Posted: August 14th, 2023

NURS 540Sample Selection, Reliability, and Validity Assessment in Advance Care Planning Research

All components of this project have been completed in previous weeks, so your final research proposal project paper should be cohesive, polished, and incorporate feedback from your instructor from the previous weeks. Your research proposal should be between 10 and 15 pages. Follow proper APA format and style and include a cover page, reference page, and any applicable tables or appendices. Your research proposal should have a nursing theoretical foundation.

Your research proposal must include the following sections:

Background and rationale for the study
Review of the relevant literature
Design and methodology
You must include the following components:

Section One: Introduction

The research proposal should:

Start with a statement of the problem and objective for the study, which articulates the main objectives that the study desires to achieve.
Include a description of the theoretical framework to be utilized and a rationale for choosing a framework.
Describe the significance and relevance of the problem. Why is this particular study needed? How will findings contribute to the field of advanced practice nursing? Why is this research needed?
Section Two: Literature Review

The literature review should:

Be a synthesis of the major concepts from recently published research findings.
Be organized by themes and not just a report about what each author discovered in his or her research findings.
Identify no fewer than six relevant research articles.
Synthesize the literature in relation to where the study fits within the context of the proposed study.
Section Three: Design and Methodology

In this section, what is to be done, and who, what, how, and where are all to be included in your proposal. The methods should be relevant to the question that is to be answered as a result of the research study. There should be information included about the study design, the setting and sample, data collection methods, and data collection analysis procedures. Ethical considerations should also be addressed in this area. Limitations and a plan for communicating the research findings should also be included in this section.

All critical elements of design and methods should be detailed, including:

Definitions of the variables
Identification of the population and sample
Procedures for sampling
Processes for obtaining consent to do the study
Informed consent form to be given to research participants
Data collection procedures
A clearly stated method of data analysis
An explanation on why your data analysis method is appropriate for your research
Issues related to validity and reliability
Ethical considerations (including plans for the protection of human subjects as appropriate)
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Course: NURS 540
Sample Selection, Reliability, and Validity Assessment in Advance Care Planning Research

This research project aims to investigate whether engagement in advance care planning (ACP) can effectively enhance end-of-life (EoL) decision-making among older adults. In alignment with the PICOT question and the research’s purpose, the target population comprises older adults who are facing the task of making crucial EoL decisions. This section details the chosen sample population and the criteria for inclusion, along with discussions on the sample’s reliability and validity.

Sample Selection

The study will focus on older adults aged 65 and above who are receiving care in palliative care facilities within a single city in the United States. The anticipated sample size is 65 participants, all of whom must meet the following inclusion criteria:

Age of 65 years or older
All gender identities
Diagnosed with a terminal or end-stage chronic health condition and under care for this condition
Admitted to a palliative care facility
For patients with impaired cognition, orientation, and consciousness, they must have a legally recognized primary caregiver or proxy
Exclusions will be made for individuals who:

Cannot provide informed consent and lack a legally recognized proxy or power of attorney
Have cognitive impairments preventing them from completing the questionnaire and where their legally recognized proxies are also unable to participate
Decline to provide consent
The chosen target sample aligns with the research’s purpose, focusing on evaluating the impact of advance care planning on EoL decisions among those who are at the EOL stage. Older adults are the primary focus, given that palliative care and terminal conditions are more prevalent in this demographic. Moreover, a sample size of 65 participants has been determined through calculations involving a population of around 200 potential participants and a 95% confidence level (Qualtrics, 2023). Consequently, the sample aligns with the research’s purpose, and the selected size is appropriate.

Reliability

To ensure reliability, a consistent data collection process will be employed using a standardized tool and approach for all participants. Data will be gathered through semi-structured interviews conducted with the patients or their legal proxies. Prior to the full study, the data collection process and interview structure underwent testing with the research team to enhance reliability. Field notes were compiled during the pilot testing phase, leading to adjustments in the semi-structured interview guide (Adeoye-Olatunde & Olenik, 2021). This iterative process enhanced the tool’s consistency and reliability. The tool’s reliability was further confirmed by its successful testing on a pilot group of older adults, producing consistent and replicable outcomes. Thus, the research methodology’s reliability is assured, leading to dependable findings.

However, it’s important to note that the findings are specifically applicable to older adults at the end of life and cannot be generalized to individuals at EoL in different age groups.

