Ask an Expert Multilevel models in health outcomes research Part I: Theory, design, and measurement

摘要

Health outcomes research studies are frequently multilevel in nature. Often, the focus is on individuals (e.g., patients or nurses) within organizational (e.g., nursing unit, clinic, or hospital) contexts. The multilevel nature of such studies presents researchers with conceptual, measurement, and methodological challenges. This two-part column will introduce health outcomes research and illustrate some unique aspects of its theory and methods.Nursing outcomes research can be defined most broadly as research to identify and quantify the effect of nursing practice on patient outcomes. Although most clinical nursing research could be considered outcomes research, the term "outcomes research" has come to be associated with a focus on how the organization of nursing impacts nursing (e.g., burnout), system (e.g., retention), and patient (e.g., 30-day mortality) outcomes rather than on the efficacy of an individual nursing interventions. The organizational focus makes this type outcomes research multilevel in nature.