Nursing Research

1. A cyclical process that begins with a curious inquiry within the human brain RESEARCH

2. Our Target Objectives: To review some basic principles of research methodology To plan / design an appropriate and adequate research project

3. What is Research? It is a systemic inquiry that uses disciplined methods to answer questions or solve problems. It is a scientific study or investigation that is pursued to discover facts, revise theories or laws based on new facts and its practical application.

4. What is Research? It is a formal, scientific and intensive process of analyzing problems through scientific means for purposes of discovery and development of an organized body of knowledge. In its broadest sense, is an attempt to find solutions to problems.

5. What is Research? A collection of data in a rigorously controlled situation for purposes of explanation and prediction. A problem-solving process that utilizes the scientific method of discovery and develop ideas and theories that give meaningful answers to complex questions about human beings and their environment.

6. What is Research? It is a way of dealing with ideas for purposes of clarifying, verifying and confirming data. “To search again” or “to examine carefully”

7. Why is RESEARCH important? It provides a theoretical or scientific basis for nursing care. It is a diligent, systematic inquiry or study that validates and refines existing knowledge and develops new knowledge .

8. What is NURSING Research? It is a systematic inquiry designed to develop trustworthy evidence about issues of importance to the nursing profession, including nursing practice, education, administration, and informatics. CLINICAL NURSING research – designed to guide nursing practice to improve the health and quality of the life of clients.

9. IMPORTANCE of Nursing Research Is essential for the development of empirical knowledge that enables nurses to provide evidence-based nursing care Broadly, the nursing profession is accountable to society for providing high quality, cost-effective care for patients and families.

10. PURPOSES of Research To have a research-based practice To document contributions to nursing and the overall health care To generate knowledge To improve the image of nursing

11. Purposes of NURSING Research Is to answer questions or solve problems of relevance to the nursing profession Basic Research To extend the base of knowledge in a discipline Ex. A researcher may perform an in depth study to better understand normal grieving processes, w/o having explicit nursing implications in mind

12. Purposes of NURSING Research Is to answer questions or solve problems of relevance to the nursing profession Applied Research Focuses on finding solutions to existing problems Ex. A study to determine the effectiveness of a nursing intervention to ease grieving

13. Purposes of NURSING Research Using this framework, specific purposes of nursing research include identification , description , exploration , explanation , prediction , & control

14. Quantitative Research – the investigation of phenomena that lend themselves to precise measurement and quantification, often involving a rigorous and controlled design. Qualitative Research – the investigation of phenomena, typically in an in-depth and holistic fashion, through the collection of rich narrative materials using a flexible research design

15. Purposes of NURSING Research Identification-identifying or naming a phenomena Quantitative Qualitative “What is this phenomenon?” “What is its name?”

16. Purposes of NURSING Research Description-focuses on the prevalence, incidence, size, measurable attributes, dimensions, variations, and importance of a phenomena Quantitative How prevalent is the phenomenon? Qualitative What is important about the phenomena?

17. Purposes of NURSING Research Exploration-investigates the full nature of a phenomena, the manner it is manifested, and the other factors to which it is related…

18. Purposes of NURSING Research Quantitative “What factors are related to the phenomenon?” “What are the antecedents of the phenomenon?” Qualitative “What is the full nature of the phenomenon?” “What is the process by which the phenomenon evolves or is experienced?”

19. Purposes of NURSING Research Explanation-understanding the underpinnings of specific natural phenomena, & to explain systematic relationships among phenomena…

20. Purposes of NURSING Research Quantitative “What is the causal pathway through which the phenomenon unfolds?” Qualitative “How does the phenomenon work?”

21. Purposes of NURSING Research Prediction-use of empirical evidence to make forecasts about how variables will behave in a new setting and with different individuals Quantitative “What will happen if we alter a phenomenon or introduce an intervention?” “If phenomenon X occurs, will phenomenon Y follow?” Qualitative

22. Purposes of NURSING Research Control-the process of holding constant confounding influences on the dependent variable under study Quantitative “How can we make the phenomenon happen or alter its prevalence?” “Can the occurrence of the phenomenon be prevented or controlled?” Qualitative

23. ROLES of Nurses in Research It has become a nurse’s responsibility to engage in 1 or more research activity along a continuum of research participation. Nurses are users (consumers) of nursing research & read research reports to develop new skills & to keep up-to-date on relevant findings that may affect their practice.

