Logistic Regression in Nursing Practice

Logistic regression is used to analyze a wide variety of variables that may surround a singular outcome. For example, logistic regression could be used to identify the likelihood of a patient having a heart attack or stroke based on a variety of factors including age, sex, genetic characteristics, weight, and any preexisting health conditions. The biological systems and issues with which the health care field is concerned represent the kinds of applications for which logistic regression is especially useful.

Logistic regression is used in the health care field for many purposes, including diagnoses, predictions, and forecasting. The three articles in this week’s Learning Resources illustrate the many uses of logistic regression in the health care field. This Discussion allows you to explore the different uses of logistic regression and cultivate a deeper understanding of the application of logistic regression in evidence-based practice.

To prepare:

• Review      the three articles in this week’s Learning Resources and evaluate their      use of logistic regression. Select one article that interests you to      examine more closely in this Discussion
• Critically      analyze the article you selected considering the following questions:

 

1. What       are the goals and purposes of the research study the article describes?
2. How       is logistic regression used in the study? What are the results of its       use?
3. What       other quantitative and statistical methods could be used to address the       research issue discussed in the article?
4. What       are the strengths and weaknesses of the study?
5. How       could the weaknesses of the study be remedied?
6. How       could findings from this study contribute to evidence-based practice, the       nursing profession, or society?

By Thursday 10/12/17, 5 pm, write a minimum of 550 words essay in APA format. Use at least 3 references from the list of required reading below.  Include the level one headings as numbered below.

Post a cohesive response that addresses the following:

1) In the first line of your posting, identify the article you examined, providing its correct APA citation. (See attached PDF file for the article).

2) Post your critical analysis of the article as outlined above (make sure to answer all the points asked above in the “To Prepare” area, bullets [1, 2, 3]).

3) Propose potential remedies to address the weaknesses of each study (bullets 4 and 5 in the “To Prepared” area).

4) Analyze the importance of this study to evidence-based practice, the nursing profession, or society (bullet 6 in the “To Prepared” area).

Learning Resources

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Required Media

“Multiple Regression”

Used by permission from SPSS VideoTutor.com A division of Consumer Raters LLC., 1121 S Military Trail, 314, Deerfield Beach, FL 33442, USA

Note: The approximate length of this media piece is 5 minutes.

“Logistic Regression”

Used by permission from SPSSVideoTutor.com A division of Consumer Raters LLC., 1121 S Military Trail, 314, Deerfield Beach, FL 33442, USA 

Note: The approximate length of this media piece is 15 minutes.

Required Readings

Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.). St. Louis, MO: Saunders Elsevier.

Chapter 24, “Using Statistics to Predict”

This chapter asserts that predictive analyses are based on probability theory instead of decision theory. It also analyzes how variation plays a critical role in simple linear regression and multiple regression.

Statistics and Data Analysis for Nursing Research

Chapter 9, “Correlation and Simple Regression” (pp. 208–222)

This section of Chapter 9 discusses the simple regression equation and outlines major components of regression, including errors of prediction, residuals, OLS regression, and ordinary least-square regression.

Chapter 10, “Multiple Regression”

Chapter 10 focuses on multiple regression as a statistical procedure and explains multivariate statistics and their relationship to multiple regression concepts, equations, and tests.

Chapter 12, “Logistic Regression”

This chapter provides an overview of logistic regression, which is a form of statistical analysis frequently used in nursing research.

Hoerster, K. D., Mayer, J. A., Gabbard, S., Kronick, R. G., Roesch, S. C., Malcarne, V. L., & Zuniga, M. L. (2011). Impact of individual-, environmental-, and policy-level factors on health care utilization among US farmworkers. American Journal of Public Health, 101(4), 685–692. doi:10.2105/AJPH.2009.190892

This article discusses the results of a study of how many U.S. farmworkers accessed U.S. health care. The study considered this question on several levels—individual, environmental, and policy—and used logistic regression to analyze the multivariate data gathered.

Tritica-Majnaric, L., Zekic-Susac, M., Sarlija, N., & Vitale, B. (2010). Prediction of influenza vaccination outcome by neural networks and logistic regression. Journal of Biomedical Informatics, 43(5), 774–781. doi:10.1016/j.jbi.2010.04.011.

This article describes the methods and results of a neural network study on the effectiveness of the influenza vaccine using historical data in three neural network algorithms. The article also provides a discussion of logistic regression in comparison to the neural network algorithms used.

Xiao, Y., Griffin, M. P., Lake, D. E., & Moorman, J. R. (2010). Nearest-neighbor and logistic regression analyses of clinical and heart rate characteristics in the early diagnosis of neonatal sepsis. Medical Decision Making, 30(2), 258–266. doi:10.1177/0272989X09337791

This article outlines the procedures and findings of a study on the use of two methods of neonatal sepsis diagnosis: nearest-neighbor analysis and logistic regression analysis. The results indicated that each method generates unique information useful to diagnosis, and therefore both methods should be used simultaneously for improved accuracy of diagnoses.

