Exploring Nursing Research in Canada Class One September 16, 2009 Judith Shaw, Ph.D.,R.N.

Exploring Nursing Research in Canada

Class OneSeptember 16, 2009

Judith Shaw, Ph.D.,R.N.

What is research?

to search again

diligent and systematic inquiry

to discovery

Define

Nursing Research

Nursing Research

a scientific process that

validates and refined existing

knowledge, and generates new knowledge that

directly and indirectly

influences nursing practice

Nursing Research

Provides the scientific basis for the

practice of the profession.

(American Association of College of Nursing)

Definition of

Nursing Research

Requires an understanding

of

what knowledge is relevant for nursing-

Definition of

Nursing Research

Specifically-

what knowledge is needed to improve

nursing practice(Burns & Grove, 2007)

Metaparadigm

A global statement that identifies the

subject matter of each discipline or field

of study.

(Fawcett, 2005)

Metaparadigm of

Nursing

Human beings

The environment

Health

Nursing

Nursing Research

A formal, systematic, and rigorous process of inquiry used to generate and test theories about the health-related experiences of human beings within their environments and about the actions and processes that nurses use in practice

(Fawcett & Garity, 2009)

ComparisonNursing Process & Nursing Research

1. Assessment & Interpretation of Data

2. Diagnosis of problem

1. Selection of a social context

2. Formulation of research question; explication of researcher’s beliefs

ComparisonNursing Process & Nursing Research

3. Development and

implementation of

plan of care

3. Develop and implement methodology plan

Cyclical process of data collection, analysis, and concept formation and modification

ComparisonNursing Process & Nursing Research

4. Evaluation of plan of care

4. Interpretation of findings

May involve review of literature at this stage

Validation of findings with participants

ComparisonNursing Process & Nursing Research

5. Revision of plan based on evaluation

5. Communication of the findings.

Implications and recommendations

OR

Nursing Process Nursing Research(Fawcett, 2005)

1. Assessment

2. Planning

3. Implementation

4. Evaluation

5. Documentation

1. Statement of the problem

2. Research Methods

3. Conduct of the Research

4. Interpretation of results

5. Research Report

The Importance of Research in Nursing

Description

(what is)

The Importance of Research in Nursing

Explanation

(relationship; nursing interventions with

client outcomes)

The Importance of Research in Nursing

Prediction

(probability of a certain outcome in a specific

situation)

The Importance of Research in Nursing

Control

(to produce the desired outcome)

Kinds of Nursing Knowledge Traditions Authority Borrowing Trial and Error Personal Experience Role-Modeling Intuition Reasoning Research

Epistemology

-the study of the nature of knowledge

How we know what we know

Ways of Knowing

Aesthetics

Ethical Knowing

Personal Knowing

Empirical Knowing (Carper, 1978)

*Socio-Political (*White, 1995)

**Unknowing in Knowledge (**Heath,1998; Munhall, 1993)

Aesthetics

The nature of beauty or art

…art of nursing

Ethical Knowing

The obligation, moral component

– what should be done– what is good, right and desired

Personal Knowledge

Interpersonal interactions and relationships between the nurse and a client

– therapeutic use of self– authentic personal relationship

Empirical Knowledge

Knowledge of the experienced or empirical world

Socio-Political

Situates nursing practice in the world of society, community life, culture, economics, and politics

Who’s voice is heard? Whose voice is silenced.

Unknowing in Knowledge

All knowledge is tentative and dynamic.

Openness, qualitative receptivity to what may be learned.

Not all important questions have been asked.

Many answers to both scientific and philosophical questions remain elusive.

How does nursing thought flow from both

concrete to abstract thinking?

The World of Nursing ResearchPhilosophy Abstract

Knowledge

Science Abstract Theory

Thought Processes

Reality Testing

(Research)

Empirical World

(Nursing Practice) Concrete

Research Nursing Knowledge

More reliable

vs.

