Design, Evaluation, and Translation of Nursing Interventions

Table of Contents:
Preface xi Acknowledgment xiii SECTION 1 INTRODUCTION 1 Introduction to Intervention Research 3 1.1 Overview of paradigm shift 4 1.1.1 Evidence-based practice: a review 5 1.1.2 Client-centered care 7 1.1.3 High-quality care redefined 9 1.2 Process for designing, evaluating, and translating interventions 11 1.2.1 Design of interventions 11 1.2.2 Evaluation of interventions 12 1.2.3 Translation of interventions 13 1.3 Overview of the book 14 SECTION 2 DESIGNING INTERVENTIONS 2 Overview of Designing Interventions 17 2.1 Nursing interventions defined 17 2.1.1 Definition of interventions 17 2.1.2 Characteristics of interventions 19 2.2 Presenting problems 21 2.2.1 Definition of problem 21 2.2.2 Characteristics of problems 21 2.3 Design of interventions 23 3 Understanding the Problem 27 3.1 Theoretical approach for understanding the problem 27 3.2 Empirical approach for understanding the problem 31 3.3 Experiential approach for understanding the problem 35 3.4 Combined approach for understanding the problem 40 3.5 Theory of the problem 42 4 Clarifying Elements of the Intervention 43 4.1 Theory-based approach for designing interventions 43 4.2 Empirical approach for designing interventions 49 4.3 Experiential approach for designing interventions 53 4.3.1 Focus group 53 4.3.2 Concept mapping 54 4.3.3 Assessment of treatment preferences 54 4.4 Specification of interventions 56 4.4.1 Intervention goals 56 4.4.2 Intervention components and activities 56 4.4.3 Intervention mode of delivery 57 4.4.4 Intervention dose 59 5 Intervention Theory 61 5.1 Delineation of intervention outcomes 61 5.2 Intervention theory 64 5.2.1 Structure 64 5.2.2 Process 68 5.2.3 Outcome 68 5.3 Utility of intervention theory 71 6 Tailored Intervention 73 6.1 Design of tailored interventions 74 6.1.1 Intervention theory 74 6.1.2 Identification of client characteristics for tailoring 75 6.1.3 Assessment of client characteristics 76 6.1.4 Construction of a list of intervention strategies 76 6.1.5 Development of algorithm 78 6.2 Effectiveness of tailored interventions 81 6.3 Mechanisms underlying effects of tailored interventions 82 SECTION 3 IMPLEMENTATION OF INTERVENTIONS 7 Overview of Implementation of Interventions 85 7.1 Variations in intervention implementation 85 7.2 Consequences of variations in intervention implementation 90 7.3 Strategies to enhance intervention implementation 91 8 Development of Intervention Manual 93 8.1 Procedure for developing the intervention manual 93 8.1.1 Contextual characteristics 94 8.1.2 Process 94 8.2 Content of the intervention manual 95 8.2.1 Section 1: overview of the intervention 95 8.2.2 Section 2: human and material resources 97 8.2.3 Section 3: procedure 100 8.3 Use of the intervention manual 108 9 Selecting, Training, and Addressing the Influence of Interventionists 111 9.1 Traditional perspective on interventionist influence 112 9.2 Interventionist influence: the evidence 113 9.3 Selection of interventionists 116 9.4 Training of interventionists 119 9.5 Methodological features of studies aimed at investigating interventionist effects 123 10 Intervention Fidelity 125 10.1 Definition of fidelity 125 10.2 Methods for monitoring fidelity 129 10.2.1 Theoretical fidelity 130 10.2.2 Operational fidelity 133 10.3 Importance of monitoring fidelity of intervention implementation 143 SECTION 4 EVALUATION OF INTERVENTIONS 11 Overview of Evaluation of Interventions 149 11.1 Criteria for inferring causality 149 11.2 Phases for intervention evaluation 154 11.2.1 Phase 1 154 11.2.2 Phase 2 155 11.2.3 Phase 3 158 11.2.4 Phase 4 160 11.3 Role of intervention theory 161 12 Testing the Acceptability and Feasibility of Interventions 163 12.1 Acceptability of interventions 164 12.1.1 Conceptualization of intervention acceptability 165 12.1.2 Operationalization of