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HAI Risk for Patients with Chronic Illnesses

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Running head: RESEARCH PAPER 1 RESEARCH PAPER 6 HOSPITAL-ACQUIRED INFECTIONS AMONG PATIENTS in hospitals in florida? (Qualitative Study) Dayana Lewandowski Florida International University HSA 6977 Dr. Mariceli Comellas May 17, 2020 Background Information Explain overall what the problem is? Statistics in the usa, in the usa there are 4574 hospitalizations due to the infections acquired in hospitals, use citations and use government websites. Download research guidelines. 1.The objective of the study is. 2. results of the study 3.connect that study with your study and how ur study fills in the gap of that study “citation”Hospital-acquired infection, otherwise known as nosocomial diseases are a common problem that affects many healthcare institutions around the world. Such diseases are not only a burden to healthcare institutions but also the patients served. The total costs associated with the management of hospital-acquired infections have constantly been rising despite the implementation of many intervention policies, (Khan, Baig, & Mehboob, 2017). The government has formulated various nursing intervention policies through various federal and state departments to resolve the issues of nosocomial infections. However, many of these interventions have barely led to a permanent solution. Hospitals and patients are still incurring huge costs as a result of hospital-acquired infections. Hospitals are often subjected to expensive litigation procedures whenever patients contract infections while admitted. On the other hand, patients are sometimes required to spend more on treatment after contracting infections while admitted in various healthcare institutions. In the University of Miami Hospital, for instance, operational costs have been increasing annually mainly because the hospital has to deal with many nosocomial infections annually, (Chang, 2017). A similar scenario is noted among healthcare institutions operating in the Southern Florida region. While this problem has been identified and discussed a lot, not much attention has been directed to dissect the most affected persons. People with pre-existing chronic diseases such as arthritis, diabetes, and asthma are more susceptible to nosocomial infections compared to people who do not have pre-existing chronic illnesses. Problem Statement Pre-existing chronic illnesses increase the risk of opportunistic illnesses and infections. For instance, diabetes type I affects immunity hence diabetic people have greater risks, (Casqueiro, Casqueiro, & Alves, 2012). Healthcare practitioners, as well as patients, are at risk of contracting nosocomial infections, especially when they have pre-existing chronic diseases. “Add citations”Past research indicates that the majority of persons who are severely affected by hospital-acquired infections have pre-existing conditions. Many healthcare institutions in the Southern Florida region have high cases of nosocomial infections because p.

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Running head: RESEARCH PAPER 1 RESEARCH PAPER 6 HOSPITAL-ACQUIRED INFECTIONS AMONG PATIENTS in hospitals in florida? (Qualitative Study) Dayana Lewandowski Florida International University HSA 6977 Dr. Mariceli Comellas May 17, 2020 Background Information Explain overall what the problem is? Statistics in the usa, in the usa there are 4574 hospitalizations due to the infections
acquired in hospitals, use citations and use government websites. Download research guidelines. 1.The objective of the study is. 2. results of the study 3.connect that study with your study and how ur study fills in the gap of that study “citation”Hospital-acquired infection, otherwise known as nosocomial diseases are a common problem that affects many healthcare institutions around the world. Such diseases are not only a burden to healthcare institutions but also the patients served. The total costs associated with the management of hospital-acquired infections have constantly been rising despite the implementation of many intervention policies, (Khan, Baig, & Mehboob, 2017). The government has formulated various nursing intervention policies through various federal and state departments to resolve the issues of nosocomial infections. However, many of these interventions have barely led to a permanent solution. Hospitals and patients are still incurring huge costs as a result of hospital-acquired infections. Hospitals are often subjected to expensive litigation procedures whenever patients contract infections while admitted. On the other hand, patients are sometimes required to spend more on treatment after contracting infections while admitted in various healthcare institutions. In the University of Miami Hospital, for instance, operational costs have been increasing annually mainly because the hospital has to deal with many nosocomial infections annually, (Chang, 2017). A similar scenario is noted among healthcare institutions operating in the Southern Florida region. While this problem has been identified and discussed a lot, not much attention has been directed to dissect the most affected persons. People with pre-existing chronic diseases such as arthritis, diabetes, and asthma are more susceptible to nosocomial infections compared to people who do not have pre-existing chronic illnesses. Problem Statement
Pre-existing chronic illnesses increase the risk of opportunistic illnesses and infections. For instance, diabetes type I affects immunity hence diabetic people have greater risks, (Casqueiro, Casqueiro, & Alves, 2012). Healthcare practitioners, as well as patients, are at risk of contracting nosocomial infections, especially when they have pre-existing chronic diseases. “Add citations”Past research indicates that the majority of persons who are severely affected by hospital-acquired infections have pre-existing conditions. Many healthcare institutions in the Southern Florida region have high cases of nosocomial infections because pre-existing conditions among nurses are often not considered during the hiring and also during the admission of patients. Nurse practitioners tasked with extending care services to patients in various wards including ICUs often contract nosocomial infections. A nurse practitioner who has a pre- existing chronic illness such as diabetes type I is more susceptible to nosocomial infection than other nurses. The same case applies to patients admitted to hospital with pre-existing chronic conditions. Similarly, asthmatic people are more susceptible to infections that affect the respiratory system. Although people with pre-existing chronic illnesses are more susceptible to hospital-acquired infections, not much has been done to develop specific intervention measures for this group of people, (Klompas, 2017). For this reason, research is needed to identify the extent to which hospital-acquired infections affect persons with pre-existing chronic illnesses. Significance of the study How the reader, why this program of acquiring infections research is going to help society? Significance of the study (cost $$ or loss of life morbidity, loss of productivity) “Citations”Nursing research has in the past been used to develop appropriate interventions to resolve various problems in the healthcare sector. (Why is it important)Therefore, research
on the prevalence of hospital-acquired infections among patients diagnosed with chronic diseases is important to identify intervention measures that could be formulated to address the problem. Also, research on the identified problem will fill existing knowledge gaps that affect the quality of healthcare services extended to patients diagnosed with chronic diseases. More so, the research will help to identify appropriate measures that could be used to reduce the financial burden among admitted patients diagnosed with chronic diseases. The prevalence of nosocomial infections among patients and healthcare professionals’ diagnosed living with various chronic illnesses is much higher than the prevalence among patients and healthcare professionals who do not have pre-existing chronic conditions. Therefore, it is necessary to undertake research that focuses on the specific group of people to better understand which nursing interventions would be most appropriate. Hospitals acquired infections in hospitals in the US Review of Literature Although all patients are exposed to nosocomial infection during their stay in various healthcare institutions, recent studies indicate a high prevalence among patients diagnosed with chronic illnesses. Chronic illnesses often weaken immunity thus exposing patients to many opportunistic infections and diseases. For instance, a hyperglycemic environment triggers immune dysfunction among diabetic patients thus exposing them to frequent infections that are in some cases very severe, (Casqueiro, et.al.,2012). In another study, Kirchgesner et.al., (2018) found that patients with chronic inflammatory bowel disease often suffer a great deal due to the high susceptibility to
nosocomial infections. For instance, catheters used have been identified to increase the prevalence of hospital-acquired infections among IBD patients. Similarly, patients who have pre-existing asthmatic conditions often contract pneumonia while admitted to the hospital. However, (continue argument) very few studies have looked into assessing hospital based infections among patients in florida. In a recent study, Klompas (2017) discovered that ventilators used in ICUs are often the cause of nosocomial infections among asthmatic patients. Hygiene compliance policies have been formulated and prevented to reduce the prevalence of nosocomial infections in the past. However, implementing hygiene standards as a preventive measure does not alleviate the problem among persons diagnosed with chronic conditions, (Smythe, et.al., 2016). A lot of research about hospital-acquired infections has been conducted in the past but very few studies have focused exclusively on a population of persons with chronic illnesses. A knowledge gap is identified from the literature reviewed, thus research on the topic is necessary. According to Chang (2017), the University of Miami Hospital is among the most affected healthcare institutions in the Southern Florida region. (Add more content) Methodology The proposed study will adopt a qualitative research design to explore the prevalence of hospital-acquired infections among patients diagnosed with chronic illnesses. An exploratory study will pave the way for further research on the same topic in the future, (Creswell & Creswell, 2018). Therefore, a synthesis of existing literature materials will be conducted to gain meaningful insights into the topic. The literature sources selected for the qualitative synthesis must cover main concepts such as the prevalence of nosocomial infections and chronic diseases. Focusing on these concepts will ensure that the data collected can be used to answer research questions and
consequently fill the existing knowledge gaps. The sample population will comprise of patients and nurses admitted and working, respectively, at Miami University Hospital. Research participants must have a pre-existing chronic illness and a history of nosocomial infections in the last 3 years. Also, the research will mainly rely on secondary data collected in previous studies. Utilizing secondary data saves time and costs associated with collecting primary data. In conclusion, patients diagnosed with chronic illnesses are more susceptible to nosocomial infections. However, not much has been done on this topic hence a lack of effective intervention measures to alleviate the problem. The existing interventions do not adequately cover the problems endured by patients who contract nosocomial infections easily due to pre- existing chronic illnesses. As such, the proposed study is meant to address this problem. References Casqueiro, J., Casqueiro, J., & Alves, C. (2012). Infections in patients with diabetes mellitus: A review of pathogenesis. Indian journal of endocrinology and metabolism, 16(Suppl1), S27. DOI: 10.4103/2230-8210.94253 Chang, D. (2017). UM Hospital can’t stop bleeding money as costs soar and admissions drop. Miami Herald. Retrieved from https://www.miamiherald.com/news/health- care/article186714813.html Creswell, J. W., & Creswell, J. D. (2018). Research design qualitative, quantitative, and mixed methods approach. Los Angeles: SAGE. Kirchgesner, J., Lemaitre, M., Carrat, F., Zureik, M., Carbonnel, F., & Dray-Spira, R. (2018). Risk of serious and opportunistic infections associated with the treatment of inflammatory bowel diseases. Gastroenterology, 155(2), 337- 346. https://doi.org/10.1053/j.gastro.2018.04.012 Klompas, M. (2017). What is new in the prevention of nosocomial pneumonia in the ICU?. Current opinion in critical care, 23(5), 378-384. DOI: 10.1097/MCC.0000000000000443
Khan, H. A., Baig, F. K., & Mehboob, R. (2017). Nosocomial infections: Epidemiology, prevention, control, and surveillance. Asian Pacific Journal of Tropical Biomedicine, 7(5), 478-482. https://doi.org/10.1016/j.apjtb.2017.01.019 Smythe, W., Engelbrecht, H., Morris, V., Patel, B., & McDonald, H. (2016). A multifaceted hospital-wide intervention increases hand hygiene compliance: in practice. African Journal of Health Professions Education, 106(4), 335-341. Statistical Techniques Used for Exploring Relationships: 1) Correlation: Explores relationship among two continuous variables (e.g. age and depression scale). a. Partial correlation: Controls for one continuous variable while explores for a relationship among two continuous variables. Example: After controlling for the effects of socially desirable responding, is there still a significant relationship between optimism and life satisfaction scores (three continuous variables) 2) Multiple regression: Predicts. One continuous dependent variable & 2 or more continuous independent variable. It can be seen as an extension of correlation and is used when you want to explore the predictive ability of a set of independent variables on one continuous dependent measure. Example: How much variance in life satisfaction scores can be explained by the following set of variables: self-esteem, optimism and perceived control? Which variables is a better predictor of life satisfaction. All variables here are continuous. 3) Chi Square: Explores relationships among two categorical
variables (e.g. sex and exercise—exercise is categorized as either (Yes or No). Example: Is there a relationship between sex (Males and Females) and exercise (Yes vs. No)? 4) Spearman’s Rank Order correlation: two variables that are either ordinal, interval or ratio. Exploring Differences Between Groups (interval scales): Parametric tests: the data is required to fit a normal distribution. 5) T-tests are used when you have 2 groups or two set of data (before & after) and when you wish to compare the mean scores on some continuous variable. Example: Are males more optimistic than females? One categorical independent variables with two groups and one continuous dependent variable. a) Independent sample t-test: Used when there are 2 different independent groups and you want to compare their scores. One categorical independent variable with only 2 groups & one continuous dependent variable. b) Paired sample t-test: Sameparticipants are tested on 2 separate occasions. One categorical independent variable (e.g. Time 1 & Time 2) & one continuous dependent variable. Example: Does ten weeks of meditation training result in a
decrease in participant level of anxiety? Is there a change in anxiety levels from Time 1 (pre intervention) to time 2 (post intervention)? One categorical independent (Time 1/Time 2) & One continuous dependent variable (anxiety score). 6) One sample between groups analyses (ANOVA): Used to compare 2 or more groups and compare their mean scores on a continuous variable. One categorical independent variables with 2 or more groups & one continuous dependent variable. Example: Is there a difference in optimism scores for people who are under 30, between 31-49 and 50 years and over. 7) Two way between groups ANOVA: Test the impact of two categorical independent variables and one continuous dependent variable. This test allows the possibility of testing for interaction effect. This is when the effect of one independent variable is influenced by another. Example: What is the effect of age on optimism scores for males and females. 8) Mixed between-within ANOVA: One between groups independent variable (intervention such as math skills and confidence building) and one within group’s independent variable (Time 1, Time 2, Time 3) & one continuous dependent variable. 9) Multivariate ANOVA: One categorical independent variable & ≥ 2 continuous dependent variables. 10) ANCOVA: One categorical independent variable & one continuousdependent variable & one or more continuous covariates. Nonparametric tests: the data is not required to fit a normal distribution. Data that is often ordinal, meaning it does not rely
on numbers, rather a ranking or order of categories. 11) Wilcoxon Signed-Rank test: is the nonparametric test equivalent to the repeated measures t-test. *Converts scores to ranks and compares these at Time 1 and at Time 2. 12) Mann-Whitney U: Non parametric measure; tests difference between 2 independent groups. 13) Kruskal–Wallis one-way analysis of variance: The non- parametric option for one-way ANOVA. It is used for comparing two or more independent samples of equal or different sample sizes. It extends the Mann–Whitney U test when there are more than two groups. a. Post hoc analyses are conducted to find out which groups are significantly different from one another. 14) McNemar’s Test: Tests 2 variables, the first recorded at time 1 and the second recorded at time 2. Both of these variables are categorical. a. E.g. Question: Is there a change in the proportion of the sample diagnosed with clinical depression prior to and following intervention. 15) Cochran’s Q Test: If you have 3 or more time points. All three are categorical variables measuring the same characteristics at 3 points in time. a. Example: Is there a proportion of participants diagnosed with clinical depression across the three time points (a) prior to the program (b) three months’ post program. Research Objective Type of DV Type of IV
Covariates Test Analysis Goal Test associations or relationships Explore associations nominal (categorical) variables nominal (categorical) variables Chi Square Is there an association between the IV+DV Explore associations and strengths Continuous Continuous Correlation Is there an association between the IV+DV Explore associations and strengths Continuous Continuous one or more Partial correlation Is there an association between the IV+DV controlling for 1 or more variables Explore associations and strength between two ranked variables Continuous Continuous Spearman Rank Order correlation (non-parametric) Is there an association between the IV+DV Differences between groups tests: Explore differences between groups (Before or After) AND Compare the mean scores on some continuous variable Continuous One nominal (categorical) variables with 2 groups
T-tests (Parametric) Do differences exist between groups. Explore the differences between independent groups to compare their scores Continuous One nominal (categorical) variable with only 2 groups Independent sample T-test (Parametric) Do differences exist between these two groups. Explore the differences between the same participants on two separate occasions to compare their scores Continuous One nominal (categorical) variable (Time 1 & Time 2) Paired Sample t-test (Parametric) Test the same participants on two separate occasions (Time 1 & Time 2) Research Objective # and type of DV # and type of IV Covariates Test Analysis Goal Explore the differences between ≥2 groups and compare their mean scores on a continuous variable Continuous Categorical with ≥2 groups ANOVA Do differences exist between ≥2 groups on one DV Test the main and interaction effects of categorical variables on a continuous dependent variable, controlling for the effects of selected other continuous variables, which co-vary with the
dependent. One continuous Categorical with ≥2 groups one or more additional ANCOVA Do differences exist between ≥2 groups on one DV after controlling for the covariates Explore the differences between ≥2 groups on multiple DVs ≥2 groups (continuous) Categorical with ≥2 groups one or more additional MANOVA Do differences exist between ≥2 groups on multiple DVs Explanation or prediction tests: How much variance in the DV is accounted for by linear combination of the IVs 1 continuous ≥2 Dichotomous Continuous Multiple regression How strongly related to the DV is the beta coefficient for each IV What is the odds or the probability of the DV occurring as the values of the IVs change? 1 dichotomous 1 or more Categorical or continuous Logistic regression What are the odds or the probability of the DV occurring as the values of the IVs change Practice exercise Research Objective # and type of DV # and type of IV Covariates
Test Analysis Goal 2
G U I D E L I N E S F O R T H E A D V A N C E D H E A L T H S E R V I C E S M A N A G E M E N T A N D R E S E A R C H S E M I N A R M A S T E R O F H E A L T H S E R V I C E S A D M I N I S T R A T I O N 1 Guidelines ............................................................................................... ............... 2 Part I: Advanced Research Seminar 6717 Research Overview ............................. 3 Advanced Health Services Management Research Seminar HSA 6717 Overview.4 Part II: 6977 Masters Research Project Overview….…………………………………………..5 Organization of the Research Proposal
.................................................................. 6 Introduction/Background ................................................................................... 6 Statement of Problem ......................................................................................... 6 Significance of Study ........................................................................................... 7 Literature Review ............................................................................................... 8 Research Methods ............................................................................... ............. 10 Part II: 6977 Masters Research Project………………………………………………………………… …………………………………………17 Data Analysis……………………………………………………………… ………………………………….18 Results………………………………………………….…………… …………………………………………..19 Discussion, Recommendations, and Conclusions………………………………………….……………… …………………………………………22
References………………………………………….………………… ……………………………………….24 CONTENTS 2 A Masters degree contributes to the professional mastery of an administrative career in health services administration. The Masters in Health Services Administration prepares students with hands-on experience in conducting research and interacting with leaders while working in an administrative residency in health service administration. The student conducts a research project on a specific healthcare management problem or enrolls in the Administrative Residency. At some point in the program, the student may choose enrollment in research or the residency based on their interest. Typically students enroll in the Professional Seminar (HSA
6930) and the Advanced Research Seminar (HSA 6717), where all students develop a research proposal by the end of the semester. The student has the choice to enroll in either the Administrative Residency (HSA 6875) or the Masters Research Project (HSA 6977). If the student chooses to enroll in the HSA 6977 instead of the HSA 6875, then the student advances in their research project. Students who completed their research proposal during the Advanced Research Seminar may continue to work in the final portion of the research project to fulfill the requirements for HSA 6977. Page 4 of this guide describes the research project structure in detail. The student who chooses to conduct a research project will finalize the research project within two semesters— during the Advanced Research Seminar (HSA 6717) and the Advanced Health Services Management and Research Seminar (HSA 6977) course. Below
there is a description of the Masters Program structure with either of these choices. Guidelines 3 The first objective of these guidelines is to provide a roadmap for the student on both the Advanced Research Seminar and the Masters Research Project. Students should know in advance about the program research expectations. If a student decides to continue on the research project path, they have the opportunity to continue to
work on the research project in their interest area. To ensure the student's success, follow these guidelines in preparation for your research project. The second objective of this guide is to show students the components for conducting quantitative and/or qualitative studies, depending on the type of research design as applicable. Students are responsible for ensuring the research paper is free of errors in form, style, spelling, and grammar. Students should follow the American Psychological Association (APA) writing format. For more information on the APA writing style, consult the 7th edition manual. 4 Advanced Research Seminar 6717 Overview
WEEK 1-2: Topic Selection o Students enrolled in the Advanced Research Seminar 6717 who are interested in research, discuss a research topic with the course instructor. o Meet the course instructor to discuss potential topics (within the first three weeks). o Search the literature to narrow down a topic of interest. o Develop an annotated bibliography. o Select a feasible research topic within the first three (3) weeks. Note: Students who do not meet the topic selection deadline will be offered the opportunity to register in the Administrative Residency HSA 6875. WEEK 3-7: Develop Research Question and Purpose of Study o Meet with the course instructor to discuss the research progress and proposed topic. o Discuss a research proposal structure/plan o Develop a research question
o Develop Introduction/Background, Statement of Problem, Purpose, and Significance of Research WEEK 8-11 o Start the Literature Review: Continue to research and annotate sources o Start the methods section WEEK 12-14 o Turn in a comprehensive research proposal including a list of references 5 Advanced Health Services Management Seminar HSA 6977 Overview
WEEK 1-3: Data collection o Meet with the course instructor to discuss the research progress and recruitment progress. o Continue data collection process. WEEK 4-5: Preliminary Analyses o Meet with the course instructor to discuss a data analysis plan and conduct analyses. o Report and discuss preliminary analyses with the course instructor WEEK 6-7: Report participant demographics and other statistics o Finalize analyses and reporting WEEK 8-10: Write recommendations and conclusions o Finalize the discussion, recommendations limitations and conclusions write up WEEK 11-12 Prepare research project presentation
o Final research project presentation o Turn in final research paper 6 Organization of the Research Proposal The research proposal allows the student to write a formal written plan put forward for consideration in the Professional Seminar. When the student is writing the research proposal, it is written in the future tense, since the research has not been conducted. Example: 'This research will explore…' Title Page The title page should include several sections: Project title,
name, name of the institution name of the course instructor, and date the proposal is submitted. Do not include a running head on the title page. The title should be brief yet informative, providing the reader with a description of the proposed topic of the research study. The title should reflect the identification of the problem the research assesses. Introduction/Background The first section must capture the reader's interest, provide a rationale for the study as a whole, and inform the reader about the research content and scope. First, explain the research background starting from a broad perspective (e.g., what is known about the problem globally? What is the prevalence of the problem nationwide? Second, describe the problem at the local/state level.) Third, describe what is known about the research topic.