Other Kinds of Nursing Knowledge

Philosophy in Nursing Research

Framework for identifying central concept

Assumptions for theory development

Relates nursing to practice world

Information on how to learn about the world

Philosophical Position

Qualitative Research

Approaches

Assumptions

- interpretive worldview - multiple realities

- many sources of information

- knowing how social experience constructs reality is important

Philosophy

philosophical research

notions question

of

scientific

truth

Philosophy

Research Methods

Question of

Inquiry in

Nursing

Qualitative Research

Six Characteristics

1. Multiple Realities

The individual:

- active participates in social action

- comes to know and understand

phenomena in very different ways

2. Multiple Ways of Understanding

Finding a method or approach

to

appropriately answer

the question

3. Participant’s Point of View

To present the participant’s view of reality

- understand the context of what is

researched

4. Context

Alter as little as possible

5. Researcher- Part of the Study

Researcher as instrument

-subjective bias

6. Reporting

Participant’s perspective

-rich, literary style -participant’s quotes,

commentaries, and stories

Development of Nursing Science

Three perspectives

1. Positivist

2. Interpretive

3. Critical [Social Theory]

Positivist Perspective

Strict rules of logic, truth, axioms,

and predictions

Interpretive Perspective

Reality is based on personal perceptions

What we know has meaning only within a given context

Critical Perspective

Human behavior consist of different groups attempting to enhance their interests at the expense of less powerful groups

Three Levels of Quantitative Research

*Construct axiom *Construct

[relationship between constructs]

*Concept proposition *Concept

[relationship between concepts]

Indicators hypotheses Indicators

*different authors reverse these; Gillis and Jackson (2002) reverse the order

Qualitative Research

Naming - discovering meanings in

contexts

- process and meaning are described

Qualitative ResearchCyclical Process

Researcher moves back and forth between the data collection and analysis stages

-to identify and describe the

participant’s perspective

QUESTIONS ASKED

HOW/WHAT

Triangulation

Use of multiple methods

to generate and collect data

about one phenomenon

Triangulation

Within-Methods

Between-Methods

Within-Methods Triangulation

Example

-different types of qualitative data collections strategies

Between-MethodsTriangulation

Example

- both qualitative/quantitative data collection procedures

Unit of Analysis

The element or set of elements selected to study

-individual

-aggregrate [group, community]

LINK OF PRACTICE, THEORY, AND

RESEARCH Practice

Theory Research

NURSING RESEARCH PRIORITIES

To Improve:

Nursing as a Profession

Nursing Practice

Patient Outcomes

Quantitative & QualitativeResearch Characteristics

Quantitative Research– Hard Science– Focus: Concise &

Narrow– Reductionistic– Objective– Reasoning: Logistic,

Deductive– Basis of Knowing:

Cause & Effect, Relationships

Qualitative Research- Soft Science

- Focus: Complex & Broad

- Holistic

- Subjective

- Reasoning: Dialectic, Inductive

- Basis of Knowing: Meaning, Discovery

Quantitative QualitativeResearch Research

– Tests Theory– Control– Instruments

– Basic Element of

Analysis: Numbers– Statistical Analysis

– Generalization

– Develop Theory– Shared Interpretation– Communication &

Observation– Basic Element of

Analysis: Words– Individual

Interpretation– Uniqueness

RESEARCH-MINDEDNESS

Research-based Practice

Deterrents to Conducting Research

Deterrents to Conducting Research

limited number of nurses prepared to conduct research

nurse researchers may not be involved with or knowledgeable about nursing practice

difficulty in asking the research question

Deterrents to Conducting Research

lack of congruency between research purposes and research methods

insufficient time

access to patients

Deterrents to Disseminating & Applying Research

Understanding by practicing nursing

Faculty not involved in research

Lack of scientific rationale/nursing textbooks

Inadequate preparation

Promotion of Research & Research-Based Practice

Increase number of B Sc..N, Master’s & doctoral prepared nurses

Emphasize students learn to critique research for quality data

Develop a climate that rewards research

Promotion of Research & Research-Based Practice

Strengthen collaboration of practice/research/education

Research-based protocols Research interest groups Increase opportunities for publishing

FINANCING NURSING RESEARCH IN CANADA

Federal Support for Research

3 categories: research grants, research fellowships, & auxiliary grants (indirect $)– 1971-McGill, first Center for Nursing

research – gradual increase in funding– increase in doctoral programs/increase in

research

FUNDING

Canadian Institutes of Health Research (CIHR) Medical Research Council, National Health Research & Development Program

Charitable organizations

Canadian Nurses Fund

Canadian Health Services Research Foundation (CHSRF)

Social Science & Humanities Research Council of Canada (SSHRC)

Nova Scotia Health Research Foundation

PRAXIS WITHIN NURSING

theory, practice and research

informing the others

to produce

powerful new forms of knowledge