Research Notes 3

8/13/2019 Research Notes 3

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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 CERCHIERmeaning to seek or to search.

The prefix re means again and signifiesreplication of the search, implying that the personhas to find out or to take another more careful look.

Is a scientific study or investigation that is pursuedto discover theories and concepts based on new factsand information and its practical application.

Systematic collection and analysis of data toilluminate, describe or explain new facts and

relationship and for the purposes of prediction orexplanation.

An attempt to gain solutions to the problem. (Treece,1986)

Refers to a problem solving process that utilizesscientific and develop ideas and theories that give

meaningful answer to complex questions abouthuman beings and the environment.

The Committee on Research of the PhilippineNurses Association has come up with its owndefinition of research: Research is an honest,

scienti fi c investigation undertaken for the pur pose

of discovering new facts or establishing new

relationship among facts alr eady known whi ch wil l

contr ibu te to the present body of knowl edge and

can lead to an effective solution of existing

problems.

Nursing Research Definition

It is defined as a formal, systematic, rigorous andintensive process used for solutions to nursing

problems or to discover and interpret new facts andtrends in the clinical practice, nursing education and

nursing administration. (Waltz and Bausell, 2001)

Systematic study and assessment of nursingproblems or phenomena; finding ways to improvenursing practice and patient care through creative

studies;initiating and evaluating change; and takingaction to make new knowledge useful in nursing(Vreeland, 1963 )

Includes the breadth and depth of the disciple ofnursing and the rehabilitative, therapeutic andpreventive aspects of nursing as well as the

preparation of practitioners and personnel involvedin the total nursing sphere.

According to NCNR, nursing research is the testingof knowledge that can be used to guide nursing

practice. It is concerned with examining questionand 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 orconditions about which little knowledge is available.

2. Provides scientific knowledge base from which nursingtheories emerge and develop.

3. Helps correct, clarify and validate perceptions andexpands these.

4. Provides theoretical and scientific basis for nursingpractice.

5. Defines the parameters of nursing and identifies itsboundaries.

6. Documents the social relevance and efficacy of nursingpractice to people and health care providers.

7. Describes the characteristics of the nursing situationabout which little knowledge is known.

8. Predicts probable outcomes of nursing decisions inrelations to client care.

9. Provides knowledge for purposes of problem solving anddecision making.

10. Develops and evaluates nursing theories, concepts andpractices 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 theoriesData pieces of information obtained in the course ofinvestigationPhenomenon 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 evaluatingeffective health care modalities.

Potential for providing quality care ofclients.


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General and Specific Purposes of Research

General Pur poses

Research in general, answer questions to solve problems.

Provide tools for observation in order to generate

knowledge as basis for predicting and controlling thephenomenon. Thus, a nurse can apply this knowledge in

practice and prescribe accurately and professionallywithout untoward client response or reactions to nursinginterventions. (Polit and Beck, 2004 )

Specif ic Pur poses

Specifically, research aims to do the following tasks: Description Exploration Explanation Prediction ControlResearch Purpose Related to Evidence- Based Practi ce

Treatment, Therapy or Intervention Diagnosis and Assessment Prognosis Prevention of harm Etiology or causation Meaning and Process

Paradigms for Nursing

Paradigmsan overall belief system, a view of the world that

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

MAJOR ASSUMPTIONS OF THE POSITIVIST AND

NATURALISTIC PARADIGMS

Positivist

Paradigm

Naturalistic

ParadigmNature of

reality

Reality exist Reality is multiple and

subjectiveRelationship

bet.

Researcher

and those

being

researched

Inquirer is independent

from those beingresearched

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 predictionsFixed designed

Outsider knowledge as

externalMeasured

Seek generalizationFocus on the product

Inductive processes

Emphasize on whole

Focus on the subjective

Flexible

Insider knowledge as

internalNarrative information

Seek in depth

understandingFocus on the product and

process

Types of Research

1. General Classification

Basic / Pure ResearchThe researcher tries to find the truth about

something.

It is done for the intellectual pleasure olearning to search for knowledge for its ownsake and eventually filter down the result intoreal life situation.

Applied ResearchApplied research seeks for practical application

of theoretical or abstract knowledge. The truthis adapted to every situation.

It results from present problems or from

socially disorganized situations. It frequentlyraises theoretical questions that must beanswered 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 ResearchThe process involves the study of certain

problem and from that experience, decisionsactions and conclusion are drawn.

Findings are limited to settings actuallystudied.

2.

According to Level of Investigation

Exploratory ResearchAllows one to study the variables pertinent to aspecific situation.

Descriptive ResearchThe 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 ResearchDescribes what is?

4. According to Duration Longitudinal Study

Follows the subjects for a long period of timein order to observe change.


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Crosssectional StudyTakes 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 thelongitudinal 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 ofthe relationship between variables or in testing

a hypothesis about a specific relationship.

ExperimentalAn objective, systematic, highly controlledinvestigation for the purpose of predicting andcontrolling phenomena in nursing practice.

The researcher actively introduces some formof treatment and has greater control over

extraneous variables.

Non ExperimentalThe researcher collects data without

introducing any treatment or making anychanges.