This section includes relevant references to support the statements part of the background. The references should be from reliable sources of information, and these should be accurate. References can be found in the peer-reviewed literature (i.e., scholarly journals), books, and other reliable sources. Statement of Problem The statement of the problem lays the foundation for the issues being explored in the research project. This section details why the problem requires research. The statement of the problem section usually starts by addressing why the student is pursuing this research topic. Is it severe enough to warrant the study? Next, place the problem and research question in perspective, develop a narrative on the demographics (introducing the population of interest), and location of the problem (setting/geographical location) or situation leading to the applied research. It is essential to provide compelling evidence the problem exists. This section should also be supported
7 by evidence-based references/citations. Cite relevant literature to support the topic of interest and the variables of the study. Significance of the Study This section narrates why the proposed research study is relevant or meaningful and why the study might be necessary. The use of literature is highly recommended to describe the gaps in the published literature, insufficient knowledge in the subject area, or the need to validate the findings of previous studies. Explain what the benefit or contribution to new knowledge is. Example: "This research is important to understand barriers to access health care services for South Florida residents with cardiovascular diseases. This study is relevant to understand better what the specific barriers are so that
intervention tailored to this population are implemented." Qualitative studies are exploratory in nature. An example of qualitative research is Interviews of clinical practitioners about the types of policies on a specific health program or available therapies to treat a disease. This type of research is recommended when a researcher wants to understand the population or area of interest from a behavioral or analytical perspective. Interpretations of the answers are required. In qualitative studies, there is a guide to topics/themes. Through this design, there is some flexibility to explore the participant's responses through a structured interview process. If a student decides to use a qualitative study as the design of their research, he/she shows the study findings' using the research participants' direct narrative quotes that should support the study conclusions. Qualitative research question example: "What are the relevant
barriers for access to healthcare are for South Florida residents with cardiovascular diseases." Quantitative Research Quantitative studies use a structured variable-specific survey questionnaire or secondary data collection. When using this type of research design, the student uses a representative sample of the population of interest. The student should be cautious about the type of questions when using questionnaires and should consult with the course instructor if they are planning to use surveys to collect data. The survey question (s) should follow the research question objectives. In these types of studies, the student should be able to speak about the data that supports the conclusions. In quantitative research, it is not possible to subjectively interpret any results, as is the case of qualitative research.
8 Quantitative research question example: "What are the most prevalent barriers to access health care services identified by South Florida residents with cardiovascular diseases?" Literature Review The purpose of the literature review is to describe the related and existent evidence about the topic of interest. Creswell (2014) suggests that the literature review shares with the reader the results of previous studies, related to the one being proposed/conducted. The literature review is a critical review and assessment of current as well as previous research studies or evidence in the field of study. This section compares and contrasts previous studies related to the topic chosen, combining, and summarizing related studies. The reader should be able to find a roadmap and a narrative describing many aspects of the
literature on what is known about the topic. Start by explaining the problem worldwide, nationwide, and explain the varying results documented in the literature. Provide a logical structure to the reader, guiding them through previous research studies and theories supporting the proposed research, establishing the importance of the topic. Be critical and consistent. Provide an assessment of the strengths and weaknesses of previous and current studies. Cooper (2010) & Creswell (2014) recognized four aspects of literature reviews described below: 1) Integrate research/evidence that others have done or said 2) Criticize scholarly work 3) Build bridges between related topics 4) Identify the principal issues in a field Example of a research question for the example below: "What are the barriers to access health care services identified by South Florida residents with cardiovascular diseases?"
Literature Example: "Access to health care seems to be improving in the United States (Clooney, 2017). However, some research has found significant increases in chronic diseases such as cardiovascular diseases in the state of Florida (Jones- Who, 2018). Therefore, more research is needed to understand barriers for access to health care services identified by South Florida residents with cardiovascular diseases, since the prevalence is rising. A recent study found positive effects on access to health care and cardiovascular disease outcomes (Clooney & Comellas, 2018). Clooney and Comellas (2018) argued there is an increasingly aging population 9 in South Florida identifying significant transportation barriers to access preventive care services."
According to Creswell (2014) (in quantitative research), the literature review starts with a (1) introduction section, followed by (2) topic 1 (the independent variable) (3) topic 2 (the dependent variable) and (4) topic 3 (studies that address both the dependent and independent variable) and (5) a summary highlighting the most important studies (Creswell, 2014, p. 47). The literature review for a qualitative and quantitative study is written as part of the research proposal. Note: Use current literature / evidence. Seek the input from your course instructor. Literature Review: Step by Step Creswell (2014) suggests several different ways to work on a literature review: 1) Identify keywords to locate different materials in a library. The keywords may emerge from the literature, and it may allow for the identification of a topic. 2) Search journals, books, databases (e.g., FIU computer databases: ProQuest, EBSCO, PubMed, etc.).
3) Gather as many reports as possible that are related to the research topic. 4) Skim through the articles. Creswell (2014) suggests that throughout this process, it is essential to try to gain a sense as to whether the research will make a useful contribution to the understanding of the literature. 5) Begin a literature map. a. This is a visual picture or groupings of the literature on the topic illustrating how the study will contribute to the literature. b. Position the study within the larger body of research. 6) Begin to draft summaries of the most relevant articles. Start critiquing the previous literature and point out deficiencies and issues with the methods. 7) Assemble the literature review. Structure of the literature thematically (use headings). The literature review conclusion should suggest how the proposed research may contribute to the current literature and could address gaps in the current literature.
10 Research Methods This section describes participant selection, the data collection of the research procedures, and data analysis. This section starts with a description of the study design (i.e., qualitative and/or quantitative design). The methods section includes the following: 1. Introduction. This section includes a reiteration of the statement of the problem and the research question. 2. Participants. This section includes the study population and sample selection (quantitative) or a description of study participants (e.g., males and/or females, age range, ethnicity, or other demographical characteristics). Describe how the participants will be chosen (qualitative), recruitment procedures, the estimated number of participants, and
reimbursement or monetary compensations are given to participants (if any) should be specified. 3. Procedures for data collection. This section includes detailed descriptions of procedures (quantitative or qualitative) used/to be used to collect the data. Anticipate how data will be collected. Explain why each procedure was chosen. It is also essential to describe how the procedure will address the research questions. 4. Data Collection. In this course, data collection will be done mainly through secondary data (data collected by others, not the principal investigator). Provide a rationale for the procedures, using arguments based on its strengths and weaknesses, costs, data availability and/or convenience. 5. Ethical Considerations. This section should describe foreseeable risks or discomforts related to participation (if any). Everyone who decides to participate in the study should receive an informed consent form. The researcher should provide their contact information in case the participants request additional research-related information. Qualitative and Quantitative Content
Qualitative Research When conducting qualitative research, the aim is to address people's experiences, needs, and different perspectives. Qualitative research aims at understanding and observing attitudes, life circumstances, beliefs, opinions, behaviors, and processes in depth. Data is collected by interviewing people and recording the responses as well as observing and documenting participant body language. The conventional approaches for facilitating interviews are: 11 a. In-depth interviews: These are one on one interviews. Researchers are interested in understanding individual experiences or opinions. b. Focus group interviews: The researcher attempts to discuss or explore participants'
opinions in a group setting. c. Telephone mediated interviews: The researcher interviews participants by phone. d. Online mediated interviews: These are one on one interviews conducted online. e. Observation: This is an approach often used as a supplement to recording participant's responses. Quantitative Research When conducting quantitative research, data is often gathered using surveys either in person or through the Internet. If the information is collected through a survey questionnaire, it usually has three sections: (a) inclusion/exclusion criteria, (b) demographic information, and (c) the questions assessing the study variable (s) of interest. Participants Qualitative Research
In qualitative research designs, the researcher purposely identifies the individuals (usually between 5 to 10 study participants) for the proposed study (Creswell, 2014). He/she should have in mind the research problem and which population (s) are affected by the problem. This section of the paper describes the selection of study participants, explains the characteristics of the participants, and describes the proposed number of participants. It also includes the inclusion and the exclusion criteria for including the research population. Quantitative Research As is the case with qualitative research designs, this section describes the selection of participants (e.g., data), explaining the demographic characteristics, and describing the proposed number in the sample being studied. It also includes the inclusion and exclusion criteria for selecting the research sample. Sample sizes may vary based upon the research aim/question (s). Large sample sizes (e.g., ≥ 100), often leads to increased
accuracy in estimates about the population. Note: Students are encouraged to ask their course instructor for recommendations on sample sizes. 12 Procedures Qualitative Research This section describes the participant's recruitment process as well as the methods used while conducting the interviews (e.g., notes, audiotape recording, and videotape recording). Discuss how the group (if a focus group) will discuss a quiet, comfortable place to ensure everyone speaks/participate. Describe the development of a topic guide.
A topic guide is used in the interview process to guide and discuss critical questions the interviewer would like to cover, including useful prompts to encourage discussion. Include an explanation about transcribing the interview once the participant's interviews/discussions have ended. After transcribing, the student reads the interviews (i.e., the data) and start coding it. Note: Coding is an approach used to organize the data by grouping pieces (categorizing the data) and writing a word representing a category (Rossman & Rallis, 2012; Creswell, 2014, p. 198). In qualitative research, data is primarily in the form of words derived from the participant's expressions on a subject matter. The data should be organized into categories of themes. Describe how validity occurs in the research process to validate the findings of the proposed study.
Describe one or more strategies for establishing the accurateness of the findings. Some of the commonly used strategies are described below: a) Triangulation: Search for different data sources and use these to build the justification of themes (Creswell, 2014). If the researcher finds that the themes are established based on converging several sources of data or participant perspectives, then this would add to the validity of the study. b) Member checking: Taking the emergent themes back to the participants and asking them if they feel the themes are correct. Note: To check the reliability, researchers may cross-check the results with an independent person who can check the codes used by the researcher. Consult the course instructor for more information on these methods.
13 Quantitative Research In this section, the student documents the participant's recruitment process (e.g., consecutively, using a snowball approach, randomly, or other procedure that is free from bias). The student must always provide informed consent and specify the research is voluntary to all participants before starting the data collection process. Therefore, the student must describe the informed consent process in the methods section (if administering a survey). This section describes the processes used while collecting the research data. It documents all the processes for gathering data, selecting participants (or sites), providing copies of the consent form (if applicable). Describe the study variables, the parameters established for the variable (s) of study (e.g., optimal health risk scores are defined as ≥10"), and how these data collected was collected.
Data Collection Qualitative Research It is common to develop structured and semi-structured questions and record each participant's responses. The interview research question should map to the main research question. When conducting qualitative research, an interview/discussion guide is developed to conduct the interviews. These questions address the main research problem. Other data collected during the interviews could include participant demographics (e.g., age, sex, race/ethnicity, income for descriptive statistics). Note: The student interviewer informs the research participant of the location, day, and time of the interview. The interviewer ensures the participants have the interviewer contact information in case they get lost, are delayed, or have
other problems before the interview. During and before the interview: a) Provide an informed consent form indicating the research is voluntary b) Remind the research participants that they will be recorded c) Remind the research participants that there are no right or wrong answers during the interview session (promote open and honest communication) d) State name and the goal of meeting with the participants e) Ask each participant to introduce themselves, state their names or initials so that you can later distinguish each participant responses 14 f) Do not redirect or interpret the respondent answers, or judge g) Know the interview guide and questions
h) Do not bring any knowledge to the table i) Be comfortable with silence Note: Use probes as needed. For example – be silent, repeat the statement they said, and then continue neutrally ("I see, uh…"), direct ("Tell me more"), and clarify (what, where, when, what). Quantitative Research This section describes how many questions are going to be used (even if it is secondary data collection) and how the survey that led to the data collection was developed. Example: "The data used in this research is from the cardiovascular diseases questionnaire used in research conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. This is a national cross-sectional research study representative of the U.S. population. The interviewers were elderly persons and minorities to provide a full representation of the U.S population. Note: If the student plans to use a survey or other form of data collection, consult the
course instructor for guidance. Sample Population (Participants) Qualitative Research In qualitative research designs, the researcher purposely identifies the individuals (usually between 5 to 10 study participants) for the proposed study (Creswell, 2014). The student should have in mind the research problem and which population (s) are affected by the problem. This section describes the selection of study participants, explains the characteristics of the participants, and describes the number of participants the student plans to recruit. To determine the sample size, consult the course instructor for guidance. This section includes the inclusion and exclusion criteria for study participation. The inclusion criteria describe which participants should be included in the research (e.g., individuals with diabetes and/or people who had an HPV vaccination, ages 18yrs and over).
