Nursing Research 1

Nursing Research 1

Research defined

It is a methodic examination that uses regimented techniques to solve questions or decipher dilemmas (Boswell & Cannon, 2007).

It is a systematic search for understanding, an attempt to gain solutions, discover and develop an organized body of knowledge.

Nursing Research

It is concerned with the systematic study and assessment of nursing problems or phenomena, finding ways to improve nursing practice and patient care through creative studies, initiating change and taking action to make new knowledge useful to nursing.

Nursing research definitions according to different authors

1. Key features in Nursing Research (Schmidt and Brown, 2009)

1. System

2. Order

3. Theory development

2. Nursing research is a systematic inquiry that uses disciplined methods to answer questions or solve problems (Polit and Beck, 2008).

3. Nursing research is a systematic, objective process of analyzing phenomena of importance to nursing (Nieswiadomy, 2008).

4. Nursing research is a scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences clinical nursing practice (Burns and Grove, 2007).

5. Nursing research is a formal, rigorous and intensive process used for solutions to nursing problems or to discover and interpret new facts and trends in clinical practice (Waltz and Bausel, 2001).

6. Nursing research has rigorous guidelines to produce unbiased, trustworthy answers to questions about nursing practice (Houser,2008).

7. Nursing research is a systemic collection and analysis of data to illuminate and describe or explain new facts and relationships (Treece and Treece, 2008)

8. Nursing research is the testing of knowledge that can be used to guide nursing practice (NCNR)

9. Research is an honest, scientific investigation undertaken for the purpose of discovering new facts which will contribute to the present body of knowledge and can lead to an effective solution of existing problems (PNA, 1963).

Problem/ Issue

New knowledge derived from the conduct of systematic research

Testing of solution/ intervention

Refinement of Theory

NURSING RESEARCH CONTINUUM

Clinical research

It is a research designed to generate knowledge to guide nursing practice and to improve the health and quality of life of nurses’ clients (Polit and Beck, 2008).

It is research that is undertaken to produce knowledge that will affect the conduct of nursing practice (Nieswiadomy, 2008).

Nursing Research

Refers to the research done on addressing the health concerns of clients and the application of research on their care

Research in Nursing

Studies on the particular concerns of nurses themselves.

Goals of Nursing ResearchEfficiency and effectiveness in nursing care

Worth and value of the nursing profession to society

Identification, implementation and evaluation of effective health care modalities

Provision of quality care to clients

Roles of Nurses in Research

A. Recruitment and retention

1.Raise awareness and introduce the study to the participant

2. Ensure complete data collection to answer research questions

3.Referral of participant to other care providers

B. Ensure that participants understand the study/ trials

Administration of trial agents/ Conduct study

C. Ensure the procedures are performed and followed-up

Data collection

Complete documentation of all trial procedures

D. Safety of participants

1.Timely reporting untoward occurrences during the study

2.Safety of clinical environment

3.Following guidelines/protocols

4.Accurate record keeping, ensure confidentiality

E. Client advocacy

1.Ensure voluntary consent of participants

2.Make certain that the participants’ interest is of prime importance

F. Communication

Multidisciplinary team: nursing, medical allied professions

G. Study Management

1.Ensure compliance to protocol, SOPs, procedure manuals, regulations

2.Resource management- human, material

3.Data Integrity- staff training, standardization of tools, quality assurance

H. Study coordinator

I. General Administration

1.Ensure compliance with regulation

2.Develop training materials

3.Ensure staff meet minimum training

4. requirements

5.Comply with monitoring efforts

6.Address audit findings

Conduct of research

Evolution of Nursing research

Reasons for Conducting Research in Nursing

1. Gathers data or information on nursing situations or conditions about which little knowledge is available.

2. Provides scientific knowledge base from which nursing theories emerge and develop.

3. Helps correct, clarify, validate and expand perceptions.

4. Provides theoretical and scientific basis for nursing practice.

Purposes/ Tasks of Nursing Research

1. Identification

2. Description

3. Exploration

4. Explanation

5. Prediction and control

Characteristics of research

1. Orderly and systematic2. Control3. Empirical4. Generalization5. Intensive

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General types of research

Basic ResearchSearch for new knowledge

Applied ResearchApplication of knowledge to solve

problems

Action ResearchStudy of certain problem where

conclusions are drawn

Classifications of Research

Research according to Approach

Purely experimental

An experiment usually tests a hypothesis, which is an expectation about how a particular process or phenomenon works. 

