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esearch A Workbookfo
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r Evidence-
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Based Practice 3rd Edit
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ion Susan Grove Daish
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EXERCISE
Identifying Levels o v l v l
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fMeasurement: Nominal, O
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rdinal, Interval, and Ratio v l
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The questions are in bold followed by answers.
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1. In Table 1, identify the level of measurement for the current therapy variable. Provide a
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rationale for your answer. vl vl vl
Answer: The current therapy variable was measured at the nominal level. These drug categori
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eswere probably developed to be exhaustive for this study and included the categories of drugs
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thesubjects were receiving. However, the categories are not exclusive, since patients are usually
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on more than one category of these drugs to manage their health problems. The current therap
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ies are not measured at the ordinal level because they cannot be rank ordered, since no drug catego
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ry can be considered more or less beneficial than another drug category (see Figure 1-
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1; Grove & Gray, 2019).
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2. What is the mode for the current therapy variable in this study? Provide a rationale
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foryour answer.
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Answer: The mode for current therapy was β blocker. A total of 100 (94%) of the cardiac patients
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were receiving this category of drug, which was the most common prescribed drug f
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or thissample.
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3. What statistics were conducted to describe the BMI of the cardiac patients in this sample
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?Discuss whether these analysis techniques were appropriate or inappropriate.
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Answer: BMI was described with a mean and standard deviation (SD). BMI measurement result
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ed in ratio- vl vl
level data with continuous values and an absolute zero (Stone & Frazier, 2017). Ratio-
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level data should be analyzed with parametric statistics such as the mean and SD (Grove & Gray
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,2017; Knapp, 2017).
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4. Researchers used the following item to measure registered nurses’ (RNs) income in a study:
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What category identifies your current income as an RN?
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a. Less than $50,000
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b. $50,000 to 59,999
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c. $60,000 to 69,999
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d. $70,000 to 80,000
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e. $80,000 or greater
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What level of measurement is this income variable? Does the income variable follow t
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he rules outlined in Figure 1-1? Provide a rationale for your answer.
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Answer: In this example, the income variable is measured at the ordinal level. The income categ
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o- ries are exhaustive, ranging from less than $50,000 to greater than $80,000. The two open-
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ended
AG 1-1 vl
,AG 1-2
vl Answerv l Guidelinesv l forv l Questionsv l tov l Bev l Graded
categories ensure that all salary levels are covered. The categories are not exclusive, since catego-
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ries (d) and (e) include an $80,000 salary, so study participants making $80,000 might mark ei
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ther (d) or (e) or both categories, resulting in erroneous data. Category (e) could be change
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dto greater than $80,000, making the categories exclusive. The categories can be rank ordered
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from the lowest salary to the highest salary, which is consistent with ordinal data (Grove & Gr
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ay, 2019; Waltz et al., 2017).
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5. What level of measurement is the CDS score? Provide a rationale for your answer.
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Answer: The CDS score is at the interval level of measurement. The CDS is a 26-
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
item Likert scale developed to measure depression in cardiac patients. Study participants rated
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their symp-
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toms on a scale of 1 to 7, with higher numbers indicating increased severity in the depression
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symptoms. The total scores for each subject obtained from this multi-vl vl vl vl vl vl vl vl vl vl
item scale are considered to be at the interval level of measurement (Gray et al., 2017; Waltz et
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al., 2017). vl
6. Were nonparametric or parametric analysis techniques used to analyze the CDS scores for
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the cardiac patients in this study? Provide a rationale for your answer.
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Answer: Parametric statistics, such as mean and SD, were conducted to describe CDS sc
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oresfor study participants (see Table 1). CDS scores are interval-
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level data as indicated in Questions 5, so parametric statistics are appropriate for this level of data (
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Gray et al., 2017; Kim & Mallory, 2017).