Non experimental research usually includes

studies where the researchers primary interestis understanding some human behavior innaturalistic contexts.

QuasiExperimentalIs like experimental research because it activelyintroduces some form of treatment ormanipulation of an independent variable.

Unlike experimental research, however, it does

not utilize randomization or control group.

Nursing Research Methodologies

Quantitative ResearchA formal, objective, systematic process in which

numerical data are used to obtain information aboutthe world.

This method is used to describe variables, examine

relationships among variables and determine causeand effect interactions between variables.

Qualitative ResearchA 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 amethod 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 ofresh perspective.

- The goal of phenomenological inquiry isto 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 selectedpeople.

- The primary purpose of grounded theoryresearch is to develop a theory. The

concepts and theories discovered throughthis research approach are derived directlyfrom the data.

- The following are the major premises ofgrounded theory: Humans act toward objects on the

basis of the meaning those objecthave for them.

Social meaning arise from sociainteraction

People use interpretive processes tohandle and change meanings in

dealing with their situations.- Fundamental characteristic of grounded

theory research is that data collection, dataanalysis and sampling of participants

occur at the same time.- In depth interview and observation are themost common data source.

Ethnographic Research- A tool for studying cultures- It has been associated with studies of

primitive, foreign or remote culturewhich allows the researcher to acquire

new perspectives beyond his/her ownethnocentric perspective.

Rigor in Quantitative

Rigor is the striving for excellence in researchand it requires discipline, adherence to detailand strict accuracy.

Control in Quantitative

Involves the imposing of rules by theresearcher to decrease the possibility of error.


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Nar rati ve 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 socialphenomenon or historical period or to

explore a personality

Case Study- Involves an in-depth description of

essential dimension and processes of thephenomenon being studied.

- Are means of providing in depth, evidencebase discussion of clinical topics alongwith practical information

COMPARISON ON PHASES OF COMPARISON OF

QUANTITATIVE AND QUALITATIVE RESEARCH

Quantitative Qualitative

Conceptual

Phase

Formulating problemReview related lit.Defining frameworkFormulating

hypotheses

Topic identificationSituation appraisalDevelophypotheses

FrameworkdevelopmentObjectiveformulation

Design /

Planning

Phase

Selecting researchdesignDevelop protocol for

interventionDesign sampling

planDevelop methods tosafeguard rights

Research planformulation

Empirical Collecting dataPreparing dataanalysis

Data gathering andcollection

Analytical

Phase

Analyze the dataInterpreting theresults

Data analysis andinterpretationConclusion

Dissemination

Phase

CommunicatingfindingsUtilizing findings in

practice

Communicatingand utilizing thefindings

COMPARISON OF QUANTITATIVE AND

QUALITATIVE RESEARCH

Quantitative Qualitative

General

Framework

Seek to confirm

hypotheses aboutphenomenon

Instrument use morerigid style ofeliciting andcategorizing

response to question

Use highlystructured methods

such asquestionnaires,survey andstructured

observation

Seek to explore

phenomena

Instrument use moreflexible, repetitiousstyle of eliciting andcategorizing

responses toquestions

Use semi structured

methods such as indepth interviews,focus groups and

participant

observation

Analytical

Objectives

To quantifyvariation

To predict causal

relationship

To describecharacteristics of a

population

To describe variation

To describe andexplain relationship

To describeindividualexperiences

To describe groupnorms

Question

Format

Close - ended Openended

Data Format Numerical Textual

Flexibility in

Design

Study design is

stable frombeginning to end

Participant

responses do notinfluence ordetermine how andwhich questions

researchers ask next

Study design is

subject to statisticalassumptions andconditions.

Some aspects of the

study are flexible.

Participant responses

affect how and whichquestions researchersask next

Study design isrepetitious, that is,data collection and

research question areadjusted according towhat is learned.


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CONTRAST OF QUANTITATIVE AND QUALITATIVE

RESEARCH APPROACHES

Element Quantitative Qualitative

View of reality Reality is

objective and canbe seen and

measured

Reality is constructed

by the individual

View of time Reality is

relatively constant

Reality is

continuouslyconstructed

Context Reality can be

separated fromcontext

Reality is embedded

in its context

Researcher

Approach

Objective,detached

Personally involved

Population

Studied

Samples thatrepresent overall

populations, as

subjects

Individual cases,represented asinformants.

Measures Human behavioror other

observablephenomena

Study the meaningthat individuals create

Observations Analyze reality asdefinable variables

Make holisticobservations of the

total context

Design Preconceived andhighly controlled

Emergent and fluid,adaptable to

informants views

Analysis Descriptive andinferentialstatistics

Analytic induction todetermine meaning

Generalization Use inference togeneralize from asample to a

defined population

Transfer knowledgefrom case analysis tosimilar cases

Reports Objective,impersonal reportsin which

researchersopinions areundetectable

Interpretative reportsthat reflect theresearchers

reconstruction of themeaning of the data

JARGONS QUANTITATIVE AND QUALITATIVE

RESEARCH APPROACHES

Concepts Quantitative Qualitative

Personcontributing

information

Study participant

Respondents

Study participant

Informant, Key

informant

Person

undertaking

the study

Researcher,investigator

Researcher,investigator

That which is

being studied

ConceptsVariables

PhenomenaConceptsVariables

Information

gathered

Data (numericvalue)

