Nursing diagnosis "altered energy field"

danu3 · Jan 22, 2006

Please do not put words into my mouth. I said the sample was inadequate and it was found inadequate by two researchers reviewing the research. I will not attempt to teach you statistics, that is the purpose of a university. And I suggest you take not only a course on nursing research but biostatistics, both undergraduate and graduate and basic undergraduate and graduate statistics well. The understanding of statistics, the use of it, the impact on the size of the relative sample, and in your case, is sorely lacking.
I suggest you study a little harder and then come back and hold a rational discussion on the statistically insignificant sampling used by some researchers.
When conducting the research for my first thesis, my sampling was more then 4,000 individuals, something that was not found to be statistically insignificant.
Grannynurse:balloons:

Grannynurse, guess we have some miscommunication here? I am not asking you to teach me statistics.

I may be wrong... but you seemed to be saying to me "I am in graduate school, and you don't know what you are talking about, so don't bug me."

Look at it this way, as a nurse, aren't you suppose to be able to teach? Not just patients and their families, but your fellow nurses too? Now I do not have a greaduate degree like you (or are you in the process of getting one?). However, I am not exactly stupid since this is my second career and I got my first degree is in Computer Science and Linguistics at UC Berkeley. And believe me, I am quite use to haveing an intellegent discussion with people who has Ph.Ds.

I am asking some very simple statistical questions which you could have answered real quick, I think I have enough intellegence to understand you. Instead I felt like I've been led in a wild goose chase with all the references which I happened to have the ability to track them down so far.

Here is your exact quote "...Using a pool of less then 100 subjects, which is what the study used, is considered, by reputable researchers, as being insignificant because the source is not large enough to draw any valid inferences from(N. Burns,PhD, S. Grove, PhD, The Pratice of Nursing Research,2001). The fact that the study was deemed statistically insignificant, not only by me but two other nursing researchers who challenged the study."

My interpretation of you quote is that studies of less than 100 subjects as being "insignificant. Am I interpreting it right?

I am bugging you because the number 100 is something brand new for me. A large sample size is usually consider to be 30, not 100 in statistics. So I was wondering maybe you made a mistake or maybe there is something new in today's statistical trends. Since you reference the book, all you need to do is to refer me to the page. Instead, you gave be tons of chapteres which most of it have nothing to do with my question. I did finally gotten the book and I think I found the answer which you could have just pointed me to (which I will detail later).

The second reason I bug you is that in your quote, if I am understanding you correctly, you are saying a sample size of less than 100 is considier "insiginificant" and then you mentioned the study is deemed "statisitically insignificant", that is weird in terms how it is used... at least not in any reputable journals I've read where a researcher critique another research by saying it is "insignificant" or it is "statistically insignificant".

I am actually now really interested in the actual paper that critique the studied mentioned above saying it is "insignificant".

Again, I am not asking you to teach me statistics. I am asking for the source of your references so I can look at up myself and make my own decision.

Here is my comment on your references.

"The practice of Nursing Research" (2001).

On page 377 "One of the questions most commonly asked by beginning researchers is. "What size sample should I use?" Historically, the response to this question has been that a sample should contain at least 30 subjects. There is no logical reason for the selection of this number, and in most cases, 30 subjects is an inadequate sample size.

Currently, the deciding factor in determining an adequate sample size for correlational, quassi-experimental, and experimental studies is power. Power is the capacity of the study to detect differences or relationships that actually exist in the population... The minimum acceptable power for a study is .80..."

My comment: No where do I find that you need more than 100 subjects to be valid. Even in this book, notice it say "IN MOST CASES, 30 subjects is an inadequate sample size". So actually it means there are some cases that 30 is an adequate sample size (way lower than 100).

Now the concept of power is new to me and also this is a trend now according to this textbook is also new.

Another quote of the word usage of "significance" on page 630-631 "The word 'significance' is used in two ways in research. Statistical significance is related to quantitative analysis of the results of the study. To be important, the results of quantitative studies that use statistical analysis must be statistically significant. Statistical significance means that the results are unlikely to be due to chance. However, statistically significant results are not necessarily important in clinical practice...The practical significance of a study is associated witth its importance to nursing's body of knowledge... (goes on for more details)".

