: "In patients with recurrent furunculosis, do prophylactic antibiotics, compared to no treatment, reduce the recurrence rate?"
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P- Patients with recurrent furunculosis I- prophylactic antibiotics. C- No treatment O- Reduction in recurrence of furunculosis
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What is a Research Problem?
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Enigmatic, perplexing, or troubling condition.
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What is a Research Question?
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Specific queries researchers want to answer in addressing the research problem.
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What is a Purpose?
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Researcher's summary of the overall goal. May identify several aims/ objectives.
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What is a Hypothesis?
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Specific prediction about answers to the research questions.
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What are the steps in developing a Research Question?
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-Define a specific question area -Review relevant literature -Examine potential significance of the question to nursing. -Pragmatically examine feasibility of studying a research question.
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What are the three characteristics of a well developed Research Question?
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1. The variables being considered are clearly identified. 2. The population being studied is specified. 3. The possibility of empirical testing is implied.
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What is the criteria for examining significance of research question?
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Knowledge derived from the study should have potential benefits for patients, medical personnel & society.
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What is the criteria for examining feasibility of research question?
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Is there TIME? Is the population of INTEREST available? Are facilities, equipment, and MONEY adequate? Does the researcher have the EXPERIENCE and skills necessary? Are there ETHICAL DIFFICULTIES?
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What is the difference between an Independent and a Dependent variable?
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Independent Variable- (X) The presumed cause, has effect on dependent variable, predictor variable, control variable, varied or manipulated by the researcher. Dependent Variable- (Y) The presumed effect/result, changes in response to independent variable, response variable, outcome variable, being observed or measured. Changes in X do NOT necessarily CAUSE changes in Y.
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What is an example of a Correlation research question?
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Is there a relationship between pain and functional disability in black and white adults? (Quantitative)
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What is an example of a Comparative research question?
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Do mothers who receive home based nursing intervention for infant irritability report less parenting stress tan mothers who did not receive the intervention? (Quantitative)
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What is an example of an Experimental research question?
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What is the difference in physical, social & emotional adjustment in women with breast cancer who have received PSS education by video vs by telephone counseling? (Quantitative)
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What is an example of an Phenomenological research question?
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What is the meaning of the health care provider relationship for women with chronic illness & how they believe it affected their health? (Qualitative)
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Identify the variables of the following question: "What is the effect of patient-controlled analgesia (PCA) on pain ratings by postoperative patients?"
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IV: Patient-controlled analgesia (PCA) DV: Pain ratings
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Identify the variables of the following question: "Is there a relationship between pain and functional disability in black and white older adults?"
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IV: Pain DV: Functional disability
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What is the definition of a Theoretical/Conceptual variable?
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Presents abstract or theoretical meaning of concepts being studied.
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What is the definition of an Operational variable?
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Specifies operations that researchers must perform to collect required information. Characterized by using "measured by".
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What are the characteristics of a good research Hypothesis?
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-Relationship Statement -Testable -Theory base -Wording clear, simple & concise terms
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What is the difference between Statistical and Research Hypotheses?
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Research H: also known as Scientific H, Predicts the expected outcome, There is a relationship between X & Y, May be directional or non-directional. Statistical H: also known as Null H, States that there is NO relationship between X & Y.
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What is the difference between a Directional and a Non-Directional research Hypothesis?
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Directional: predicts the expected direction of the relationship between X and Y. Non-Directional: does NOT predict the anticipated direction of the relationship between X and Y but shows differences.
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What questions should you ask when critiquing the Research Question?
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Does the research question express a relationship between two or more variables, or at least between an IV and a DV? Does the research question specify the nature of the population being studied? Does the research question imply the possibility of empirical testing?
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What question should you ask when critiquing a Clinical Question?
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Does the clinical question specify the patient population, intervention, comparison intervention and outcome?
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What is a literature review?
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A systematic and critical appraisal that provides the development and foundation of a research study and theoretical framework.
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What is theoretical or conceptual framework?
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The basis for the development of research questions or hypotheses that can be viewed as a map for understanding the relationships between or among the variables in quantitative studies.
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What is a primary source for literature review?
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Research articles and books by the original author.
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What is a secondary source for literature review?
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Published articles or books that are written by persons other than the individual who conducted the research study or developed the theory.
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What are the components of the Research Process?
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-Research question and hypothesis -Design and method -Outcome of the analysis
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What is the goal of the researcher in the Literature Review?
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-Develop the knowledge foundation necessary to design a sound study -Generate research questions and hypotheses
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What is the goal of the consumer in the Literature Review?
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Answer a clinical question or solve a problem to improve patient outcomes.
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What are the first three steps of the Evidence-Based Practice Process?
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-Asking clinical questions -Identifying and gathering evidence -Critically appraising and synthesizing the evidence or literature
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How far back should a search go?
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Usually 5 years is good, but some advanced projects may require searches that go back 10+ years.
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What should the critique of each reviewed study include?
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Strengths, Weaknesses, Limitations of the design, Conflicts, and Gaps in information.
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Which source provide the most information on Evidence-Based Practice?
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Cochrane Systematic Review
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A nurse researcher finds four useful resources. What is an appropriate next action?
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Review the resources in the articles.
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The author of the nursing theory on which you are basing a review is in attendance at a social function. What might you do next?
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Introduce yourself and ask for an appointment at a later date.
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What is a theory?
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Set of interrelated concepts that provides a systematic view of a phenomenon which allows relationships to be proposed and predictions made, which in turn can suggest potential actions .
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What are concepts and constructs?
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Major components of theories that convey the essential ideas or elements of a theory.
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What are Grand Nursing Theories?
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Sometimes referred to as "nursing conceptual models." All-inclusive conceptual structures that tend to include views on person, health, and environment to create a perspective of nursing.
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What are Middle Range Nursing Theories?
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Theories that contain a limited number of concepts and are focused on a limited aspect of reality. More readily used as frameworks for research studies.
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What are Situation-Specific Nursing Theories?
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Sometimes referred to as "micro-range," "practice," or "prescriptive" theories. Narrow in scope; explain a small aspect of phenomena and processes of interest to nurses; usually limited to specific populations or field of practice.
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How is Theory used in Nursing Research?
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-Generated as the outcome of a research study -Used as a research framework, as the context for a study -Research is undertaken to test a theory
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A set of interrelated concepts that provide a systematic view of a phenomenon is:
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Theory
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Which type of theory would be best to use when studying self-care habits of patients with type 1 diabetes mellitus?
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Situation-specific theories
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What is the first question to ask when critiquing the theoretical framework of a research study?
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Is the framework for research clearly identified?
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What is the application to Research and Evidence-Based Practice?
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Provides parameters for the research and enables the researcher to weave the facts together. Identify whether Intent is to (1) generate a theory, (2) use the theory as the framework that guides the study, or (3) test a theory.
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What is the application of Theory in Qualitative Research?
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Grounded theory. Findings grouped into "themes." Framework or theory usually found at the end of the manuscript in the discussion section.
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What is the application of Theory in Quantitative Research?
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The framework is typically identified and explained at the beginning of the paper, before the discussion of study methods.