24. ROLES of Nurses in Research Related activities: Participate in journal club in a practice setting to discuss & critique research articles Attend research presentations at professional conferences Evaluate completed research for its possible use in practice Help to develop an idea for a clinical study Review a proposed research plan and other clinical expertise to improve the plan

25. ROLES of Nurses in Research Related activities: (cont’d) Assist researchers in collecting information for study Provide information and advise to clients who are participating in studies Discuss the implications and relevance of research findings with clients

26. ROLES of Nurses in Research Level of Education Preparation Participation Post Doctorate ● Develop and coordinate funded research programs PhD / DNS ● Develop nursing knowledge through research and theory development ● Conduct funded independent research projects

27. ROLES of Nurses in Research Level of Education Preparation Participation MS / MN ● Collaborate in research projects ● Provide clinical expertise for research BS ● Critique research findings for use in practice ● Use research findings in practice

28. ROLES of Nurses in Research Level of Education Preparation Participation AD ● Assist with the identification of research problems ● Assist with data collection ● Use research findings in practice with supervision

29. BASIC RESEARCH TERMINOLOGY Conceptualization-refers to the process of developing and refining abstract ideas .

30. BASIC RESEARCH TERMINOLOGY Concept-abstractions that are formulated by generalizing from particular manifestations of certain behaviors of characteristics Categories/generalizations from particular instances Names given to things which share common char. Intellectual abstractions, creation of the human intellect

31. BASIC RESEARCH TERMINOLOGY Construct-refers to an abstraction or a mental representation inferred from situations, events or behavior Is a concept that has been deliberately and consciously invented or adopted for a special scientific purpose

32. BASIC RESEARCH TERMINOLOGY Operationalizing constructs : Property-a concept or logical construct that describes characteristic which is common to all members of a set, but which members of a set vary. Example: punctuality Indicant-something that points to the property and helps define it. Example: is never late in class

33. BASIC RESEARCH TERMINOLOGY Theory-is an abstract generalization that presents a systematic explanation about the interrelationship among phenomena .

34. BASIC RESEARCH TERMINOLOGY Variable-something that varies Are concepts that assume more than 1 value Takes on different values as the situation changes, example: height, weight, body temp. Is any quality of an organism, group or situation that takes on different values

35. Kinds of Variables Continuous vs. Categorical Variables Continuous-are expressed in whole number & fractions which can be broken down to the smallest decimal

36. Kinds of Variables Continuous vs. Categorical Variables Categorical-represent discrete categories rather than incremental placement along a continuum Types: Two-category or dichotomous variables provide for only 2 possibilities indicating the incidence of the variable Multiple-category variables assume more than 2 categories

37. Kinds of Variables Active vs. Attribute Variables Active or Manipulated-defined in terms of an experimental/operational definition Example: Type of mouth care used after vomiting - ice chips - ginger ale Teaching Methods - laboratory method - modular method - traditional method

38. Kinds of Variables Active vs. Attribute Variables Attribute or Qualitative-often called non-manipulative variables, focuses on traits and characteristics, also expressed in non-numerical forms but can be measured Example: age, sex, height, intelligence, civil status

39. Kinds of Variables Independent vs. Dependent Variables Independent Variable Dependent Variable ● stimulus variable ● input variable ● presumed cause ● it is the factor that affect the value of the dependent condition that produce the outcome ● response variable ● output variable ● presumed effect ● it is the factor which is observed & measured to determine the effect of the independent variable

40. Other Variables Confounding Variables-are those variables that interfere with the study design and the data gathering process by influencing the subjects or the dependent variable. Example: What is the effect of unwanted pregnancies on the incidence of child abuse ?

