Statistical Limitations

The research questions were developed to ascertain which of the major variables under study were associated with Outcome Attainment Capability as the dependent variables. To answer the research questions, analysis included a significant number of bivariate statistics. By doing so, the chance of finding results that are not truly present was increased considerably. Often a type 1 error is related to large sample sizes, but this was not the case in this study. .

While developing a regression model was an option, the magnitudes of the relationships were weak and made such calculations of minimal value. For example, the second research question examined the relationships between Average Abuse per Year and variables associated with Organizational Power. Spearman Rho test statistics ranged from - 0.16 to -0.24 with p values <.001. Lacking clinical significance, a regression model was not generated because it would produce meaningless results. The inherent multi co-linearity of some of the independent variables would have resulted in models with low R2 _{values and thus, few if any predictors.}

A larger limitation may focus on the 24.4% response rate which may have biased the responses. It is unknown if those responding, did so because they had received verbal abuse and its resulting consequences more or less than non-responders. Also of the 176,727 potential RNs

from the list of all RNs registered with the PA State Board of Nursing, 293 participants represent only .002% of the population. Because of the high rate of non-response and the low percentage of the total population that were randomly chosen for participation, inferences cannot be made to the larger population in the Commonwealth of PA or the United States. With the current data set, it was determined that additional statistical testing would not provide any additional results that would be considered credible and would only add to the increase chance of spurious results.

Although there were statistical limitations to this study, it is important to point out that the study was not underpowered. A power analysis was conducted during the planning stages and showed that a total sample size of 293 was required to achieve a power of .80 using a two-tailed test of significance set at 0.05 and an effect size of 0.50. In addition, randomization procedures were used to recruit the sample population and thus, provided rigor to this study.

6.6 Summary

The study found that verbal abuse from physicians as perceived by RNs was a pervasive problem, and that frequent occurrence may have forced RNs to develop specific coping styles Nurses were found to neither agree nor disagree that they had sufficient organizational power to achieve their goals of reducing verbal abuse from physicians. This lack of power and the current surge of reaching for increased autonomy may provide a preliminary explanation as to why perpetrated physician verbal abuse still continues after multiple interventions have been attempted within the nursing profession.

Because this study consisted of multiple bivariate data that could cause false positive results, a comparison of these findings was made with prior studies. For most of the variables the results were found to be consistent with results from prior studies. This adds support for the findings in this study.

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Appendix A. Postcard