Conversely, the exclusion criteria disqualify those individuals (potential participants) who do not meet the described characteristics the researcher is looking for. Quantitative Research 15 As is the case with qualitative research designs, this section of the paper also describes the selection of research participants, explains the characteristics of the participants, and describes the proposed number of participants. It also includes the inclusion and exclusion criteria for study participation (as described above). Samples sizes may vary based upon the research aim/question (s). Large sample sizes (e.g., ≥ 100), often leads to increased accuracy in estimates about the population. Students are encouraged to ask their
course instructor for recommendations on sample sizes. The requirements for sample sizes may vary by study design. Instrumentation Qualitative Research This section describes the qualitative research approach to open-ended questions. In qualitative research, the … Research Paper Checklist & Assessment for MHSA Students The research paper information should be discussed with the course instructor throughout all stages of the writing process. Title 1 Fifteen (15) words or less. APA capitalization rules should be followed. Abstract (10pts) 2 The abstract should be written last. However, it is usually placed after the Cover Page; not after the reference or anywhere else. The abstract should be no more than 250 words. It includes the following succinct parts: Introduce the research topic (no citations) The objective(s) of the study Describe the participants characteristics (brief of results) State the type of methodology (quantitative, qualitative, or mixed method) Include only key results of the study
Ex. Quantitative: use p-values to show significance and strength of association Ex. Qualitative: discuss major themes Recommendations and Conclusions Upon completion of the research, change the future tense to past tense and include the results of the study. Pagination and document format (10pts) Use Microsoft Word. You may watch several YouTube videos and choose one that you are comfortable with to guide you in this process. This will require you to change the headings throughout the document, which is totally fine. It will be in accordance with APA format. Change/add more headings and subheadings and update the work. Finally, include page numbers. Paper I: Introduction This information should stimulate the interest of the reader. Explain why this research is so important in the health field/health services administration. Background Provide a rationale for the study Discuss the variables Have one or two sentences that introduce the other headings in this paper Last sentence is the purpose statement This information should give an overview of the current importance of the topic.
Problem Statement Briefly highlight major actions that have been taken in regards to the topic (use several citations). Include prevalence / relevant statistics pertaining to the variables under study. Write a paragraph describing the problem. The problem statement should be supported by current literature. Who is affected by this problem? Where is the problem taking place? Why is it important for the problem to be fixed? What steps should be taken (possible solutions) to correct the problem. For this, use the current literature (not older than 6yrs from today). Use recent literature unless the information pertains to a seminal/historic discovery paper/publication. Research Aim/Question(s) At the end of the study, what overall question will be answered? Hypothesis Quantitative Research (only): If you are doing a quantitative study, a hypothesis should be provided. Back up the hypothesis with literature. The hypothesis clearly aligned with the purpose statement. Each research aim/question should be followed by the research hypothesis (Ha), then the null hypothesis (Ho). Purpose of the Study The purpose state is usually one or two sentences (not more than two sentences). It should reflect the research aim/question. Ask “Why is this study conducted?” Be sure not to confuse the purpose with the problem. The purpose of the study should include the following:
Describe the characteristics of the target participants Significance of the Study For this section, the researcher uses information from the literature to justify the need for the research. Definitions Define important terms used in thestudy (very important). Citation is needed for each definition. Delimitations Informs the reader the study is limited in scope. Examples: Describe the specific aspects of the data, sample size, participants’ characteristics, geographical location of the study, and other factors to define the limits of the study. Assumptions: Assumptions are primarily derived from the literature. Researchers assume that the participants answer the questions honestly and correctly; that they are able to read and understand the survey questions; that they follow the instructions carefully; that the test instrument is valid and reliable. This section tells the reader why the study is needed. Who will benefit? What contribution does this research bring to society? Gaps in the literature and/or insufficient knowledge in the subject area is clearly stated Literature Review Use peer review journal article topics are related to the research aim/question. Begin writing this section with a statement that describes the purpose of the research. Discuss how the literature is organized. You might have to
revise this statement as you add or subtract information from Paper2. Use subheadings to separate various parts of the Literature Review. Check the APA Manual for different levels of headings (for example, when to use Level 1, 2 or 3 headings). Provide information that explains the search terms that you used and describe the databases that were used to obtain the information. Only include the search terms that helped you to find information about the study. After reading several published literature of the variables of interest, you will need to synthesize them. Synthesizing involves taking similar studies and looking at topics that they have in common, (or different) to make themes. Write your literature review in past tense. For example, Brown and Forrester (2013) conducted a research on …. As you are writing this section you should cite information from the sources and build your reference list using APA format. Methodology This paper describes in details the data collection plan. This section is called the “cookbook” or “recipe” portion of the study. Therefore, the “ingredients” to bake the “cake” should be listed, and a step-by step procedure explained. This includes collecting and analyzing the data. Restate the purpose of the study Describe how the methodology is organized Describe the Study design – cross-sectional, correlational, descriptive, and others. Characteristics of the participants
Selection of participants – how did you choose the research participants? Include the inclusion and exclusion criteria for choosing the participants. Development and Selection of the instrumentation – give a general description of the survey. For example, how many questions and what the question will attempt to answer. Is the instrument valid? Reliable? Provide such evidence Ensure that the instrument answers the research aim/question(s) Data collection procedures – how did you collect the data? Data Analysis Procedures – How will you analyze the data? Ex. SPSS, Excel, NVivo, etc. Describe how you will analyze the independent and dependent variables Restate the research aim/question(s) and write the research and null hypotheses for each research aim/question. Ethical considerations – How did you protect the privacy and confidentiality of the participants? How did you store the data? **Did you analyzed the data collected? If yes, continue. If not, consult your course instructor. Part II Data analysis and Results (10pts) Results After analyzing the data, you will need to report the results of the study. This is the section that you will display the charts, diagrams, frequencies etc.). Use / draw Microsoft Word tables to depict the data accordingly.
This section includes the demographic information of the research participants; descriptive information about the various measures, and the results of the data analysis. Start with the descriptive statistics, then go to the analytical data. Discussion, Conclusions and Recommendations (10pts) The purpose of the study is restated and important findings should be summarized here. (No need to go into details). The paper should include a summary of the research, interpretation the results, the limitations of the study, and the researcher makes recommendations based on the outcome of the research. As you discuss the implications, state how the research may impact the individuals, family or society. Only materials mentioned earlier should be included in the summary. The conclusion should be the last one or two paragraphs of the thesis. Provide a strong take-home message by bringing all the main points together. Avoid saying exactly what you have said before. Limitations refer to weaknesses in the study. These weaknesses often relate to the following: a. sampling errors – ex. Small sample size limits generalization of the study b. uncontrolled variables c. faulty instrumentation d. representativeness of the data e. compromises to internal and external validity References (10pts) References should be properly cited and typed according to the APA Manual, 6th edition. The references go on a separate page. All references used in-text must be typed in the reference
section. Similarly, all the references in this section should also be in the text. References should be placed in alphabetical order. Appendix (10pts) Documents that must be included in the appendix are: 1. Sample of informed consent letter 2. Permission letter to conduct research from stakeholders 3. Copy of the instrument (survey, questionnaire, interview questions etc.) **This section Comments: _________________________________________ 4 | Page
G U I D E L I N E S F O R T H E A D V A N C E D H E A L T H S E R V I C E S M A N A G E M E N T A N D R E S E A R C H S E M I N A R M A S T E R O F H E A L T H S E R V I C E S A D M I N I S T R A T I O N 1 Guidelines ............................................................................................... ............... 2 Part I: Advanced Research Seminar 6717 Research Overview ............................. 3 Advanced Health Services Management Research Seminar HSA 6717 Overview.4 Part II: 6977 Masters Research Project
Overview….…………………………………………..5 Organization of the Research Proposal .................................................................. 6 Introduction/Background ................................................................................... 6 Statement of Problem ......................................................................................... 6 Significance of Study ........................................................................................... 7 Literature Review ............................................................................................... 8 Research Methods ............................................................................................ 10 Part II: 6977 Masters Research Project………………………………………………………………… …………………………………………17 Data Analysis……………………………………………………………… ………………………………….18 Results………………………………………………….…………… …………………………………………..19 Discussion, Recommendations, and
Conclusions………………………………………….……………… …………………………………………22 References………………………………………….………………… ……………………………………….24 CONTENTS 2 A Masters degree contributes to the professional mastery of an administrative career in health services administration. The Masters in Health Services Administration prepares students with hands-on experience in conducting research and interacting with leaders while working in an administrative residency in health service administration. The student conducts a research project on a specific healthcare management problem or enrolls in the Administrative Residency. At some point in the program, the student may choose enrollment in research or the residency based on their interest.
Typically students enroll in the Professional Seminar (HSA 6930) and the Advanced Research Seminar (HSA 6717), where all students develop a research proposal by the end of the semester. The student has the choice to enroll in either the Administrative Residency (HSA 6875) or the Masters Research Project (HSA 6977). If the student chooses to enroll in the HSA 6977 instead of the HSA 6875, then the student advances in their research project. Students who completed their research proposal during the Advanced Research Seminar may continue to work in the final portion of the research project to fulfill the requirements for HSA 6977. Page 4 of this guide describes the research project structure in detail. The student who chooses to conduct a research project will finalize the research project within two semesters— during the Advanced Research Seminar (HSA 6717) and the
Advanced Health Services Management and Research Seminar (HSA 6977) course. Below there is a description of the Masters Program structure with either of these choices. Guidelines 3 The first objective of these guidelines is to provide a roadmap for the student on both the Advanced Research Seminar and the Masters Research Project. Students should know in advance about the program research expectations. If a student
decides to continue on the research project path, they have the opportunity to continue to work on the research project in their interest area. To ensure the student's success, follow these guidelines in preparation for your research project. The second objective of this guide is to show students the components for conducting quantitative and/or qualitative studies, depending on the type of research design as applicable. Students are responsible for ensuring the research paper is free of errors in form, style, spelling, and grammar. Students should follow the American Psychological Association (APA) writing format. For more information on the APA writing style, consult the 7th edition manual. 4
Advanced Research Seminar 6717 Overview WEEK 1-2: Topic Selection o Students enrolled in the Advanced Research Seminar 6717 who are interested in research, discuss a research topic with the course instructor. o Meet the course instructor to discuss potential topics (within the first three weeks). o Search the literature to narrow down a topic of interest. o Develop an annotated bibliography. o Select a feasible research topic within the first three (3) weeks. Note: Students who do not meet the topic selection deadline will be offered the opportunity to register in the Administrative Residency HSA 6875. WEEK 3-7: Develop Research Question and Purpose of Study o Meet with the course instructor to discuss the research progress and proposed topic. o Discuss a research proposal structure/plan
o Develop a research question o Develop Introduction/Background, Statement of Problem, Purpose, and Significance of Research WEEK 8-11 o Start the Literature Review: Continue to research and annotate sources o Start the methods section WEEK 12-14 o Turn in a comprehensive research proposal including a list of references 5 Advanced Health Services Management Seminar
HSA 6977 Overview WEEK 1-3: Data collection o Meet with the course instructor to discuss the research progress and recruitment progress. o Continue data collection process. WEEK 4-5: Preliminary Analyses o Meet with the course instructor to discuss a data analysis plan and conduct analyses. o Report and discuss preliminary analyses with the course instructor WEEK 6-7: Report participant demographics and other statistics o Finalize analyses and reporting WEEK 8-10: Write recommendations and conclusions o Finalize the discussion, recommendations limitations and conclusions write up
WEEK 11-12 Prepare research project presentation o Final research project presentation o Turn in final research paper 6 Organization of the Research Proposal The research proposal allows the student to write a formal written plan put forward for consideration in the Professional Seminar. When the student is writing the research proposal, it is written in the future tense, since the research has not been conducted. Example: 'This research will explore…'
Title Page The title page should include several sections: Project title, name, name of the institution name of the course instructor, and date the proposal is submitted. Do not include a running head on the title page. The title should be brief yet informative, providing the reader with a description of the proposed topic of the research study. The title should reflect the identification of the problem the research assesses. Introduction/Background The first section must capture the reader's interest, provide a rationale for the study as a whole, and inform the reader about the research content and scope. First, explain the research background starting from a broad perspective (e.g., what is known about the problem globally? What is the prevalence of the problem nationwide? Second, describe the problem at the local/state level.) Third, describe what is
known about the research topic. This section includes relevant references to support the statements part of the background. The references should be from reliable sources of information, and these should be accurate. References can be found in the peer-reviewed literature (i.e., scholarly journals), books, and other reliable sources. Statement of Problem The statement of the problem lays the foundation for the issues being explored in the research project. This section details why the problem requires research. The statement of the problem section usually starts by addressing why the student is pursuing this research topic. Is it severe enough to warrant the study? Next, place the problem and research question in perspective, develop a narrative on the demographics (introducing the population of interest), and location of the problem (setting/geographical location) or situation leading to the applied research. It is
essential to provide compelling evidence the problem exists. This section should also be supported 7 by evidence-based references/citations. Cite relevant literature to support the topic of interest and the variables of the study. Significance of the Study This section narrates why the proposed research study is relevant or meaningful and why the study might be necessary. The use of literature is highly recommended to describe the gaps in the published literature, insufficient knowledge in the subject area, or the need to validate the findings of previous studies. Explain what the benefit or contribution to new knowledge is. Example: "This research is important to understand barriers to access health care services for South Florida residents with cardiovascular diseases. This
study is relevant to understand better what the specific barriers are so that intervention tailored to this population are implemented." Qualitative studies are exploratory in nature. An example of qualitative research is Interviews of clinical practitioners about the types of policies on a specific health program or available therapies to treat a disease. This type of research is recommended when a researcher wants to understand the population or area of interest from a behavioral or analytical perspective. Interpretations of the answers are required. In qualitative studies, there is a guide to topics/themes. Through this design, there is some flexibility to explore the participant's responses through a structured interview process. If a student decides to use a qualitative study as the design of their research, he/she shows the study findings' using the research participants' direct narrative quotes that should support the study conclusions.
Qualitative research question example: "What are the relevant barriers for access to healthcare are for South Florida residents with cardiovascular diseases." Quantitative Research Quantitative studies use a structured variable-specific survey questionnaire or secondary data collection. When using this type of research design, the student uses a representative sample of the population of interest. The student should be cautious about the type of questions when using questionnaires and should consult with the course instructor if they are planning to use surveys to collect data. The survey question (s) should follow the research question objectives. In these types of studies, the student should be able to speak about the data that supports the conclusions. In quantitative research, it is not possible to subjectively interpret any results, as is the case of qualitative research.
8 Quantitative research question example: "What are the most prevalent barriers to access health care services identified by South Florida residents with cardiovascular diseases?" Literature Review The purpose of the literature review is to describe the related and existent evidence about the topic of interest. Creswell (2014) suggests that the literature review shares with the reader the results of previous studies, related to the one being proposed/conducted. The literature review is a critical review and assessment of current as well as previous research studies or evidence in the field of study. This section compares and contrasts previous studies related to the topic chosen, combining, and summarizing related studies.
The reader should be able to find a roadmap and a narrative describing many aspects of the literature on what is known about the topic. Start by explaining the problem worldwide, nationwide, and explain the varying results documented in the literature. Provide a logical structure to the reader, guiding them through previous research studies and theories supporting the proposed research, establishing the importance of the topic. Be critical and consistent. Provide an assessment of the strengths and weaknesses of previous and current studies. Cooper (2010) & Creswell (2014) recognized four aspects of literature reviews described below: 1) Integrate research/evidence that others have done or said 2) Criticize scholarly work 3) Build bridges between related topics 4) Identify the principal issues in a field Example of a research question for the example below: "What are the barriers to access
health care services identified by South Florida residents with cardiovascular diseases?" Literature Example: "Access to health care seems to be improving in the United States (Clooney, 2017). However, some research has found significant increases in chronic diseases such as cardiovascular diseases in the state of Florida (Jones- Who, 2018). Therefore, more research is needed to understand barriers for access to health care services identified by South Florida residents with cardiovascular diseases, since the prevalence is rising. A recent study found positive effects on access to health care and cardiovascular disease outcomes (Clooney & Comellas, 2018). Clooney and Comellas (2018) argued there is an increasingly aging population 9 in South Florida identifying significant transportation barriers to access preventive care services."
According to Creswell (2014) (in quantitative research), the literature review starts with a (1) introduction section, followed by (2) topic 1 (the independent variable) (3) topic 2 (the dependent variable) and (4) topic 3 (studies that address both the dependent and independent variable) and (5) a summary highlighting the most important studies (Creswell, 2014, p. 47). The literature review for a qualitative and quantitative study is written as part of the research proposal. Note: Use current literature / evidence. Seek the input from your course instructor. Literature Review: Step by Step Creswell (2014) suggests several different ways to work on a literature review: 1) Identify keywords to locate different materials in a library. The keywords may emerge from the literature, and it may allow for the identification of a topic.
2) Search journals, books, databases (e.g., FIU computer databases: ProQuest, EBSCO, PubMed, etc.). 3) Gather as many reports as possible that are related to the research topic. 4) Skim through the articles. Creswell (2014) suggests that throughout this process, it is essential to try to gain a sense as to whether the research will make a useful contribution to the understanding of the literature. 5) Begin a literature map. a. This is a visual picture or groupings of the literature on the topic illustrating how the study will contribute to the literature. b. Position the study within the larger body of research. 6) Begin to draft summaries of the most relevant articles. Start critiquing the previous literature and point out deficiencies and issues with the methods. 7) Assemble the literature review. Structure of the literature thematically (use headings). The literature review conclusion should suggest how the proposed research may contribute to the current literature and could address gaps in the current literature.
10 Research Methods This section describes participant selection, the data collection of the research procedures, and data analysis. This section starts with a description of the study design (i.e., qualitative and/or quantitative design). The methods section includes the following: 1. Introduction. This section includes a reiteration of the statement of the problem and the research question. 2. Participants. This section includes the study population and sample selection (quantitative) or a description of study participants (e.g., males and/or females, age range, ethnicity, or other demographical characteristics). Describe how
the participants will be chosen (qualitative), recruitment procedures, the estimated number of participants, and reimbursement or monetary compensations are given to participants (if any) should be specified. 3. Procedures for data collection. This section includes detailed descriptions of procedures (quantitative or qualitative) used/to be used to collect the data. Anticipate how data will be collected. Explain why each procedure was chosen. It is also essential to describe how the procedure will address the research questions. 4. Data Collection. In this course, data collection will be done mainly through secondary data (data collected by others, not the principal investigator). Provide a rationale for the procedures, using arguments based on its strengths and weaknesses, costs, data availability and/or convenience. 5. Ethical Considerations. This section should describe foreseeable risks or discomforts related to participation (if any). Everyone who decides to participate in the study should receive an informed consent form. The researcher should provide their contact information in case the participants request additional research-related information.