41. Other Variables Intervening Variables-comes between the independent and dependent variables which cannot be measured, seen or manipulated

42. Other Variables Extraneous Variables-those that lie outside the principal interest in the study but may have the effect on the independent and dependent variable Discrete Variables-those variables expressed in whole numbers

43. Other Variables Antecedent Variable-occurs earlier than the independent variable and bears a relationship both to it and the dependent variable Organismic Variables-those that cannot be changed through manipulation

44. EVIDENCE-BASED NURSING RESEARCH Evidence-based practice (EBP) is defined as the use of the best clinical evidence in making patient care decisions.

45. Importance of building an Evidence-based Nursing Research Empirical knowledge can be developed to improve nursing care, patient outcomes, & health care delivery system Document the effectiveness of selected nursing interventions in treating particular patient problems and promoting positive patient and family outcomes

46. Importance of building an Evidence-based Nursing Research Determines the best way to deliver health care services to ensure that the greatest number of people receive care

47. Utilization of Evidence-based Nursing Research Priorities for Nursing Research Health care and prevention of illness Development of cost-efficient delivery systems or nursing care Development of strategies that provide effective nursing care to high risk groups

48. PARADIGM & CATEGORIES OF RESEARCH Paradigm – refers to a world, a general perspective on the complexities of reality.

49. Positivist vs. Naturalist Type of Assumption POSITIVIST PARADIGM NATURALIST PARADIGM The nature of reality ● Reality exists; there is a real world driven by real natural causes ● Reality is multiple, subjective& mentally constructed by individuals The rel. b/w researcher & those being studied ● The researcher is independent from those being researched ● The researcher interacts with those being researched & findings are the creation of the interaction.

50. Positivist vs. Naturalist Type of Assumption POSITIVIST PARADIGM NATURALIST PARADIGM The role of values in the inquiry ● Values are to be held in check, objectivity is sought ● Subjectivity and values are inevitable and desirable Best methods for obtaining evidence/ knowledge ● seeks generalizations ● emphasis on discrete concepts ● fixed design ● focus on the objective & quantifiable ● measured, quantitative info, statistical analysis ● seeks patterns ● emphasis on the whole ● flexible design ● focus on the subjective & non-quantifiable ● narrative info, qualitative analysis

51. Positivist vs. Naturalist Type of Assumption POSITIVIST PARADIGM NATURALIST PARADIGM Best methods for obtaining evidence / knowledge ● control over context; decontextualized ● outsider knowledge – researcher as external ● verification of researcher’s hunches ● focus on the product ● context-bound; contextualized ● insider knowledge – researcher as internal ● emerging interpretations grounded in participants’ experiences ● focus on product & process

52. Quantitative or Qualitative The Bedrock Axiom: The nature of the data and the problem for research dictate the methodology

53. TWO Broad Types of Research Methods QUANTITATIVE QUALITATIVE ● involves the systematic collection of numerical info. often under conditions of considerable control, and the analysis of that info. using statistical procedures ● focuses on a relatively small number of specific concepts ● begins with pre-conceived ideas about how concepts are interrelated ● involves the systematic collection & analysis of more subjective narrative materials using procedures in which that tends to be a minimum of researcher-imposed control ● attempts to understand the entirety of some phenomena rather than focus on specific concepts ● has few pre-conceived ideas and stresses the importance of people’s interpretation of events and circumstances rather than the researcher’s interpretation

54. TWO Broad Types of Research Methods QUANTITATIVE QUALITATIVE ● uses structured procedures & formal instruments to collect information ● collects info. under conditions of control ● emphasizes objectivity in the collection and analysis of information ● analyzes numerical information through statistical procedures ● collects info. without formal, structured instruments ● does not attempt to control the context of the research but rather attempts to capture in its entirety ● attempts to capitalize on the subjective as a means for understanding & interpreting human experiences ● analyzes narrative information in an organized, but intuitive fashion

55. Contrasting Qualitative & Quantitative Type Aspects QUANTITATIVE QUALITATIVE Perspective Outsider: Arriving at an understanding of facts by maintaining a detached, objective view that, hypothetically, is free from all bias Insider: Talking to and/or observing subjects who have experienced firsthand the activities or procedures under scrutiny (Firsthand experience provides more meaningful data) Reality Static: Accumulation of facts and causes of behavior and believes that the facts gathered do not change Dynamic: Concern with the changing and dynamic nature of reality