Optional Resources

Walden University. (n.d.). Linear regression. Retrieved August 1, 2011, from http://streaming.waldenu.edu/hdp/researchtutorials/educ8106_player/educ8106_linear_regression.html

Heart;Blood Vessels

   Anterior cross section showing the valves and chambers of the heart
What blood-tight partition divides the left heart from the right heart?

Which portion of the ECG represents a small deflection sometimes seen just after the T wave, representing the final phase of ventricular repolarization?

Does heart size increase or decrease with age? why?
Make a chart describing the characteristics of the following types of chest pain:

1. Angina
2. Esophageal
3. Pain from a peptic ulcer
4. Biliary
5. Arthritis or bursitis
6. Cervical
7. Musculoskeletal (chest)
8. Psychoneurotic

A patient is complaining of prolonged fever, signs of neurologic dysfunctions, and the sudden onset of congestive heart failure. What should be expected?

Name the five traditionally designated auscultatory areas

Is the absence of S3 and S4 an unusual finding?

Splitting of S2 is greatest during which part of respiration?

Describe a pericardial friction rub.

Not all murmurs are the result of valvular defects. Name four other causes of murmurs

Which four cardiac defects make up the tetralogy of Fallot?

TY is a 67-year-old female patient who presents for follow-up for her hypertension and hyperlipidemia. Her PMH includes a diagnosis of aortic stenosis diagnosed 2 years ago, IBS, and a seizure disorder. Her family history includes her father, who died at age 55 years of a myocardial infarction and her mother, who is deceased, who had hypertension, diabetes, and coronary artery disease. Her social history is positive for smoking 1 PPD for 30 years; she quit 9 years ago. She is negative for alcohol and drug use. She lives in a two-bedroom condominium on one floor.

On examination, describe the murmur that you would hear for aortic stenosis.

Describe the cause of aortic stenosis. What is the cause for TY?

If TY’s past medical history did not include a diagnosis of aortic stenosis as well as cardiac risk factors, what other causes are there for a heart murmur?

If TY’s past medical history did not include a diagnosis of aortic stenosis as well as cardiac risk factors, describe a subaortic stenosis.

   Palpation of arterial pulses: Carotid, Brachial,  Radial, Femoral, Popliteal, Dorsalis pedis,  Posterior tibial.Define arterial blood pressure

Define arterial blood pressure

Which variables contribute to the characteristics of the pulses?

A pregnant patient (32 weeks’ gestation) is having difficulty with dependent edema and painful varicosities. What can you suggest to help this patient’s problem?

What should you do if you have trouble finding the patient’s pulse?

Describe the scale of 0 to 4 with regard to the amplitude of the pulse

If a patient experiences pain in the calf muscles, which artery is probably obstructed?

What two values are recorded for the blood pressure?

What is the mechanism behind cardiac tamponade?

Where are the most common places for venous ulcers to appear?

TB is a 56-year-old female patient with Raynaud phenomenon. Her past medical history includes spinal stenosis, systemic lupus erythematosus, bipolar disorder, and overactive bladder.

A-Differentiate the primary and secondary types of Raynaud phenomenon.

B-In the patient’s initial presentation what would be the chief complaint if the patient had primary Raynaud phenomenon? Secondary Raynaud phenomenon?

C-Based on TB’s presentation, what assessment results would you expect to find? What if is she had primary Raynaud phenomenon?

Advocacy Through Legislation
Nurses often become motivated to change aspects within the larger health care system based on their real-world experience. As such, many nurses take on an advocacy role to influence a change in regulations, policies, and laws that govern the larger health care system.

For this assignment, identify a problem or concern in your state, community, or organization that has the capacity for advocacy through legislation. Research the issue and use the “Advocacy Through Legislation” template to complete this assignment.

You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

AttachmentsNRS-440V-RS4-AdvocacyThroughLegislation.docx

In a 4-page paper, describe the procedures for each of the two compliance plans. Break each procedure section into 2 pages each. Remember to support your procedures for each of two plans with a total of three research sources (1-2 per procedure), cited at the end in APA format. Write your procedures in a way that all employees will understand at a large medical facility where you are the Compliance Officer.

Remember, you chose two compliance policy plans under the key compliance areas of Compliance Standards, High-Level Responsibility, Education, Communication, Monitoring/Auditing (for Safety), Enforcement/Discipline, and Response/Prevention. (Check them out if you forget! Remember, you may have written about different policies for the two different compliance plans.)