Qualitative and Quantitative Content Qualitative Research When conducting qualitative research, the aim is to address people's experiences, needs, and different perspectives. Qualitative research aims at understanding and observing attitudes, life circumstances, beliefs, opinions, behaviors, and processes in depth. Data is collected by interviewing people and recording the responses as well as observing and documenting participant body language. The conventional approaches for facilitating interviews are: 11 a. In-depth interviews: These are one on one interviews. Researchers are interested in understanding individual experiences or opinions.
b. Focus group interviews: The researcher attempts to discuss or explore participants' opinions in a group setting. c. Telephone mediated interviews: The researcher interviews participants by phone. d. Online mediated interviews: These are one on one interviews conducted online. e. Observation: This is an approach often used as a supplement to recording participant's responses. Quantitative Research When conducting quantitative research, data is often gathered using surveys either in person or through the Internet. If the information is collected through a survey questionnaire, it usually has three sections: (a) inclusion/exclusion criteria, (b) demographic information, and (c) the questions assessing the study variable (s) of interest. Participants
Qualitative Research In qualitative research designs, the researcher purposely identifies the individuals (usually between 5 to 10 study participants) for the proposed study (Creswell, 2014). He/she should have in mind the research problem and which population (s) are affected by the problem. This section of the paper describes the selection of study participants, explains the characteristics of the participants, and describes the proposed number of participants. It also includes the inclusion and the exclusion criteria for including the research population. Quantitative Research As is the case with qualitative research designs, this section describes the selection of participants (e.g., data), explaining the demographic characteristics, and describing the proposed number in the sample being studied. It also includes the inclusion and exclusion criteria for selecting the research sample. Sample sizes may vary based
upon the research aim/question (s). Large sample sizes (e.g., ≥ 100), often leads to increased accuracy in estimates about the population. Note: Students are encouraged to ask their course instructor for recommendations on sample sizes. 12 Procedures Qualitative Research This section describes the participant's recruitment process as well as the methods used while conducting the interviews (e.g., notes, audiotape recording, and videotape recording). Discuss how the group (if a focus group) will discuss a quiet, comfortable
place to ensure everyone speaks/participate. Describe the development of a topic guide. A topic guide is used in the interview process to guide and discuss critical questions the interviewer would like to cover, including useful prompts to encourage discussion. Include an explanation about transcribing the interview once the participant's interviews/discussions have ended. After transcribing, the student reads the interviews (i.e., the data) and start coding it. Note: Coding is an approach used to organize the data by grouping pieces (categorizing the data) and writing a word representing a category (Rossman & Rallis, 2012; Creswell, 2014, p. 198). In qualitative research, data is primarily in the form of words derived from the participant's expressions on a subject matter. The data should be organized into categories of themes. Describe how validity occurs in the
research process to validate the findings of the proposed study. Describe one or more strategies for establishing the accurateness of the findings. Some of the commonly used strategies are described below: a) Triangulation: Search for different data sources and use these to build the justification of themes (Creswell, 2014). If the researcher finds that the themes are established based on converging several sources of data or participant perspectives, then this would add to the validity of the study. b) Member checking: Taking the emergent themes back to the participants and asking them if they feel the themes are correct. Note: To check the reliability, researchers may cross-check the results with an independent person who can check the codes used by the researcher. Consult the course instructor for more information on these methods.
13 Quantitative Research In this section, the student documents the participant's recruitment process (e.g., consecutively, using a snowball approach, randomly, or other procedure that is free from bias). The student must always provide informed consent and specify the research is voluntary to all participants before starting the data collection process. Therefore, the student must describe the informed consent process in the methods section (if administering a survey). This section describes the processes used while collecting the research data. It documents all the processes for gathering data, selecting participants (or sites), providing copies of the consent form (if applicable). Describe the study variables, the parameters established for the variable (s) of study (e.g.,
optimal health risk scores are defined as ≥10"), and how these data collected was collected. Data Collection Qualitative Research It is common to develop structured and semi-structured questions and record each participant's responses. The interview research question should map to the main research question. When conducting qualitative research, an interview/discussion guide is developed to conduct the interviews. These questions address the main research problem. Other data collected during the interviews could include participant demographics (e.g., age, sex, race/ethnicity, income for descriptive statistics). Note: The student interviewer informs the research participant of the location, day, and time of the interview. The interviewer ensures the participants
have the interviewer contact information in case they get lost, are delayed, or have other problems before the interview. During and before the interview: a) Provide an informed consent form indicating the research is voluntary b) Remind the research participants that they will be recorded c) Remind the research participants that there are no right or wrong answers during the interview session (promote open and honest communication) d) State name and the goal of meeting with the participants e) Ask each participant to introduce themselves, state their names or initials so that you can later distinguish each participant responses 14 f) Do not redirect or interpret the respondent answers, or judge
g) Know the interview guide and questions h) Do not bring any knowledge to the table i) Be comfortable with silence Note: Use probes as needed. For example – be silent, repeat the statement they said, and then continue neutrally ("I see, uh…"), direct ("Tell me more"), and clarify (what, where, when, what). Quantitative Research This section describes how many questions are going to be used (even if it is secondary data collection) and how the survey that led to the data collection was developed. Example: "The data used in this research is from the cardiovascular diseases questionnaire used in research conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. This is a national cross-sectional research study representative of the U.S. population. The interviewers were elderly persons and minorities to provide a full representation of the U.S population.
Note: If the student plans to use a survey or other form of data collection, consult the course instructor for guidance. Sample Population (Participants) Qualitative Research In qualitative research designs, the researcher purposely identifies the individuals (usually between 5 to 10 study participants) for the proposed study (Creswell, 2014). The student should have in mind the research problem and which population (s) are affected by the problem. This section describes the selection of study participants, explains the characteristics of the participants, and describes the number of participants the student plans to recruit. To determine the sample size, consult the course instructor for guidance. This section includes the inclusion and exclusion criteria for study participation. The inclusion criteria describe which participants should be included in the research (e.g., individuals with diabetes and/or people who had an HPV
vaccination, ages 18yrs and over). Conversely, the exclusion criteria disqualify those individuals (potential participants) who do not meet the described characteristics the researcher is looking for. Quantitative Research 15 As is the case with qualitative research designs, this section of the paper also describes the selection of research participants, explains the characteristics of the participants, and describes the proposed number of participants. It also includes the inclusion and exclusion criteria for study participation (as described above). Samples sizes may vary based upon the research aim/question (s). Large sample sizes (e.g., ≥ 100), often leads to
increased accuracy in estimates about the population. Students are encouraged to ask their course instructor for recommendations on sample sizes. The requirements for sample sizes may vary by study design. Instrumentation Qualitative Research This section describes the qualitative research approach to open-ended questions. In qualitative research, the …
G U I D E L I N E S F O R T H E A D V A N C E D H E A L T H S E R V I C E S M A N A G E M E N T A N D R E S E A R C H S E M I N A R M A S T E R O F H E A L T H S E R V I C E S A D M I N I S T R A T I O N 1 Guidelines ............................................................................................... ............... 2 Part I: Advanced Research Seminar 6717 Research Overview ............................. 3 Advanced Health Services Management Research Seminar HSA 6717 Overview.4
Part II: 6977 Masters Research Project Overview….…………………………………………..5 Organization of the Research Proposal .................................................................. 6 Introduction/Background ................................................................................... 6 Statement of Problem ......................................................................................... 6 Significance of Study ........................................................................................... 7 Literature Review ............................................................................................... 8 Research Methods ............................................................................................ 10 Part II: 6977 Masters Research Project………………………………………………………………… …………………………………………17 Data Analysis……………………………………………………………… ………………………………….18 Results………………………………………………….…………… …………………………………………..19
Discussion, Recommendations, and Conclusions………………………………………….……………… …………………………………………22 References………………………………………….………………… ……………………………………….24 CONTENTS 2 A Masters degree contributes to the professional mastery of an administrative career in health services administration. The Masters in Health Services Administration prepares students with hands-on experience in conducting research and interacting with leaders while working in an administrative residency in health service administration. The student conducts a research project on a specific healthcare management problem or enrolls in the Administrative Residency. At some point in the program, the student may choose enrollment
in research or the residency based on their interest. Typically students enroll in the Professional Seminar (HSA 6930) and the Advanced Research Seminar (HSA 6717), where all students develop a research proposal by the end of the semester. The student has the choice to enroll in either the Administrative Residency (HSA 6875) or the Masters Research Project (HSA 6977). If the student chooses to enroll in the HSA 6977 instead of the HSA 6875, then the student advances in their research project. Students who completed their research proposal during the Advanced Research Seminar may continue to work in the final portion of the research project to fulfill the requirements for HSA 6977. Page 4 of this guide describes the research project structure in detail. The student who chooses to conduct a research project will finalize the research project within two semesters— during the Advanced Research Seminar
(HSA 6717) and the Advanced Health Services Management and Research Seminar (HSA 6977) course. Below there is a description of the Masters Program structure with either of these choices. Guidelines 3 The first objective of these guidelines is to provide a roadmap for the student on both the Advanced Research Seminar and the Masters Research Project. Students should know in
advance about the program research expectations. If a student decides to continue on the research project path, they have the opportunity to continue to work on the research project in their interest area. To ensure the student's success, follow these guidelines in preparation for your research project. The second objective of this guide is to show students the components for conducting quantitative and/or qualitative studies, depending on the type of research design as applicable. Students are responsible for ensuring the research paper is free of errors in form, style, spelling, and grammar. Students should follow the American Psychological Association (APA) writing format. For more information on the APA writing style, consult the 7th edition manual.
4 Advanced Research Seminar 6717 Overview WEEK 1-2: Topic Selection o Students enrolled in the Advanced Research Seminar 6717 who are interested in research, discuss a research topic with the course instructor. o Meet the course instructor to discuss potential topics (within the first three weeks). o Search the literature to narrow down a topic of interest. o Develop an annotated bibliography. o Select a feasible research topic within the first three (3) weeks. Note: Students who do not meet the topic selection deadline will be offered the opportunity to register in the Administrative Residency HSA 6875. WEEK 3-7: Develop Research Question and Purpose of Study o Meet with the course instructor to discuss the research progress and proposed topic.
o Discuss a research proposal structure/plan o Develop a research question o Develop Introduction/Background, Statement of Problem, Purpose, and Significance of Research WEEK 8-11 o Start the Literature Review: Continue to research and annotate sources o Start the methods section WEEK 12-14 o Turn in a comprehensive research proposal including a list of references 5
Advanced Health Services Management Seminar HSA 6977 Overview WEEK 1-3: Data collection o Meet with the course instructor to discuss the research progress and recruitment progress. o Continue data collection process. WEEK 4-5: Preliminary Analyses o Meet with the course instructor to discuss a data analysis plan and conduct analyses. o Report and discuss preliminary analyses with the course instructor WEEK 6-7: Report participant demographics and other statistics o Finalize analyses and reporting WEEK 8-10: Write recommendations and conclusions
o Finalize the discussion, recommendations limitations and conclusions write up WEEK 11-12 Prepare research project presentation o Final research project presentation o Turn in final research paper 6 Organization of the Research Proposal The research proposal allows the student to write a formal written plan put forward for consideration in the Professional Seminar. When the student is writing the research proposal, it is written in the future tense, since the research has not been conducted. Example: 'This research will explore…'
Title Page The title page should include several sections: Project title, name, name of the institution name of the course instructor, and date the proposal is submitted. Do not include a running head on the title page. The title should be brief yet informative, providing the reader with a description of the proposed topic of the research study. The title should reflect the identification of the problem the research assesses. Introduction/Background The first section must capture the reader's interest, provide a rationale for the study as a whole, and inform the reader about the research content and scope. First, explain the research background starting from a broad perspective (e.g., what is known about the problem globally? What is the prevalence of the problem nationwide? Second, describe
the problem at the local/state level.) Third, describe what is known about the research topic. This section includes relevant references to support the statements part of the background. The references should be from reliable sources of information, and these should be accurate. References can be found in the peer-reviewed literature (i.e., scholarly journals), books, and other reliable sources. Statement of Problem The statement of the problem lays the foundation for the issues being explored in the research project. This section details why the problem requires research. The statement of the problem section usually starts by addressing why the student is pursuing this research topic. Is it severe enough to warrant the study? Next, place the problem and research question in perspective, develop a narrative on the demographics (introducing the population of interest), and location of the problem (setting/geographical location) or situation leading
to the applied research. It is essential to provide compelling evidence the problem exists. This section should also be supported 7 by evidence-based references/citations. Cite relevant literature to support the topic of interest and the variables of the study. Significance of the Study This section narrates why the proposed research study is relevant or meaningful and why the study might be necessary. The use of literature is highly recommended to describe the gaps in the published literature, insufficient knowledge in the subject area, or the need to validate the findings of previous studies. Explain what the benefit or contribution to new knowledge is. Example: "This research is important to understand barriers to access health care services
for South Florida residents with cardiovascular diseases. This study is relevant to understand better what the specific barriers are so that intervention tailored to this population are implemented." Qualitative studies are exploratory in nature. An example of qualitative research is Interviews of clinical practitioners about the types of policies on a specific health program or available therapies to treat a disease. This type of research is recommended when a researcher wants to understand the population or area of interest from a behavioral or analytical perspective. Interpretations of the answers are required. In qualitative studies, there is a guide to topics/themes. Through this design, there is some flexibility to explore the participant's responses through a structured interview process. If a student decides to use a qualitative study as the design of their research, he/she shows the study findings' using the research participants' direct narrative quotes that should support the study
conclusions. Qualitative research question example: "What are the relevant barriers for access to healthcare are for South Florida residents with cardiovascular diseases." Quantitative Research Quantitative studies use a structured variable-specific survey questionnaire or secondary data collection. When using this type of research design, the student uses a representative sample of the population of interest. The student should be cautious about the type of questions when using questionnaires and should consult with the course instructor if they are planning to use surveys to collect data. The survey question (s) should follow the research question objectives. In these types of studies, the student should be able to speak about the data that supports the conclusions. In quantitative research, it is not possible to subjectively interpret any results, as is the
case of qualitative research. 8 Quantitative research question example: "What are the most prevalent barriers to access health care services identified by South Florida residents with cardiovascular diseases?" Literature Review The purpose of the literature review is to describe the related and existent evidence about the topic of interest. Creswell (2014) suggests that the literature review shares with the reader the results of previous studies, related to the one being proposed/conducted. The literature review is a critical review and assessment of current as well as previous research studies or evidence in the field of study. This section compares and contrasts previous studies related to the topic chosen, combining, and summarizing related
studies. The reader should be able to find a roadmap and a narrative describing many aspects of the literature on what is known about the topic. Start by explaining the problem worldwide, nationwide, and explain the varying results documented in the literature. Provide a logical structure to the reader, guiding them through previous research studies and theories supporting the proposed research, establishing the importance of the topic. Be critical and consistent. Provide an assessment of the strengths and weaknesses of previous and current studies. Cooper (2010) & Creswell (2014) recognized four aspects of literature reviews described below: 1) Integrate research/evidence that others have done or said 2) Criticize scholarly work 3) Build bridges between related topics 4) Identify the principal issues in a field
Example of a research question for the example below: "What are the barriers to access health care services identified by South Florida residents with cardiovascular diseases?" Literature Example: "Access to health care seems to be improving in the United States (Clooney, 2017). However, some research has found significant increases in chronic diseases such as cardiovascular diseases in the state of Florida (Jones- Who, 2018). Therefore, more research is needed to understand barriers for access to health care services identified by South Florida residents with cardiovascular diseases, since the prevalence is rising. A recent study found positive effects on access to health care and cardiovascular disease outcomes (Clooney & Comellas, 2018). Clooney and Comellas (2018) argued there is an increasingly aging population 9 in South Florida identifying significant transportation barriers to access preventive care
services." According to Creswell (2014) (in quantitative research), the literature review starts with a (1) introduction section, followed by (2) topic 1 (the independent variable) (3) topic 2 (the dependent variable) and (4) topic 3 (studies that address both the dependent and independent variable) and (5) a summary highlighting the most important studies (Creswell, 2014, p. 47). The literature review for a qualitative and quantitative study is written as part of the research proposal. Note: Use current literature / evidence. Seek the input from your course instructor. Literature Review: Step by Step Creswell (2014) suggests several different ways to work on a literature review: 1) Identify keywords to locate different materials in a library. The keywords may emerge from the literature, and it may allow for the identification of a
topic. 2) Search journals, books, databases (e.g., FIU computer databases: ProQuest, EBSCO, PubMed, etc.). 3) Gather as many reports as possible that are related to the research topic. 4) Skim through the articles. Creswell (2014) suggests that throughout this process, it is essential to try to gain a sense as to whether the research will make a useful contribution to the understanding of the literature. 5) Begin a literature map. a. This is a visual picture or groupings of the literature on the topic illustrating how the study will contribute to the literature. b. Position the study within the larger body of research. 6) Begin to draft summaries of the most relevant articles. Start critiquing the previous literature and point out deficiencies and issues with the methods. 7) Assemble the literature review. Structure of the literature thematically (use headings). The literature review conclusion should suggest how the proposed research may contribute
to the current literature and could address gaps in the current literature. 10 Research Methods This section describes participant selection, the data collection of the research procedures, and data analysis. This section starts with a description of the study design (i.e., qualitative and/or quantitative design). The methods section includes the following: 1. Introduction. This section includes a reiteration of the statement of the problem and the research question. 2. Participants. This section includes the study population and sample selection (quantitative) or a description of study participants (e.g., males
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
HAI Risk for Patients with Chronic Illnesses
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HAI Risk for Patients with Chronic Illnesses

