Incomplete quality of life data in lung transplant research:

comparing cross sectional

Background
In longitudinal studies on Health Related Quality of Life (HRQL) it frequently occurs that
patients have one or more missing forms, which may cause bias, and reduce the sample size.
Aims of the present study were to address the problem of missing data in the field of lung
transplantation (LgTX) and HRQL, to compare results obtained with different methods of
analysis, and to show the value of each type of statistical method used to summarize data.

Methods
Results from cross-sectional analysis, repeated measures on complete cases (ANOVA), and a
multi-level analysis were compared. The scores on the dimension 'energy' of the Nottingham
Health Profile (NHP) after transplantation were used to illustrate the differences between
methods.

Results
Compared to repeated measures ANOVA, the cross-sectional and multi-level analysis included
more patients, and allowed for a longer period of follow-up. In contrast to the cross sectional
analyses, in the complete case analysis, and the multi-level analysis, the correlation between
different time points was taken into account. Patterns over time of the three methods were
comparable. In general, results from repeated measures ANOVA showed the most favorable
energy scores, and results from the multi-level analysis the least favorable. Due to the separate
subgroups per time point in the cross-sectional analysis, and the relatively small number of
patients in the repeated measures ANOVA, inclusion of predictors was only possible in the
multi-level analysis.

Conclusion
Results obtained with the various methods of analysis differed, indicating some reduction of bias
took place. Multi-level analysis is a useful approach to study changes over time in a data set
where missing data, to reduce bias, make efficient use of available data, and to include
predictors, in studies concerning the effects of LgTX on HRQL.

Karin M Vermeulen, Wendy J Post, Mark M Span, Wim van der Bij, Gerard H Koter and Elisabeth M
TenVergert
 Nurses' perceptions of online continuing education

Background
There is increasing attention to online learning as a convenient way of getting professional
training. The number and popularity of online nursing continuing education programs are
increasing rapidly in many countries. Understanding these may contribute to designing these
programs to maximize success. Also, knowing the perceptions and preferences in online learning
aids development and orientation of ONLINE PROGRAMS. The aims of this study are to show
nurses' perceptions of online continuing education and to determine perceptions of various
groups; area groups, working companies, frequency of computer usage and age.

Methods
The survey method was used in this quantitative study to reveal perception levels and
relationship with related variables. Data were collected through an online instrument from a
convenience sample of 1041 Registered Nurses (RNs) at an online bachelor's degree program.
Descriptive and inferential analysis techniques were performed.

Data analysis
In this study, quantitative data were analyzed through descriptive and inferential statistics
techniques. Data analysis was performed using SPSS 18. Descriptive analysis was used to
measure nurses' perception levels. Correlation analysis was performed to test relationships;
ANOVA and independent sample t-tests were performed to test differences.

Results
Nurses generally have positive perceptions about online learning (X = 3.86; SD = 0.48). A
significant difference was seen between nurses who used computers least and those with the
highest computer usage [F (3, 1033) = 3.040; P < .05]. Neither nurses' ages nor lengths of
working experience are significantly related to perceptions of ONLINE PROGRAMS (r = -
.013; P > .05 and r = -.036; P > .05, respectively). Nurses' perceptions are significantly different
depending on the settings where they work [F (3,989) = 3.193; P < .05]. The difference between
perceptions of nurses living in urban areas (X = 3.82; SD = .51) and those living in rural areas
(X = 3.88; SD = .47) was not significant [t(994) = -1.570, P > .05].

Conclusions
We found that nurses regard online learning opportunities as suitable for their working
conditions and needs. Nurses should be provided with continued training through online learning
alternatives, regardless of age, working experience or area of residence.

Selcuk Karaman, Open Education Faculty, Ataturk University, 25240 Erzurum, Turkey