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NSRCH01CESARIA A. YALONG, RN, MAN

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objectives

At the end of the lesson, the students willbe able to:

yFormulate their own definition of research and nursing research

yDescribe the characteristics of researchand the researcher

yExplain the importance/purpose of nursing research/ roles of nurses inresearch

yTrace the history of nursing research

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.A - WHAT is Research?

1. Research

2. Nursing research

B. Importance of research in nursing

C. Roles of nurses in research

D. Purposes of nursing researchE. Evolution/ History of nursing research

F. Future directions for nursing research

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WHAT IS

RESEARCH?

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RESEARCH

French word . CERCHIER== To search

Prefix re=== again Search again & again

Examine Carefully

Diligent, To validate & refine existing KnowledgeSystematic and

inquir y or Develop new knowledge

study

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NURSING

RESEARCH?

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Various def inition:y A systematic search for and validation of knowledge

about issues of importance to the nursing

profession (Polit and Hungler, 1999).

y Concerned with knowledge that directly and indirectly

influences clinical nursing practice (Burns and Grove,

1997).

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NURSING RESEARCH A systematic process that

validates & refines and generates ne wkno wledge existing kno wledge

that directl y and indirectl y influence nursing practice

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NU

RSING

RESEARCHdevelopment of knowledge about...

health & promotion of health over the full life span,

care of persons with health problems & disabilities,

& nursing actions

to enhance the abilit y of individuals to respond effectivelyto actual or potential problems (ANA, 1981)

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3 MAJOR AREAS OF CONCERN IN NURSINGRESEARCH:

1. nursing education

2. practice of nursing

3. nursing service

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B - The importance of research

in nursingthe primar y task of nursing

research is the development

and refinement of nursing theories which serve asguides to nursing practice

and which can be organized into a bod y of scientific nursing kno wledge

(R ozella Schlotfeldt, 1960)

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11 Characteristics of Research

1. Directed to wards the solution of a problem.

2. Emphasizes the develop-ment of generalizations,

principles and theories that

ma y be helpful in predicting future occurrences.

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3. It involves the gathering of ne w and existing data from ne w sources or first-hand information

y Research is original work.

4. A nal y tical.- Collect data-> R igorous anal ysis/interpretation

y critical analysis of all the data used so that there is no errorin their interpretation.

y careful examination of detailed components of the objectof study.

y

uses published research to bolster that insight.

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5. R equires expertise

y

Research is done by an expert.yThe researcher uses valid and carefully

designed procedures, valid data gathering

instruments, and valid data.

6. It is empirical.

All procedures employed and the datagathered are perceived in the same mannerby all observers.

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7. Strives to be logical- apply every possible test to validatethe procedures being employed <- researcher hasconfidence in the results.

y Research is objective, unbiased, and logical.

y

All findings and conclusions are logically based onempirical data and no effort is made to alter the results of the research.

8. Honest and characterized b y patient & unhurried activities.

y Research is patient and unhurried activity.

y This to ensure accuracy.

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9. Can be replicated.- Reproducibility: Is your experiment/thesis

designed flawlessly with clear procedures

so that others can test your findings?

10 R equires innovative approaches.

- uses or shows new methods, ideas, etc

11. Carefull y recorded and reported - to

other persons interested in the problem.

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y V alues Derived in R esearch

y

yCritical thinking

yCreativity and innovativeness

y

Intellectual integrity yPatience and perseverance

y Widening of perspective

y Advancement of moral/social responsibility yObjectivity/adherence to truth

y

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yDifficulties encountered in R esearch

y

yRecognizing problems

yDuplication

y Indifference to ResearchyLack of facilities and materials

yFinancial difficulties

yLack of adequate and expert researchconsultants

yOthers (technical, know-how, vocabulary,

uncooperative subjects/respondents, etc.)