56. Contrasting Qualitative & Quantitative Type Aspects QUANTITATIVE QUALITATIVE Focus Particularistic: To gain control of the events under scrutiny, the situation is structured by identifying& isolating specific variables for study & by employing specific measurement devices to collect info. on variables Holistic: Gains a complete or holistic view of what is being studied To achieve this end, a wide array of data are needed: documents, records, photographs, observations, interviews, case histories, & even quantitative data

57. Contrasting Qualitative & Quantitative Type Aspects QUANTITATIVE QUALITATIVE Orientation Verification: The procedures employed are usually high structured and designed to verify or disproved predetermined hypotheses. To eliminate as much bias as possible, flexibility is kept to a minimum Discovery: The research procedures employed are flexible, exploratory and discovery oriented. As the study progresses, the researcher can add to or change the types and sources of data gathered. This type of flexibility permits a deeper understanding of what is being investigated than can be achieved through a more rigid approach

58. Contrasting Qualitative & Quantitative Type Aspects QUANTITATIVE QUALITATIVE Data Objective: Focus is on objective data that exist apart from the feelings and thoughts of individuals and is typically expressed in numbers Subjective: Focus is on subjective data that exist within the minds of individuals and is typically expressed or reported through language. It is essential to understand the meaning that persons attach to events in their environ.

59. Contrasting Qualitative & Quantitative Type Aspects QUANTITATIVE QUALITATIVE Conditions Controlled: Usually quantitative data are collected under controlled conditions in order to rule out the possibility that variables other than the ones under study could account for the relationships among the variables Naturalistic: Qualitative data are collected within the context of their natural occurrence. This permits any variable that naturally influences the data to operate without interference

60. Contrasting Qualitative & Quantitative Type Aspects QUANTITATIVE QUALITATIVE Results Reliable: Heavy focus on reliability – data that are consistent or stable as indicated by the researcher’s ability to replicate the findings Valid: Concentration on validity – data that are representative of a true and full picture of what the researcher is attempting to investigate

61. Major Classes of Qualitative Research Grounded theory study-which has its roots in sociology, seeks to describe and understand the key social, psychological & structural processes that occur in a social setting. Example: King & colleagues (2006) conducted a series of grounded theory studies with men and women from five groups in Canada who had been diagnosed with coronary artery disease. The analysis focused on the process through which patients met the challenge of managing CAD risk.

62. Major Classes of Qualitative Research Phenomenology-rooted in philosophical tradition, concerned with the lived experiences of humans. It is an approach to thinking about what life experiences of people are like and what they mean. (essence) Example: O’Dell & Jacelon (2005) conducted in-depth interviews to explore the experiences of women who had undergone vaginal closure surgery to correct severe vaginal prolapse .

63. Major Classes of Qualitative Research Ethnography-is the primary research tradition within anthropology, and provides a framework for studying the patterns, lifeways and experiences of a cultural group in a holistic fashion. (immersion) Example: Schoenfeld & Juarbe (2005) conducted ethnographic fieldwork in two rural Ecuadorian communities and studied the burdens of women’s roles, the women’s perceived health needs, and their health care resources.

64. Major Classes of Quantitative Research Experimental Research – researchers actively introduce an intervention or treatment (AKA controlled or clinical trial ) Non-Experimental Research – researchers are bystanders, they collect data without introducing treatments or making changes (AKA observational study )

65. Major Classes of Quantitative Research Exercise A researcher gave flakes to 1 group of subjects & prune juice to another to evaluate which method facilitated elimination more effectively, this study would be…

66. Major Classes of Quantitative Research Exercise EXPERIMENTAL because the researcher intervened in the normal course of things, he/she created an “active variable” involving a dietary intervention

67. Major Classes of Quantitative Research Exercise A researcher compared elimination patterns of 2 groups of people whose regular eating patterns differed-for example, some normally took foods that stimulated bowel elimination & others did not, this study would be …

68. Major Classes of Quantitative Research Exercise NON-EXPERIMENTAL because there is no intervention, such study focuses on existing attributes only

69. Reference: Polit , D. F., & Beck, C. T. ( 2008). Nursing Research : Generating and Assessing Evidence for Nursing Practice (8 th ed.)