Validity

To uphold validity, the recruitment process will play a pivotal role. Participants will enhance the validity of the sample if they accurately represent the phenomenon under study (Hayashi et al., 2019). Thus, patient records will be meticulously reviewed to ensure alignment with the inclusion criteria for individuals who consent to participate. Furthermore, recruitment will be confined to palliative and terminal care centers, ensuring that only individuals in end-of-life care are included in the study, aligning with the target population.

In addition, a focus group and pilot testing will be conducted to validate the research instrument. A focus group composed of experts in end-of-life care will discuss all aspects of the research guide. Adjustments will be made based on their recommendations and alignment with the research purpose. A pilot test will assess the interview questions for response consistency and type of answers, enabling further refinement. This thorough review process before actual data collection will contribute to the tool’s validity.

References

Adeoye-Olatunde, O. A., & Olenik, N. L. (2021). Research and scholarly methods: Semi-structured interviews. Journal of the American College of Clinical Pharmacy, 4(10), 1358-1367. https://doi.org/10.1002/jac5.1441

Hayashi, P., Abib, G., & Hoppen, N. (2019). Validity in qualitative research: A processual approach. The Qualitative Report, 24(1), 98-112.

Qualtrics. (2023, Apr. 12). Sample size calculator. https://www.qualtrics.com/blog/calculating-sample-size/

Santivasi, W. L., Partain, D. K., & Whitford, K. J. (2020). The role of geriatric palliative care in hospitalized older adults. Hospital Practice, 48(sup1), 37-47. https://doi.org/10.1080/21548331.2019.1703707

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NURS 540

Implementation Plan

Participant Recruitment

The process of recruiting participants will be carried out at various palliative care centers throughout the city. The initial step involves presenting an official request letter to the administrators of the palliative care facilities. Healthcare professionals, including nurses, as well as other caregivers, will be informed about the project through a concise project overview. These professionals will also receive a recruitment advertisement that they can present to the patients under their care. Utilizing the existing rapport between healthcare providers and patients ensures ethical recruitment, minimizing the potential for manipulation or emotional distress in the patients (LoBiondo-Wood & Haber, 2021). Following this, healthcare professionals will share project details with patients or their primary caregivers and offer them informed consent forms. Adequate time, specifically three days, will be provided to allow participants to consider their involvement and make an informed decision. The informed consent form (Appendix A) has been designed using clear language to facilitate understanding, outlining potential benefits and risks associated with the study. In cases where aspects of the form are unclear, nurses will be readily available to offer Helpance to patients and caregivers (LoBiondo-Wood & Haber, 2021). The approach ensures ethical recruitment, minimizing coercion, and manipulation. No incentives, apart from post-intervention education on advance care planning, will be provided to participants.

Data Collection

Quantitative data collection will encompass patient demographics, health-related information, and satisfaction levels. This data will be gathered using a structured questionnaire. The questionnaire will encompass demographic details such as age and gender, along with health-related information, including the primary diagnosis, comorbidities, and ongoing treatments. To guarantee confidentiality, no personally identifiable information like names or social security numbers will be captured (West, 2020). The questionnaire will also incorporate inquiries concerning life satisfaction and health satisfaction. These questions will gauge both the participants’ contentment with the care received at the facility and their satisfaction regarding end-of-life considerations. Participants or their proxies will be responsible for completing the questionnaire. In cases where a patient is unable to complete the questionnaire independently and lacks a primary caregiver or proxy, the nurse or healthcare aide will offer Helpance.

Ethical Considerations

The implementation of this project will adhere to the highest ethical standards during both the recruitment and data collection phases. Central to this is obtaining informed consent through clear communication, allowing participants ample time to decide their involvement. Participants will be made aware of their right to withdraw from the study without repercussions. Additionally, provisions will be in place to minimize potential harm, including the option for withdrawal if the research process causes emotional distress. Furthermore, counseling services will be provided free of charge to all participants to address any potential adverse psychological impacts of the study (West, 2020). The data collection questionnaires will refrain from collecting personally identifiable information to safeguard participant confidentiality. Before the research begins, participants will receive comprehensive information about research procedures and the absence of incentives to prevent any form of deception. Overall, the implementation plan firmly upholds the principles of ethical research.

References

LoBiondo-Wood, G., & Haber, J. (2021). Nursing research E-book: Methods and critical appraisal for evidence-based practice. Elsevier Health Sciences.

West, E. (2020). Ethics and integrity in nursing research. Handbook of research ethics and scientific integrity, 1051-1069. https://doi.org/10.1007/978-3-030-16759-2_46

Appendix A: Informed Consent Form

Title of Research:
Principal Investigator:
Institutional Contact:

Purpose of the Study

You are being invited to take part in a research study. This study aims to explore end-of-life planning among older adults. Specifically, it seeks to understand how older adults with health conditions unlikely to improve approach their end-of-life planning. The study’s findings will contribute insights into how such planning influences their quality of life during this phase.