Data (narrativedescriptions)

Links

between

concepts

Relationships(causal,functional)

Patterns

Logical

reasoning

processes

Deductivereasoning

Inductive reasoning

Quality of

evidence

Reliability,

validity,generalization

Trustworthiness

Parts/phases

of research

output

Statement of theproblemsResults

Literature reviewSamplingStudy frameworkMain problem

Specific problemInterview guideData analysisMethod

Aim of the study

Findings

ReconnaissanceSelectionStudy simulacrumCentral question

IssuesAide memoirMode of analysisDesign

Outcome ResearchThis method examines the results of care andmeasures the change in health status of clients.

The following are areas that require investigationthrough outcome research: Clinical client response to medical and nursing

interventions. Functional maintenance or improvement o

physical functioning Financial outcomes achieved with mos

efficient use of resources. Perceptual clients satisfaction with outcomes

care received and providers.

Intervention ResearchInvolves the investigation of the effectiveness of anursing 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 theintervention, the health professionals to deliver theintervention, the setting where the intervention is to

be provided, the type of client to receive the

intervention and the selection and measurement ofoutcome variables.

Components of Scientific Research

Order and system Control Empiricism Generalization

Characteristics of Research

It involves the gathering of new data from new sources ofirst-hand information.

It is directed towards the solution of a problem It is characterized by carefully designed procedure

applying rigorous analysis


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It emphasizes the development of generalizations,principles hypotheses and theories that may be helpful inpredicting 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 theproject.

The individual researcher The scope of knowledge or information available about

the topic and the problem under study also must beconsidered.

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 forpatients.

2. Unless the nurse has had academic training in theoreticalconceptualizations, 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 tofeel confident in doing clinical research.

5. The ethics or research tends to researchers. Fear ofharming a patient is also a hindrance to some researchers.

6. Unless administrators are research-oriented, the nursingstaff 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 thecontinuum whose involvement in research is indirectThese nurses:

Identify clinical problems in nursing practice

Use library and information technology resources.

Read research reports to develop new skills andsearch 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 researchproject.

Reviews a research proposal for feasibility and offersuggestion 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 thecontinuum are the nurses who actively participate in:

Designing and implementing studies

Conducting studies

Disseminating research findings

Appraising the clinical relevance of researchfindings.

Provides leadership for integrating findings inclinical practice.

Nursing Research Guidelines for the Investigative

Function of Nurses

1. Associate Degree in NursingDemonstrates awareness of the value or relevance ofresearch 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 OrientedE - EfficientS - ScientificE - Effective

A - ActiveR - ResourcefulC - CreativeH - HonestE - EconomicalR - Religous


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2. Baccalaureate Degree in NursingReads, interprets and evaluates research for

applicability to nursing practice.

Identifies nursing problems that need to be

investigated and participates in the implementationof scientific studies.

Uses nursing practice as a means of gathering dataand refining and extending practice.

Applies established findings of nursing and other

health related research to nursing practice.

Shares research findings with colleagues.

3. Masters Degree in NursingAnalyzes and reformulates nursing practice

problems so that scientific knowledge and scientificmethods can be used to find solutions.

Provides expertise in clinical problems by providingknowledge about the way clinical services are

delivered which enhances quality and clinicalrelevance of nursing.

Facilitates investigation of problems in clinical

settings by contributing to a climate of supportiveinvestigative activities, collaborating with others ininvestigations and enhancing nurses access toclients and data.

Investigates for the purpose of monitoring thequality of nursing practice in a clinical setting.

Assists others in applying scientific knowledge in

nursing practice.

4. Doctorate Degree in Nursing or Related DisciplineProvides 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 nursingpractice in a clinical setting and to evaluatecontributions 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 ResearchEthics 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 QualityNursing, 1sted. Philippines: C&E Publishing Inc.

2. Barrientos-Tan. 2006. A Research Guide in Nursing Education, 3 red. Philippines: Visual Print Enterprises.

3. Reyes & Layug. 2009. Comprehensive Reviewer for the NurseLicensure Exam, Philippines: East West Educational Specialists

C&E Publishing Inc.

4. Brink & Wood. 2001. Basic Steps in Planning Nursing Research5thed. Philippines: Jones and Bartlett Publisher Inc.

5. Burns & Grove. 2007. Understanding Nursing Research : Buildingan Evidence-Based Practice, 4th ed. China; Elsevier, Health

Sciences.

6. LoBiondo-Wood & Haber. 2006. Nursing Research: Methods andCritical Appraisal for Evidence-Based Practice, 6 thed. USA: Mosby

Inc.

7. Polit & Beck. 2008. Nursing Research: Generating and AssessingEvidence for Nursing Practice, 8 th ed. Philadelphia: Lippincot

Williams & Wilkins.

Ethics in research requires honesty and accuracy ofdata. The researcher must guarantee factual and

evidenced based data. There should be noplagiarism such as presenting the ideas or words ofanother as ones 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 andartist .

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