  • 1. Running head: RESEARCH PAPER 1 RESEARCH PAPER 6 HOSPITAL-ACQUIRED INFECTIONS AMONG PATIENTS in hospitals in florida? (Qualitative Study) Dayana Lewandowski Florida International University HSA 6977 Dr. Mariceli Comellas May 17, 2020 Background Information Explain overall what the problem is? Statistics in the usa, in the usa there are 4574 hospitalizations due to the infections
  • 2. acquired in hospitals, use citations and use government websites. Download research guidelines. 1.The objective of the study is. 2. results of the study 3.connect that study with your study and how ur study fills in the gap of that study “citation”Hospital-acquired infection, otherwise known as nosocomial diseases are a common problem that affects many healthcare institutions around the world. Such diseases are not only a burden to healthcare institutions but also the patients served. The total costs associated with the management of hospital-acquired infections have constantly been rising despite the implementation of many intervention policies, (Khan, Baig, & Mehboob, 2017). The government has formulated various nursing intervention policies through various federal and state departments to resolve the issues of nosocomial infections. However, many of these interventions have barely led to a permanent solution. Hospitals and patients are still incurring huge costs as a result of hospital-acquired infections. Hospitals are often subjected to expensive litigation procedures whenever patients contract infections while admitted. On the other hand, patients are sometimes required to spend more on treatment after contracting infections while admitted in various healthcare institutions. In the University of Miami Hospital, for instance, operational costs have been increasing annually mainly because the hospital has to deal with many nosocomial infections annually, (Chang, 2017). A similar scenario is noted among healthcare institutions operating in the Southern Florida region. While this problem has been identified and discussed a lot, not much attention has been directed to dissect the most affected persons. People with pre-existing chronic diseases such as arthritis, diabetes, and asthma are more susceptible to nosocomial infections compared to people who do not have pre-existing chronic illnesses. Problem Statement
  • 3. Pre-existing chronic illnesses increase the risk of opportunistic illnesses and infections. For instance, diabetes type I affects immunity hence diabetic people have greater risks, (Casqueiro, Casqueiro, & Alves, 2012). Healthcare practitioners, as well as patients, are at risk of contracting nosocomial infections, especially when they have pre-existing chronic diseases. “Add citations”Past research indicates that the majority of persons who are severely affected by hospital-acquired infections have pre-existing conditions. Many healthcare institutions in the Southern Florida region have high cases of nosocomial infections because pre-existing conditions among nurses are often not considered during the hiring and also during the admission of patients. Nurse practitioners tasked with extending care services to patients in various wards including ICUs often contract nosocomial infections. A nurse practitioner who has a pre- existing chronic illness such as diabetes type I is more susceptible to nosocomial infection than other nurses. The same case applies to patients admitted to hospital with pre-existing chronic conditions. Similarly, asthmatic people are more susceptible to infections that affect the respiratory system. Although people with pre-existing chronic illnesses are more susceptible to hospital-acquired infections, not much has been done to develop specific intervention measures for this group of people, (Klompas, 2017). For this reason, research is needed to identify the extent to which hospital-acquired infections affect persons with pre-existing chronic illnesses. Significance of the study How the reader, why this program of acquiring infections research is going to help society? Significance of the study (cost $$ or loss of life morbidity, loss of productivity) “Citations”Nursing research has in the past been used to develop appropriate interventions to resolve various problems in the healthcare sector. (Why is it important)Therefore, research
  • 4. on the prevalence of hospital-acquired infections among patients diagnosed with chronic diseases is important to identify intervention measures that could be formulated to address the problem. Also, research on the identified problem will fill existing knowledge gaps that affect the quality of healthcare services extended to patients diagnosed with chronic diseases. More so, the research will help to identify appropriate measures that could be used to reduce the financial burden among admitted patients diagnosed with chronic diseases. The prevalence of nosocomial infections among patients and healthcare professionals’ diagnosed living with various chronic illnesses is much higher than the prevalence among patients and healthcare professionals who do not have pre-existing chronic conditions. Therefore, it is necessary to undertake research that focuses on the specific group of people to better understand which nursing interventions would be most appropriate. Hospitals acquired infections in hospitals in the US Review of Literature Although all patients are exposed to nosocomial infection during their stay in various healthcare institutions, recent studies indicate a high prevalence among patients diagnosed with chronic illnesses. Chronic illnesses often weaken immunity thus exposing patients to many opportunistic infections and diseases. For instance, a hyperglycemic environment triggers immune dysfunction among diabetic patients thus exposing them to frequent infections that are in some cases very severe, (Casqueiro, et.al.,2012). In another study, Kirchgesner et.al., (2018) found that patients with chronic inflammatory bowel disease often suffer a great deal due to the high susceptibility to
  • 5. nosocomial infections. For instance, catheters used have been identified to increase the prevalence of hospital-acquired infections among IBD patients. Similarly, patients who have pre-existing asthmatic conditions often contract pneumonia while admitted to the hospital. However, (continue argument) very few studies have looked into assessing hospital based infections among patients in florida. In a recent study, Klompas (2017) discovered that ventilators used in ICUs are often the cause of nosocomial infections among asthmatic patients. Hygiene compliance policies have been formulated and prevented to reduce the prevalence of nosocomial infections in the past. However, implementing hygiene standards as a preventive measure does not alleviate the problem among persons diagnosed with chronic conditions, (Smythe, et.al., 2016). A lot of research about hospital-acquired infections has been conducted in the past but very few studies have focused exclusively on a population of persons with chronic illnesses. A knowledge gap is identified from the literature reviewed, thus research on the topic is necessary. According to Chang (2017), the University of Miami Hospital is among the most affected healthcare institutions in the Southern Florida region. (Add more content) Methodology The proposed study will adopt a qualitative research design to explore the prevalence of hospital-acquired infections among patients diagnosed with chronic illnesses. An exploratory study will pave the way for further research on the same topic in the future, (Creswell & Creswell, 2018). Therefore, a synthesis of existing literature materials will be conducted to gain meaningful insights into the topic. The literature sources selected for the qualitative synthesis must cover main concepts such as the prevalence of nosocomial infections and chronic diseases. Focusing on these concepts will ensure that the data collected can be used to answer research questions and
  • 6. consequently fill the existing knowledge gaps. The sample population will comprise of patients and nurses admitted and working, respectively, at Miami University Hospital. Research participants must have a pre-existing chronic illness and a history of nosocomial infections in the last 3 years. Also, the research will mainly rely on secondary data collected in previous studies. Utilizing secondary data saves time and costs associated with collecting primary data. In conclusion, patients diagnosed with chronic illnesses are more susceptible to nosocomial infections. However, not much has been done on this topic hence a lack of effective intervention measures to alleviate the problem. The existing interventions do not adequately cover the problems endured by patients who contract nosocomial infections easily due to pre- existing chronic illnesses. As such, the proposed study is meant to address this problem. References Casqueiro, J., Casqueiro, J., & Alves, C. (2012). Infections in patients with diabetes mellitus: A review of pathogenesis. Indian journal of endocrinology and metabolism, 16(Suppl1), S27. DOI: 10.4103/2230-8210.94253 Chang, D. (2017). UM Hospital can’t stop bleeding money as costs soar and admissions drop. Miami Herald. Retrieved from https://www.miamiherald.com/news/health- care/article186714813.html Creswell, J. W., & Creswell, J. D. (2018). Research design qualitative, quantitative, and mixed methods approach. Los Angeles: SAGE. Kirchgesner, J., Lemaitre, M., Carrat, F., Zureik, M., Carbonnel, F., & Dray-Spira, R. (2018). Risk of serious and opportunistic infections associated with the treatment of inflammatory bowel diseases. Gastroenterology, 155(2), 337- 346. https://doi.org/10.1053/j.gastro.2018.04.012 Klompas, M. (2017). What is new in the prevention of nosocomial pneumonia in the ICU?. Current opinion in critical care, 23(5), 378-384. DOI: 10.1097/MCC.0000000000000443
  • 7. Khan, H. A., Baig, F. K., & Mehboob, R. (2017). Nosocomial infections: Epidemiology, prevention, control, and surveillance. Asian Pacific Journal of Tropical Biomedicine, 7(5), 478-482. https://doi.org/10.1016/j.apjtb.2017.01.019 Smythe, W., Engelbrecht, H., Morris, V., Patel, B., & McDonald, H. (2016). A multifaceted hospital-wide intervention increases hand hygiene compliance: in practice. African Journal of Health Professions Education, 106(4), 335-341. Statistical Techniques Used for Exploring Relationships: 1) Correlation: Explores relationship among two continuous variables (e.g. age and depression scale). a. Partial correlation: Controls for one continuous variable while explores for a relationship among two continuous variables. Example: After controlling for the effects of socially desirable responding, is there still a significant relationship between optimism and life satisfaction scores (three continuous variables) 2) Multiple regression: Predicts. One continuous dependent variable & 2 or more continuous independent variable. It can be seen as an extension of correlation and is used when you want to explore the predictive ability of a set of independent variables on one continuous dependent measure. Example: How much variance in life satisfaction scores can be explained by the following set of variables: self-esteem, optimism and perceived control? Which variables is a better predictor of life satisfaction. All variables here are continuous. 3) Chi Square: Explores relationships among two categorical
  • 8. variables (e.g. sex and exercise—exercise is categorized as either (Yes or No). Example: Is there a relationship between sex (Males and Females) and exercise (Yes vs. No)? 4) Spearman’s Rank Order correlation: two variables that are either ordinal, interval or ratio. Exploring Differences Between Groups (interval scales): Parametric tests: the data is required to fit a normal distribution. 5) T-tests are used when you have 2 groups or two set of data (before & after) and when you wish to compare the mean scores on some continuous variable. Example: Are males more optimistic than females? One categorical independent variables with two groups and one continuous dependent variable. a) Independent sample t-test: Used when there are 2 different independent groups and you want to compare their scores. One categorical independent variable with only 2 groups & one continuous dependent variable. b) Paired sample t-test: Sameparticipants are tested on 2 separate occasions. One categorical independent variable (e.g. Time 1 & Time 2) & one continuous dependent variable. Example: Does ten weeks of meditation training result in a
  • 9. decrease in participant level of anxiety? Is there a change in anxiety levels from Time 1 (pre intervention) to time 2 (post intervention)? One categorical independent (Time 1/Time 2) & One continuous dependent variable (anxiety score). 6) One sample between groups analyses (ANOVA): Used to compare 2 or more groups and compare their mean scores on a continuous variable. One categorical independent variables with 2 or more groups & one continuous dependent variable. Example: Is there a difference in optimism scores for people who are under 30, between 31-49 and 50 years and over. 7) Two way between groups ANOVA: Test the impact of two categorical independent variables and one continuous dependent variable. This test allows the possibility of testing for interaction effect. This is when the effect of one independent variable is influenced by another. Example: What is the effect of age on optimism scores for males and females. 8) Mixed between-within ANOVA: One between groups independent variable (intervention such as math skills and confidence building) and one within group’s independent variable (Time 1, Time 2, Time 3) & one continuous dependent variable. 9) Multivariate ANOVA: One categorical independent variable & ≥ 2 continuous dependent variables. 10) ANCOVA: One categorical independent variable & one continuousdependent variable & one or more continuous covariates. Nonparametric tests: the data is not required to fit a normal distribution. Data that is often ordinal, meaning it does not rely
  • 10. on numbers, rather a ranking or order of categories. 11) Wilcoxon Signed-Rank test: is the nonparametric test equivalent to the repeated measures t-test. *Converts scores to ranks and compares these at Time 1 and at Time 2. 12) Mann-Whitney U: Non parametric measure; tests difference between 2 independent groups. 13) Kruskal–Wallis one-way analysis of variance: The non- parametric option for one-way ANOVA. It is used for comparing two or more independent samples of equal or different sample sizes. It extends the Mann–Whitney U test when there are more than two groups. a. Post hoc analyses are conducted to find out which groups are significantly different from one another. 14) McNemar’s Test: Tests 2 variables, the first recorded at time 1 and the second recorded at time 2. Both of these variables are categorical. a. E.g. Question: Is there a change in the proportion of the sample diagnosed with clinical depression prior to and following intervention. 15) Cochran’s Q Test: If you have 3 or more time points. All three are categorical variables measuring the same characteristics at 3 points in time. a. Example: Is there a proportion of participants diagnosed with clinical depression across the three time points (a) prior to the program (b) three months’ post program. Research Objective Type of DV Type of IV
  • 11. Covariates Test Analysis Goal Test associations or relationships Explore associations nominal (categorical) variables nominal (categorical) variables Chi Square Is there an association between the IV+DV Explore associations and strengths Continuous Continuous Correlation Is there an association between the IV+DV Explore associations and strengths Continuous Continuous one or more Partial correlation Is there an association between the IV+DV controlling for 1 or more variables Explore associations and strength between two ranked variables Continuous Continuous Spearman Rank Order correlation (non-parametric) Is there an association between the IV+DV Differences between groups tests: Explore differences between groups (Before or After) AND Compare the mean scores on some continuous variable Continuous One nominal (categorical) variables with 2 groups
  • 12. T-tests (Parametric) Do differences exist between groups. Explore the differences between independent groups to compare their scores Continuous One nominal (categorical) variable with only 2 groups Independent sample T-test (Parametric) Do differences exist between these two groups. Explore the differences between the same participants on two separate occasions to compare their scores Continuous One nominal (categorical) variable (Time 1 & Time 2) Paired Sample t-test (Parametric) Test the same participants on two separate occasions (Time 1 & Time 2) Research Objective # and type of DV # and type of IV Covariates Test Analysis Goal Explore the differences between ≥2 groups and compare their mean scores on a continuous variable Continuous Categorical with ≥2 groups ANOVA Do differences exist between ≥2 groups on one DV Test the main and interaction effects of categorical variables on a continuous dependent variable, controlling for the effects of selected other continuous variables, which co-vary with the
  • 13. dependent. One continuous Categorical with ≥2 groups one or more additional ANCOVA Do differences exist between ≥2 groups on one DV after controlling for the covariates Explore the differences between ≥2 groups on multiple DVs ≥2 groups (continuous) Categorical with ≥2 groups one or more additional MANOVA Do differences exist between ≥2 groups on multiple DVs Explanation or prediction tests: How much variance in the DV is accounted for by linear combination of the IVs 1 continuous ≥2 Dichotomous Continuous Multiple regression How strongly related to the DV is the beta coefficient for each IV What is the odds or the probability of the DV occurring as the values of the IVs change? 1 dichotomous 1 or more Categorical or continuous Logistic regression What are the odds or the probability of the DV occurring as the values of the IVs change Practice exercise Research Objective # and type of DV # and type of IV Covariates
  • 15. G U I D E L I N E S F O R T H E A D V A N C E D H E A L T H S E R V I C E S M A N A G E M E N T A N D R E S E A R C H S E M I N A R M A S T E R O F H E A L T H S E R V I C E S A D M I N I S T R A T I O N 1 Guidelines ............................................................................................... ............... 2 Part I: Advanced Research Seminar 6717 Research Overview ............................. 3 Advanced Health Services Management Research Seminar HSA 6717 Overview.4 Part II: 6977 Masters Research Project Overview….…………………………………………..5 Organization of the Research Proposal
  • 16. .................................................................. 6 Introduction/Background ................................................................................... 6 Statement of Problem ......................................................................................... 6 Significance of Study ........................................................................................... 7 Literature Review ............................................................................................... 8 Research Methods ............................................................................... ............. 10 Part II: 6977 Masters Research Project………………………………………………………………… …………………………………………17 Data Analysis……………………………………………………………… ………………………………….18 Results………………………………………………….…………… …………………………………………..19 Discussion, Recommendations, and Conclusions………………………………………….……………… …………………………………………22
  • 17. References………………………………………….………………… ……………………………………….24 CONTENTS 2 A Masters degree contributes to the professional mastery of an administrative career in health services administration. The Masters in Health Services Administration prepares students with hands-on experience in conducting research and interacting with leaders while working in an administrative residency in health service administration. The student conducts a research project on a specific healthcare management problem or enrolls in the Administrative Residency. At some point in the program, the student may choose enrollment in research or the residency based on their interest. Typically students enroll in the Professional Seminar (HSA
  • 18. 6930) and the Advanced Research Seminar (HSA 6717), where all students develop a research proposal by the end of the semester. The student has the choice to enroll in either the Administrative Residency (HSA 6875) or the Masters Research Project (HSA 6977). If the student chooses to enroll in the HSA 6977 instead of the HSA 6875, then the student advances in their research project. Students who completed their research proposal during the Advanced Research Seminar may continue to work in the final portion of the research project to fulfill the requirements for HSA 6977. Page 4 of this guide describes the research project structure in detail. The student who chooses to conduct a research project will finalize the research project within two semesters— during the Advanced Research Seminar (HSA 6717) and the Advanced Health Services Management and Research Seminar (HSA 6977) course. Below
  • 19. there is a description of the Masters Program structure with either of these choices. Guidelines 3 The first objective of these guidelines is to provide a roadmap for the student on both the Advanced Research Seminar and the Masters Research Project. Students should know in advance about the program research expectations. If a student decides to continue on the research project path, they have the opportunity to continue to
  • 20. work on the research project in their interest area. To ensure the student's success, follow these guidelines in preparation for your research project. The second objective of this guide is to show students the components for conducting quantitative and/or qualitative studies, depending on the type of research design as applicable. Students are responsible for ensuring the research paper is free of errors in form, style, spelling, and grammar. Students should follow the American Psychological Association (APA) writing format. For more information on the APA writing style, consult the 7th edition manual. 4 Advanced Research Seminar 6717 Overview
  • 21. WEEK 1-2: Topic Selection o Students enrolled in the Advanced Research Seminar 6717 who are interested in research, discuss a research topic with the course instructor. o Meet the course instructor to discuss potential topics (within the first three weeks). o Search the literature to narrow down a topic of interest. o Develop an annotated bibliography. o Select a feasible research topic within the first three (3) weeks. Note: Students who do not meet the topic selection deadline will be offered the opportunity to register in the Administrative Residency HSA 6875. WEEK 3-7: Develop Research Question and Purpose of Study o Meet with the course instructor to discuss the research progress and proposed topic. o Discuss a research proposal structure/plan o Develop a research question
  • 22. o Develop Introduction/Background, Statement of Problem, Purpose, and Significance of Research WEEK 8-11 o Start the Literature Review: Continue to research and annotate sources o Start the methods section WEEK 12-14 o Turn in a comprehensive research proposal including a list of references 5 Advanced Health Services Management Seminar HSA 6977 Overview
  • 23. WEEK 1-3: Data collection o Meet with the course instructor to discuss the research progress and recruitment progress. o Continue data collection process. WEEK 4-5: Preliminary Analyses o Meet with the course instructor to discuss a data analysis plan and conduct analyses. o Report and discuss preliminary analyses with the course instructor WEEK 6-7: Report participant demographics and other statistics o Finalize analyses and reporting WEEK 8-10: Write recommendations and conclusions o Finalize the discussion, recommendations limitations and conclusions write up WEEK 11-12 Prepare research project presentation
  • 24. o Final research project presentation o Turn in final research paper 6 Organization of the Research Proposal The research proposal allows the student to write a formal written plan put forward for consideration in the Professional Seminar. When the student is writing the research proposal, it is written in the future tense, since the research has not been conducted. Example: 'This research will explore…' Title Page The title page should include several sections: Project title,
  • 25. name, name of the institution name of the course instructor, and date the proposal is submitted. Do not include a running head on the title page. The title should be brief yet informative, providing the reader with a description of the proposed topic of the research study. The title should reflect the identification of the problem the research assesses. Introduction/Background The first section must capture the reader's interest, provide a rationale for the study as a whole, and inform the reader about the research content and scope. First, explain the research background starting from a broad perspective (e.g., what is known about the problem globally? What is the prevalence of the problem nationwide? Second, describe the problem at the local/state level.) Third, describe what is known about the research topic.
