The Individualized Education and the Anxiety Level of Patients with Myocardial Infraction - Assignment Example

TOPIC: QUANTITATIVE ANALYSIS (NAME) (INSTITUTIOS NAME) (COURSE NAME) 28th MAY 2008. Question one The variables in this study were the individualized education and the anxiety level of patients with myocardial infraction (MI). There is a dependency between the two variables as it was proved by the findings that an individualized program is effective in decreasing the anxiety of patients and their relatives when the patients are transferred from the CCU to the general care unit. The period of anxiety was also found to decrease with the administering of the individualized education between the patients and the relatives. Individualized education was found also to have an effect on the transfer anxiety of relatives and their patients that resulted into a decrease in the patients’ anxiety level as well as preventing the relatives’ anxiety level from increasing. In addition the information score of relatives and their patients after the education in the experimental group were significantly higher than those of the comparison group that indicated clearly that this development was as a result of the individualized education that the experimental group had gone through and based on the specific needs. This research indicated clearly that the two variables were therefore dependent upon each other as the recommendations of the researchers showed that patients should be evaluated emotionally on admission to the CCU and at routine intervals. The researchers moved with the dependence of the two variables also indicated that the patients and their relatives should go through an individualized education program which is focused on meeting the needs of the relatives as well as their patients and a CCU transfer policy should be developed. Multiple t-tests ought not to be used to compare the means of more than two groups. This is because of the cumulative type I error rejecting a true null hypothesis. The type I error risk is equivalent to the alpha level and is additive for every test carried out on the same variable that is dependent. For example the study carried out by the researchers had four groups of 45 people in every group. If multiple t-tests are used to compare the mean of the 4 group with the alpha level set at 0.05 as is the case in the study carried out then the cumulative type I error or family wise error would be 0.30 since at least six comparisons would be required. Yes because the Bonferroni procedure would have helped control the risk of rejecting one or more null hypothesis that is true without much regard to the significance tests performed by the researchers. It would also have permitted the risk of failing to reject false null hypothesis to grow with the number of tests. Statistical power loss associated with the utilization of the above procedure is also demonstrated and particularly two options for alleviating the problem explored. In addition a less stringent level of significance for the test is shown to be less effective than the need to increase the sample size. Question four If the researchers conducted 5 t-tests in their data analysis then the level of significance using the Bonferroni procedure when a= 0.05 or a confidence level of 95 percent will be 0.05 = 0.01 5 Calculating the t* gives TNIV (0.01) = 46.34117083 The first computed parameter is the significance level corrected for multiple comparisons and the second is the number of degrees off freedom for the ANOVA. Question five The experimental group’s informational scores were not statistically significant. This is because the t ratio is less than the t* that is t= 16.819 while the t*= 46.34117083 hence t< t* 16.819< 46.34117083. Question six The results mean that there was a greater variation of the results obtained by the researchers between the two groups, that is, between the experimental group and the patients. Question seven The null hypothesis should be accepted because the results showed that there was a significant difference between the two groups. Question eight There were 180 subjects who participated in the study. They consisted of 90 patients who had first time diagnosis of MI in the CCU who were conscious and could communicate. In addition there were 90 relatives of the patients who were either patient’s spouses or child and who had the primary responsibility of caring for their patients. Question nine Forty five patients and their forty five relatives were in the experimental group and the forty five patients and their forty five relatives made up the comparison group. The study had equal numbers in the two groups and the weights were therefore distributed equally among the members in the two groups. The numbers were also large which ensured that the data found would represent the entire population hence minimizing the errors that would emerge if a small sample participated in this research. Therefore the study was strength. Question ten The sample criteria for this study included the selection of the patients and their relatives in who made the experimental sample and selection of patients and their relatives who would be in the comparison sample. Since the study needed to determine the difference in the reaction levels of the