I am quoting this to show why I could not understand the way you use "significance" and I doubt it is because my lack of knowledge in statistics.

The thing is, all you have to do is to point me to these pages instead of giving me a whole range of chapters and maybe explaining that is what you mean? If that is what you mean, I would be fine with it.

A side comment. 30 does have some logicall reason behind it because you need 30 for the Central Limit T to have a some kind of normal distrubution. It is, however, not a magic number. The power number 0.80 is actually an arbitary number also, that is my guess. It is a reasonable arbitary number however.

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Statistics for Dummies

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I checked this out from a local library. The stuff I quote again show maybe where I may have misunderstood you.

Pg 56 "A statistically significant" result is one that would have had a very small probability of happening just by chance. The p-value reflects that probability. For example, if a drug is found to be more effective at treating breast cancer than the current treatment is, researchers say that the new drug shows a statistically significant improvement in the survival rate of patients with breast cancer. That means that based on their data, the difference in the results from patients on the new drug compared to those using the old treatment is so big that it would be hard to say it was just a coincidence." As you can see, "statistically significant" is used in the study itself to say whether the data supporting the study's hypothesis is not likely to be chance. Another researcher would not disagree with a study by saying it is "statistically insignificant".

Pg 166 on central limit theorem "...the larger the sample size (n) is, the closer the distribution of the sample means will be to a normal distribution. (Most statisticians agree that if n is at least 30, it will do a reasonable job in most cases)

Pg 184 on Sample size " ... However, statisticians have worked out several general rules to be sure that the sample sizes are large enough.

For sample proportions, you need to be sure that n x p is at least 5, and n x(1-p) is at least 5. For example, in a preceding example of a poll on the president, n= 1000, p=0.52 ... Both of these are safely above 5, so everything is okay.

For sample averages, you need only look at the sample size itself. In general, the sample size, n, should be above about 30 for the statistical theory to hold. Now, if it's 29, don't panic; 30 is not a magic number, it's just a general rule."

Your reference to the dummies book is actually important. I think you would understand why those of us who have basic statistics would find your statement of "100" subjects to be questionable. If you would have just explained briefly maybe you are refering to a new statistical trend using "power", that would benefit all of us.

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The Economist, June 29, 2004 Signifying nothing

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Small typo, it is in Jan 31st, 2004.

Basically this paper focus on the importance of telling the differences between "statistical significance" and "economic significance". In terms of nursing, we have to do the same. Instead of "economic significance", we need to ask the question is it "clinically significant"? (pg 486 of The Practice of Nursing Research book).

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Journal of Statistical Education, Vol 9, No 1, 2001. Eric R Sowey,Studying Demonstrations in Teaching Statistics.

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A good article if one is having problems with basic statistics as it has a number very interesting ways of conveying the basic concepts. The basic principles here (striking demonstration) can probably be apply to nursing education and even our day to day patient teaching.

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How to understand statistics, July 28, 2003 bbc.co.uk

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chadash has already summarized it pretty good.

danu3 · Jan 22, 2006

Amen! I am just beginning to wonder, as a lowly LPN student, if the worst thing to ever happen to Nurses was Masters and PhD's being awarded in the field.
An education that promotes better patient care is great; an education that promotes bureaucracy, excess "administration", lofty "ivory tower" crud like "nursing diagnoses", and managers that manage paperwork rather than patient care is a useless education IMHO.

Actually, there are goods in graduate level educations if one has the opportunites to get it. One of my professor once said "The only reason you want to go to grad school is that so you won't get 'snow' or intimidated by high sound words and phrases". He also said "Education is the only thing people paid for and they want less off (refering to us complaining about all the homework we have to do).

Long Term Care Columnist / Guide · Jan 22, 2006

It is not necessary to talk down to people.:stone Heck, I consider myself well-informed and intelligent, but these long-winded treatises on statistics are not only boring, they are waaaaay over a lot of peoples' heads---including mine---and while I'm sure this was not the intent, I don't particularly appreciate being made to feel stupid.