If an experiment is carefully conducted, the results usually either support or disprove the hypothesis. 

Non-experimental

Non-experimental research designs do not involve a manipulation of the situation, circumstances or experience of the participants.

Types:

1.Correlational (without causation)

2.Comparative

3.Longitudinal

Quasi experimental

It is an empirical study used to estimate the causal impact of an intervention on its target population. 

This typically allows the researcher to control the assignment to the treatment condition, but using some criterion other than random assignment (e.g., an eligibility cutoff mark)

Assignment to a given treatment condition is based on something other than random assignment. 

Eg. Pre-post testing

Research According to Measurement and Data

AnalysisQuantitative Research

It is a formal, objective, systematic process in which the numerical data are used to obtain information; None-experimental in nature.

Research Methods:

1. Descriptive Research- provides an accurate portrayal or account of characteristics of particular individuals. Eg. surveys

2. Correlational Research

Examines the relationships between two or more variables and determines the type (positive or negative) or degree (strength) of the relationship.

Qualitative research

It is systematic, interactive and subjective approach used to describe life experiences and give them meaning (Marshall and Rossman, 2006).

It is conducted to describe and promote understanding of human experience such as pain, caring and comfort.

it is an interpretative methodological approach to produce more of a subjective science than quantitative research.

Mixed research

Research According to the Time frame used

1. Longitudinal- future data

2. Cross-sectional-Present data

3. Retrospective- past data

Research according to Motive or Objective

1. Pure research/ Basic Research/Fundamental Research- is a systematic study directed toward greater knowledge or understanding of the fundamental aspects of phenomena.

2. Applied research

It is a form of systematic inquiry involving the practical application of science. It accesses and uses some part of the research communities' (the academes) accumulated theories, knowledge, methods, and techniques, for a specific, often state,  business or client-driven purpose or to improve professional practice.

3.Historical research

It is employed by researchers who are interested in reporting events and/or conditions that occurred in the past. An attempt is made to establish facts in order to arrive at conclusions concerning past events or predict future events.

Research according to Research Environment

1. Field research-

Community research

2. Laboratory research

Demonstration; laboratory experimentation

Clinical research

Clinical setting such as the hospitals; elated learning experiences

Alternative routes to problem solving

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NP and NS

Nursing process is similar to research process

both consist of a number of closely related activities that overlap

Both involve problem solving and the use of logical systems of inductive and deductive reasoning

Methodologies for Developing Research Evidence in Nursing

Evidence-based practice is the conscientious use of current best evidence of making clinical decisions about patient care (Sachett et al., 2000).

This evolves from the integration of the best research evidence with clinical expertise and patient needs and values (Institute of Medicine, 2001).

Components of Evidence- Based Practice

Evidence from Research/ Evidence-based theories, Opinion leaders/ Expert panels

Evidence from assessment of the patient’s History and PE & Availability of Health care resources

Clinical Expertise

Information about Patient’s Preferences & Values

Evidence- Based Clinical Decision

Key Steps in Evidence-Based Practice

1. Formulation of an answerable clinical question that will yield the most relevant and best evidence.

2. Collection of the most relevant and research-based evidence to answer the clinical question, including searching for systematic reviews/ meta-analysis or clinical practice guidelines

