RAC 2

Order Description

this is a course work

it’s multiple choice questions

ORIGINAL RESEARCH
Subjective sleep quality in relation to objective sleep estimates:
comparison, gender differences and changes between the acute phase
and the six-month follow-up after stroke
Linda N. Bakken, Hesook Suzie Kim, Arnstein Finset & Anners Lerdal
Accepted for publication 20 July 2013
Correspondence to L.N. Bakken:
e-mail: linda.bakken@hibu.no
Linda N. Bakken MSc RN
PhD candidate
Faculty of Health Sciences, Buskerud
University College, Drammen, Norway
and Department of Behavioural Sciences in
Medicine, Institute of Basic Medical
Sciences, Faculty of Medicine, University of
Oslo, Norway
Hesook Suzie Kim PhD RN
Professor
Faculty of Health Sciences, Buskerud
University College, Drammen, Norway
Arnstein Finset PhD
Professor
Department of Behavioural Sciences in
Medicine, Institute of Basic Medical
Sciences, Faculty of Medicine, University of
Oslo, Norway
Anners Lerdal PhD RN
Professor
Department of Research, Lovisenberg
Diakonale Hospital, Oslo, Norway
and Department of Nursing Science,
Institute of Health and Society, Faculty of
Medicine, University of Oslo, Norway
BAKKEN L . N . , KIM H.S . , FINSET A. & LERDAL A. (2014) Subjective sleep
quality in relation to objective sleep estimates: comparison, gender differences and
changes between the acute phase and the six-month follow-up after stroke.
Journal of Advanced Nursing 70(3), 639–650. doi: 10.1111/jan.12228
Abstract
Aims. To describe sleep experiences after stroke using subjective and objective
indicators and identify possible gender differences in sleep in the acute phase and
at 6-month follow-up.
Background. Sleep disturbances after stoke are recognized, but poorly described.
Gender differences in sleep exist in other populations, but have not been reported
after stroke.
Design. A longitudinal cohort study.
Method. Subjective sleep quality was measured with the Pittsburgh Sleep Quality
Index and objective sleep was estimated with actigraphy in 100 patients in the
acute phase and six months after stroke, from April 2007–March 2009.
Findings. Subjective sleep quality was better and objective wake percentage was
lower at follow-up than in the acute phase after stroke. Actigraphy estimated low
sleep efficiency and many awakenings at both time points. Subjective and objective
measures were correlated at the 6-month follow-up, but not in the acute phase.
Women’s subjective sleep efficiency and total score on the Pittsburgh Sleep Quality
Index were worse than men’s in the acute phase, but actigraphy estimated that
women slept more than men in the course of a day. Women’s subjective sleep
quality was better at follow-up than in the acute phase. Men reported worse
subjective sleep quality, but better subjective sleep efficiency at follow-up than in
the acute phase, and also had lower objective wake percentage at follow-up.
Conclusions. Subjective sleep quality was poor and actigraphy indicated
disturbed sleep–wake patterns in the acute phase and at 6-month follow-up.
Gender differences existed in subjective and objective sleep in the acute phase,
but not at follow-up.
Keywords: actigraphy, gender differences, longitudinal study, nursing, pittsburgh
sleep quality index, sleep, stroke
© 2013 John Wiley & Sons Ltd 639

Instructions:  A major skill that is learned in this course is how to critically read and critique nursing research articles.  The purpose for critiquing an article is to critically evaluate the research process followed by the author(s) of the assigned article. This is an information-intensive, time-intensive process that is not learned overnight.   To demonstrate your skill at critiquing an article, you will complete this open-book multiple choice assignment.
Here’s how you should approach completing this week’s assignment to finish critiquing an article:
1.  First, do your assigned reading in Grove, Gray, and Burns (2015) and complete the reading worksheets early in the week.  This will introduce you to the critique skills you will need for the week.
2.  Skim the entire instructor assigned research article that has been posted on Blackboard for you so that you will have an idea of what it is about.  Lightly cross out the abstract for the article (you won’t be using it). Then, for this week, re-read carefully the methods, results, discussion, implications, and conclusions sections of the article again.
3.  Print this document and find the best answer to each question below based on your Grove, Gray, and Burns (2015) assigned reading for the week and what you have read in the instructor assigned research article.
4.  Some of the questions in the critique assignment below will seem unfamiliar to you. Look up key terms from the question in your textbook.  Some examples of these terms might be: power analysis, inter-rater reliability, and generalization. You can also look in Chapter 12 for an example of a critical appraisal (or critique) of a quantitative research article.
5. Once you have completed this assignment “on paper”, go into blackboard and enter your answers by the assignment due date and time listed in the syllabus.  Ignore any wording from Blackboard that indicates that “this is a test” and carefully enter your answers from this document.
6.  You will have two access attempts to record your answers.  This is given to you so that if you encounter technical difficulties on your first attempt, you will have another attempt to enter your answers successfully.
If you have questions about this assignment, you can post them to your group discussion board for help.  Please do not post the exact question from the assignment below and ask the group for the answer as this would constitute academic dishonesty.