I for one would appreciate it if we can get this thread back on track. I'll be honest, I think this so-called 'nursing diagnosis' is a steaming pile of guano, but I will defend to the death the right to discuss it........in terms ALL of us can understand, if you please.

Thank you.

danu3 · Jan 22, 2006

Here are the three problems I have with the "altered energy field".
2. In the facility that I am at, any diagnosis that is made must be charted to by every subsequent nurse. Therefore, if one nurse makes this diagnosis, then every nurse who takes care of that patient must evaluate and intervene, whether they have received any training (or believe) in energy manipulation.
.

Good point, I have not even thought about that potential problem.

danu3 · Jan 22, 2006

It is not necessary to talk down to people.:stone Heck, I consider myself well-informed and intelligent, but these long-winded treatises on statistics are not only boring, ..

Would short-winded treatises be ok ?

Sorry for going off topic again...

Long Term Care Columnist / Guide · Jan 22, 2006

Would short-winded treatises be ok ?
Sorry for going off topic again...

'S okay.:) I'd just noticed that this thread was becoming a bit ugly in its tone over the past few pages, and I thought a reminder to 'play nice' was in order.

As you were, folks!:chuckle

chadash · Jan 22, 2006

'S okay.:) I'd just noticed that this thread was becoming a bit ugly in its tone over the past few pages, and I thought a reminder to 'play nice' was in order.
As you were, folks!:chuckle

ok, ok, I'll be nice. :rolleyes:

This is interesting. What other unusual nursing diagnosis are out there?

clee1 · Jan 22, 2006

Actually, there are goods in graduate level educations if one has the opportunites to get it. One of my professor once said "The only reason you want to go to grad school is that so you won't get 'snow' or intimidated by high sound words and phrases". He also said "Education is the only thing people paid for and they want less off (refering to us complaining about all the homework we have to do).

Agreed. I plan to eventually get an advanced degree... to further my goal of becoming an NP.

My point is that advanced nursing degrees are great.... IF they lead to better patient care rather than a greater ability to play political games.

Like my father says (a PhD himself): "PhD stands for Piled Higher & Deeper".

clee1 · Jan 22, 2006

I'll be honest, I think this so-called 'nursing diagnosis' is a steaming pile of guano, but I will defend to the death the right to discuss it........in terms ALL of us can understand, if you please.
Thank you.

:yeahthat:

LeahJet, ASN, RN · Jan 22, 2006

Hope I wasn't rude guys, just kidding around.:imbar

oh no, chadash, i wasn't referring to you at all!:)

danu3 · Jan 22, 2006

Agreed. I plan to eventually get an advanced degree... to further my goal of becoming an NP.

Good for you!

My point is that advanced nursing degrees are great.... IF they lead to better patient care rather than a greater ability to play political games.

Actually, come to think of it... the ability to play political games is quite important as it can affect greatly patient care one way or another. Maybe nursing school should have a course on how to play political games (is that in the leadership courses?)... I mean nurses seemed to do everything anyway from taking care of patients to fixing computers (know where and how hard to kick the computer) to fixing toilets.

tylertyler · Jan 22, 2006

I'm sorry if you view my post as an attack. To use a sixth graders poor attempt to put down TT is one founded in a non-scientific approach. And you did do just that. And if you had done a little more research, you would have found:
1. the sixth grader didn't do her own research, which was highly questionable
2. several adults did, which was also not very scientific
3. their attempt was an extremely poor one.
4. the sixth grader's mother was a member of a known quack organization, whose own research is highly suspect.
All I suggested was that one look into the research that has been done, both in support and against the validity of TT. There are several articles, which used the scientific model to validate, the use of TT. And while I do not have the titles of the articles or journals handy, a review of the literature will provide them.
Grannynurse:balloons:

I for one am tired of the :smiley_ab between you and Jolie. It is ok for her to express her opinion and for you to do the same without subjecting readers to your antics. You are obviously a very intelligent woman who I am sure is fully capable of expressing her opinion without offending or coming across as a rude, know it all, who enjoys putting others down while lifting herself up, all in the name of "educating" and giving "granny advice" Enough already. You make valid comments but they often come with a twist of sarcasm + a condesending tone which should be filtered as :spam: