Demographic Biographic Data Its Types And Measurement

How to Handle Biographic or Demographic Data

  Demographic data its collection measure and mangement 

 Most nursing research studies involve the collection of data through self-reports or  observations. However, there are other methods of collecting data, several of which are reviewed in this chapter. The most important alternative method is biophysiologic measures, which are used primarily in quantitative studies.

Demographic Measure or Biophysiologic Measures

    The trend in nursing research has been toward increased use of measures to assess the physiologic status of study participants, and to evaluate clinical outcomes. Indeed, the National Institute for Nursing Research has emphasized the need for more physiologically based nursing research. Bond and Heitkemper (2001) note that enormous advances in basic physiologic science (eg, the human genome project) in the past decade offer new opportunities for the evolving physiologic nursing science. 

    Many clinically relevant variables do not require biophysiologic instrumentation for their measurement. Data on physiological activity or dysfunction can often be gathered through direct observation (eg, vomiting, cyanosis, edema, wound status). Other biophysiologic data can be gathered by asking people directly (eg, ratings of pain, fatigue, or nausea). This section focuses on biophysiologic phenomena that are measured through specialized technical equipment. 

    Settings in which nurses operate are typically filled with a wide variety of technical instruments for measuring physiologic functions. It is beyond the scope of this book to describe the many kinds of biophysiologic measures available to nurse researchers. Our goals are to present an overview of biophysiologic measures, to illustrate their use in research, and to note considerations in decisions to use them. 

    Purposes of Biophysiologic Measures Clinical nursing studies may involve specialized equipment and instruments both for creating independent variables (eg, an intervention using biofeedback equipment) and for measuring dependent variables. For the most part, our discussion focuses on the use of biophysiologic measures as outcome or dependent variables. 

    Most nursing studies in which biophysiologic measures have been used fall into one of six classes.

    1. Basic physiological processes. Some studies investigate basic physiologic processes that are relevant to nursing care. Such studies often involve subjects who are healthy and normal, or some subhuman animal species.

    2. Physiological outcomes of nursing care. Nurse researchers are increasingly interested in exploring and documenting the ways in which nursing actions affect patients' biophysiologic outcomes. Some of these studies are undertaken when there is concern that standard procedures are not having the intended beneficial effects.

    3. Evaluations of nursing interventions. These evaluation studies differ from those in the second category in that they involve the testing of a new intervention, usually in comparison with standard methods of care or with alternative interventions. Typically, these studies involve a hypothesis stating that the innovative nursing procedure will result in improved biophysiologic outcomes among patients.

    4. Product assessments. A number of nursing studies are designed to evaluate alternative products designed to enhance patient health or comfort, rather than to evaluate nursing interventions.

    5. Measurement and diagnosis improvement. Nurse researchers sometimes undertake studies to improve the measurement and recording of biophysiologic information regularly gathered by nurses. Similarly, some researchers investigate methods to improve clinical diagnosis.

    6. Studies of physiological correlates. Nurse researchers have also studied biophysiologic outcomes in relation to social or psychological characteristics. In some cases, the studies are prospective and are designed to identify antecedents to physiologic problems. In other cases, the researcher is trying to describe concurrently the psychological status of people with different physiologic conditions.

    The physiological phenomena that interest nurse researchers run the full gamut of available measures, some of which are discussed

Types

    Types of Biophysiologic Measures Physiologic measurements can be classified in one of two major categories. In vivo measurements are those performed directly in or on living organisms. Examples include measures of oxygen saturation, blood pressure, and body temperature. An in vitro measure, by contrast, is performed outside the organism's body, as in the case of measuring serum potassium concentration in the blood. 

    In Vivo Measures In vivo measures often involve the use of highly complex instrumentation systems. An instrumentation system is the apparatus and equipment used to measure one or more attributes of a subject and the presentation of that measurement data in a manner that humans can interpret. Organism instrument systems involve up to six major components:

    1. A stimulus 2. A subject 3. Sensing equipment (eg, transducers) 4. Signal-conditioning equipment (to reduce interference signals) 5. Display equipment 6. Recording, data processing, and transmission equipment Not all instrumentation systems involve all six components.

    Some systems, such as an electronic thermometer, are simple; others are extremely complex. For example, some electronic monitors yield simultaneous measures of such physiological variables as cardiac responsivity, respiratory rate and rhythm, core temperature, and muscular activity. 