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7. Is the prevalence of depression linked to the NYHA class? Discuss the clinical importanc
vl vl vl vl vl vl vl vl vl vl vl vl vl
e of this result.
vl vl vl
Answer: The study narrative indicated that the prevalence of depression increased with the gre
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ater NYHA class. In NYHA class III, 64% of the subjects were depressed, whereas 11% of thesubj
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl l
v
ects were depressed in NYHA class I. Thus, as the NYHA class increased, the number of sub-
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
jects with depression increased. This is an expected finding because as the NYHA class increases,
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
cardiac patients have more severe physical symptoms, which usually result in emotional distress, s
vl vl vl vl vl vl vl vl vl vl vl vl vl
uch as depression. Nurses need to actively assess cardiac patients for depression, especially tho
vl vl vl vl vl vl vl vl vl vl vl vl vl
sein higher NYHA classes, so they might be diagnosed and treated as needed.
vl vl vl vl vl vl vl vl vl vl vl vl vl
8. What frequency and percent of cardiac patients in this study were not being treated with
vl vl vl vl vl vl vl vl vl vl vl vl vl vl
an antidepressant? Show your calculations and round your answer to the nearest whole
vl vl vl vl vl vl vl vl vl vl vl vl vl vl
percent (%). vl
Answer: A total of 106 cardiac patients participated in this study. The sample included
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15 patients who were receiving an antidepressant (see Table 1). The number of cardiac pati
vl vl vl vl vl vl vl vl vl vl vl vlvl vlvl vlvl vl
ents not treated for depression was 91 (106 –
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15 = 91). The group percent is calculatedby the following formula: (group frequency
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v v l v l v l v l v l
÷ total sample size) × 100%. For this study,(91 patients ÷ 106 sample size) × 100%
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v vl vl vl vl vl vl vl vl
= 0.858 × 100% = 85.8% = 86%. The finalanswer is rounded to the nearest whole per
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v vl vl vl vl vl vl vl
cent as directed in the question. You could havealso subtracted the 14% of patients treate
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d with antidepressants from 100% and obtained the 86% who were not treated with an antide
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pressant.
9. What was the purpose of the 6- vl vl vl vl vl vl
minute walk test (6MWT)? Would the 6MWT be useful in clinical practice?
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Answer: Ha et al. (2018) stated, ―The 6- vl vl vl vl vl vl vl
min walk test (6MWT) is a measure of the submaximal,steady-
vl vl vl vl vl vl vl vl vl l
v
state functional capacity‖ of cardiac patients. This test would be a quick, easy way to determin
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
e a cardiac patient’s functional status in a clinical setting. This functional statusscore could
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be used to determine the treatment plan to promote or maintain functional statusof cardi
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ac patients.vl
, Answerv l Guidelinesv l forv l Questionsv l tov l Bev l Graded AG 1-3
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10. How was exercise confidence measured in this study? What was the level of measuremen
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tfor the exercise confidence variable in this study? Provide a rationale for your answer.
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
Answer: Exercise confidence of the patients with heart failure (HF) in this study was measure
vl vl vl vl vl vl vl vl vl vl vl vl vl vl
dwith the Exercise Confidence Scale that included four subscales focused on walking, climbin
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g,lifting objects of graded weight, and running (see the study narrative). This was a rating s
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
calewith values ranging from 0 to 100. The patients’ scores for the Total Exercise Confidence s
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caleand the subscales were considered interval-
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level data and analyzed with parametric statistics,such as means and SDs (see the study narra
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v vl vl vl vl vl vl vl vl
tive; Waltz et al., 2017).
vl vl vl vl
Statistics for Nursing R vl vl vl
esearch A Workbookfo
vl vl vl
r Evidence-
vl
Based Practice 3rd Edit
vl vl vl
ion Susan Grove Daish
vl vl vl
a
, Answer Guidelines for Questions to Be Graded vl vl vl vl vl vl
EXERCISE
Identifying Levels o v l v l
v
l
fMeasurement: Nominal, O
vl
rdinal, Interval, and Ratio v l
vl
v l v l
vl
1
The questions are in bold followed by answers.
vl vl vl vl vl vl vl
1. In Table 1, identify the level of measurement for the current therapy variable. Provide a
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
rationale for your answer. vl vl vl
Answer: The current therapy variable was measured at the nominal level. These drug categori
vl vl vl vl vl vl vl vl vl vl vl vl vl
eswere probably developed to be exhaustive for this study and included the categories of drugs
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
thesubjects were receiving. However, the categories are not exclusive, since patients are usually
vl vl vl vl vl vl vl vl vl vl vl vl vl v
on more than one category of these drugs to manage their health problems. The current therap
l vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
ies are not measured at the ordinal level because they cannot be rank ordered, since no drug catego
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
ry can be considered more or less beneficial than another drug category (see Figure 1-
vl vl vl vl vl vl vl vl vl vl vl vl vl vl
1; Grove & Gray, 2019).
