Support program decisions with good research
April 1, 2000
Support program decisions with good research
If the patient education study isn’t valid, toss it!
Every patient education manager occasionally needs to find research studies that support an idea for a program, help determine if a particular teaching technique is effective, or find information to prepare for a class. Therefore, it’s important to develop two skills: learning how to find good patient education studies and evaluating the research to make sure it is valid.
There are no journals where patient education studies can automatically be found. These studies are published in a variety of publications. The best way to find them is to conduct a literature search on the Internet, says Kate Lorig, RN, DrPH, director of the Stanford Patient Education Research Center in Palo Alto, CA. A literature search entails using a database’s search function to look for key words describing your topic. For example, if the topic is diabetes, you might start with "diabetes, patient education evaluation," explains Lorig. Lorig often conducts literature searches on Medline (http://www.ncbi.nlm.nih. gov/PubMed/).
Determine exactly what you are looking for, and then ask a librarian to help you select key words to use in your search, advises Mary Szczepanik, MS, BSN, RN, manager, cancer education, support and outreach for Grant/Riverside Methodist Hospitals in Columbus, OH.
"Librarians do searches all the time and are very good. If you talk with them for five minutes about what you want to find, they can give you 20 key words to use," she explains.
If you live near a university library, start there, because it likely subscribes to a large variety of research-based journals or has a license to obtain copies of articles from search engine sites. If not, go to the medical library at your hospital, says Szczepanik.
Abstracts, bibliographies contain key words
Once you’ve found a couple of articles, the search gets easier, because key words for the article are found in the abstract or on the first page of the article. This makes it easier to find additional articles pertaining to your topic, explains Szczepanik. Also, look at the bibliography at the end of the article for related studies.
It is important to evaluate the articles you find to determine if good research methods were used. Before spending time on this task, however, look at the abstract to determine if the researcher’s findings are relevant to your purposes, says Szczepanik. For example, will the studies help you design a program or help you determine if a given teaching technique is useful?
Strong studies measure more than patients’ knowledge or behavior changes, says Lorig. "For patient education, I want studies that look at health status change or health care utilization," she says. For example, if patients participate in a successful asthma education program, they not only learn about their asthma triggers, but they avoid them, and therefore they have fewer visits to the emergency department.
Once studies are selected, it’s important to look carefully at the research methods and the evaluation of the data to determine if the conclusions are valid. Look at the study design, says Szczepanik. Ask several questions, including:
• How did the researchers collect the data?
• How many people were in the study?
• How did the researchers get their sample?
The instruments used to collect the data must be proven methods. "If it is survey research, it is important to know who did the survey and if there are any factors that might have influenced the way people answered the questions," says Szczepanik. The sample size is important as well. The smaller the sample, the harder it is to apply the results to the general population, she says.
The stronger studies always are randomized trials, says Lorig. "If it is not a randomized study, I would look for a study that has a comparison control group," she says.
The study authors should explain how they analyzed the data. If the analysis was performed incorrectly, the study’s results could be wrong, says Szczepanik. If you don’t understand statistical analysis, take the article to someone who does, she advises.
The study should include a description of the results and a discussion of the findings. In the discussion, the authors should answer the original research questions raised in the introduction. They also should address how the results support or differ from the findings they uncovered in the literature review they completed before conducting the research. The conclusion will offer the authors’ opinion about the research findings.
"If you find all these components in an article, then it is worth reading. However, you must check to see if rules and regulations for good research were followed," says Szczepanik.
Another good way to find sound research studies for patient education is to determine if the journal in which they are published is peer reviewed. A peer-reviewed journal is a must, says Lorig.
For more information on finding sound research in patient education, contact:
• Kate Lorig, RN, DrPH, Director, Stanford Patient Education Research Center, 1000 Welch Road, Suite 204, Palo Alto, CA 94304. Telephone: (650) 723-7935. Fax: (650) 723-9656.
• Mary Szczepanik, MS, BSN, RN, Manager, Cancer Education, Support and Outreach, Grant-Riverside Methodist Hospitals, 3535 Olentangy River Road, Columbus, OH 43214. Telephone: (614) 566-3280. Fax: (614) 447-0652. E-mail: [email protected].
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