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Biomedical subjects

S Muncer

Publications and source records attributed to S Muncer.

8 recordsLinked to original sources
PubMed2000

Redressing the power and effect of significance. A new approach to an old problem: teaching statistics to nursing students.

Many barriers to learning are present when teaching research methods. Developing, within students of nursing, the skills of reading and interpreting research reports is vital if the profession is to contribute to the general aim of achieving a sound basis for all health care interventions. This paper overviews the current move toward evidence based practice, the challenges that are present when teaching research to nursing students and offers an approach to teaching quantitative research that will help students of nursing to understand the key concepts that form the basis of inferential statistics. In this work we argue that the traditional emphasis on probability and statistical significance needs to be redressed and that effect size and power should form the basis of teaching students the concepts involved in inferential statistics. We argue that introducing students to the key concepts in statistical decision making in a particular order, effect size then power and lastly statistical significance, will lead to a better understanding of Type I and Type II errors. After all, the purpose of hypothesis testing is to detect a treatment or intervention effect. Power is dependent upon the size of the treatment effect, thus it must be introduced after effect size. Students, we argue, must be able to understand the concept of effect size. We consider this to be a foundational concept that will help to develop a firmer grasp of the decision making processes involved in hypothesis testing. Such an approach will form a more logical approach to teaching this subject and will allow for the use of real world examples to form the basis of learning.

Bias↗
PubMed1999

Nurses' cognitive structural models of work-based stress.

This study examined the causes of stress experienced by National Health Service nurses in England over the course of a single week with the aim of generating a cognitive structural model. Qualitative data served as the foundation of a network study which employed inductive eliminative analysis. These data were also analysed using conventional qualitative methods and by content analysis. The results were consistent with previous studies that identified a number of primary sources of stress. However, the network study indicated that two systems of causation were operating. The first centres on inadequate staffing levels, which were seen as leading to poor attitudes and abilities among colleagues, multiple work roles and lack of support. Lack of support also contributed to powerlessness and poor attitudes and abilities. The behaviour of managers was strongly endorsed as a direct cause of stress, but the strongest explanatory link was through staffing levels and powerlessness. The second system of causation related patients' suffering to stress. The qualitative data validated the network study results through elaborating the understanding of the respondents' nominated causes. Discussion focused on the pressure and frustration experienced by nurses because of organizational factors and interaction effects with the caring nature of nursing work. It is suggested that nursing discourse is subordinated to managerial and biomedical discourse reflecting the relative powerlessness of nurses. The extent to which such powerlessness is primarily a result of the failure of nurses to assert themselves or intrinsic organizational factors is not clear. The consequences of a stressed and demoralized nursing workforce on the quality of patient care and risk profile are identified as the focus for future research.

Cognition↗
PubMed1997

Sex differences in aggression: does social representation mediate form of aggression?

In contrast to the usual pattern of higher male aggression, girls have been shown to exceed boys on frequency measures of indirect aggression. Women also tend to view aggression in terms of an expressive social representation whereby it is seen to result from loss of self-control, in contrast to men who tend to describe it as an instrumental act aimed at exerting control over others. Sixteen items measuring different forms of aggressive behaviour were given to 105 undergraduates together with Expagg, a psychometric measure of social representation of aggression. Factor analysis of the aggression items revealed three scales: direct (verbal and physical), indirect instrumental and indirect expressive aggression. The only aggression scale showing a significant sex difference was indirect expressive aggression on which women scored higher than men. There was also a significant sex difference on Expagg with women showing a more expressive representation of aggression. However the point biserial correlation between sex and indirect expressive aggression was not diminished when expressive representation of aggression was partialled out. It is argued that indirect expressive aggression (involving bitching and avoiding) fails to show a relationship with social representation because it lacks the formal requirements of intentional harm and consequently is not an act of 'aggression'.

Adolescent↗
PubMed1994

Sex differences in aggression: social representation and social roles.

Previous research suggests that men hold an instrumental social representation of aggression in which aggression is viewed as a functional interpersonal act aimed at imposing control over other people while women view aggression in expressive terms as a breakdown of self-control over anger. The present study examines the relative contribution of gendered personality differences (communality-agency) and occupational role in accounting for these differences. Men and women in the armed forces and nursing profession completed the Personal Attributes Questionnaire (PAQ: Spence & Helmreich, 1976) together with a psychometric measure of their tendency to view aggression as expressive rather than instrumental (Expagg: Campbell, Muncer & Coyle, 1992). The results indicate that occupational role and sex are both important correlates of individuals' representations of aggression. Though agency showed a significant negative zero-order correlation with expressive aggression, the impact of gendered personality traits was diminished when occupation and sex were taken into account. The data strongly support social role theory's emphasis upon contemporaneous occupational factors in explaining sex differences in the understanding of aggression but are less supportive of the role of masculine and feminine personality traits.

Aggression↗
PubMed1985

Predicting our own aggression: person, subculture or situation?

Using a self-report technique, teenaged subjects (stratified by sex and social class) were asked to report their predicted behaviour over 24 conflict scenarios involving 12 male and 12 female targets. In terms of degree of aggression predicted, there was a strong effect of situation. Towards male targets, lower middle-class subjects were more aggressive than upper middle-class subjects and males were more aggressive than females. With respect to female targets, the social class difference again appeared but there was no simple sex difference. The interaction of sex and social class indicated that lower middle-class females were most aggressive toward female targets. Cross-situational consistency was low even controlling for class and sex, indicating little support for a generalized 'aggressive personality'. The most powerful single effect was the situation being judged. Feature analysis of situations tending to produce fight vs. flight responses suggested that flight is associated with perceived high risk encounters whereas fighting is the modal response in 'fair fight' situations where the risk of injury is lower. It is suggested that impression management concerns operate only in these low risk situations.

Adolescent↗
PubMedDate not supplied

Reliability of health information on the Internet: an examination of experts' ratings.

BACKGROUND: The use of medical experts in rating the content of health-related sites on the Internet has flourished in recent years. In this research, it has been common practice to use a single medical expert to rate the content of the Web sites. In many cases, the expert has rated the Internet health information as poor, and even potentially dangerous. However, one problem with this approach is that there is no guarantee that other medical experts will rate the sites in a similar manner. OBJECTIVES: The aim was to assess the reliability of medical experts' judgments of threads in an Internet newsgroup related to a common disease. A secondary aim was to show the limitations of commonly-used statistics for measuring reliability (eg, kappa). METHODS: The participants in this study were 5 medical doctors, who worked in a specialist unit dedicated to the treatment of the disease. They each rated the information contained in newsgroup threads using a 6-point scale designed by the experts themselves. Their ratings were analyzed for reliability using a number of statistics: Cohen's kappa, gamma, Kendall's W, and Cronbach's alpha. RESULTS: Reliability was absent for ratings of questions, and low for ratings of responses. The various measures of reliability used gave conflicting results. No measure produced high reliability. CONCLUSIONS: The medical experts showed a low agreement when rating the postings from the newsgroup. Hence, it is important to test inter-rater reliability in research assessing the accuracy and quality of health-related information on the Internet. A discussion of the different measures of agreement that could be used reveals that the choice of statistic can be problematic. It is therefore important to consider the assumptions underlying a measure of reliability before using it. Often, more than one measure will be needed for "triangulation" purposes.

Delivery of Health Care↗