nursing research introduction

Lecture Notes on Nursing Research

Prepared By: Mark Fredderick R Abejo R.N, MAN

Introduction to Nursing Research Abejo

NURSING RESEARCH

Lecturer: Mark Fredderick R. Abejo RN, MAN ________________________________________________

NATURE OF RESEARCH

Research Definition

Derived from the old French word “CERCHIER”

meaning to seek or to search.

The prefix “re” means again and signifies

replication of the search, implying that the person

has to find out or to take another more careful look.

Is a scientific study or investigation that is pursued

to discover theories and concepts based on new facts

and information and its practical application.

Systematic collection and analysis of data to

illuminate, describe or explain new facts and

relationship and for the purposes of prediction or

explanation.

An attempt to gain solutions to the problem. (Treece,

1986)

Refers to a problem solving process that utilizes

scientific and develop ideas and theories that give

meaningful answer to complex questions about

human beings and the environment.

The Committee on Research of the Philippine

Nurses Association has come up with its own

definition of research: Research is an honest,

scientific investigation undertaken for the purpose

of discovering new facts or establishing new

relationship among facts already known which will

contribute to the present body of knowledge and

can lead to an effective solution of existing

problems.

Nursing Research Definition

It is defined as a formal, systematic, rigorous and

intensive process used for solutions to nursing

problems or to discover and interpret new facts and

trends in the clinical practice, nursing education and

nursing administration. (Waltz and Bausell, 2001)

Systematic study and assessment of nursing

problems or phenomena; finding ways to improve

nursing practice and patient care through creative

studies;initiating and evaluating change; and taking

action to make new knowledge useful in nursing.

(Vreeland, 1963 )

Includes the breadth and depth of the disciple of

nursing and the rehabilitative, therapeutic and

preventive aspects of nursing as well as the

preparation of practitioners and personnel involved

in the total nursing sphere.

According to NCNR, nursing research is the testing

of knowledge that can be used to guide nursing

practice. It is concerned with examining questions

and verifying interventions based on human

experiences.

Sources of Knowledge in Nursing

Faith, Habits and Traditions

Authority

Borrowing

Clinical / Personal Experience

Trial and Error

Intuition

Role Modeling

Logical Reasoning

Assembled Information

Disciplined Research

Reason for Conducting Research in Nursing

1. Gather 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 and validate perceptions and

expands these.

4. Provides theoretical and scientific basis for nursing

practice.

5. Defines the parameters of nursing and identifies its

boundaries.

6. Documents the social relevance and efficacy of nursing

practice to people and health care providers.

7. Describes the characteristics of the nursing situation

about which little knowledge is known.

8. Predicts probable outcomes of nursing decisions in

relations to client care.

9. Provides knowledge for purposes of problem solving and

decision making.

10. Develops and evaluates nursing theories, concepts and

practices these for clarity and validity of nursing actions.

11. Prevents undesirable client reactions.

12. Develops a considerable degree of confidence.

Theory – systematic, abstract explanation of some

aspect of reality.

Concepts – building blocks of theories

Data – pieces of information obtained in the course of

investigation

Phenomenon – an event, happening, incident and

observable facts.

The Goals of Nursing Research

Efficiency and effectiveness in nursing care.

Worthiness and value of the nursing

profession.

Indentify, implementing and evaluating

effective health care modalities.

Potential for providing quality care of

clients.




General and Specific Purposes of Research

General Purposes

Research in general, answer questions to solve problems.

Provide tools for observation in order to generate

knowledge as basis for predicting and controlling the

phenomenon. Thus, a nurse can apply this knowledge in

practice and prescribe accurately and professionally

without untoward client response or reactions to nursing

interventions. (Polit and Beck, 2004 )

Specific Purposes

Specifically, research aims to do the following tasks:

Description

Exploration

Explanation

Prediction

Control

Research Purpose Related to Evidence- Based Practice

Treatment, Therapy or Intervention

Diagnosis and Assessment

Prognosis

Prevention of harm

Etiology or causation

Meaning and Process

Paradigms for Nursing

Paradigms – an overall belief system, a view of the world that

strives to make sense of the nature of reality and the basis of

knowledge.