vl vl vl vl
2. What is the mode for the current therapy variable in this study? Provide a rationale
vl vl vl vl vl vl vl vl vl vl vl vl vl vl v
foryour answer.
l vl vl
Answer: The mode for current therapy was β blocker. A total of 100 (94%) of the cardiac patients
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were receiving this category of drug, which was the most common prescribed drug f
v l v l v l v l v l v l v l v l v l v l v l v l v l
or thissample.
v l vl
3. What statistics were conducted to describe the BMI of the cardiac patients in this sample
vl vl vl vl vl vl vl vl vl vl vl vl vl vl
?Discuss whether these analysis techniques were appropriate or inappropriate.
vl vl vl vl vl vl vl vl vl
Answer: BMI was described with a mean and standard deviation (SD). BMI measurement result
vl vl vl vl vl vl vl vl vl vl vl vl vl
ed in ratio- vl vl
level data with continuous values and an absolute zero (Stone & Frazier, 2017). Ratio-
vl vl vl vl vl vl vl vl vl vl vl vl vl
level data should be analyzed with parametric statistics such as the mean and SD (Grove & Gray
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
,2017; Knapp, 2017).
l
v vl vl
4. Researchers used the following item to measure registered nurses’ (RNs) income in a study:
vl vl vl vl vl vl vl vl vl vl vl vl vl l
v
What category identifies your current income as an RN?
vl vl vl vl vl vl vl vl
a. Less than $50,000
v l vl vl
b. $50,000 to 59,999
v l vl vl
c. $60,000 to 69,999
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d. $70,000 to 80,000
v l vl vl
e. $80,000 or greater
v l vl vl
What level of measurement is this income variable? Does the income variable follow t
vl vl vl vl vl vl vl vl vl vl vl vl vl
he rules outlined in Figure 1-1? Provide a rationale for your answer.
vl vl vl vl vl vl vl vl vl vl vl
Answer: In this example, the income variable is measured at the ordinal level. The income categ
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
o- ries are exhaustive, ranging from less than $50,000 to greater than $80,000. The two open-
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
ended
AG 1-1 vl
,AG 1-2
vl Answerv l Guidelinesv l forv l Questionsv l tov l Bev l Graded
categories ensure that all salary levels are covered. The categories are not exclusive, since catego-
vl vl vl vl vl vl vl vl vl vl vl vl vl vl
ries (d) and (e) include an $80,000 salary, so study participants making $80,000 might mark ei
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
ther (d) or (e) or both categories, resulting in erroneous data. Category (e) could be change
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
dto greater than $80,000, making the categories exclusive. The categories can be rank ordered
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
from the lowest salary to the highest salary, which is consistent with ordinal data (Grove & Gr
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
ay, 2019; Waltz et al., 2017).
vl vl vl vl vl
5. What level of measurement is the CDS score? Provide a rationale for your answer.
vl vl vl vl vl vl vl vl vl vl vl vl vl
Answer: The CDS score is at the interval level of measurement. The CDS is a 26-
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
item Likert scale developed to measure depression in cardiac patients. Study participants rated
vl vl vl vl vl vl vl vl vl vl vl vl v
their symp-
l vl
toms on a scale of 1 to 7, with higher numbers indicating increased severity in the depression
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
symptoms. The total scores for each subject obtained from this multi-vl vl vl vl vl vl vl vl vl vl
item scale are considered to be at the interval level of measurement (Gray et al., 2017; Waltz et
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
al., 2017). vl
6. Were nonparametric or parametric analysis techniques used to analyze the CDS scores for
vl vl vl vl vl vl vl vl vl vl vl vl l
v
the cardiac patients in this study? Provide a rationale for your answer.
vl vl vl vl vl vl vl vl vl vl vl
Answer: Parametric statistics, such as mean and SD, were conducted to describe CDS sc
vl vl vl vl v l v l v l v l v l v l v l v l v l
oresfor study participants (see Table 1). CDS scores are interval-
vl vl vl vl vl vl vl vl vl vl
level data as indicated in Questions 5, so parametric statistics are appropriate for this level of data (
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
Gray et al., 2017; Kim & Mallory, 2017).
vl vl vl vl vl vl vl
7. Is the prevalence of depression linked to the NYHA class? Discuss the clinical importanc
vl vl vl vl vl vl vl vl vl vl vl vl vl
e of this result.