  • 26. This section includes relevant references to support the statements part of the background. The references should be from reliable sources of information, and these should be accurate. References can be found in the peer-reviewed literature (i.e., scholarly journals), books, and other reliable sources. Statement of Problem The statement of the problem lays the foundation for the issues being explored in the research project. This section details why the problem requires research. The statement of the problem section usually starts by addressing why the student is pursuing this research topic. Is it severe enough to warrant the study? Next, place the problem and research question in perspective, develop a narrative on the demographics (introducing the population of interest), and location of the problem (setting/geographical location) or situation leading to the applied research. It is essential to provide compelling evidence the problem exists. This section should also be supported
  • 27. 7 by evidence-based references/citations. Cite relevant literature to support the topic of interest and the variables of the study. Significance of the Study This section narrates why the proposed research study is relevant or meaningful and why the study might be necessary. The use of literature is highly recommended to describe the gaps in the published literature, insufficient knowledge in the subject area, or the need to validate the findings of previous studies. Explain what the benefit or contribution to new knowledge is. Example: "This research is important to understand barriers to access health care services for South Florida residents with cardiovascular diseases. This study is relevant to understand better what the specific barriers are so that
  • 28. intervention tailored to this population are implemented." Qualitative studies are exploratory in nature. An example of qualitative research is Interviews of clinical practitioners about the types of policies on a specific health program or available therapies to treat a disease. This type of research is recommended when a researcher wants to understand the population or area of interest from a behavioral or analytical perspective. Interpretations of the answers are required. In qualitative studies, there is a guide to topics/themes. Through this design, there is some flexibility to explore the participant's responses through a structured interview process. If a student decides to use a qualitative study as the design of their research, he/she shows the study findings' using the research participants' direct narrative quotes that should support the study conclusions. Qualitative research question example: "What are the relevant
  • 29. barriers for access to healthcare are for South Florida residents with cardiovascular diseases." Quantitative Research Quantitative studies use a structured variable-specific survey questionnaire or secondary data collection. When using this type of research design, the student uses a representative sample of the population of interest. The student should be cautious about the type of questions when using questionnaires and should consult with the course instructor if they are planning to use surveys to collect data. The survey question (s) should follow the research question objectives. In these types of studies, the student should be able to speak about the data that supports the conclusions. In quantitative research, it is not possible to subjectively interpret any results, as is the case of qualitative research.
  • 30. 8 Quantitative research question example: "What are the most prevalent barriers to access health care services identified by South Florida residents with cardiovascular diseases?" Literature Review The purpose of the literature review is to describe the related and existent evidence about the topic of interest. Creswell (2014) suggests that the literature review shares with the reader the results of previous studies, related to the one being proposed/conducted. The literature review is a critical review and assessment of current as well as previous research studies or evidence in the field of study. This section compares and contrasts previous studies related to the topic chosen, combining, and summarizing related studies. The reader should be able to find a roadmap and a narrative describing many aspects of the
  • 31. literature on what is known about the topic. Start by explaining the problem worldwide, nationwide, and explain the varying results documented in the literature. Provide a logical structure to the reader, guiding them through previous research studies and theories supporting the proposed research, establishing the importance of the topic. Be critical and consistent. Provide an assessment of the strengths and weaknesses of previous and current studies. Cooper (2010) & Creswell (2014) recognized four aspects of literature reviews described below: 1) Integrate research/evidence that others have done or said 2) Criticize scholarly work 3) Build bridges between related topics 4) Identify the principal issues in a field Example of a research question for the example below: "What are the barriers to access health care services identified by South Florida residents with cardiovascular diseases?"
  • 32. Literature Example: "Access to health care seems to be improving in the United States (Clooney, 2017). However, some research has found significant increases in chronic diseases such as cardiovascular diseases in the state of Florida (Jones- Who, 2018). Therefore, more research is needed to understand barriers for access to health care services identified by South Florida residents with cardiovascular diseases, since the prevalence is rising. A recent study found positive effects on access to health care and cardiovascular disease outcomes (Clooney & Comellas, 2018). Clooney and Comellas (2018) argued there is an increasingly aging population 9 in South Florida identifying significant transportation barriers to access preventive care services."
  • 33. According to Creswell (2014) (in quantitative research), the literature review starts with a (1) introduction section, followed by (2) topic 1 (the independent variable) (3) topic 2 (the dependent variable) and (4) topic 3 (studies that address both the dependent and independent variable) and (5) a summary highlighting the most important studies (Creswell, 2014, p. 47). The literature review for a qualitative and quantitative study is written as part of the research proposal. Note: Use current literature / evidence. Seek the input from your course instructor. Literature Review: Step by Step Creswell (2014) suggests several different ways to work on a literature review: 1) Identify keywords to locate different materials in a library. The keywords may emerge from the literature, and it may allow for the identification of a topic. 2) Search journals, books, databases (e.g., FIU computer databases: ProQuest, EBSCO, PubMed, etc.).
  • 34. 3) Gather as many reports as possible that are related to the research topic. 4) Skim through the articles. Creswell (2014) suggests that throughout this process, it is essential to try to gain a sense as to whether the research will make a useful contribution to the understanding of the literature. 5) Begin a literature map. a. This is a visual picture or groupings of the literature on the topic illustrating how the study will contribute to the literature. b. Position the study within the larger body of research. 6) Begin to draft summaries of the most relevant articles. Start critiquing the previous literature and point out deficiencies and issues with the methods. 7) Assemble the literature review. Structure of the literature thematically (use headings). The literature review conclusion should suggest how the proposed research may contribute to the current literature and could address gaps in the current literature.
  • 35. 10 Research Methods This section describes participant selection, the data collection of the research procedures, and data analysis. This section starts with a description of the study design (i.e., qualitative and/or quantitative design). The methods section includes the following: 1. Introduction. This section includes a reiteration of the statement of the problem and the research question. 2. Participants. This section includes the study population and sample selection (quantitative) or a description of study participants (e.g., males and/or females, age range, ethnicity, or other demographical characteristics). Describe how the participants will be chosen (qualitative), recruitment procedures, the estimated number of participants, and
  • 36. reimbursement or monetary compensations are given to participants (if any) should be specified. 3. Procedures for data collection. This section includes detailed descriptions of procedures (quantitative or qualitative) used/to be used to collect the data. Anticipate how data will be collected. Explain why each procedure was chosen. It is also essential to describe how the procedure will address the research questions. 4. Data Collection. In this course, data collection will be done mainly through secondary data (data collected by others, not the principal investigator). Provide a rationale for the procedures, using arguments based on its strengths and weaknesses, costs, data availability and/or convenience. 5. Ethical Considerations. This section should describe foreseeable risks or discomforts related to participation (if any). Everyone who decides to participate in the study should receive an informed consent form. The researcher should provide their contact information in case the participants request additional research-related information. Qualitative and Quantitative Content
  • 37. Qualitative Research When conducting qualitative research, the aim is to address people's experiences, needs, and different perspectives. Qualitative research aims at understanding and observing attitudes, life circumstances, beliefs, opinions, behaviors, and processes in depth. Data is collected by interviewing people and recording the responses as well as observing and documenting participant body language. The conventional approaches for facilitating interviews are: 11 a. In-depth interviews: These are one on one interviews. Researchers are interested in understanding individual experiences or opinions. b. Focus group interviews: The researcher attempts to discuss or explore participants'
  • 38. opinions in a group setting. c. Telephone mediated interviews: The researcher interviews participants by phone. d. Online mediated interviews: These are one on one interviews conducted online. e. Observation: This is an approach often used as a supplement to recording participant's responses. Quantitative Research When conducting quantitative research, data is often gathered using surveys either in person or through the Internet. If the information is collected through a survey questionnaire, it usually has three sections: (a) inclusion/exclusion criteria, (b) demographic information, and (c) the questions assessing the study variable (s) of interest. Participants Qualitative Research
  • 39. In qualitative research designs, the researcher purposely identifies the individuals (usually between 5 to 10 study participants) for the proposed study (Creswell, 2014). He/she should have in mind the research problem and which population (s) are affected by the problem. This section of the paper describes the selection of study participants, explains the characteristics of the participants, and describes the proposed number of participants. It also includes the inclusion and the exclusion criteria for including the research population. Quantitative Research As is the case with qualitative research designs, this section describes the selection of participants (e.g., data), explaining the demographic characteristics, and describing the proposed number in the sample being studied. It also includes the inclusion and exclusion criteria for selecting the research sample. Sample sizes may vary based upon the research aim/question (s). Large sample sizes (e.g., ≥ 100), often leads to increased
  • 40. accuracy in estimates about the population. Note: Students are encouraged to ask their course instructor for recommendations on sample sizes. 12 Procedures Qualitative Research This section describes the participant's recruitment process as well as the methods used while conducting the interviews (e.g., notes, audiotape recording, and videotape recording). Discuss how the group (if a focus group) will discuss a quiet, comfortable place to ensure everyone speaks/participate. Describe the development of a topic guide.
  • 41. A topic guide is used in the interview process to guide and discuss critical questions the interviewer would like to cover, including useful prompts to encourage discussion. Include an explanation about transcribing the interview once the participant's interviews/discussions have ended. After transcribing, the student reads the interviews (i.e., the data) and start coding it. Note: Coding is an approach used to organize the data by grouping pieces (categorizing the data) and writing a word representing a category (Rossman & Rallis, 2012; Creswell, 2014, p. 198). In qualitative research, data is primarily in the form of words derived from the participant's expressions on a subject matter. The data should be organized into categories of themes. Describe how validity occurs in the research process to validate the findings of the proposed study.
  • 42. Describe one or more strategies for establishing the accurateness of the findings. Some of the commonly used strategies are described below: a) Triangulation: Search for different data sources and use these to build the justification of themes (Creswell, 2014). If the researcher finds that the themes are established based on converging several sources of data or participant perspectives, then this would add to the validity of the study. b) Member checking: Taking the emergent themes back to the participants and asking them if they feel the themes are correct. Note: To check the reliability, researchers may cross-check the results with an independent person who can check the codes used by the researcher. Consult the course instructor for more information on these methods.
  • 43. 13 Quantitative Research In this section, the student documents the participant's recruitment process (e.g., consecutively, using a snowball approach, randomly, or other procedure that is free from bias). The student must always provide informed consent and specify the research is voluntary to all participants before starting the data collection process. Therefore, the student must describe the informed consent process in the methods section (if administering a survey). This section describes the processes used while collecting the research data. It documents all the processes for gathering data, selecting participants (or sites), providing copies of the consent form (if applicable). Describe the study variables, the parameters established for the variable (s) of study (e.g., optimal health risk scores are defined as ≥10"), and how these data collected was collected.
  • 44. Data Collection Qualitative Research It is common to develop structured and semi-structured questions and record each participant's responses. The interview research question should map to the main research question. When conducting qualitative research, an interview/discussion guide is developed to conduct the interviews. These questions address the main research problem. Other data collected during the interviews could include participant demographics (e.g., age, sex, race/ethnicity, income for descriptive statistics). Note: The student interviewer informs the research participant of the location, day, and time of the interview. The interviewer ensures the participants have the interviewer contact information in case they get lost, are delayed, or have
  • 45. other problems before the interview. During and before the interview: a) Provide an informed consent form indicating the research is voluntary b) Remind the research participants that they will be recorded c) Remind the research participants that there are no right or wrong answers during the interview session (promote open and honest communication) d) State name and the goal of meeting with the participants e) Ask each participant to introduce themselves, state their names or initials so that you can later distinguish each participant responses 14 f) Do not redirect or interpret the respondent answers, or judge g) Know the interview guide and questions
  • 46. h) Do not bring any knowledge to the table i) Be comfortable with silence Note: Use probes as needed. For example – be silent, repeat the statement they said, and then continue neutrally ("I see, uh…"), direct ("Tell me more"), and clarify (what, where, when, what). Quantitative Research This section describes how many questions are going to be used (even if it is secondary data collection) and how the survey that led to the data collection was developed. Example: "The data used in this research is from the cardiovascular diseases questionnaire used in research conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. This is a national cross-sectional research study representative of the U.S. population. The interviewers were elderly persons and minorities to provide a full representation of the U.S population. Note: If the student plans to use a survey or other form of data collection, consult the
  • 47. course instructor for guidance. Sample Population (Participants) Qualitative Research In qualitative research designs, the researcher purposely identifies the individuals (usually between 5 to 10 study participants) for the proposed study (Creswell, 2014). The student should have in mind the research problem and which population (s) are affected by the problem. This section describes the selection of study participants, explains the characteristics of the participants, and describes the number of participants the student plans to recruit. To determine the sample size, consult the course instructor for guidance. This section includes the inclusion and exclusion criteria for study participation. The inclusion criteria describe which participants should be included in the research (e.g., individuals with diabetes and/or people who had an HPV vaccination, ages 18yrs and over).
  • 48. Conversely, the exclusion criteria disqualify those individuals (potential participants) who do not meet the described characteristics the researcher is looking for. Quantitative Research 15 As is the case with qualitative research designs, this section of the paper also describes the selection of research participants, explains the characteristics of the participants, and describes the proposed number of participants. It also includes the inclusion and exclusion criteria for study participation (as described above). Samples sizes may vary based upon the research aim/question (s). Large sample sizes (e.g., ≥ 100), often leads to increased accuracy in estimates about the population. Students are encouraged to ask their
  • 49. course instructor for recommendations on sample sizes. The requirements for sample sizes may vary by study design. Instrumentation Qualitative Research This section describes the qualitative research approach to open-ended questions. In qualitative research, the … Research Paper Checklist & Assessment for MHSA Students The research paper information should be discussed with the course instructor throughout all stages of the writing process. Title 1 Fifteen (15) words or less. APA capitalization rules should be followed. Abstract (10pts) 2 The abstract should be written last. However, it is usually placed after the Cover Page; not after the reference or anywhere else. The abstract should be no more than 250 words. It includes the following succinct parts: Introduce the research topic (no citations) The objective(s) of the study Describe the participants characteristics (brief of results) State the type of methodology (quantitative, qualitative, or mixed method) Include only key results of the study
  • 50. Ex. Quantitative: use p-values to show significance and strength of association Ex. Qualitative: discuss major themes Recommendations and Conclusions Upon completion of the research, change the future tense to past tense and include the results of the study. Pagination and document format (10pts) Use Microsoft Word. You may watch several YouTube videos and choose one that you are comfortable with to guide you in this process. This will require you to change the headings throughout the document, which is totally fine. It will be in accordance with APA format. Change/add more headings and subheadings and update the work. Finally, include page numbers. Paper I: Introduction This information should stimulate the interest of the reader. Explain why this research is so important in the health field/health services administration. Background Provide a rationale for the study Discuss the variables Have one or two sentences that introduce the other headings in this paper Last sentence is the purpose statement This information should give an overview of the current importance of the topic.