    In vivo instruments have been developed to measure all bodily functions, and technological improvements continue to advance our ability to measure biophysiologic phenomena more accurately, more conveniently, and more rapidly than ever before. The uses to which such instruments have been put by nurse researchers are richly diverse and impressive.

    In Vitro Measures With in vitro measures, data are gathered by extracting physiologic material from subjects and submitting it for laboratory analysis. Nurse researchers may or may not be involved in the extraction of the material; however, the analysis is normally done by specialized laboratory technicians. Usually, each laboratory establishes a range of normal values for each measurement, and this information is critical for interpreting the results. 

    Several classes of laboratory analysis have been used in studies by nurse researchers, including the following: Chemical measurements, such as the measure of hormone levels, sugar levels, or potassium levels Microbiologic measures, such as bacterial counts and identification Cytologic or histologic measures, such as tissue biopsies It is impossible, of course, to catalog the thousands of laboratory tests available. Laboratory analyzes of blood and urine samples are the most frequently used in vitro measures in nursing investigations.

Selection Biophysiologic Measure

    For nurses unfamiliar with the hundreds of biophysiologic measures available in institutional settings, the selection of appropriate research measures may pose a challenge. There are, unfortunately, no comprehensive handbooks to guide interested researchers to the measures, instruments, and interpretations that may be required in collecting physiologic data. Probably the best approach is to consult knowledgeable colleagues or experts at a local institution. 

    It also may be possible to obtain useful information on biophysiologic measures from research articles on a problem similar to your own, a review article on the central phenomenon under investigation, manufacturers ' catalogs , and exhibits of manufacturers at professional conferences. Obviously, the most basic issue to address in selecting a physiologic measure is whether it will yield good information about the research variable. 

    In some cases, researchers need to consider whether the variable should be measured by observation or self-report instead of (or in addition to) using biophysiologic equipment. For example, stress could be measured by asking people questions (eg, using the State Trait Anxiety Inventory); by observing their behavior during exposure to stressful stimuli; or by measuring heart rate, blood pressure, or levels of adrenocorticotropic hormone in urine samples. 

    Several other considerations should be kept in mind in selecting a biophysiologic measure. Some key questions include the following:

1. Is the equipment or laboratory analysis you need readily available to you? If not, can it be borrowed, rented, or purchased?
2. If equipment must be purchased, is it affordable? Can funding be acquired to cover the purchase (or rental) price?
3. Can you operate the required equipment and interpret its results, or do you need training? Are there resources available to help you with operation and interpretation?
4. Will you have difficulty obtaining permission to use the equipment from an Institutional Review Board or other institutional authority?
5. Does the measure need to be direct (eg, a direct measure of blood pressure by way of an arterial line), or is an indirect measure (eg, blood pressure measurement by way of a sphygmomanometer) sufficient?
6. Is continuous monitoring necessary (eg, electrocardiogram readings), or is a point-in-time measure adequate?
7. Do your activities during data collection permit you to record data simultaneously, or do you need an instrument system with recording equipment (or a research assistant)?
8. Is a mechanical stimulus needed to get meaningful measurements? Does available equipment include the required stimulus?
9. Is a single measure of your dependent variable sufficient, or are multiple measures preferable? If multiple measures are better, what burden does this place on you and on subjects?

Are your measures likely to be influenced by reactivity (ie, subjects' awareness of their subject status)? If so, can alternative or supplementary nonreactive measures be identified, or can the extent of reactivity bias be assessed?

1. Can your research variable be measured using a noninvasive procedure, or is an invasive procedure required?
2. Is the measure you plan to use sufficiently accurate and sensitive to variation?

1. Are you thoroughly familiar with rules and safety precautions, such as grounding procedures, especially when using electrical equipment? Evaluation of Biophysiologic Measures Biophysiologic measures offer the following advantages to nurse researchers:

1. Biophysiologic measures are relatively accurate and precise, especially compared with psychological measures (eg, self-report measures of anxiety).
2. Biophysiologic measures are objective. Two nurses reading from the same spirometer output are likely to record the same tidal volume measurements, and two different spirometers are likely to produce identical readouts. Patients cannot easily distort measurements of biophysiologic functioning deliberately.
3. Biophysiologic instrumentation provides valid measures of the targeted variables: thermometers can be dependent on to measure temperature and not blood volume, and so forth. For nonbiophysiologic measures, the question of whether an instrument is really measuring the target concept is an ongoing concern.
4. Because equipment for obtaining biophysiologic measurements is available in hospital settings, the cost of collecting biophysiologic data may be low or nonexistent. Biophysiologic measures also have a few disadvantages:
5. The measuring tool may affect the variables it is attempting to measure. The presence of a sensing device, such as a transducer, located in a blood vessel partially blocks that vessel and, hence, alters the pressure-flow characteristics being measured.
6. There are normally interferences that create artifacts in biophysiologic measures. For example, noise generated in a measuring instrument interferes with the signal being produced.