patients and their relatives when the patients are transferred from the CCU to the general care unit the equal portions of sampling was required. This would ensure that the results were equally distributed due to equal representation sampling criteria. PART II Question one There is an improvement in the rate of movement over time of the between the time interval prior to surgery and the time interval one month post surgery as depicted by the data on degrees of movement of the ar4m between this two periods. For example the movement of the arm was 36 degrees before surgery but it increased to 46 degrees prior to surgery. In the same perspective the degree of arm movement was 22 before surgery but it increased to 75 after surgery, which shows that there was a significant improvement in the range of arm movement over time. The time interval before the surgery and 12 months after the surgery did not depict a significant improvement in the arm movement. For example before surgery the movement in several patients dropped drastically from the 98 degrees before surgery to 51 degrees. In other patients the movement improved slowly as depicted by the arm movement in some patients with 49 degrees of arm movement to 52 degrees of arm movement in 12 months after surgery. The movement of the arm between one month after surgery to 12 months after surgery of showed a steady decrease in the arm movement in all the patients. Question two The baseline collected on every patient at randomization in controlled trials can be used to give an explanation of the patient’s population and also to asses comparability of treatment groups to gain a balanced randomization to adjust comparisons of treatment of prognostic factors and to undertake analyses of subgroups. Using the linear regression model formulae a= y – bx and taking a sample of 14 patients we get b =n ∑xiyi - ∑xiyi = 2.89883 n∑xi2 – (∑xi)2 The root mean square will be 1.7025 which is the square root of the slope b. It is therefore true to say that the range of movement depends on the patients’ age. Age Movement one 21 36 18 22 28 87 28 80 27 98 27 90 16 41 25 107 28 32 29 100 19 49 27 90 22 63 20 81 Question three. The severity of injury depends on gender and dominant side. This can be depicted by the graph below. Severity Gender, dominant side. The figure above shows that severity of injury does depend on gender as well as the dominant side since it is a straight line. Hence severity = constant – slope (gender) which shows that severity depend on gender, that is female are more prone to severity than male. PART III Question one The variables involved in answering this question include children born prematurely and mental and motor sore. Yes there is dependence between the two variables because children born prematurely from the results have both mental and motor score problems once they reach the school going age. According to science children born prematurely have both mental and motor score problems once they reach the school going age. Their level of measurement was 70-130 both for the physical as well as the mental score. The t tests at the level of significance of 0.05 or 95 percent confidence level will be used to test the hypothesis. The t tests will be used because of the need to minimize the error between different variables. Question two The variables involved in answering this question are premature born children, full term infants, motor as well as mental scores which were taken from the sample. There is a dependency between the variables because the motor as well as the mental scores taken were closely related to the premature born children and the full term infants’ measurement of the mental and motor score measured by the Development Quotients (DQ). The results showed that there was a significance difference between the premature born children and full term infants in motor and mental scores. There are differences that exist between premature born children and full term infants in motor and mental scores. The t- test will also be used to test the level of significance in testing the hypothesis because of its simplicity and accuracy in comparing two variables. The t -test is preferable because it also minimizes the level of the error that might arise due to the use of a large data. References Benjamin, Y. (1995). Controlling the false discovery rate—a practical and powerful approach to multiple testing, London: Zed Books, J. R. Stat. Soc. Ser. B 57: 289–300. Fernando, R. et al (2004). Controlling the proportion of false positives in multiple dependent tests. New York: New York Press Genetics 166: 611–619 Sabatti, C. and Freimer, N. (2003). False discovery rate in linkage and association genome screens for complex disorders. Genetics 164: 829–833. Southey, B. (1998). Controlling the proportion of false positives among significant results in QTL detection. Armidale: Australia, Vol. 26, pp. 221–224. Storey, J. (2002). A direct approach to false discovery rates. New York: New York Press release pp 64: 479–498. Storey, J. (2003). The positive false discovery rate: a Bayesian interpretation and the q-value. New York: New York Press pp 31: 2013–2035. Westfall, P. and Johnson, J. (1997). A Bayesian perspective on the Bonferroni adjustment, Biometrika: Australia pp 84: 419–427. Read More