Questions 1 – 9: Sample.  (For help with these questions, refer to chapters:  9 & 12)
1.  What sampling method or plan was used by the authors in this study?

a.  simple random sampling
b.  systematic sampling
c.  convenience sampling
d.  network sampling
e.  none of the above

2.  According to Grove, Gray, and Burns (2015), what are the potential biases of this sampling method?

a.  this is a strong probability sampling method with very little potential for bias
b.  this method is used when an ordered list of all members of the population are available, and
provides a random but not equal chance for inclusion in the study.
c.   this method provides little opportunity to control for bias because subjects are included in
the study merely because they happen to be in the right place at the right time.
d.  this method is specific to the individuals who were recruited and the information gained
cannot be generalized to others who don’t share these types of experiences.
e.  none of the above biases best describe the sampling method chosen by the author.

3.  What was the final sample size reported by the authors for this study?

a.   193
b.   152
c.    125
d.   100

4.  Was a power analysis conducted?  If so, which statement best describes the results of the power analysis?

a.  The authors indirectly mention that a power analysis was conducted by describing the desired effect size, alpha, and power desired.
b.  The authors mention that a power analysis was conducted, and  193 subjects were
determined to be needed for the study.
c.  The authors do not report that a power analysis was conducted.

5.  Which of these statements would be considered to be an inclusion criterion for the sample in the research article? (select all that apply).

a.  The author did not report inclusion criteria.
b.  Older than 18 years old.
c.  First time clinical presentation of stroke.
d.  Satisfactory cognitive function as recorded on the Scandinavian Stroke Scale

6.  Which of these statements would be considered to be an exclusion criterion for the sample in the research article?

a.  The patient is cognitively incompetent.
b.  The patient has satisfactory cognitive function determined by the Scandinavian Stroke Scale.
c.  First time clinical presentation of stroke.
d.  The author did not report exclusion criteria.

7.  What is the refusal rate for this study? (Hint: see page 253 in your text)

a.  125/152  X 100% = 82%
b.  The authors did not report an acceptance rate.
c.  27/152 X 100% = 18%
d.  6

8.  Which of the following would be accurate for the attrition rate for this study?

a.  19/119 X 100% =  16%
b.  100/119 X 100% = 84%
c.  125/152  X 100% = 82%
d.  There is no attrition rate recorded for this study because it is a cross-sectional study.

9. What was the setting for this research study?  Briefly describe the setting and indicate whether it was appropriate for conducting this study.

a.  The setting for this study was a natural or field setting and was appropriate for this study’s research design.
b.  The setting for this study was a partially controlled setting and was appropriate for this study’s research design.
c.  The setting for this study was a highly controlled setting and was appropriate for this study’s research design.
d.  The setting for this study was not well described by the authors and therefore not appropriate for conducting this study.

Question 10 – 14: Measurement Methods.  (For help with these questions, refer to chapters 10 & 12.)

10.  Which of these questionnaires, scales, or physiologic measures are used in this research study? Select all that apply.

a.  The Beck Depression Inventory (BDI)
b.  Physical Functioning (PF) from the Short Form-36, acute version (SF-36-A)
c.  The Pittsburgh Sleep Quality Index (PSQI)
d.  Motionlogger Actigraph (AA-32)

11.  How do the authors describe the CURRENT reliability of The Pittsburgh Sleep Quality Index (PSQI)?

a.  they compared two pencil and paper forms of the test to determine their equivalence
b.  they compared two observers of the same group of subjects to determine their equivalence
in making observations
c.  they tested the current group of subjects twice using the same questionnaire or scale.
d.  they computed a Cronbach’s alpha on the questionnaires that were administered to this
group of subjects.

12. How do the authors describe the validity of Physical Functioning (PF) from the Short Form-36, acute version (SF-36-A)?

a.  content validity
b.  evidence of validity from contrasting groups
c.   evidence of validity from convergence
d.  evidence of validity from divergence
e.   the authors did not describe the validity of this questionnaire using any of these methods.