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C - ROLES OF NURSES IN RESEARCH

P R R I D E S A C C U

1. PRINCIPAL IN V ESTIGATOR - leader of research team

2. R ESEARCH ASSISTANT- trained in a specific methodof data collection

3. R ESEARCH COOR DINATOR - helps run the daily operations of the study

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4. IDENTIFIER

5. D ATA COLLECTOR - MEMBER

- collect data from clients for another persons research project

6. E V ALUATOR/CRITIC-

- assesses quality of a scientific research document forpublication, securing support funds, fulfillment of university requirements or obtaining permission for oral

presentation

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7. SUBJECT or PARTICIPANT- a person who has decided to

take part in the research by signing a consent form and by providing target information with the aid of appropriateresearch instruments

8. A D V ISER/ CONSULTANT- shares his knowledge to theinvestigator/researcher/research team and offers guidance inthe proper conduct of the study

9. CLIENT / PATIENT A D V OCATE- protects the rights of thehealthcare providers client and speaks on his behalf if hehappens to be a subject in a research investigation conductedin a clinical setting.

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10. CO-IN V ESTIGATOR - member of the

research team with the responsibility of helping the principal investigator andother member of the team in the proper

conduct of the study.

11. USER/CONSUMER OF RESEARCH

FINDINGS- Promoter of better quality care of clients

by utilizing evidence-based best practice

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1. 7 Characteristics of Nurse Researcher

2. Evolution of Nursing Research3. 6 Purposes of Nursing Research

4. Types of research

a. Experimental True experimental, Quasi-

experimental, Pre-experimental ( TPQ)

b. Non-experimental

b.1. Pure or basic research

b. 2. Applied research- Descriptive, Developmental, Ex PostFacto, Action, Correlational, Cause and Field, Historical (

DDEACH)

3. Sources of Evidence for Nursing Practice

4. Paradigm for Nursing Research

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ASSIGNMENT

1. Trace the Evolution of Nursing Research starting fromthe time of Florence Nightingale.

2. Place in a short coupon bond ( maximum of 5 pages

and of any color)3. Submit next Monday

4. Criteria of grading= 20 pts.

a. Content------------ 10 pts.

b. Organization----- 5 pts.

c. Creativity----------5 pts

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7 CHARACTERISTICS OF NURSE RESEARCHERS-

(C3H2AP)

y

C- Curiosit y ------ eager to seek information

undertake inquiry and serious thinking about situations andproblems affecting nurses and nursing.

y C- Creative Thinking

-----abilit y to go be y ond what alread y exist & develop various wa ys of doing things

y C- Critical Thinking----- A bilit y to relate stud y to a kno wn theor y

Clinical expertise and a working knowledge of the scientificproblem-solving technique help to a great extent in formalizingthe study.

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y H- Honest y

----Intellectual honest y==collecting, anal y zing and

reporting datay Intellectual honest y Researchers are honest in

collecting, analyzing, and reporting data

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Characteristics of Nurse Researchers- (C3H2AP)

y H- Humour

----sense of humour as to accept inadequacies in the stud y as basis for improvements

y A - A bilit y to relate their stud y to a kno wn Theor y

y P- Patience and discipline to see the stud y through

--- long hour of digging up, sorting, re writing manuscripts until the stud y becomes an integrated

whole

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D - EVOLUTION OF NURSING

RESEARCHFlorence Nightingale in 1859

---- focus:significance of a health y environment in thepromotion of the patients

physical and well-being

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Evolution of nursing researchNursing R esearch in 1900-19501st publication of A merican Journal of Nursing,

research emphasis is on the organization and

deliver y

of nur

sing

of

nur

sing

service

s

Nursing R esearch in 1950 and 1960research emerged as high priority with support from nursing

leaders HENDERSON & ABDELLAH.

Research was introduced & the steps in baccalaureate level by nursing schools

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Evolution of nursing researchNursing R esearch in 1970

- researches was on the improvement of nursingpractice; new journals were published (Advances

in Nursing Sciences, Image, Research in Nursing &Health, Western Journal of Nursing research);

Nursing R esearch in 1980

- focus was on the conduct of clinical nursingresearch. Many clinical journals published likecancer nursing, CV nursing, etc. NCNR (nationalcenter for nursing research) created in 1985.