3. Clinical appraisal and synthesis and evidence that has been collected for validity, relevance and applicability

4. Integration of the evidence with other factors.

5. Assessment of the effectiveness resulting from the implementation of the evidence in practice

Overview of the step in NR

There are variety of steps in conducting research

Most authors differ slightly but they have common sequence

Steps in nursing research

1. Identify problem2. Conduct literature review3. Identify theoretical concept4. Formulate hypothesis5. Operationalize variables6. Select research design7. Ascertain and select sample8. Conduct a pilot study9. Collect data10. analyze data11. Interpret results12. Disseminate information

steps

1. Formulate the Problem• Define the problem• Define purpose of research• Review related literature• Formulate theoretical framework• Define the population• State the SPECIFIC research problem• State the assumptions• State the scope and limitation• Define the research terms

steps

2. Formulate the hypothesis

3. Determine research design and methodology

4. Select and develop tools for data collection

5. Develop analysis of data plan

steps

6. Collect the data

7. Organize and process the data

8. Analyze and interpret the data

9. Formulate conclusions

10. Write the research reports

Formulate the problemCuriosity or burning interest form the researcher may lead to the formulation of a problemThe problem must be:FeasibleImportantClearly definedObservableSatisfies the interests of the QUALIFIED

researcher

Review of related literature

1. To define research questions, models and tools that may be useful in problem identification

2. To provide comparative data that are available for analysis

3. To compare one’s findings with other theoretical an conceptual frameworks

4. To identify studies that may be replicated

Formulate theoretical framework

Useful guides are the data from literature

Previous theories

Delineate the population

The POPULATION refers to the largest body of the individuals being research

SAMPLING is the process of selecting a PORTION of the POPULATION to represent the whole

Delineate the population

Factors that can influence sample size include:

1. Accessibility

2. Cost

3. Amount of time available

Delineate the population

TYPES OF SAMPLING

1. Probability sampling• Individuals are given chance to be selected

2. Non probability sampling• Selection is based upon the criteria of

researcher, persons are NOT given equal chance

Delineate the population

PROBABILITY SAMPLING

Simple random= selection is done by chance, usually lottery or table of random numbers

Stratified random sampling= population is divided into LEVELS or strata and selection is done per level

Delineate the population

PROBABILITY SAMPLING

3. Systematic Random sampling= this consist of establishing a pattern like: every 5th person, every 8th household

4. Cluster sampling= involves selection of sample form various section of the population

Delineate the population

NON-PROBABILITY SAMPLING

CONVENIENCE sampling/accidental sampling= data are collected from anyone available

Snowball or network sampling= data are collected from those referred by another person

Delineate the population

NON-PROBABILITY SAMPLING

3. Purposive sampling= selection of subjects based on certain characteristics

4. Cross cultural= variety of culture

5. Cross sectional= one point only

Scope and limitations

Scope is the extent to which the study will be made

Limitations are perceived weaknesses

Delimitations are restrictions that the researches places on the study

STEP 2

Formulate Hypothesis

Hypothesis is a scientific guess. It is only tested not proved

1. Simple hypothesis

2. Complex hypothesis

3. Null hypothesis= assumption that there is NO difference

Step 2

Variable

A quality, property or characteristic of a person or thing to be studied that can be quantitatively measured

It is a factor that varies

Step 2

Variable

1. INDEPENDENT Variable= the presumed CAUSE. The one MANIPULATED by the researcher

2. DEPENDENT VARIABLE= the presumed EFFECT or the response. It is otherwise called CRITERION VARIBALE

Step 2Variable

3. EXTRANEOUS or UNCONTROLLED or CONFOUNDING variable= variable that may affect the dependent variable

Step 2Variable

Dichotomous variable= sex

Polychotomous variable= many categories

Step 3

Research Design

1. EXPERIMENTAL research• Conducted in a specialized setting

2. NON experimental research• Conducted in a natural setting such as

hospital, clinic

Step 3

DESCRIPTIVE RESEARCH approach

Describes and interprets what IS and reveals conditions and relationships that EXIST or DO NOT exist