intervention acceptability 167 12.2 Feasibility of interventions 180 12.2.1 Definition of feasibility 180 12.2.2 Indicators of feasibility 181 12.3 Feasibility of research methods 185 12.3.1 Recruitment procedures 186 12.3.2 Screening 188 12.3.3 Randomization 189 12.3.4 Retention 191 12.3.5 Data collection 192 12.4 Design of pilot study 193 13 Examining the Efficacy of Interventions 197 13.1 Factors affecting the causal relationship between intervention and outcomes 198 13.1.1 Conceptual factors 198 13.1.2 Methodological factors 200 13.1.3 Addressing conceptual and methodological factors 201 13.2 Design features of an efficacy study 201 13.2.1 Careful selection of participants 219 13.2.2 Control of experimental condition 222 13.2.3 Selection of comparison group 223 13.2.4 Allocation of participants to groups 228 13.2.5 Standardized treatment implementation 230 13.2.6 Outcome measurement 231 13.2.7 Outcome data analysis 231 14 Determining the Effectiveness of Interventions 233 14.1 Efficacy versus effectiveness: A brief review 234 14.2 Limitations of the RCT design in effectiveness research 235 14.2.1 Unrepresentativeness of the sample 235 14.2.2 Highly select setting 236 14.2.3 Limited applicability of interventions 237 14.2.4 Irrelevance of comparison treatment 238 14.2.5 Limited utility of randomization 239 14.2.6 Limited relevance of findings 240 14.3 Alternative designs for evaluating effectiveness 241 14.3.1 Overall function or goal 241 14.3.2 Broad representative sample 241 14.3.3 Selection of different settings 242 14.3.4 Comparison of clinically relevant alternative treatments 242 14.3.5 Assessment of relevant health outcomes at follow-up 243 14.3.6 Allocation to treatment 243 14.3.7 Additional features 245 15 Preferences for Treatment 251 15.1 Conceptualization of treatment preferences 251 15.1.1 Factors influencing treatment preferences 252 15.1.2 Consequences of treatment preferences 253 15.2 Mechanisms underlying influence of treatment preferences in intervention research 254 15.2.1 Influence of treatment preferences on external validity 254 15.2.2 Influence of treatment preferences on internal validity 256 15.2.3 Research designs accounting for treatment preferences 258 SECTION 5 TRANSLATION OF INTERVENTIONS 16 Translation of Interventions 263 16.1 Systematic review of evidence 264 16.2 Translation of evidence 265 16.3 Transfer of guideline to practice 268 16.3.1 Adaptation of guideline 268 16.3.2 Dissemination and implementation of guideline 270 References 271 Index 295

About the Author :
Souraya Sidani, Ph.D. is Professor and Canada Research Chair at the School of Nursing, Ryerson University. She has served as an investigator on over 20 funded grants and has numerous publications in peer-reviewed journals and books. Dr. Sidani's research focuses on evaluating interventions and advanced practice roles, examining patient preferences for treatments, and refining research methods and measures for determining the clinical effectiveness of interventions. Carrie Jo Braden, Ph.D. is Associate Dean for Research and Hugh Roy Cullen Professor of Nursing at the University of Texas Health Sciences Center at San Antonio. Dr. Braden is a Fellow of both the American Academy of Nursing and the Western Academy of Nursing. Her research focuses on learned response to chronic illness, mechanisms enhancing scholarly achievement (interprofessional research mentoring), and support resources for health disparities research. She has served as an investigator on 23 funded grants. She is a recipient of the Nurse of the Year Award for Excellence in Nursing Research and has authored or co-authored three books and numerous articles for refereed journals.

Review :
"This book is a must for healthcare professionals interested in this type of research. The authors do an excellent job of bringing this type of research to life." (Doody's, 3 February 2012)