Study Procedures

Upon entering the study, you will be requested to complete a questionnaire and respond to some questions.

The questionnaire will inquire about personal and health-related information such as age, gender, medical condition, and ongoing treatment. Your name or any other information that could identify you will not be included in the questionnaire. The questionnaire will also include inquiries about your life and health satisfaction.

A researcher will engage in an interview with you to explore whether and how you have undertaken end-of-life planning. This interview may be audio-recorded with your consent, but you can decline recording if you prefer.

Following the interview, the researcher will provide education about advance care planning—an important process involving decisions about end-of-life preferences.

Risks

Discussing end-of-life matters could potentially evoke stress or discomfort. It’s essential to recognize that you can exit the study at any point without facing any consequences. To support you in managing any challenging emotions that may arise from the research, counseling services will be readily available.

Benefits

Participating in the study offers you an opportunity to learn more about advance care planning and engage in the process with guidance from the researcher if you choose. The interview will allow you to discuss your plans and identify any additional considerations for this phase of life.

Confidentiality

Your responses to the questionnaire will remain confidential. Please refrain from including your name or any other identifying details on the questionnaire. For the interview, you will interact directly with the researcher. Stringent measures will be taken to safeguard your information.

Unless legally obligated, your data will be kept confidential. This includes situations where concerns of abuse or suicide arise.

Compensation

The study will be conducted at your location, such as your bedside. No monetary or material compensation will be provided. However, the researcher will offer education on advance care planning.

Voluntary Participation

Your involvement in this study is entirely voluntary. You have the autonomy to decide whether to participate or not. Even after providing informed consent, you can choose to withdraw from the study at any time.

Consent
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NURS 540

Data Analysis Plan

Introduction

The primary objective of this project is to assess whether engaging in advance care planning (ACP) can contribute to improved end-of-life (EoL) decision-making among older adults. To achieve this objective, a robust data analysis plan is crucial for extracting meaningful insights from the collected quantitative data. This section outlines the data analysis approach for evaluating the association between ACP engagement and EoL decision-making satisfaction. By investigating this relationship, we aim to offer valuable contributions to both the field of palliative care practice and the academic community.

Research Question

The central research question for this study is: Does engagement in ACP enhance EoL decision-making satisfaction among older adults in palliative care?

Hypotheses

Null Hypothesis (H0): There is no significant difference in EoL decision-making satisfaction between older adults who engage in ACP and those who do not.
Research Hypothesis (H1): Engagement in ACP is associated with higher levels of EoL decision-making satisfaction among older adults in palliative care.
Variables

Independent Variable (IV): Engagement in ACP, a categorical variable with options “Yes” or “No.”
Dependent Variable (DV): EoL decision-making satisfaction, measured on a Likert scale as a continuous variable.
Choice of Analysis

For addressing the research question and hypotheses, the most appropriate analysis approach is the independent samples t-test. This statistical method allows us to compare the means of two independent groups, specifically those engaged in ACP and those not engaged, in order to determine the presence of a statistically significant difference in EoL decision-making satisfaction.

Significance Level

The significance level (α) is set at 0.05, indicating a willingness to tolerate a 5% chance of committing a Type I error (i.e., incorrectly rejecting a true null hypothesis).

Expected Results

If the p-value derived from the t-test is lower than the chosen significance level (p < 0.05), we will reject the null hypothesis. This would suggest that engagement in ACP is linked to a meaningful difference in EoL decision-making satisfaction among older adults, as supported by Mishra et al. (2019). Conversely, if the p-value surpasses the significance level, we will not reject the null hypothesis, indicating no substantial difference in satisfaction between the two groups. It's important to acknowledge that the execution and analysis of the study will necessitate the use of specialized statistical software such as SPSS, R, or Excel, along with the expertise to ensure accurate interpretation. Conclusion By utilizing this well-defined data analysis plan, we aim to shed light on the potential impact of ACP engagement on enhancing EoL decision-making satisfaction among older adults in palliative care. Reference Mishra, P., Singh, U., Pandey, C. M., Mishra, P., & Pandey, G. (2019). Application of student's t-test, analysis of variance, and covariance. Annals of Cardiac Anesthesia, 22(4), 407.

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Tags: and Validity Assessment in Advance Care Planning Research, NURS 540 Sample Selection, Reliability