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Evolution

o

f nursing

researc

hR esearch in 1990 (Present and Future)

NCNR renamed NINR( national institute fornursing research) under Dr. Hinshaw;

outcomes research has come out as animportant methodology.

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y thurs

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E - 6 PURPOSES OF NURSING RESEARCHP I E C E D

1. P- Prediction

provides knowledge to estimate effects of a given situation,or a prevailing condition.

Examples:

(1) What are the effect of health behaviours like balanceddiet, regular exercises, and no smoking on healthstatus and longevity?

(2) What are the effects of prolonged bed rest on thehospitalized patients recovery?

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Purposes of nursing research

2. I- Identification

Identifying or naming an unknown phenomenon inrelation to the practice; defining or conceptualizing

under inquiry.

Example: People with diabetes investigation aimed at

discovering the basic social problems affecting theiradherence to health care directives.

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3.

Exploration

NOT only simply observing and describing it, exploratory research investigates the full nature of the

phenomenon, the manner in which it is manifested, andthe factors to which it is related

Provides insights. It asks the question WHAT in order toinvestigate the causes or full nature of an existingparticular question.

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Examples:

(1) What factors diminish or increase a patients

stress?

(2) How is a patients stress related to the behavioursof the nursing staff?

(3) To what extent stress relates to the patientscultural backgrounds?

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4. C- Control

The manipulation of a given situation to produce the desiredoutcome .

Follows prediction of the outcome of a given situation. Itprovides a barrier to hinder or minimize the effects of a predicted outcome.

Prediction and control combined in nursing research may specify psychological and physiological reactions possible tonursing intervention.

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Example:

Research has shown that the incidence of Down Syndrome ininfant increases with the age of the mother.

---We can predict that a woman aged 40 yrs old is at higher riskfor bearing a child with Down Syndrome than a women aged25 years.

--- We can partially control the outcome by educating womenabout the risks and offering amniocentesis to women olderthan 35 years of age.

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Amniocentesis (also referred to as amniotic fluid test or AFT), is a procedure

used in prenatal diagnosis of chromosomal abnormalities and fetal infections ,

in which a small amount of amniotic fluid, which contains fetal tissues, is

extracted from the amnion or amniotic sac surrounding a developing fetus, and

the fetal DNA is examined for genetic abnormalities.

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Down syndrome (DS), also called Trisomy 21, is a condition in

which extra genetic material causes delays in the way achild develops, both mentally and physically. It affectsabout 1 in every 800 babies.

Normally, at the time of conception a baby inherits geneticinformation from its parents in the form of 46chromosomes: 23 from the mother and 23 from the father.In most cases of Down syndrome, a child gets an extrachromosome 21 for a total of 47 chromosomes instead of 46. It's this extra genetic material that causes the physicalfeatures and developmental delays associated with DS.

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5. E- Explanation

- Attempts to provide understanding of the underlyingcauses or full nature of a phenomenon.

- Offers understanding, clarification, and informationWHY a certain phenomenon occurs.

Examples: (1) Why do patients in the ICU need to feelsafe? or Why is it significant to provide for thepsychological needs of patients in the ICU?

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Purposes of nursing research 6. D- Description

Describing a phenomenon affecting the nursing profession.

Nurse researcher observes, count, delineate, and classify. It provides

new information.Examples: (1) Describing varied phenomena such as: patients stress

and coping, pain management, adaptation processes, healthbeliefs and practices, rehabilitation success and nursing care.

(2) Describing quantitative changes in psychological andpsychosocial resources six months after kidney transplantation.

(3) Describing the experience of waiting in a critical care room.

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SOURCES OF NURSING KNOWLEDGEyCustoms and Traditions

y Authority

yTrial and error as means of discovering knowledge/Staff

Development and ExperienceyDisciplined research

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SOURCES OF EVIDENCE FOR NURSING PRACTICE

1. Custom and Tradition

handling down knowledge from one generation to

another and leads to actions that occur because wevealways done it that way

2. Authority

experts or authorities in a given field often provideknowledge for other people.