MAJOR ASSUMPTIONS OF THE POSITIVIST AND

NATURALISTIC PARADIGMS

Positivist

Paradigm

Naturalistic

Paradigm Nature of

reality

Reality exist Reality is multiple and

subjective Relationship

bet.

Researcher

and those

being

researched

Inquirer is independent

from those being researched

Inquirer interacts with

those being research

The role of

values in

inquiry

Values and biases are

to be held in check

Subjectivity and value

are inevitable

Best method

for obtaining

evidence

Deductive processes

Emphasis on discrete,

specific concept Focus on objectives

Verification of

researchers predictions Fixed designed

Outsider knowledge as

external Measured

Seek generalization Focus on the product

Inductive processes

Emphasize on whole

Focus on the subjective Flexible

Insider knowledge as

internal Narrative information

Seek in depth

understanding Focus on the product and

process

Types of Research

1. General Classification

Basic / Pure Research

The researcher tries to find the truth about

something.

It is done for the intellectual pleasure of

learning to search for knowledge for its own

sake and eventually filter down the result into

real life situation.

Applied Research

Applied research seeks for practical application

of theoretical or abstract knowledge. The truth

is adapted to every situation.

It results from present problems or from

socially disorganized situations. It frequently

raises theoretical questions that must be

answered by basic/ pure research.

Purpose of Conducting Applied Research

To solve a problem

To make a decision

To develop a new program, product,

methods and procedure

To evaluate program and methods.

Action Research

The process involves the study of certain

problem and from that experience, decisions,

actions and conclusion are drawn.

Findings are limited to settings actually

studied.

2. According to Level of Investigation

Exploratory Research

Allows one to study the variables pertinent to a

specific situation.

Descriptive Research

The exploration and description of phenomena

in real life situation.

Provides an accurate account of characteristics

of particular individuals, situations or groups.

3. According to Time Element

Historical Research

Describes what was?

Descriptive Research

Describes what is?

4. According to Duration

Longitudinal Study

Follows the subjects for a long period of time

in order to observe change.




Cross – sectional Study

Takes information one at a time and may

require subjects to recall past events or feelings.

It may contribute to a loss of accuracy and

support bias. It is more often done than the

longitudinal studies

5. According to Research Design

Correlational Research

Involves the systematic investigation of

relationship between or among variables.

This design is used to quantify the strength of

the relationships in the real world.

This design is used to quantify the strength of

the relationship between variables or in testing

a hypothesis about a specific relationship.

Experimental

An objective, systematic, highly controlled

investigation for the purpose of predicting and

controlling phenomena in nursing practice.

The researcher actively introduces some form

of treatment and has greater control over

extraneous variables.

Non Experimental

The researcher collects data without

introducing any treatment or making any

changes.

Non experimental research usually includes

studies where the researcher’s primary interest

is understanding some human behavior in

naturalistic contexts.

Quasi – Experimental

Is like experimental research because it actively

introduces some form of treatment or

manipulation of an independent variable.

Unlike experimental research, however, it does

not utilize randomization or control group.

Nursing Research Methodologies

Quantitative Research

A formal, objective, systematic process in which

numerical data are used to obtain information about

the world.

This method is used to describe variables, examine

relationships among variables and determine cause

and effect interactions between variables.

Qualitative Research

A systematic, interactive, subjective approach used

to describe life experiences and give them meaning.

A type of research conducted to describe and

promote understanding of human experiences.

Evolved from the behavioral and social sciences as a

method of understanding unique, dynamic, holistic

nature of human beings.

Approaches in Qualitative Research

Phenomenological Research

- Used to answer questions of meaning

- Begin with accumulation of evidence

when little topic is known or when

studying new topic it involves gathering of

fresh perspective.

- The goal of phenomenological inquiry is

to understand fully lived experience and

perceptions.

- Aspects of Lived Experience involves:

a. Lived Space (spatiality)

b. Live Body (corporeality)

c. Lived Time (temporality)

d. Live Human Relation (relationality)

Grounded Theory Research - Method designed to inductively develop a

theory based observations of selected

people.

- The primary purpose of grounded theory

research is to develop a theory. The

concepts and theories discovered through

this research approach are derived directly

from the data.

