Examine two research articles which incorporate a statistical analysis discussed in this course.Briefly summarize and report on each statistic and discuss whether the assumptions of each test were met and if the type of data was appropriate for each statistical test.
This report relates to all the details of two articles that are being analyzed and evaluated in this report. The first Article is Impact of patient involvement in mental health research: longitudinal study and the second one considered here is the Reports of Insurance-Based Discrimination in Health Care and Its Association with Access to Care. Both the articles are related to health care field and give details regarding several practices in this field.
1. Problem Of Research Studies
Article 1- Man aim was to recognize whether the patient involvement actually is linked to the study success. Also some other problems were to be solved like what are the elements of successful recruitment? Are there any predictors of the level of the patient involvement? Is all the patient involvement linked with the successful recruitment? What are the barriers and the facilitators towards involvement? What are all the possible mechanisms and implications of the study that will be conducted? What are the real impacts of the patient involvement within the mental health research? What are the fluctuations in the rate of patient involvement in health care and also what are the reasons for these changes? (Brackett, n.d.)
Article 2- The problems to be researches were like what is the extent of insurance based discrimination by the health care providers? What is the level of variant in insurance based discrimination in health care sector? Find out effective ways to assess and examine reports of the insurance-based discrimination. What is the link of insurance based discrimination with the insurance type as well as access to the care in early years of Patient Protection plus Affordable Care Act? What are the researches done till date on the issue related to insurance based biasness within the health care plus all its association along with access to the care (Brown & Wiggins, 2004).
2. Data Collection Procedure
Article 1- The research used secondary data for the study under which it considered many studies that were previously made by other scholars. All the research used was the non-commercial research registered upon MHRN portfolio and database. No survey or any other measure was undertaken and also no primary method for collection of data was used. This method of data collection helped the researcher to attain all the available data from different sources like internet, books, journals and websites as well. Also for the study and the research to be continued properly a good pragmatic decision was made for defining the successful recruitment (Carpenito, 2009).
Article 2- Similar to the first article this also used secondary method of data collection and no primary research was undertaken. Also a proper primary research was undertaken in which respondents and selected sample were asked to fill the questionnaire and return back to the researcher. Also the researcher used information and data from the Minnesota 2013 Survey of the health access. The researcher then modeled the link amid the biasness and the insurance type and even predicted all the odds of carrying decreased access towards care amongst those that have reported biasness, controlling for the socio-demographic elements. All the data were also weighed to present state’s populace (Chaubey, 2002).
3. data collection sources:
Article 1- MHRN database was used as the basic source for collection of data in this article or within this study. The entire database was most comprehensive database of the mental health research within England and also contained studies that were supported by MHRN. All the studies that were listed on mental health research network portfolio database were cross-examined using the logistic regression and ANOVA as well as Pearson’s correlation. All the research used was the non-commercial research registered upon MHRN portfolio and database. About 374 studies that were previously made and registered were used as base for collecting information and later analysis was done (Cheng, 2005).
Article 2- The study used the data from 2013 Minnesota Health Access Survey towards indentifying 4123 Minnesota adults aged amid 18 years to 64 years and who reported their experiences of the insurance based discrimination. Department of the Health & University of Minnesota State Health Access Data Assistance that had 11778 interviews previously held were used as the basic source of data. The primary research used some 11778 interviews that were earlier collected from the month of August to November in the year 2013 within Minnesota. The researcher used information and data from the Minnesota 2013 Survey of the health access (Creswell & Plano Clark, 2007).
4. Independent Plus Dependent Variables
Article 1- independent variable in the research was those that could be changed within a provided model. These variables provided "input" that was modified by this model to alter the real "output” of the study. Whereas dependent variables where those that resulted from all the independent variables. The independent variables within the study were patient’s involvement, funder, clinical study group and complexity, follow-up of the study and also randomization. Whereas the dependent variables were recruitment of the participant, the associated results and linked outcome, language used and consequences of the study that was totally based on effectiveness of the study made (Davies, 2002).