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3. Clinical Experience

4. Trial and error

- alternatives are tried successively until a solution to aproblem is found

5. Logical Reasoning

- Combines experience, intellectual faculties, and formal

system of thought.

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G - RESEARCH PRIORITIES IN THE FUTURE1. Promotion of evidence-based practice

aim: Provide the best possible care based on the bestavailable research

2. Increased multidisciplinar y collaboration

3. Greater focus on outcomes researchaim: assessing and document the effectiveness of

health care services

4. Use of multiple, confirmator y strategies

5. Expanded dissemination of research findings

6. Increased visibilit y of nursing research

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yII PARADIGMS OF RESEARCH

y A. positivismsyScientific

y

Post positivismyB. naturalistic/ constructivism

yC. participatory/ advocacy

yD. pragmatism

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The design of a research studybegins with the selection of a

topic and a paradigm.

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PARADIGMS FOR NURSING RESEARCH

A world vie w: basic set of belief s that

guide action (Guba, 1990: 17)

A general perspective on the complexities of

the real world, with certain assumption about realit y

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PARADIGMy A diagrammatic representation of a conceptual

framework

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y It provides a conceptual framework for seeing andmaking sense of the social world;

y

to be located in a particular paradigm is to view the world in a particular way.

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y The significance of paradigms is that they shapehow we perceive the world and are reinforced by thosearound us, the community of practitioners.

y For the researcher it is important to recognise theirparadigm, it allows them to identify their role in the

research process, determine the course of any researchproject and distinguish other perspectives.

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y Therefore, paradigms are never right or wrong butmerely different ways of looking at society. In thatrespect, they are to be judged as useful or useless inspecific situations only.

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A PARADIGM ENCOMPASSES

FOUR ELEMENTS/ CATEGORIES- Epistemolog y,- Ontolog y - A xiolog y and- Methodolog y

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y Epistomology asks How do we know the world? Whatis the relationship between the inquirer and the known?Source of Data: Subject or Participant (reciprocity)

y Epistemology: what is the relationship between theinquirer and the known: "epistemology is the branch of philosophy that studies the nature of knowledge and theprocess by which knowledge is acquired and validated"(Gall, Borg, & Gall, 1996)

y Ontology raises basic questions about the nature of reality. What is there that can be known about the form

and nature of reality? Single or multiple

y Denzin and Lincoln (2001) listed three categories of thosebeliefs:

y

Ontology: what kind of being is the human being.

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y Ontology raises basic questions about the nature of reality. What is there that can be known about theform and nature of reality? Single or multiple

y Denzin and Lincoln (2001) listed three categories of those beliefs:

y Ontology: what kind of being is the human being.

y Ontology deals with the question of what is real.

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y Axiology- values: objectivity vs. Subjectivity: Bias

y axiology deals with the issues about value.y Specific assumptions about research include the role

of value in research, how to avoid value frominfluencing research, and how best to use researchproducts (Baptiste, 2000).

y

Methodology focuses on how we gain knowledgeabout the world. How can the inquirer (would-be-knower) go about finding out whatever he or shebelieves can be known?: Data obtained

y Methodology: how do we know the world, or gain

knowledge of it?

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ontologyy Norman Blaikie offers a fuller definition,

suggesting that ontological claims are claims and assumptions that are made about the nature of social realit y, claims about what exists, what it looks like, what units make it up and ho w these units interact with each other.

y In short, ontological assumptions are concerned with what we believe constitutes social realit y(Blaikie, 2000, p. 8)

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y Epistemolog y, one of the core branches of philosoph y, is concerned with the theor y of kno wledge, especiall y in regard to its methods, validation and the possible wa ys of gaining kno wledge of social realit y, whatever it isunderstood to be.

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Epistemologic

Ho w is theinquirer related

to those being researched?