- The following are the major premises of

grounded theory:

Humans act toward objects on the

basis of the meaning those objects

have for them.

Social meaning arise from social

interaction

People use interpretive processes to

handle and change meanings in

dealing with their situations.

- Fundamental characteristic of grounded

theory research is that data collection, data

analysis and sampling of participants

occur at the same time.

- In depth interview and observation are the

most common data source.

Ethnographic Research - A tool for studying cultures

- It has been associated with studies of

primitive, foreign or remote cultures

which allows the researcher to acquire

new perspectives beyond his/her own

ethnocentric perspective.

Rigor in Quantitative

Rigor is the striving for excellence in research

and it requires discipline, adherence to detail

and strict accuracy.

Control in Quantitative

Involves the imposing of rules by the

researcher to decrease the possibility of error.




Narrative Research - Focus on story as the object of inquiry, to

determine how individuals make sense of

events in their lives.

- The data can be collected as a story or

filed notes.

- It may be used for comparison among

groups, to learn about a social

phenomenon or historical period or to

explore a personality

Case Study - Involves an in-depth description of

essential dimension and processes of the

phenomenon being studied.

- Are means of providing in depth, evidence

base discussion of clinical topics along

with practical information

COMPARISON ON PHASES OF COMPARISON OF

QUANTITATIVE AND QUALITATIVE RESEARCH

Quantitative Qualitative

Conceptual

Phase

Formulating problem

Review related lit.

Defining framework

Formulating

hypotheses

Topic identification

Situation appraisal

Develop

hypotheses

Framework

development

Objective

formulation

Design /

Planning

Phase

Selecting research

design

Develop protocol for

intervention

Design sampling

plan

Develop methods to

safeguard rights

Research plan

formulation

Empirical Collecting data

Preparing data

analysis

Data gathering and

collection

Analytical

Phase

Analyze the data

Interpreting the

results

Data analysis and

interpretation

Conclusion

Dissemination

Phase

Communicating

findings

Utilizing findings in

practice

Communicating

and utilizing the

findings

COMPARISON OF QUANTITATIVE AND

QUALITATIVE RESEARCH

Quantitative Qualitative

General

Framework

Seek to confirm

hypotheses about

phenomenon

Instrument use more

rigid style of

eliciting and

categorizing

response to question

Use highly

structured methods

such as

questionnaires,

survey and

structured

observation

Seek to explore

phenomena

Instrument use more

flexible, repetitious

style of eliciting and

categorizing

responses to

questions

Use semi structured

methods such as in

depth interviews,

focus groups and

participant

observation

Analytical

Objectives

To quantify

variation

To predict causal

relationship

To describe

characteristics of a

population

To describe variation

To describe and

explain relationship

To describe

individual

experiences

To describe group

norms

Question

Format

Close - ended Open – ended

Data Format Numerical Textual

Flexibility in

Design

Study design is

stable from

beginning to end

Participant

responses do not

influence or

determine how and

which questions

researchers ask next

Study design is

subject to statistical

assumptions and

conditions.

Some aspects of the

study are flexible.

Participant responses

affect how and which

questions researchers

ask next

Study design is

repetitious, that is,

data collection and

research question are

adjusted according to

what is learned.




CONTRAST OF QUANTITATIVE AND QUALITATIVE

RESEARCH APPROACHES

Element Quantitative Qualitative

View of reality

Reality is

objective and can

be seen and

measured

Reality is constructed

by the individual

View of time Reality is

relatively constant

Reality is

continuously

constructed

Context

Reality can be

separated from

context

Reality is embedded

in its context

Researcher

Approach

Objective,

detached

Personally involved

Population

Studied

Samples that

represent overall

populations, as

subjects

Individual cases,

represented as

informants.

