Extraneous Variables and Controlling Plan
The research devoted to the testing of the cocreation of possibilities intervention (CP) as presented by Bergdahl, Benzein, Ternstedt, Elmberger, and Andershed (2013) is going to be a field study and have a correspondent number of extraneous variables (EV), many of which can be unexpected. According to Polit and Beck (2014), randomization is a strategy that “controls all possible confounding variables without researchers having to identify them” (p. 174). Also, the patients will be in relatively matching conditions: they will proceed to see their NP and receive relevant treatment; the changes in the data will be analyzed individually. Therefore, the “matching” EV control strategy will be used (Polit & Beck, 2014). Besides, the significant changes in the QoL of the patients that are related to specific changes of extraneous variables (disease, unexpected developments in the environment or family relations) will be documented separately and taken into account; in other words, they will be controlled.
Instruments
Existing Instruments
Validity (warranty) and reliability (stability) are the key identifiers of the usability of a tool, especially one aimed at measuring abstract ideas and based on self-reporting, which is the case with the current research (Kimberlin & Winetrstein, 2008). Indeed, the study needs to measure the quality of life (QoL) of the patients, their relationships with NPs, and NPs’ ideas concerning CP. The WHO (2016) QoL Group has been developing and testing a WHO QoL tool. In it, five-responses Likert scale questionnaires provide the ordinal data that reflects patients’ assessment of their physical and psychological, social relationships, and the general perception of the QoL. According to WHO (n.d.) the questionnaires “display good discriminant validity, content validity and test-retest reliability,” but the specific estimates are not provided (p. 4).
The number of scales available to measure specifically NP-patient interpersonal relationships does not appear to be very abundant. Cossette (2006) has developed the Caring Nurse-Patient Interactions Scale that is capable of demonstrating the way the patient perceives various aspects of the NPs’ care, including the problem-solving, educational, supportive, and other behavior. This questionnaire also uses the Likert scale; its internal consistency (reliability) estimates ranged from middle to high for different subsections (Cossette, 2006, p. 707). Also, the data to demonstrate its construct (correlational with respect to theoretical expectations) validity has been accumulating, and its content validity appears to be obvious (Cossette, 2006, p. 208).
The specific parts of the tools will be selected when the final sample is confirmed (they may depend on the disease).
New Instruments
The only new instrument that we plan to introduce is the qualitative data questionnaire devoted to the NPs’ opinions on CP. The questions will be used for semi-structured interviews: such a means of data collection will encourage more extensive answers and suggestions, which will improve the content validity of the data gathered. This instrument is unlikely to require testing for reliability.
Description of the Intervention
CP as described by Bergdahl et. al (2013) consists of the determination, discussion, approval or substitution, and planning with respect to patients’ needs and wishes (goals) that are not connected to healthcare directly but may be influenced by it. This intervention is often carried out intuitively, but informed CP is proposed to ensure its success in this study.
The “intervention” of this research, therefore, consists in training the NPs from the CP group. The training will include providing the NPs with the reading material and carrying out a workshop during which CP will be explained, discussed, and roleplayed.
Data Collection Procedures
It would be expected that practicing CP will change the effectiveness of NPs’ related activities, and their attitude to it, which is why the data will be gathered several times. The data of the patients will be collected before the intervention for both groups and every three months after it. The place of data collection will depend on patients’ conditions, and the questionnaires may be administered by NPs. For the intervention NP group, the data will be gathered immediately after the training and after the study.
References
Bergdahl, E., Benzein, E., Ternstedt, B., Elmberger, E., & Andershed, B. (2013). Co-creating possibilities for patients in palliative care to reach vital goals: A multiple case study of home-care nursing encounters. Nursing Inquiry, 20(4), 341-351. Web.
Cossette, S. (2006). CNPI User Guide and Related Articles. Web.
Kimberlin, C. L., & Winetrstein, A. G. (2008). Validity and reliability of measurement instruments used in research. American Journal Of Health-System Pharmacy,65(23), 2276-2284.
Polit, D., & Beck, C. (2014). Essentials of nursing research. Philadelphia: Lippincott Williams & Wilkins.
WHO. (2016). The World Health Organization Quality of Life (WHOQOL). Web.
WHO. (n.d.).Introducing the WHOQOL instruments. Web.