Survey, Case analysis, comparative studies, relationship studies

Step 3

DESCRIPTIVE RESEARCH approachSurvey

Data are gathered from a relatively LARGE number of cases at a particular time

1. Normative survey= norms or typical condition

2. Social survey= current social problem3. Community survey4. School survey

Non-experimental

ADVANTAGES DISADVANTAGES

Less expensive CANNOT establish causal relationships

Completed in SHORT time NOT used for diagnosis and explanation

Cooperation of subjects easily obtained

NOT always useful for theory development

Translation of findings is more acceptable to consumers of research

Difficult to get financial aid

Use for PREDICTIVE purpose CANNOT be applied to test a program or procedure

Step 4

Select data collection method

1. Reliability= ACCURACY or precision of the tool. The measurements are the same if REPEATED

Step 4

Select data collection method

2. VALIDITY= relevancy of measurements. It measures what it is supposed to measure

Step 4

Select data collection method

3. SENSITIVITY= measures the fine differences among the subjects

Step 5

Develop the data analysis plan

consider how the data should be analyze

Step 6

COLLECTION OF DATA

1. Use of existing records

2. Observation

3. Questionnaire

4. interview

Data

Nominal data Data that can be organized into CATEGORIES of a defined property but cannot be compared

Ordinal Used when data can be assigned categories that can be ranked

Interval Have equal numerical distance between intervals. NO ZERO SCALE

Ratio Highest form of measure, similar to interval BUT with ZERO POINT

Step 6

Questionnaire

The most common

Written in a form that is distributed

Questions constructed and pre-tested carefully

1. FREE response/ unstructured= respondents can write

2. Close-ended/Structured= respondents just check the prepared response

Step 6 Questionnaire

Advantages Disadvantages

Simple method Responses may lack depth

Less time consumed Omission of items

Data gathered can be widely scattered

Responses may not be the actual responses

Researcher does not need to see respondents personally

Printing, distribution and collection are expensive and maybe difficult

Step 6

INTERVIEWSecond most commonRelevant ideas and depth van be explored

1. Structured interview= read to the respondents

2. Unstructured interview= guide questions only

Step 6 InterviewAdvantages disadvantages

Complete answers possible

Requires more time

Misunderstanding minimized

Interpersonal relationship between subject and researcher may not be the same

Topics can be pursued Cost, time, effort are even greater than interview

No items omitted

Subjects does not have to be literate

Step 6

ObservationMost directive meansCommon in nursing care research

1. Participant observation= investigator blends with subject

2. Non-participant= use of weighing scale, BP to monitor quantitative changes

Step 6: Observation

Advantages Disadvantages

Valuable in studying nursing practice

Observed clients are subject to bias

Inexpensive. Can be continued anytime

Events may occur rapidly and impossible to record

Subjects are available Extensive training necessary

Simple to develop Time needed to wait for the occurrence

Allows view of situation Difficult to be always PRESENT to view

Step 6

HAWTHORNE effect

People may INTENTIONALY change their behavior because they know that they are being studied

Step 6

HALO effect

Observer may have the TENDENCY to rate certain subjects as either LOW or HIGH depending on the impression the subject gives to the observer

Step 7

ORGANIZE AND PROCESS DATA

Editing

Coding

Scoring

Sealing summarizing

Use of tables and computer to calculate the data

Step 7

ORGANIZE AND PROCESS DATA

For QUALITATIVE DATA

Rate and percentages

For QUANTITATIVE DATA

Measures of central tendency and measures of variation

Step 8

ANALYZE the DATA

Draw meaning from the finding

The researcher should be able to say if the NULL hypothesis is accepted or rejected

Step 9

FORMULATE CONCLUSIONS and Recommendations

These are judgment about the data collected and the suggestions of possible application of the research

Step 10

WRITE THE RESEARCH REPORT

Report may be prepared for publication

The MAIN purpose is to disseminate the findings of the study for others to utilize

Ethical Issues in Research

1. Confidentiality

2. Autonomy

3. Beneficence

4. Non-maleficence

5. Justice