Unit 1: Nursing Research

Unit 1: Nursing Research

Dileep kumar(R.N, CHN, Post R.N BSc.N)

Lecturer, Ilmiya Institute of Nursing, Karachi

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ObjectivesBy the end of my this lecture Students will be

able;• To define research and nursing research • To discuss role of Nurse in research participation• To enlist the process of research.• To Know about the importance of Research.• Discuss the historical trends or history of Nursing

Research.• To review the types of research methods “ Qualitative,

Quantitative and outcomes ”• To discuss areas of high priorities for nurse researchers

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Research

• Research means– To Search Again.– To examine carefully.

• Research seeks answers to questions in an orderly and systematic way.

• It is a method of problem solving.

Definition of ResearchIt is diligent (careful), systematic inquiry or study that Validates and refines existing knowledge and develops new knowledge.

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Nursing ResearchDefinitions

• A scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences clinical nursing practice.

• Nursing research is systematic inquiry designed to develop knowledge about issues of importance to the nursing profession, including nursing practice, education, administration, and informatics.

Example of research question• How do adults with acquired brain injury perceive their

social interactions and relationships (Paterson & Stewart, 2002)

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What does research do?Research enables nurses to:Describe the characteristics of a particular nursing

situation about which little is known.

Explain phenomenon that must be considered in planning

nursing care.

Predict the probable outcome of certain nursing decisions

made in relation to client care.

Control the occurrence of undesired client outcomes.

Initiate, with a fair degree of confidence, activities that

will achieve desired client behavior.

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Why do nurses need research?

• For the continuous growth of nursing profession.

• Helps nursing to achieve its own professional identity.

• Helps to identify the boundaries of nursing.

• To define the parameters of nursing.

• For cost containment practices.

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Role of Nurse in research participation at various levels of education preparation (ANA-1989)

BSN Degree1. Critiquing & synthesizing research findings from nursing profession and other discipline for use in practice.2. Provide valuable assistance in identifying research problems

and collecting data for studies.

Master's degree1. To lead health care teams

– Making essential changes in nursing practice– Health care system based on research

2. Conduct investigations3. Initial studies in collaboration with other investigators4. Facilitate research and Provide consultation

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Doctoral Degree1. Assume a major role in the conduct of research.

2. Generation of nursing knowledge in a selected area of interest.

– Extend scientific basis

– Develop methods to measure nursing phenomena

Post doctoral degree1. Assumed a full researcher role and has a funded

program of research

2. Develop and coordinate funded research programs

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Nursing Research priorities

To Improve:

• Nursing as a profession

• Nursing practice

• Patient outcomes

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Research Process in quantitative research

• Phase 1: The Conceptual Phase– Step 1: Formulating and Delimiting (state clearly) the Problem– Step 2: Reviewing the Related Literature– Step 3: Undertaking Clinical Fieldwork– Step 4: Defining Framework & Developing Conceptual Definitions– Step 5: Formulating Hypotheses

• Phase 2: The Design and Planning Phase– Step 6: Selecting a Research Design– Step 7: Developing Protocols for the Intervention– Step 8: Identifying the Population to be Studied– Step 9: Designing the Sampling Plan– Step 10: Specifying Methods to Measure the Research Variables

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– Step 11: Developing Methods for Safeguarding human/ Animal Rights

– Step 12: Finalizing and Reviewing the Research Plan

• Phase 3: The Empirical (Practical) Phase– Step 13: Collecting the Data– Step 14: Preparing the Data for Analysis

• Phase 4: The Analytic Phase– Step 15: Analyzing the Data– Step 16: Interpreting the Results

• Phase 5: The Dissemination Phase– Step 17: Communicating the Findings– Step 18: Utilizing the Findings in Practice

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Why is research important in nursing?• Knowledge generated through research is essential to provide a

scientific basis for:-

• Description– What exist in N/practice and discover a new knowledge.

• Explanation– Explains the existing knowledge in relation to the effect and the outcome

• Like bed sore occur in the old people due to lack of mobility

• Prediction– A nurse could predict the out come on the bases of interventions

• Control– Ability to write a prescription to produce the desire result.

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History in nursing research

Began with Florence Nightingale over 150 years ago (1850).

In (1859) describes her initial research activities which looked at the importance of leading environment in promoting physical and mental well being

Ventilation Cleanliness Purity of water Diet

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History in nursing research

In addition collected the data of morbidity from Crimean War this made the military provide:

Enough food. Clear quarters for the sick. Appropriate medical treatment.

• These interventions made impact on public health (military help)– drastically reduces mortality from 43% up-to 2% in the Crimean War.

– Testing public water

– Improve sanitation

– preventing starvation.

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History in nursing research

• 1900- 20’s– First Journal Published “ American Journal of nursing (1900)

• Case study appeared ( 1920 - 1930)

– In-depth analysis and systematic description of one patient or group to promote understanding of nursing Research.