Measures Human behavior

or other

observable

phenomena

Study the meaning

that individuals create

Observations Analyze reality as

definable variables

Make holistic

observations of the

total context

Design Preconceived and

highly controlled

Emergent and fluid,

adaptable to

informant’s views

Analysis Descriptive and

inferential

statistics

Analytic induction to

determine meaning

Generalization Use inference to

generalize from a

sample to a

defined population

Transfer knowledge

from case analysis to

similar cases

Reports Objective,

impersonal reports

in which

researcher’s

opinions are

undetectable

Interpretative reports

that reflect the

researcher’s

reconstruction of the

meaning of the data

JARGONS QUANTITATIVE AND QUALITATIVE

RESEARCH APPROACHES

Concepts Quantitative Qualitative

Person

contributing

information

Study participant

Respondents

Study participant

Informant, Key

informant

Person

undertaking

the study

Researcher,

investigator

Researcher,

investigator

That which is

being studied

Concepts

Variables

Phenomena

Concepts

Variables

Information

gathered

Data (numeric

value)

Data (narrative

descriptions)

Links

between

concepts

Relationships

(causal,functional)

Patterns

Logical

reasoning

processes

Deductive

reasoning

Inductive reasoning

Quality of

evidence

Reliability,

validity,

generalization

Trustworthiness

Parts/phases

of research

output

Statement of the

problems

Results

Literature review

Sampling

Study framework

Main problem

Specific problem

Interview guide

Data analysis

Method

Aim of the study

Findings

Reconnaissance

Selection

Study simulacrum

Central question

Issues

Aide memoir

Mode of analysis

Design

Outcome Research

This method examines the results of care and

measures the change in health status of clients.

The following are areas that require investigation

through outcome research:

Clinical client response to medical and nursing

interventions.

Functional maintenance or improvement of

physical functioning

Financial outcomes achieved with most

efficient use of resources.

Perceptual client’s satisfaction with outcomes,

care received and providers.

Intervention Research

Involves the investigation of the effectiveness of a

nursing intervention in achieving the desired

outcome or outcomes in natural setting.

Intervention research should be theory driven, which

means that the theory determines the nature of the

intervention, the health professionals to deliver the

intervention, the setting where the intervention is to

be provided, the type of client to receive the

intervention and the selection and measurement of

outcome variables.

Components of Scientific Research

Order and system

Control

Empiricism

Generalization

Characteristics of Research

It involves the gathering of new data from new sources or

first-hand information.

It is directed towards the solution of a problem

It is characterized by carefully designed procedures

applying rigorous analysis




It emphasizes the development of generalizations,

principles hypotheses and theories that may be helpful in

predicting future occurrences.

It requires expertise

It demands accurate observation and description of what

is being studied.

It strives to be logical, applying every possible test to

validate the procedures being employed.

It is characterized by patient and unhurried activities.

It requires innovative approaches and determination to

succeed.

It is carefully and accurately recorded and reported.

Limitations of Research

Result of faulty planning and implementation of the

project.

The individual researcher

The scope of knowledge or information available about

the topic and the problem under study also must be

considered.

Sources of data

The tools of measurement may be inadequate or entirely

lacking.

Reasons for Lack of Clinical Research

1. Nurses tend to feel that they are “too busy to care for

patients”.

2. Unless the nurse has had academic training in theoretical

conceptualizations, research may not seem important.

3. Unless the importance of research is felt and recognized,

nurses may not be able to identify researchable problems.

4. Many nurse do not have the academic training needed to

feel confident in doing clinical research.

5. The ethics or research tends to researchers. Fear of

harming a patient is also a hindrance to some researchers.

6. Unless administrators are research-oriented, the nursing

staff feels the futility of support for nursing research,

hence, there is no motivation to pursue this.

7. Research takes time, time costs money which must be

budgeted.

Characteristics of the Good Nurse Researcher

Honest and Credible

Intellectual Curiosity

Accurate in his/her data

Organized and Systematic

Prudence

Logic

Self- Awareness

Healthy Criticism

Intellectual Honestly

Good Relationship with his/her respondents

The Consumer-Producer Continuum in Nursing Research

Consumer of Producer of

Research Research

The consumers of research are nurses at one end of the

continuum whose involvement in research is indirect.

These nurses:

Identify clinical problems in nursing practice

Use library and information technology resources.

Read research reports to develop new skills and

search for relevant findings that affect practice.

Participates in journal clubs

Use research to solve clinical problems

Use research in clinical decisions

Collaborate in developing an idea for a research

project.