    Energy must often be applied to the organism when taking the biophysiologic measurements; extreme caution must continually be exercised to avoid the risk of damaging cells by high energy concentrations. The difficulty in choosing biophysiologic measures for nursing research investigations lies not in their shortage, nor in their questionable utility, nor in their inferiority to other methods. 

    Indeed, they are plentiful, often highly reliable and valid, and extremely useful in clinical nursing studies. However, care must be exercised in selecting appropriate instruments or laboratory analyzes with regard to practical, ethical, medical, and technical considerations.

Records, Documents, of  Available Data

    Thus far, we have examined data collection strategies that require researchers to collect their own data and, in some cases, to develop data collection instruments. However, data that are gathered for non research purposes can often be used to answer research questions of both qualitative and quantitative researchers.

    Data Sources The places where nurse researchers can find useful records and documents are too numerous to list, but a few suggestions may be helpful. In hospitals and other health care settings, excellent records are kept routinely. 

    For example, patient charts, physicians' and nurses' orders, care plan statements, and shift reports constitute rich data sources. In addition to medical and nursing records, hospitals maintain financial records, personnel records, nutrition records, and so forth.

    Educational institutions maintain various records. For example, most schools of nursing have permanent files on their students. Public school systems also keep records, including both academic and health-related information. 

    Industries and businesses normally maintain a variety of records that may interest industrial nurse researchers, such as information on employees' absenteeism, health status, on-the-job accidents, job performance ratings, and alcoholism or drug problems. Governments also maintain records of potential interest, such as birth or death records.

    In addition to quantified institutional records, narrative documents are potential data sources for qualitative researchers. Personal documents such as diaries and letters are sometimes available. 

    Ethnographers frequently collect and analyze a range of personal documents and institutional records, including minutes of meetings, organizational bylaws or policy statements, and promotional literature, to name only a few. Such materials can provide useful insight into lived experiences.

    Advantages and Disadvantages of Using Records Research data obtained from records and documents are advantageous for several reasons. The most salient advantage of records is that they are economical; the collection of original data is often time-consuming and costly. Preexisting records also permit an examination of trends over time, if the information is collected repeatedly. 

    Problems of reactivity and response bias may be completely absent when researchers obtain data from records. Furthermore, investigators do not have to rely on participants' cooperation. On the other hand, when researchers are not responsible for collecting and recording data, they may be unaware of the records' limitations and biases. Two major sources of bias in records are selective deposit and selective survival. 

    If the available records are not the entire set of all possible such records, researchers must address the question of how representative existing records are. Many record keepers intend to maintain an entire universe of records but may fail to adhere to this ideal. Lapses from the ideal may be the result of systematic biases, and careful researchers should attempt to learn just what those biases may be. Another problem confronting researchers is the increasing reluctance of institutions to make their records available for study. 

    The Privacy Act, a federal regulation enacted to protect individuals against possible misuse of records, has made hospitals, agencies, schools, and businesses sensitive to the possibility of legal action from people who think their right to privacy has been violated. The major issue is divulgence of individual identities. 

    If records are maintained with an identifying number rather than a name, permission to use the records may be easy to secure. Most institutions do maintain records by their clients' names, however. In such situations, researchers may need the help of staff at the institution to maintain client anonymity, and some organizations may be unwilling to use their staff for such purposes. 

    Other difficulties also may be relevant. Sometimes records have to be verified for their authenticity, authorship, or accuracy, a task that may be difficult if the records are old. Researchers using records must be prepared to deal with forms and file systems they do not understand. Codes and symbols that had meaning to the record keeper may have to be translated to be usable. In using records to study trends, researchers should be alert to possible changes in record-keeping procedures. 

    For example, does a dramatic increase or decrease in the incidence of sudden infant death syndrome reflect changes in the causes or cures of this problem, or does it reflect a change in diagnosis or record-keeping? Thus, although existing records may be plentiful, inexpensive, and accessible, they should not be used without paying attention to potential problems.