vl vl vl
Answer: The study narrative indicated that the prevalence of depression increased with the gre
vl vl vl vl vl vl vl vl vl vl vl vl vl
ater NYHA class. In NYHA class III, 64% of the subjects were depressed, whereas 11% of thesubj
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl l
v
ects were depressed in NYHA class I. Thus, as the NYHA class increased, the number of sub-
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
jects with depression increased. This is an expected finding because as the NYHA class increases,
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
cardiac patients have more severe physical symptoms, which usually result in emotional distress, s
vl vl vl vl vl vl vl vl vl vl vl vl vl
uch as depression. Nurses need to actively assess cardiac patients for depression, especially tho
vl vl vl vl vl vl vl vl vl vl vl vl vl
sein higher NYHA classes, so they might be diagnosed and treated as needed.
vl vl vl vl vl vl vl vl vl vl vl vl vl
8. What frequency and percent of cardiac patients in this study were not being treated with
vl vl vl vl vl vl vl vl vl vl vl vl vl vl
an antidepressant? Show your calculations and round your answer to the nearest whole
vl vl vl vl vl vl vl vl vl vl vl vl vl vl
percent (%). vl
Answer: A total of 106 cardiac patients participated in this study. The sample included
vl vl vlvl vlvl vlvl vlvl vlvl vlvl vlvl vlvl vlvl vlvl vlvl
15 patients who were receiving an antidepressant (see Table 1). The number of cardiac pati
vl vl vl vl vl vl vl vl vl vl vl vlvl vlvl vlvl vl
ents not treated for depression was 91 (106 –
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15 = 91). The group percent is calculatedby the following formula: (group frequency
vl vl vl vl vl vl vl vl l
v v l v l v l v l v l
÷ total sample size) × 100%. For this study,(91 patients ÷ 106 sample size) × 100%
v l vl v l v l v l vl v l v l v l l
v vl vl vl vl vl vl vl vl
= 0.858 × 100% = 85.8% = 86%. The finalanswer is rounded to the nearest whole per
vl vl vl vl vl vl vl vl vlvl l
v vl vl vl vl vl vl vl
cent as directed in the question. You could havealso subtracted the 14% of patients treate
vl vl vl vl vl vl vl v l l
v vl vl vl vl vl vl
d with antidepressants from 100% and obtained the 86% who were not treated with an antide
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
pressant.
9. What was the purpose of the 6- vl vl vl vl vl vl
minute walk test (6MWT)? Would the 6MWT be useful in clinical practice?
vl vl vl vl vl vl vl vl vl vl vl
Answer: Ha et al. (2018) stated, ―The 6- vl vl vl vl vl vl vl
min walk test (6MWT) is a measure of the submaximal,steady-
vl vl vl vl vl vl vl vl vl l
v
state functional capacity‖ of cardiac patients. This test would be a quick, easy way to determin
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
e a cardiac patient’s functional status in a clinical setting. This functional statusscore could
vl vl vl vl vl vl vl vl vlvl vlvl vlvl vlvl l
v vl
be used to determine the treatment plan to promote or maintain functional statusof cardi
vl vl vl vl vl vl vl vl vl vl vl vl vl l
v vl
ac patients.vl
, Answerv l Guidelinesv l forv l Questionsv l tov l Bev l Graded AG 1-3
vl
10. How was exercise confidence measured in this study? What was the level of measuremen
vl vl vl vl vl vl vl vl vl vl vl vl vl
tfor the exercise confidence variable in this study? Provide a rationale for your answer.
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
Answer: Exercise confidence of the patients with heart failure (HF) in this study was measure
vl vl vl vl vl vl vl vl vl vl vl vl vl vl
dwith the Exercise Confidence Scale that included four subscales focused on walking, climbin
vl vl vl vl vl vl vl vl vl vl vl vl vl
g,lifting objects of graded weight, and running (see the study narrative). This was a rating s
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
calewith values ranging from 0 to 100. The patients’ scores for the Total Exercise Confidence s
vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl vl
caleand the subscales were considered interval-
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level data and analyzed with parametric statistics,such as means and SDs (see the study narra
vl vl vl vl vl vl l
v vl vl vl vl vl vl vl vl
tive; Waltz et al., 2017).
vl vl vl vl