  • 51. Problem Statement Briefly highlight major actions that have been taken in regards to the topic (use several citations). Include prevalence / relevant statistics pertaining to the variables under study. Write a paragraph describing the problem. The problem statement should be supported by current literature. Who is affected by this problem? Where is the problem taking place? Why is it important for the problem to be fixed? What steps should be taken (possible solutions) to correct the problem. For this, use the current literature (not older than 6yrs from today). Use recent literature unless the information pertains to a seminal/historic discovery paper/publication. Research Aim/Question(s) At the end of the study, what overall question will be answered? Hypothesis Quantitative Research (only): If you are doing a quantitative study, a hypothesis should be provided. Back up the hypothesis with literature. The hypothesis clearly aligned with the purpose statement. Each research aim/question should be followed by the research hypothesis (Ha), then the null hypothesis (Ho). Purpose of the Study The purpose state is usually one or two sentences (not more than two sentences). It should reflect the research aim/question. Ask “Why is this study conducted?” Be sure not to confuse the purpose with the problem. The purpose of the study should include the following:
  • 52. Describe the characteristics of the target participants Significance of the Study For this section, the researcher uses information from the literature to justify the need for the research. Definitions Define important terms used in thestudy (very important). Citation is needed for each definition. Delimitations Informs the reader the study is limited in scope. Examples: Describe the specific aspects of the data, sample size, participants’ characteristics, geographical location of the study, and other factors to define the limits of the study. Assumptions: Assumptions are primarily derived from the literature. Researchers assume that the participants answer the questions honestly and correctly; that they are able to read and understand the survey questions; that they follow the instructions carefully; that the test instrument is valid and reliable. This section tells the reader why the study is needed. Who will benefit? What contribution does this research bring to society? Gaps in the literature and/or insufficient knowledge in the subject area is clearly stated Literature Review Use peer review journal article topics are related to the research aim/question. Begin writing this section with a statement that describes the purpose of the research. Discuss how the literature is organized. You might have to
  • 53. revise this statement as you add or subtract information from Paper2. Use subheadings to separate various parts of the Literature Review. Check the APA Manual for different levels of headings (for example, when to use Level 1, 2 or 3 headings). Provide information that explains the search terms that you used and describe the databases that were used to obtain the information. Only include the search terms that helped you to find information about the study. After reading several published literature of the variables of interest, you will need to synthesize them. Synthesizing involves taking similar studies and looking at topics that they have in common, (or different) to make themes. Write your literature review in past tense. For example, Brown and Forrester (2013) conducted a research on …. As you are writing this section you should cite information from the sources and build your reference list using APA format. Methodology This paper describes in details the data collection plan. This section is called the “cookbook” or “recipe” portion of the study. Therefore, the “ingredients” to bake the “cake” should be listed, and a step-by step procedure explained. This includes collecting and analyzing the data. Restate the purpose of the study Describe how the methodology is organized Describe the Study design – cross-sectional, correlational, descriptive, and others. Characteristics of the participants
  • 54. Selection of participants – how did you choose the research participants? Include the inclusion and exclusion criteria for choosing the participants. Development and Selection of the instrumentation – give a general description of the survey. For example, how many questions and what the question will attempt to answer. Is the instrument valid? Reliable? Provide such evidence Ensure that the instrument answers the research aim/question(s) Data collection procedures – how did you collect the data? Data Analysis Procedures – How will you analyze the data? Ex. SPSS, Excel, NVivo, etc. Describe how you will analyze the independent and dependent variables Restate the research aim/question(s) and write the research and null hypotheses for each research aim/question. Ethical considerations – How did you protect the privacy and confidentiality of the participants? How did you store the data? **Did you analyzed the data collected? If yes, continue. If not, consult your course instructor. Part II Data analysis and Results (10pts) Results After analyzing the data, you will need to report the results of the study. This is the section that you will display the charts, diagrams, frequencies etc.). Use / draw Microsoft Word tables to depict the data accordingly.
  • 55. This section includes the demographic information of the research participants; descriptive information about the various measures, and the results of the data analysis. Start with the descriptive statistics, then go to the analytical data. Discussion, Conclusions and Recommendations (10pts) The purpose of the study is restated and important findings should be summarized here. (No need to go into details). The paper should include a summary of the research, interpretation the results, the limitations of the study, and the researcher makes recommendations based on the outcome of the research. As you discuss the implications, state how the research may impact the individuals, family or society. Only materials mentioned earlier should be included in the summary. The conclusion should be the last one or two paragraphs of the thesis. Provide a strong take-home message by bringing all the main points together. Avoid saying exactly what you have said before. Limitations refer to weaknesses in the study. These weaknesses often relate to the following: a. sampling errors – ex. Small sample size limits generalization of the study b. uncontrolled variables c. faulty instrumentation d. representativeness of the data e. compromises to internal and external validity References (10pts) References should be properly cited and typed according to the APA Manual, 6th edition. The references go on a separate page. All references used in-text must be typed in the reference
  • 56. section. Similarly, all the references in this section should also be in the text. References should be placed in alphabetical order. Appendix (10pts) Documents that must be included in the appendix are: 1. Sample of informed consent letter 2. Permission letter to conduct research from stakeholders 3. Copy of the instrument (survey, questionnaire, interview questions etc.) **This section Comments: _________________________________________ 4 | Page
  • 57. G U I D E L I N E S F O R T H E A D V A N C E D H E A L T H S E R V I C E S M A N A G E M E N T A N D R E S E A R C H S E M I N A R M A S T E R O F H E A L T H S E R V I C E S A D M I N I S T R A T I O N 1 Guidelines ............................................................................................... ............... 2 Part I: Advanced Research Seminar 6717 Research Overview ............................. 3 Advanced Health Services Management Research Seminar HSA 6717 Overview.4 Part II: 6977 Masters Research Project
  • 58. Overview….…………………………………………..5 Organization of the Research Proposal .................................................................. 6 Introduction/Background ................................................................................... 6 Statement of Problem ......................................................................................... 6 Significance of Study ........................................................................................... 7 Literature Review ............................................................................................... 8 Research Methods ............................................................................................ 10 Part II: 6977 Masters Research Project………………………………………………………………… …………………………………………17 Data Analysis……………………………………………………………… ………………………………….18 Results………………………………………………….…………… …………………………………………..19 Discussion, Recommendations, and
  • 59. Conclusions………………………………………….……………… …………………………………………22 References………………………………………….………………… ……………………………………….24 CONTENTS 2 A Masters degree contributes to the professional mastery of an administrative career in health services administration. The Masters in Health Services Administration prepares students with hands-on experience in conducting research and interacting with leaders while working in an administrative residency in health service administration. The student conducts a research project on a specific healthcare management problem or enrolls in the Administrative Residency. At some point in the program, the student may choose enrollment in research or the residency based on their interest.
  • 60. Typically students enroll in the Professional Seminar (HSA 6930) and the Advanced Research Seminar (HSA 6717), where all students develop a research proposal by the end of the semester. The student has the choice to enroll in either the Administrative Residency (HSA 6875) or the Masters Research Project (HSA 6977). If the student chooses to enroll in the HSA 6977 instead of the HSA 6875, then the student advances in their research project. Students who completed their research proposal during the Advanced Research Seminar may continue to work in the final portion of the research project to fulfill the requirements for HSA 6977. Page 4 of this guide describes the research project structure in detail. The student who chooses to conduct a research project will finalize the research project within two semesters— during the Advanced Research Seminar (HSA 6717) and the
  • 61. Advanced Health Services Management and Research Seminar (HSA 6977) course. Below there is a description of the Masters Program structure with either of these choices. Guidelines 3 The first objective of these guidelines is to provide a roadmap for the student on both the Advanced Research Seminar and the Masters Research Project. Students should know in advance about the program research expectations. If a student
  • 62. decides to continue on the research project path, they have the opportunity to continue to work on the research project in their interest area. To ensure the student's success, follow these guidelines in preparation for your research project. The second objective of this guide is to show students the components for conducting quantitative and/or qualitative studies, depending on the type of research design as applicable. Students are responsible for ensuring the research paper is free of errors in form, style, spelling, and grammar. Students should follow the American Psychological Association (APA) writing format. For more information on the APA writing style, consult the 7th edition manual. 4
  • 63. Advanced Research Seminar 6717 Overview WEEK 1-2: Topic Selection o Students enrolled in the Advanced Research Seminar 6717 who are interested in research, discuss a research topic with the course instructor. o Meet the course instructor to discuss potential topics (within the first three weeks). o Search the literature to narrow down a topic of interest. o Develop an annotated bibliography. o Select a feasible research topic within the first three (3) weeks. Note: Students who do not meet the topic selection deadline will be offered the opportunity to register in the Administrative Residency HSA 6875. WEEK 3-7: Develop Research Question and Purpose of Study o Meet with the course instructor to discuss the research progress and proposed topic. o Discuss a research proposal structure/plan
  • 64. o Develop a research question o Develop Introduction/Background, Statement of Problem, Purpose, and Significance of Research WEEK 8-11 o Start the Literature Review: Continue to research and annotate sources o Start the methods section WEEK 12-14 o Turn in a comprehensive research proposal including a list of references 5 Advanced Health Services Management Seminar
  • 65. HSA 6977 Overview WEEK 1-3: Data collection o Meet with the course instructor to discuss the research progress and recruitment progress. o Continue data collection process. WEEK 4-5: Preliminary Analyses o Meet with the course instructor to discuss a data analysis plan and conduct analyses. o Report and discuss preliminary analyses with the course instructor WEEK 6-7: Report participant demographics and other statistics o Finalize analyses and reporting WEEK 8-10: Write recommendations and conclusions o Finalize the discussion, recommendations limitations and conclusions write up
  • 66. WEEK 11-12 Prepare research project presentation o Final research project presentation o Turn in final research paper 6 Organization of the Research Proposal The research proposal allows the student to write a formal written plan put forward for consideration in the Professional Seminar. When the student is writing the research proposal, it is written in the future tense, since the research has not been conducted. Example: 'This research will explore…'
  • 67. Title Page The title page should include several sections: Project title, name, name of the institution name of the course instructor, and date the proposal is submitted. Do not include a running head on the title page. The title should be brief yet informative, providing the reader with a description of the proposed topic of the research study. The title should reflect the identification of the problem the research assesses. Introduction/Background The first section must capture the reader's interest, provide a rationale for the study as a whole, and inform the reader about the research content and scope. First, explain the research background starting from a broad perspective (e.g., what is known about the problem globally? What is the prevalence of the problem nationwide? Second, describe the problem at the local/state level.) Third, describe what is
  • 68. known about the research topic. This section includes relevant references to support the statements part of the background. The references should be from reliable sources of information, and these should be accurate. References can be found in the peer-reviewed literature (i.e., scholarly journals), books, and other reliable sources. Statement of Problem The statement of the problem lays the foundation for the issues being explored in the research project. This section details why the problem requires research. The statement of the problem section usually starts by addressing why the student is pursuing this research topic. Is it severe enough to warrant the study? Next, place the problem and research question in perspective, develop a narrative on the demographics (introducing the population of interest), and location of the problem (setting/geographical location) or situation leading to the applied research. It is
  • 69. essential to provide compelling evidence the problem exists. This section should also be supported 7 by evidence-based references/citations. Cite relevant literature to support the topic of interest and the variables of the study. Significance of the Study This section narrates why the proposed research study is relevant or meaningful and why the study might be necessary. The use of literature is highly recommended to describe the gaps in the published literature, insufficient knowledge in the subject area, or the need to validate the findings of previous studies. Explain what the benefit or contribution to new knowledge is. Example: "This research is important to understand barriers to access health care services for South Florida residents with cardiovascular diseases. This
  • 70. study is relevant to understand better what the specific barriers are so that intervention tailored to this population are implemented." Qualitative studies are exploratory in nature. An example of qualitative research is Interviews of clinical practitioners about the types of policies on a specific health program or available therapies to treat a disease. This type of research is recommended when a researcher wants to understand the population or area of interest from a behavioral or analytical perspective. Interpretations of the answers are required. In qualitative studies, there is a guide to topics/themes. Through this design, there is some flexibility to explore the participant's responses through a structured interview process. If a student decides to use a qualitative study as the design of their research, he/she shows the study findings' using the research participants' direct narrative quotes that should support the study conclusions.
  • 71. Qualitative research question example: "What are the relevant barriers for access to healthcare are for South Florida residents with cardiovascular diseases." Quantitative Research Quantitative studies use a structured variable-specific survey questionnaire or secondary data collection. When using this type of research design, the student uses a representative sample of the population of interest. The student should be cautious about the type of questions when using questionnaires and should consult with the course instructor if they are planning to use surveys to collect data. The survey question (s) should follow the research question objectives. In these types of studies, the student should be able to speak about the data that supports the conclusions. In quantitative research, it is not possible to subjectively interpret any results, as is the case of qualitative research.
  • 72. 8 Quantitative research question example: "What are the most prevalent barriers to access health care services identified by South Florida residents with cardiovascular diseases?" Literature Review The purpose of the literature review is to describe the related and existent evidence about the topic of interest. Creswell (2014) suggests that the literature review shares with the reader the results of previous studies, related to the one being proposed/conducted. The literature review is a critical review and assessment of current as well as previous research studies or evidence in the field of study. This section compares and contrasts previous studies related to the topic chosen, combining, and summarizing related studies.
  • 73. The reader should be able to find a roadmap and a narrative describing many aspects of the literature on what is known about the topic. Start by explaining the problem worldwide, nationwide, and explain the varying results documented in the literature. Provide a logical structure to the reader, guiding them through previous research studies and theories supporting the proposed research, establishing the importance of the topic. Be critical and consistent. Provide an assessment of the strengths and weaknesses of previous and current studies. Cooper (2010) & Creswell (2014) recognized four aspects of literature reviews described below: 1) Integrate research/evidence that others have done or said 2) Criticize scholarly work 3) Build bridges between related topics 4) Identify the principal issues in a field Example of a research question for the example below: "What are the barriers to access
  • 74. health care services identified by South Florida residents with cardiovascular diseases?" Literature Example: "Access to health care seems to be improving in the United States (Clooney, 2017). However, some research has found significant increases in chronic diseases such as cardiovascular diseases in the state of Florida (Jones- Who, 2018). Therefore, more research is needed to understand barriers for access to health care services identified by South Florida residents with cardiovascular diseases, since the prevalence is rising. A recent study found positive effects on access to health care and cardiovascular disease outcomes (Clooney & Comellas, 2018). Clooney and Comellas (2018) argued there is an increasingly aging population 9 in South Florida identifying significant transportation barriers to access preventive care services."
  • 75. According to Creswell (2014) (in quantitative research), the literature review starts with a (1) introduction section, followed by (2) topic 1 (the independent variable) (3) topic 2 (the dependent variable) and (4) topic 3 (studies that address both the dependent and independent variable) and (5) a summary highlighting the most important studies (Creswell, 2014, p. 47). The literature review for a qualitative and quantitative study is written as part of the research proposal. Note: Use current literature / evidence. Seek the input from your course instructor. Literature Review: Step by Step Creswell (2014) suggests several different ways to work on a literature review: 1) Identify keywords to locate different materials in a library. The keywords may emerge from the literature, and it may allow for the identification of a topic.
  • 76. 2) Search journals, books, databases (e.g., FIU computer databases: ProQuest, EBSCO, PubMed, etc.). 3) Gather as many reports as possible that are related to the research topic. 4) Skim through the articles. Creswell (2014) suggests that throughout this process, it is essential to try to gain a sense as to whether the research will make a useful contribution to the understanding of the literature. 5) Begin a literature map. a. This is a visual picture or groupings of the literature on the topic illustrating how the study will contribute to the literature. b. Position the study within the larger body of research. 6) Begin to draft summaries of the most relevant articles. Start critiquing the previous literature and point out deficiencies and issues with the methods. 7) Assemble the literature review. Structure of the literature thematically (use headings). The literature review conclusion should suggest how the proposed research may contribute to the current literature and could address gaps in the current literature.
  • 77. 10 Research Methods This section describes participant selection, the data collection of the research procedures, and data analysis. This section starts with a description of the study design (i.e., qualitative and/or quantitative design). The methods section includes the following: 1. Introduction. This section includes a reiteration of the statement of the problem and the research question. 2. Participants. This section includes the study population and sample selection (quantitative) or a description of study participants (e.g., males and/or females, age range, ethnicity, or other demographical characteristics). Describe how
  • 78. the participants will be chosen (qualitative), recruitment procedures, the estimated number of participants, and reimbursement or monetary compensations are given to participants (if any) should be specified. 3. Procedures for data collection. This section includes detailed descriptions of procedures (quantitative or qualitative) used/to be used to collect the data. Anticipate how data will be collected. Explain why each procedure was chosen. It is also essential to describe how the procedure will address the research questions. 4. Data Collection. In this course, data collection will be done mainly through secondary data (data collected by others, not the principal investigator). Provide a rationale for the procedures, using arguments based on its strengths and weaknesses, costs, data availability and/or convenience. 5. Ethical Considerations. This section should describe foreseeable risks or discomforts related to participation (if any). Everyone who decides to participate in the study should receive an informed consent form. The researcher should provide their contact information in case the participants request additional research-related information.
  • 79. Qualitative and Quantitative Content Qualitative Research When conducting qualitative research, the aim is to address people's experiences, needs, and different perspectives. Qualitative research aims at understanding and observing attitudes, life circumstances, beliefs, opinions, behaviors, and processes in depth. Data is collected by interviewing people and recording the responses as well as observing and documenting participant body language. The conventional approaches for facilitating interviews are: 11 a. In-depth interviews: These are one on one interviews. Researchers are interested in understanding individual experiences or opinions.