Article 2- This study and experiment was a real prime instance of how idea of the experimental variables could actually become a very little complex one. Basic and most effective independent variables were the race and ethnicity, society, civilization, plus feeling discrimination, discrimination based on demographics, health status as well as insurance status that were used in the research. All the dependent variables were the CAHPS reports and also their entire ratings of the care and discrimination. Even the variables that were derived from the CAHPS reports were all dependent one as they were not actually derived from any independent variables (Dutter, 2003)
5. Sample Size and Sample Fit
Article 1- A nonequivalent correlation gathering outline was utilized to look at three gatherings of members: (a) the individuals who were constantly dynamic in CSIs over a 36-month period (n = 25); (b) the individuals who had been dynamic in CSIs at 9-and 18-month subsequent periods, however who were no more dynamic at 36 months (n = 35); and (c) an examination gathering of members who were never dynamic in CSIs (n = 42). Out of the studies that were used 374 were included within the portfolio from which 207 were then observational and 154 were actually interventional.
Article 2- The study populace was initially confined to 7201 nonelderly targets matured 18 to 64 years, barring 2734 kids more youthful than 18 years whose meetings were finished by grown-ups and 1843 grown-ups more seasoned than 64 years who were for the most part secured by Medicare and liable to have distinctive encounters with medicinal services and access to wellbeing protection than the nonelderly grown-ups. Further the specimen was restricted to 4222 nonelderly grown-up respondents who addressed the overview themselves to guarantee estimation of individual experience (Elford, 2009).
6. Statistics Used To Answer The Research Hypothesis
Article 1- For analyzing the need and element of successful recruitment pragmatic decision were made to properly define the successful recruitment being “a priority” as the binary variable along. For answering the query related to existence of predictors of the level of patients all the patient involvement were modestly yet significantly linked to study entry schema, r=0.12,P
Article 2- Firstly the study performed Pearson X^2 test for examining the variation within the reports of the insurance- oriented discrimination amongst the uninsured and publicly insured, as well as privately insured youths. The study also ran some two multivariate logistic regression replicas. Results and tables depicted that the adults who reported insurance based biasness were actually more probable to lack general source for care and even lacked confidence in attaining the required care. Also they forgo required care just because of the cost and the experience provider level barriers while seeking the real care. This entire pattern held for every sole person acted as indicator of care (G.M. & Metri, 2011)
7. Strength And Weaknesses Of Displays
Article 1- The study has majority of detailed data attainable which also fulfilled the categories of the involvement. The tables were used which were easily understandable. It is known that there exist no other real databases all across UK or world that has baseline as well as longitudinal data of such caliber, thus use of MHRN was the most efficient decision (Gillard, Simons, Turner, Lucock & Edwards, 2012)
Article 2- The display has provided all current and reliable data. The database used to access the data was much updated one and thus the study was capable to attain all updated information. The findings of the study highlight need for academic as well as policy attention towards addressing the insurance-based biasness in the health care scenery (Govaert, 2009)
Article 1- Use of MHRN database and representation of the information from same was not sufficient. The presentation denied involvement to principle investigators. Of course, the researcher could have investigated some more variables which would have allowed more detailed recommendations. The article ignored many facets and variables and also several fields inclusion of which could have made it better (Gulanick & Myers, 2007)
Article 2- The cross sectional nature of the design limited the ability to recognize casual pathway amid insurance-based discrimination and assess to the care. Many general assumptions were made which proved to be false and vague ones later, this destroyed the quality of the study to some extent. Very limited literatures were examined and this left much gap in the result and the reality (Voelker, Orton & Adams, 2001)
What did the data analysis depict?
The data analysis showed that proportion of the studies which involved patients on every of three phases of the involvement being a function of the funding body. The non-follow-up researches were less probable to hit recruitment target as well as with enhancement in complexities the probability of attaining recruitment target also falls. It even depicted that researches with greater levels of the patient involvement also were more probable to attain the success in the recruitment (Han, Call, Pintor, Alarcon-Espinoza & Simon, 2015). The main and basic variables recognized here were complication and the presence of the follow-up.
In this article the data analysis demonstrated that 9.3% of the Minnesota nonelderly youths reported the insurance-based unfairness by the providers of health care. There are vital differences within the access towards care amid the adults that did and those that did not report any discrimination. Also, results and tables depicted that the adults who reported insurance based biasness were actually more probable to lack general source for care and even lacked confidence in attaining the required care. In the states that never expand Medicaid, community programs might be viewed as a very less acceptable one within their entire health care scheme, potentially exacerbate rates of the discrimination (Harris, 2002).