13. Did the authors develop a questionnaire or survey for this research study?

a.  No, they used only previously developed questionnaires or surveys.
b.  Yes, they developed their own questions to ask about demographic information.
c.  Interviews were reportedly used, but the authors do not expound on what was included.
d.  Yes, they reported adding a few of their own “short-answer” questions at the end of the
questionnaire.
e.  Yes, they developed the Sleep-Awake Questionnaire.
f.  This study did not use any questionnaires or surveys.

14. Did the authors use any physiological measurements in this study?
a.  Yes
b.  No

Question 15- 16: Data Collection. (For help with these questions, refer to chapters 10 & 12)

15. Which of the following best describes the data collection process used in this study. Select all that apply.

a.  questionnaires / surveys were completed and returned to the researchers
b.  questionnaires / surveys were completed via the internet
c.  data was collected by two of the authors or a trained research assistant (all nurses)
d.  trained observers watched the subjects and collected the data
e.  nurse researchers interviewed the study participants
f.  questionnaires / surveys were completed via the telephone

16.  If there were more than one data collector for the study, would an estimation of inter-rater reliability be an important concept for the authors to report on for this study?

a.  yes, and the authors reported their efforts to achieve inter-rater reliability.
b.  yes, but the authors do not discuss any efforts to achieve inter-rater reliability.
c.  no, the issue of inter-rater reliability does not apply here.

Question 17 – 19:  Data Analysis. (For help with these questions, refer to chapters 11 & 12)
17.  What descriptive statistics are used in this study?  Select all that apply.

a.  mean
b. median
c.  mode
d.  range
e.  standard deviation
f.  scatterplot
g.  standard error of the mean

18.  What inferential statistics are used to examine the data obtained from the subjects?  Select all that apply.

a.  Pearson’s Product-Moment Correlation
b.  Factor Analysis
c.  Regression Analysis
d.  Chi-Square
e.  ANCOVA
f.  ANOVA
g.  t-Test
h.  None of the above inferential statistics were used in this study.

19.  What is the level of significance (alpha) set at for this study? ( Hint: is there an alpha given under the
tables?)

a.  .05 or 5%
b.  .10 or 90%
c   .01 or 1%
d.  a level of significance was not specifically mentioned by the author.

Question 20-25: Researcher’s Interpretation of the Findings. (For help with these questions, refer to chapters 11 & 12)

20.  There are many significant findings in this study. Which of these statements from the article would be considered a significant and predicted result? Select all that apply.

a.  Women reported better sleep quality at the 6-month follow-up than in the acute phase of
stroke (t = 2.36,  p =0.02)
b.  Women reported worse habitual sleep efficacy than men based on PSQI scores
(t = -2.81, p = 0.01)
c.  Subjective sleep quality was poorer overall (for both men and women) at the 6 month
follow-up.
d.  None of the above.

21.  Which one of these statements from the article would be considered a non-significant result.

a.  Women reported better sleep quality at the 6-month follow-up than in the acute phase of
stroke (t = 2.36,  p =0.02)
b.  Women sleep more minutes each night in the acute phase of stroke based on actigraphy than men.
c.  There were no non-significant results reported in this study.
d.   None of the above.

22.  Which one of these statements from the article would be considered clinically important?

a.  Nurses should screen for sleep disturbances after a stroke.
b.  The environment is not important for sleep hygiene of the stroke patients in the acute
phase.
c.  Men should get more sleep than women during the day.

23.  Which one of these statements from the article would be considered a limitation of the study?

a.  This study has shown that subjective and objective measures of sleep are not always comparable after a stroke.
b.  The size of the sample was not sufficient for evaluating the impact of stroke type and
location on sleep.
c.  Using a longitudinal design is a weakness of the study.
d.  There are no limitations discussed in this study.

24.  Which one of these statements from the article would be considered a statement regarding
generalization of these results?

a.  The sample consists of stroke survivors without severe disabilities and results cannot be
generalized to persons with severe disabilities.
b.  The sample consists of stroke survivors without severe disabilities and results can be
generalized to persons with severe disabilities.
c.  Due to the function of actigraphy, being awake at night and inactive may underestimate
sleep time.
d.  Since women report better sleep quality, they need fewer minutes of sleep per night.

25.  Which one of these statements from the article would be considered a recommendation for future studies?

a.  Nurses should screen for sleep disturbances after a stroke.
b.  Further studies on the role of sleep quality and the effect on rehabilitation after stroke are needed.
c.  Even if this convenience sample appears to have characteristics in common with the target
population, the views of non-responders are unknown.
d.  The authors did not give any recommendations for future studies.