– Little research done except for a few important educational studies recommending establishing School of nursing in a university. (Gold mark report, 1923)

– First doctoral program for nurses was at Teachers college in Colombia. (NYC) in 1924.

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History in nursing research

• 1950– American Nurse Association (ANA) initiated a five

year study on nursing functions and activities. – Clinical Research began– Research took on new importance due to vision of

Virginian Henderson & Faye Abdullah; • One could see more nurses with Master's degree and

School of Nursing began introducing research as a separate course

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• 1952– First Journal Of Nursing Research published.

– Researches conducted at Baccalaureate and masters level.

• 1953– The institute of Research and services in Nursing education

established at teachers collage Columbia University, New York.

• Provided learning experience in research for Doctoral studies.

• late 60's saw more research being done that imported clinical and quality of care

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• 1970's

• Saw nursing process as focus for many studies.• Saw increase in number of nursing theories and

models.• Image: Journal of nursing scholarly, first

published in 1967 and Advance in nursing science in 1978 ( Including Nursing Theories) by STTI.• To tackle the issue of communication / dissemination

of information

• Council of Nurse research establish

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• 1980's

• Clinical research became the important design in

research

• Saw many new journals being published e.g. Cancer

nursing; Pediatric nursing, Dimension of critical care

nursing etc.., Applied nursing research.

• Clinical research written priority of the 80's

– increase funding for nursing research.

– The ANA achieved a victory by establishing the National

Center for Nursing Research in 1985.

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• Priorities of National Center for Nursing Research 1999 includes:

– Community based nursing models.

– Effectiveness of nursing interventions in HIV/AIDS.

– Cognitive impairment.

– Living with chronic illness.

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NURSING RESEARCH

Qualitative research Quantitative research Outcome research

- Phenomenological - Descriptive - Grounded theory - Correlational

- Ethnographic - Quasi-experimental - Historical - Experimental

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Quantitative research• Is a formal, objective, systematic process in which numerical

data are used to obtain information about the world.

• Is "hard science" it is perceived as rigorous (exact), systematic and objective focusing on numerical data and using statistical analysis and controls in an attempt to eliminate bias.

• It is conducted to test theory by;– Describing variables

– Examining relationship among variables

– Determine cause and effect interaction between variables.

Types of Quantitative Research: Descriptive- explore new areas/describe situations. Correlational- examine relationships Quasi-experimental- effectiveness of intervention. Experimental- producing positive outcomes.

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Qualitative research Is a systematic, subjective approach used to describe life experiences

and situation and to give them meaning. "Mode of systematic inquiry concerned with understanding human

beings and the nature of their transaction with themselves and with

their surrounding" (Benoliel, 1984, p.3). Qualitative research is often described as holistic, that is, concerned

with humans and their environment in all their complexities. It is lived

and as it is defined by the actors themselves

Types of Qualitative Research:Phenomenological- describes experience as lived.

Grounded theory- formulate, test and refine a theory about a phenomena.

Ethnographic- investigates cultures in depth. Historical- description analysis of events that occurred in past.

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Outcome Research

• Is focused on examining the end results of care or determining the changes in health status for the patient.

Four essential areas require for this reason: The patients responses to medical or N/Intervention. Functional maintenance/improvement of physical functioning

for the patient. Financial outcome achieved with the provision of health care

services. Patients satisfaction with the health outcomes care received and

the health care provider.

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Quantitative & Qualitative research characteristics

S.#

Quantitative Research Qualitative Research

1. Hard science Soft Science 2. Focus: Concise and

Narrow Focus: Complex and Broad

3. Reductionistic Holistic 4. Objective Subjective 5. Reasoning:

Logistic Deductive

Reasoning: Dialectic, Inductive

6. Basis of knowing: cause and effects, relationships

Basis of knowing: meaning discovery

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Quantitative and qualitative research characteristics

S.# Quantitative Research Qualitative Research 7. Tests theory Develops theory 8. Control Shared interpretation 9. Instruments Communication and

observation 10. Basic elements of

analysis: numbers Basic elements of analysis: words

11. Statistical analysis Individual interpretation. 12. Generalization Uniqueness

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Areas of High Priority for Nurse Researcher

• Patient focused research• The management processes within health care

services • Cultural issues for nurses and patients • The history of nursing• Ethical decision making• Nursing and professional regulation• Education of nurses• Nursing workforce skills mix

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References

• Polit, D.F., and Bech, C.T. “Nursing Research; principles and Methods” 7th edition, LWW.

• Burns, N., and Grove, S.K. (2007). “Understanding Nursing Research; building an evidence based practice” 4th edition, New Delhi, Elsevier.

• Anonymous, (n.d). Promoting Research in Clinical Practice: Strategies for Implementing Research Initiatives. Journal of Trauma Nursing, April/June 2009

Acknowledgements• Dr. Fauziya Ali Ph.D

• Tazeen Saeed Ali RN, RM, BScN, MSc ( Epidemiology)