Conclusions drawn by author
Authors felt that this was literally the first and foremost time that associations with the study success got identified for the patient involvement. They felt it as right time when researchers may consider paths to involve the patients extra comprehensively because this is linked with the study success. But some more research is required to explore the findings of the study. Without a database enumerating both the levels of association and data in regards to study outline and enlistment achievement, these inquiries can't be replied. At present, the grittiest proof is just accessible through the MHRN database. The following arrangement of studies needs to recognize the particular component by which understanding contribution apparently enhances enlistment (Held, 2000)
Similar to the earlier article, authors about this research also felt that there still are rooms left for future research and lying down of several policies and interventions. Also many strategies and involvement studies are yet needed to address the entire insurance based discrimination within the health care settings. Health insurance coverage, albeit significant, may not be adequate to accomplish available and impartial medicinal services. Protection based separation ads to variations in human services and may diminish individuals' capacity to get to medicinal services when required. Given its negative impact on social insurance use and potential danger to longer term wellbeing outcomes, state and neighborhood governments ought to embrace strategies focusing on the lessening of protection based segregation in human service (Jeffers, n.d.)
Agree or disagree with conclusions- why or else why not?
Article 1- I agree with the conclusion made by the author in article one because this is just the first and most initial study that was carried like an investigation and yet there are several additional questioned that have remained unanswered and all these questions are related to patient’s involvement which also needs consideration. It is also agreeable just because the study requires both level of the involvement along with additional details on progress of the involvement in study. Devoid of these data everything that can be concluded is that the patient involvement actually is linked with, yet not necessarily a real reason of, the study success (Jütting, 2004).
Article 2- Here also I agree with the author’s viewpoint because though the researcher has found a vital relation amid the racial discrimination and the insurance based biasness yet several future researchers are yet needed to consider linking to some other information and data sets for controlling for the supply-side measures like medically unreserved areas. Also the fact is that, addressing the insurance-based biasness, especially reducing stigma linked with the public agendas plus poverty more commonly, requires the long-run commitment as well as joint efforts at government as well as societal level (Kearns, Athay & Riemer, 2012)
Were study limitations discussed? What were the limitations if any? How did the authors deal with the limitations?
Article 1- Yes all the limitation and weaknesses of the study were totally discussed in the report. The limitations mentioned were
- The study did not account for probable contributions of the factors such as quantity of the funding otherwise design elements like the basic science v. epidemiological study that also limited level of the patient participation.
- The presentation used in the research denied involvement to principle and basic investigators
For overcoming this limitation the researcher used MHRN database that as per an audit has been found to be very reliable. Use of MHRN’s viability plus support to timely recruitment of research service also provided very fast and easy access towards people having experience of the mental health issues and solved limitations to vast extent
Article 2-In this article also all the limitations of the study have been clearly mentioned. The said limitations were
- The generalizing capability of the study to nation and to other state merit discussion was not possible
- The study design was cross sectional in nature which limited researchers capability to recognize casual pathway amid insurance based biasness and access to care
For overcoming this, direct questions were asked with straightforward reference to the respondent’s insurance type and status (Manos, 2001)
There were things that went really well. The sample selected was perfect and also the mode of attainment of data was good enough to depict appropriate results and also the data collection method was appropriate as MHRN database was really feasible and reliable one. Though few things went wrong like there were several fields and areas that were not touched or included by the researcher and also some more researches could have been used which were not included in the study at all. The level of trust in this article is low because the conclusion has yet left rooms for many studies to be undertaken(Messina & Grainger, 2012).
Things that went good in this article was that mode of data collection was the most efficient way that was adopted by the researcher. Mix of primary and secondary data made it a proper study. Though there were drawbacks like the study did not consider any specific policy context in every state. Also the study ignored many basic principles that were very necessary for efficient result to be derived from the study. Level of trust here also will be low because this study also has left many areas in dark also the use of data and information were not appropriate (McFarlane & Van Hooff, 2009).
Provide the discussion of usefulness of every study to the nursing peers:
What might they think of study?
Article 1- The nurses might think that this research and study will give them all details about patient’s involvement in the mental health research. They might think that it will be a longitudinal study and thus will give those data and information in general. But as per the conclusion that was brought proved that the study lacked the generalization capability. Nurses may also think that this research will permit them you to chase their interests, towards learn something really novel, to sharpen their problem-solving knowledge and skills as well as to challenge people in several ways (Palanisamy & Subramanian, 2011)
Article 2- The nurses about this article might think that this article will give full details about discrimination that is done to the patients on basis of their insurance. They might think that this study has not attained a better result as it was just specified and confined to a particular area and did not consider general conceptions. As per nurses the main aim and goal of such study is not just to build facts and bring out results at very lower cost, rather it must have its impacts on the real life of people as well. Also nurses might feel the research to be inappropriate (Parker, Hunte & Ohmit, 2015)
What might they find confusing?