Inquirer is independent

from those

being

researched;

findings are

not influencedby the researcher

Inquirer interactswith those being

researched;

findings are the

creation of theinteractive process

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Axiologic

W hat is the role of

values in

the inquir y ?

Values& biases

are to be

held incheck;

objectivityis sought.

Subjectivityand values

are inevitable

and desirable

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ASSUMPTION POSITI V IST PARA DIGM NATURALISTIC PARADIGM

Ont l ic

( at is t eat re f eality?)

Reality exists, there

is a real worlddriven by real

natural causes

Reality is multiple and

subjective, mentallyconstructed by

individuals

Epistemologic

How is theinquirer relatedto those beingresearched?

The inquirer is

independent from

those being

researched; findings

are not influenced by theresearcher

The inquirer interacts

with those beingresearched; findings

are the creation of theinteractive process

A xiologic What is the roleof values in theinquiry?

Values andbiases are to be

held in check;

objectivity is

sought.

Subjectivity andvalues are

inevitable anddesirable

Methodologic Deductive processes Inductive processes

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Methodologic

Ho w is the evidence best obtained?

Emphasis on discrete,specificconcepts

Focus on the objective andquantifiable

V erifications of researchers prediction

Outsider kno wledge-researcher is external separate

Fixed pre-specified design

Measured, QuantitativeInformation;statisticalanal ysis

Seeks generalization

Emphasis on entiret y of somephenomenon, holistic.

Focus on the subjective andnonquantifiable

Emerging insights grounded in participantsexperiences.

Insider kno wledge-researcher is internal, part of the process

Flexible, emergent design

Narrative information,qualitativeanal ysis

Seeks indepth understanding

Focus on the product and the

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4 different worldviews

y1. Positivism/Postpositivism

y2. Constructivism/ Naturalism

y 3. A dvocac y/Participator y

y4. Pragmatism

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FOUR WORLDVIEWS USED IN RESEARCH

Postpositivism Constructivism Advocacy and

Participatory

Pragmatism

- Determination

- Reductionism

- Empirical

observation

and

measurement

- Theory

verification

- Understanding

- Multiple

participant

meanings

- Social and

historical

construction

- Theory

generation

- Political

- Empowerment

and

issue oriented

- Collaborative

- Change

oriented

- Consequences

of

actions

- Problem

centered

- Pluralistic

- Real-world

practice

oriented

Source: Creswell (2003)

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Types of Research according to General Classification

A. Quantitative R esearch

Types:

1. Descriptive Research

2. Correlational research

3. Quasi-experimental

4. Expereimental

B. Qualitative R esearch

Types:

1. Phenomenological

2. Grounded theory

3. Ethnographic

4. Historical

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Quantitative R esearch

- Is a formal, objective, systematic process in whichnumerical data are used to obtain information aboutthe world

Qualitative R esearch- Systematic subjective approach to describe life

experiences and give meaning

- Used to describe and promote understanding of human experinces such as pain, caring, powerlessnessand comfort.

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Comparison of Research Approaches

Quantitati

y Ob jectivity val e

y One reality

y

e cti n, c ntr l, andpredicti n

y Meas rable

y arts e al t e le

y eport statistical analyses

y esearc er separate

y eneralization

Qualitative

y Subjectivity valued

y Multiple realities

y

Discovery, description, andunderstanding

y Interpretive

y Whole is greater than theparts

y Report rich narrative

y Researcher part of the process

y Uniqueness

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A. Quantitative R esearch

Types:1. Descriptive Research

2. Correlational research

3. Quasi-experimental

4. Expereimental

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Purposes of Nursing ResearchI D E E C P

1. Identification

3. D..escription4. E..xploration

5. E..xplanation

6. C..ontrol

7. P.rediction

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Purposes of Nursing Research1. Identification

Naming an unknown phenomenon in relation to the nursingpractice

Example : People with diabetes and hypertension investigation

discovering the basic social problems affecting their adherenceto health care directives.

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Documents

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