  • 80. b. Focus group interviews: The researcher attempts to discuss or explore participants' opinions in a group setting. c. Telephone mediated interviews: The researcher interviews participants by phone. d. Online mediated interviews: These are one on one interviews conducted online. e. Observation: This is an approach often used as a supplement to recording participant's responses. Quantitative Research When conducting quantitative research, data is often gathered using surveys either in person or through the Internet. If the information is collected through a survey questionnaire, it usually has three sections: (a) inclusion/exclusion criteria, (b) demographic information, and (c) the questions assessing the study variable (s) of interest. Participants
  • 81. Qualitative Research In qualitative research designs, the researcher purposely identifies the individuals (usually between 5 to 10 study participants) for the proposed study (Creswell, 2014). He/she should have in mind the research problem and which population (s) are affected by the problem. This section of the paper describes the selection of study participants, explains the characteristics of the participants, and describes the proposed number of participants. It also includes the inclusion and the exclusion criteria for including the research population. Quantitative Research As is the case with qualitative research designs, this section describes the selection of participants (e.g., data), explaining the demographic characteristics, and describing the proposed number in the sample being studied. It also includes the inclusion and exclusion criteria for selecting the research sample. Sample sizes may vary based
  • 82. upon the research aim/question (s). Large sample sizes (e.g., ≥ 100), often leads to increased accuracy in estimates about the population. Note: Students are encouraged to ask their course instructor for recommendations on sample sizes. 12 Procedures Qualitative Research This section describes the participant's recruitment process as well as the methods used while conducting the interviews (e.g., notes, audiotape recording, and videotape recording). Discuss how the group (if a focus group) will discuss a quiet, comfortable
  • 83. place to ensure everyone speaks/participate. Describe the development of a topic guide. A topic guide is used in the interview process to guide and discuss critical questions the interviewer would like to cover, including useful prompts to encourage discussion. Include an explanation about transcribing the interview once the participant's interviews/discussions have ended. After transcribing, the student reads the interviews (i.e., the data) and start coding it. Note: Coding is an approach used to organize the data by grouping pieces (categorizing the data) and writing a word representing a category (Rossman & Rallis, 2012; Creswell, 2014, p. 198). In qualitative research, data is primarily in the form of words derived from the participant's expressions on a subject matter. The data should be organized into categories of themes. Describe how validity occurs in the
  • 84. research process to validate the findings of the proposed study. Describe one or more strategies for establishing the accurateness of the findings. Some of the commonly used strategies are described below: a) Triangulation: Search for different data sources and use these to build the justification of themes (Creswell, 2014). If the researcher finds that the themes are established based on converging several sources of data or participant perspectives, then this would add to the validity of the study. b) Member checking: Taking the emergent themes back to the participants and asking them if they feel the themes are correct. Note: To check the reliability, researchers may cross-check the results with an independent person who can check the codes used by the researcher. Consult the course instructor for more information on these methods.
  • 85. 13 Quantitative Research In this section, the student documents the participant's recruitment process (e.g., consecutively, using a snowball approach, randomly, or other procedure that is free from bias). The student must always provide informed consent and specify the research is voluntary to all participants before starting the data collection process. Therefore, the student must describe the informed consent process in the methods section (if administering a survey). This section describes the processes used while collecting the research data. It documents all the processes for gathering data, selecting participants (or sites), providing copies of the consent form (if applicable). Describe the study variables, the parameters established for the variable (s) of study (e.g.,
  • 86. optimal health risk scores are defined as ≥10"), and how these data collected was collected. Data Collection Qualitative Research It is common to develop structured and semi-structured questions and record each participant's responses. The interview research question should map to the main research question. When conducting qualitative research, an interview/discussion guide is developed to conduct the interviews. These questions address the main research problem. Other data collected during the interviews could include participant demographics (e.g., age, sex, race/ethnicity, income for descriptive statistics). Note: The student interviewer informs the research participant of the location, day, and time of the interview. The interviewer ensures the participants
  • 87. have the interviewer contact information in case they get lost, are delayed, or have other problems before the interview. During and before the interview: a) Provide an informed consent form indicating the research is voluntary b) Remind the research participants that they will be recorded c) Remind the research participants that there are no right or wrong answers during the interview session (promote open and honest communication) d) State name and the goal of meeting with the participants e) Ask each participant to introduce themselves, state their names or initials so that you can later distinguish each participant responses 14 f) Do not redirect or interpret the respondent answers, or judge
  • 88. g) Know the interview guide and questions h) Do not bring any knowledge to the table i) Be comfortable with silence Note: Use probes as needed. For example – be silent, repeat the statement they said, and then continue neutrally ("I see, uh…"), direct ("Tell me more"), and clarify (what, where, when, what). Quantitative Research This section describes how many questions are going to be used (even if it is secondary data collection) and how the survey that led to the data collection was developed. Example: "The data used in this research is from the cardiovascular diseases questionnaire used in research conducted by the National Center for Health Statistics of the Centers for Disease Control and Prevention. This is a national cross-sectional research study representative of the U.S. population. The interviewers were elderly persons and minorities to provide a full representation of the U.S population.
  • 89. Note: If the student plans to use a survey or other form of data collection, consult the course instructor for guidance. Sample Population (Participants) Qualitative Research In qualitative research designs, the researcher purposely identifies the individuals (usually between 5 to 10 study participants) for the proposed study (Creswell, 2014). The student should have in mind the research problem and which population (s) are affected by the problem. This section describes the selection of study participants, explains the characteristics of the participants, and describes the number of participants the student plans to recruit. To determine the sample size, consult the course instructor for guidance. This section includes the inclusion and exclusion criteria for study participation. The inclusion criteria describe which participants should be included in the research (e.g., individuals with diabetes and/or people who had an HPV
  • 90. vaccination, ages 18yrs and over). Conversely, the exclusion criteria disqualify those individuals (potential participants) who do not meet the described characteristics the researcher is looking for. Quantitative Research 15 As is the case with qualitative research designs, this section of the paper also describes the selection of research participants, explains the characteristics of the participants, and describes the proposed number of participants. It also includes the inclusion and exclusion criteria for study participation (as described above). Samples sizes may vary based upon the research aim/question (s). Large sample sizes (e.g., ≥ 100), often leads to
  • 91. increased accuracy in estimates about the population. Students are encouraged to ask their course instructor for recommendations on sample sizes. The requirements for sample sizes may vary by study design. Instrumentation Qualitative Research This section describes the qualitative research approach to open-ended questions. In qualitative research, the …
  • 92. G U I D E L I N E S F O R T H E A D V A N C E D H E A L T H S E R V I C E S M A N A G E M E N T A N D R E S E A R C H S E M I N A R M A S T E R O F H E A L T H S E R V I C E S A D M I N I S T R A T I O N 1 Guidelines ............................................................................................... ............... 2 Part I: Advanced Research Seminar 6717 Research Overview ............................. 3 Advanced Health Services Management Research Seminar HSA 6717 Overview.4
  • 93. Part II: 6977 Masters Research Project Overview….…………………………………………..5 Organization of the Research Proposal .................................................................. 6 Introduction/Background ................................................................................... 6 Statement of Problem ......................................................................................... 6 Significance of Study ........................................................................................... 7 Literature Review ............................................................................................... 8 Research Methods ............................................................................................ 10 Part II: 6977 Masters Research Project………………………………………………………………… …………………………………………17 Data Analysis……………………………………………………………… ………………………………….18 Results………………………………………………….…………… …………………………………………..19
  • 94. Discussion, Recommendations, and Conclusions………………………………………….……………… …………………………………………22 References………………………………………….………………… ……………………………………….24 CONTENTS 2 A Masters degree contributes to the professional mastery of an administrative career in health services administration. The Masters in Health Services Administration prepares students with hands-on experience in conducting research and interacting with leaders while working in an administrative residency in health service administration. The student conducts a research project on a specific healthcare management problem or enrolls in the Administrative Residency. At some point in the program, the student may choose enrollment
  • 95. in research or the residency based on their interest. Typically students enroll in the Professional Seminar (HSA 6930) and the Advanced Research Seminar (HSA 6717), where all students develop a research proposal by the end of the semester. The student has the choice to enroll in either the Administrative Residency (HSA 6875) or the Masters Research Project (HSA 6977). If the student chooses to enroll in the HSA 6977 instead of the HSA 6875, then the student advances in their research project. Students who completed their research proposal during the Advanced Research Seminar may continue to work in the final portion of the research project to fulfill the requirements for HSA 6977. Page 4 of this guide describes the research project structure in detail. The student who chooses to conduct a research project will finalize the research project within two semesters— during the Advanced Research Seminar
  • 96. (HSA 6717) and the Advanced Health Services Management and Research Seminar (HSA 6977) course. Below there is a description of the Masters Program structure with either of these choices. Guidelines 3 The first objective of these guidelines is to provide a roadmap for the student on both the Advanced Research Seminar and the Masters Research Project. Students should know in
  • 97. advance about the program research expectations. If a student decides to continue on the research project path, they have the opportunity to continue to work on the research project in their interest area. To ensure the student's success, follow these guidelines in preparation for your research project. The second objective of this guide is to show students the components for conducting quantitative and/or qualitative studies, depending on the type of research design as applicable. Students are responsible for ensuring the research paper is free of errors in form, style, spelling, and grammar. Students should follow the American Psychological Association (APA) writing format. For more information on the APA writing style, consult the 7th edition manual.
  • 98. 4 Advanced Research Seminar 6717 Overview WEEK 1-2: Topic Selection o Students enrolled in the Advanced Research Seminar 6717 who are interested in research, discuss a research topic with the course instructor. o Meet the course instructor to discuss potential topics (within the first three weeks). o Search the literature to narrow down a topic of interest. o Develop an annotated bibliography. o Select a feasible research topic within the first three (3) weeks. Note: Students who do not meet the topic selection deadline will be offered the opportunity to register in the Administrative Residency HSA 6875. WEEK 3-7: Develop Research Question and Purpose of Study o Meet with the course instructor to discuss the research progress and proposed topic.
  • 99. o Discuss a research proposal structure/plan o Develop a research question o Develop Introduction/Background, Statement of Problem, Purpose, and Significance of Research WEEK 8-11 o Start the Literature Review: Continue to research and annotate sources o Start the methods section WEEK 12-14 o Turn in a comprehensive research proposal including a list of references 5
  • 100. Advanced Health Services Management Seminar HSA 6977 Overview WEEK 1-3: Data collection o Meet with the course instructor to discuss the research progress and recruitment progress. o Continue data collection process. WEEK 4-5: Preliminary Analyses o Meet with the course instructor to discuss a data analysis plan and conduct analyses. o Report and discuss preliminary analyses with the course instructor WEEK 6-7: Report participant demographics and other statistics o Finalize analyses and reporting WEEK 8-10: Write recommendations and conclusions
  • 101. o Finalize the discussion, recommendations limitations and conclusions write up WEEK 11-12 Prepare research project presentation o Final research project presentation o Turn in final research paper 6 Organization of the Research Proposal The research proposal allows the student to write a formal written plan put forward for consideration in the Professional Seminar. When the student is writing the research proposal, it is written in the future tense, since the research has not been conducted. Example: 'This research will explore…'
  • 102. Title Page The title page should include several sections: Project title, name, name of the institution name of the course instructor, and date the proposal is submitted. Do not include a running head on the title page. The title should be brief yet informative, providing the reader with a description of the proposed topic of the research study. The title should reflect the identification of the problem the research assesses. Introduction/Background The first section must capture the reader's interest, provide a rationale for the study as a whole, and inform the reader about the research content and scope. First, explain the research background starting from a broad perspective (e.g., what is known about the problem globally? What is the prevalence of the problem nationwide? Second, describe
  • 103. the problem at the local/state level.) Third, describe what is known about the research topic. This section includes relevant references to support the statements part of the background. The references should be from reliable sources of information, and these should be accurate. References can be found in the peer-reviewed literature (i.e., scholarly journals), books, and other reliable sources. Statement of Problem The statement of the problem lays the foundation for the issues being explored in the research project. This section details why the problem requires research. The statement of the problem section usually starts by addressing why the student is pursuing this research topic. Is it severe enough to warrant the study? Next, place the problem and research question in perspective, develop a narrative on the demographics (introducing the population of interest), and location of the problem (setting/geographical location) or situation leading
  • 104. to the applied research. It is essential to provide compelling evidence the problem exists. This section should also be supported 7 by evidence-based references/citations. Cite relevant literature to support the topic of interest and the variables of the study. Significance of the Study This section narrates why the proposed research study is relevant or meaningful and why the study might be necessary. The use of literature is highly recommended to describe the gaps in the published literature, insufficient knowledge in the subject area, or the need to validate the findings of previous studies. Explain what the benefit or contribution to new knowledge is. Example: "This research is important to understand barriers to access health care services
  • 105. for South Florida residents with cardiovascular diseases. This study is relevant to understand better what the specific barriers are so that intervention tailored to this population are implemented." Qualitative studies are exploratory in nature. An example of qualitative research is Interviews of clinical practitioners about the types of policies on a specific health program or available therapies to treat a disease. This type of research is recommended when a researcher wants to understand the population or area of interest from a behavioral or analytical perspective. Interpretations of the answers are required. In qualitative studies, there is a guide to topics/themes. Through this design, there is some flexibility to explore the participant's responses through a structured interview process. If a student decides to use a qualitative study as the design of their research, he/she shows the study findings' using the research participants' direct narrative quotes that should support the study
  • 106. conclusions. Qualitative research question example: "What are the relevant barriers for access to healthcare are for South Florida residents with cardiovascular diseases." Quantitative Research Quantitative studies use a structured variable-specific survey questionnaire or secondary data collection. When using this type of research design, the student uses a representative sample of the population of interest. The student should be cautious about the type of questions when using questionnaires and should consult with the course instructor if they are planning to use surveys to collect data. The survey question (s) should follow the research question objectives. In these types of studies, the student should be able to speak about the data that supports the conclusions. In quantitative research, it is not possible to subjectively interpret any results, as is the
  • 107. case of qualitative research. 8 Quantitative research question example: "What are the most prevalent barriers to access health care services identified by South Florida residents with cardiovascular diseases?" Literature Review The purpose of the literature review is to describe the related and existent evidence about the topic of interest. Creswell (2014) suggests that the literature review shares with the reader the results of previous studies, related to the one being proposed/conducted. The literature review is a critical review and assessment of current as well as previous research studies or evidence in the field of study. This section compares and contrasts previous studies related to the topic chosen, combining, and summarizing related
  • 108. studies. The reader should be able to find a roadmap and a narrative describing many aspects of the literature on what is known about the topic. Start by explaining the problem worldwide, nationwide, and explain the varying results documented in the literature. Provide a logical structure to the reader, guiding them through previous research studies and theories supporting the proposed research, establishing the importance of the topic. Be critical and consistent. Provide an assessment of the strengths and weaknesses of previous and current studies. Cooper (2010) & Creswell (2014) recognized four aspects of literature reviews described below: 1) Integrate research/evidence that others have done or said 2) Criticize scholarly work 3) Build bridges between related topics 4) Identify the principal issues in a field
  • 109. Example of a research question for the example below: "What are the barriers to access health care services identified by South Florida residents with cardiovascular diseases?" Literature Example: "Access to health care seems to be improving in the United States (Clooney, 2017). However, some research has found significant increases in chronic diseases such as cardiovascular diseases in the state of Florida (Jones- Who, 2018). Therefore, more research is needed to understand barriers for access to health care services identified by South Florida residents with cardiovascular diseases, since the prevalence is rising. A recent study found positive effects on access to health care and cardiovascular disease outcomes (Clooney & Comellas, 2018). Clooney and Comellas (2018) argued there is an increasingly aging population 9 in South Florida identifying significant transportation barriers to access preventive care
  • 110. services." According to Creswell (2014) (in quantitative research), the literature review starts with a (1) introduction section, followed by (2) topic 1 (the independent variable) (3) topic 2 (the dependent variable) and (4) topic 3 (studies that address both the dependent and independent variable) and (5) a summary highlighting the most important studies (Creswell, 2014, p. 47). The literature review for a qualitative and quantitative study is written as part of the research proposal. Note: Use current literature / evidence. Seek the input from your course instructor. Literature Review: Step by Step Creswell (2014) suggests several different ways to work on a literature review: 1) Identify keywords to locate different materials in a library. The keywords may emerge from the literature, and it may allow for the identification of a
  • 111. topic. 2) Search journals, books, databases (e.g., FIU computer databases: ProQuest, EBSCO, PubMed, etc.). 3) Gather as many reports as possible that are related to the research topic. 4) Skim through the articles. Creswell (2014) suggests that throughout this process, it is essential to try to gain a sense as to whether the research will make a useful contribution to the understanding of the literature. 5) Begin a literature map. a. This is a visual picture or groupings of the literature on the topic illustrating how the study will contribute to the literature. b. Position the study within the larger body of research. 6) Begin to draft summaries of the most relevant articles. Start critiquing the previous literature and point out deficiencies and issues with the methods. 7) Assemble the literature review. Structure of the literature thematically (use headings). The literature review conclusion should suggest how the proposed research may contribute
  • 112. to the current literature and could address gaps in the current literature. 10 Research Methods This section describes participant selection, the data collection of the research procedures, and data analysis. This section starts with a description of the study design (i.e., qualitative and/or quantitative design). The methods section includes the following: 1. Introduction. This section includes a reiteration of the statement of the problem and the research question. 2. Participants. This section includes the study population and sample selection (quantitative) or a description of study participants (e.g., males