Article 1- In the article 1 use of MHRN database might not be a suitable source as per the nurses because this database might provider older and non-updated data which has also ruined the result of the report, nurses might dislike this and feel the result as confusing and unreliable. The study also varies to the degree that it could also benefit from the patient involvement, but the analysis here actually has revealed that researches funded by some UK funder, MRC, had all poor phases of the patient involvement, and this is really a confusing statement. Though there were several obvious tangible benefits, report even described several problems which might be unacceptable by the nurses (Sarantakos, 2007)
Article 2- This study provided all recent proof of the discrimination based on insurance and its link with contact to care of the adult residents in Minnesota, but why only adults are taken into consideration is a big issue that can be raised by the nurses and why other segments of the society has been ignored by the researcher. Several limitations were seen in the research and this might make it a bit confusing as well. First, the generalizing ability of the results to nation and also to some other states merits the discussion. Even, cross-sectional character of study design limited the nurses and did not allow them determine causal pathway amid discrimination based on insurance and the patient’s access towards care (Stevens, 2006)
What aspects of the studies might they question?
Article 1- The nurse might think that that some more future support will be needed for this study to be reliable and thus the study might be questioned for not being taken into account by the funders to make sure involvement becomes meaningful and probable to be additionally cost-effective. Also next set of studies might be questioned as they need to recognize specific and concise mechanism through which patient involvement might seemingly enhance and improve the recruitment of staffs in the health care institutes and the study ignored this part as well. Study might also be assumed to need both level of the involvement along with additional details on progress of the involvement in study (Storm, Hausken & Mikkelsen, 2010)
Article 2- Many factors, like being the member of some underrepresented racial otherwise ethnic community, might also influence respondents towards reporting the discrimination and their right of entry towards care, but the question here can be related to the fact that why these samples and such populace were included in the study when it was known that such samples might hamper the reliability and un-biasness of the final result. It was mentioned in the study that some 53 of the analysis relied upon a sole measure to incarcerate respondents’ know how and experiences of the discrimination based on insurance but these measures ignored the fact of specifying what type of the unfair treatment were encountered by the respondents (Tambuyzer & Van Audenhove, 2013)
Summarize why you think the studies do or do not provide sufficient evidence to change practice.
Article 1- To some extent all questions may be approached either quantitatively or qualitatively. It all depends on what is the chief goal of the study. This study was approaching a field that was too vast and really large. Considering only secondary data, as per my view was not at all sufficient to give out proper results. As the study was interested within some systematic loom, for producing proper comparable, general sable data, the researcher should have produced a very "thick" description of the specific case/sets/situation and context as well. Each option should have involved some dissimilar types of planning that might best be chased by a exacting research design (Tambuyzer, Pieters & Van Audenhove, 2011)
Article 2- The research was carried out at the time when the researcher liked to attain and understand meanings, describe as well as understand experience, concepts, beliefs as well as values and other elements like this. If the study would have been considered and an area of research would have got benefited from the quantitative research it would prove to be better learning than what came out. Also tables and data represented were confusing and good explanations for the same were not provided in the report which made it literally confusing (Teunissen et al., 2013)
Summarize your thoughts related to the usefulness of the statistics.
Article 1- Statistics use here was real science behind collection, analysis plus making of the inference that were derived from data. Statistics was a chiefly useful branch in the study which was not just studied theoretically rather was used as advanced measure to bring out better and qualitative result. But as the research only included secondary data search thus it lacked an appropriate statistical carry out. It was also important for the researcher to understand the statistics to get informed, and then evaluate the trustworthiness and value of the data and the information, and then make proper decisions (Taylor, 2008)
Article 2- Statistical methods were used to conclude and summarize otherwise describe a gathering of data; which was called the descriptive statistics. Additionally, patterns in data were also to be modeled within a way which would have accounted accounts for the randomness as well as uncertainty in observations. Also the study ignored the greater use of quantitative data and this decreased the level of statistical result in the research (Tse, Tang & Kan, 2012)
Considering the first article working with such faculty-initiated study might also give nurses the chance to work intimately with the mentor. In the second article measuring and monitoring presence as well as impact of the insurance-based biasness in the health care settings also helped the researcher to overcome this problem. Also as per the results attained from data the entire study success got associated with some higher levels of the patient involvement
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