Reviews a research proposal for feasibility and offer

suggestion to improve the plan.

Assist in data collection

Participate in research study or survey

Lead a journal club or ground discussion.

Participate in unit or service based research councils.

The producers of research at the other end of the

continuum are the nurses who actively participate in:

Designing and implementing studies

Conducting studies

Disseminating research findings

Appraising the clinical relevance of research

findings.

Provides leadership for integrating findings in

clinical practice.

Nursing Research Guidelines for the Investigative

Function of Nurses

1. Associate Degree in Nursing

Demonstrates awareness of the value or relevance of

research in nursing

Assists in identifying problem areas in nursing

practice.

Assists in collection of data within an established

structured format.

Qualities of a Good

Researcher

R - Research Oriented

E - Efficient

S - Scientific

E - Effective

A - Active

R - Resourceful

C - Creative

H - Honest

E - Economical

R - Religous




2. Baccalaureate Degree in Nursing

Reads, interprets and evaluates research for

applicability to nursing practice.

Identifies nursing problems that need to be

investigated and participates in the implementation

of scientific studies.

Uses nursing practice as a means of gathering data

and refining and extending practice.

Applies established findings of nursing and other

health related research to nursing practice.

Shares research findings with colleagues.

3. Master’s Degree in Nursing

Analyzes and reformulates nursing practice

problems so that scientific knowledge and scientific

methods can be used to find solutions.

Provides expertise in clinical problems by providing

knowledge about the way clinical services are

delivered which enhances quality and clinical

relevance of nursing.

Facilitates investigation of problems in clinical

settings by contributing to a climate of supportive

investigative activities, collaborating with others in

investigations and enhancing nurse’s access to

clients and data.

Investigates for the purpose of monitoring the

quality of nursing practice in a clinical setting.

Assists others in applying scientific knowledge in

nursing practice.

4. Doctorate Degree in Nursing or Related Discipline

Provides leadership for the integration of scientific

knowledge with others types of knowledge for the

advancement of practice.

Conducts investigations to evaluate the contributions

of nursing activities to the well-being of clients.

Develops methods to monitor the quality of nursing

practice in a clinical setting and to evaluate

contributions of nursing activities to the well-being

of clients.

Role of Nurses in Research

As Principal Investigators

As Member of a Research Team

As Evaluator of Research Findings

As Consumers of Research Findings

As Client Advocate in a Research Study

As Subject of Research

Ethics in Research

Informed Consent

Beneficence and Non-maleficence

- Freedom from any Physical and Psychological Harm

- Freedom from Exploitation

Respect for Human Dignity

- The right to self determination

- The right to full disclosure

- Anonymity and Confidentiality

Justice and Fairness

_________________________________________

References:

1. Venzon. 2004. Introduction to Nursing Research: Quest for Quality

Nursing, 1st ed. Philippines: C&E Publishing Inc.

2. Barrientos-Tan. 2006. A Research Guide in Nursing Education, 3rd

ed. Philippines: Visual Print Enterprises.

3. Reyes & Layug. 2009. Comprehensive Reviewer for the Nurse

Licensure Exam, Philippines: East West Educational Specialists,

C&E Publishing Inc.

4. Brink & Wood. 2001. Basic Steps in Planning Nursing Research,

5th ed. Philippines: Jones and Bartlett Publisher Inc.

5. Burns & Grove. 2007. Understanding Nursing Research : Building

an Evidence-Based Practice, 4th ed. China; Elsevier, Health

Sciences.

6. LoBiondo-Wood & Haber. 2006. Nursing Research: Methods and

Critical Appraisal for Evidence-Based Practice, 6th ed. USA: Mosby

Inc.

7. Polit & Beck. 2008. Nursing Research: Generating and Assessing

Evidence for Nursing Practice, 8th ed. Philadelphia: Lippincott

Williams & Wilkins.

Ethics in research requires honesty and accuracy of

data. The researcher must guarantee factual and

evidenced based data. There should be no

“plagiarism” such as presenting the ideas or words of

another as one’s own, nor distort or fabricate data for

purposes of completing the research on time.

The Philippine Copyright Law (R.A No. 8293 )

protects the intellectual property rights of authors and

artist .