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Evidence-Based Practice and Nursing Research
Chapter 6
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Nursing Research
Nursing research makes a difference to the care of clients, advances the discipline of nursing, and helps develop nursing knowledge.
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The Historical Development of Nursing Research
1936 First research grant awarded by Sigma Theta Tau.
1952 Nursing Research became official research journal of American Nurses Association.
1955 American Nurses Foundation formed.
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The Historical Development of Nursing Research
1963 Surgeon General’s Consultant Group on nursing research.
1965 First research conference to stimulate clinical studies focusing on quality of care.
1970s Establishment of three nursing research journals.
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Organizations that Support Nursing Research
American Nurses Association American Nurses Foundation National Institute for Aging
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National Institute of Nursing Research (NINR)
Fundamental organization for coordinating and supporting the research efforts within the nursing profession
Established in 1993 Formerly National Center for Nursing
Research (1985)
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The Historical Development of Nursing Research
Three major areas of nursing research funding for the 21st Century: • Health Promotion/Disease Prevention• Acute and Chronic Illness• Nursing System
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Development of Nursing Knowledge
Evidence-Based Practice (research-based practice, best practice)• Integration of best research evidence with
clinical expertise and patient values
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Evidence-Based Practice
A move toward supporting practice with evidence began in the mid-1980s.
Agency for Healthcare Research and Quality oversees publishing reviews of evidence and clinical guidelines and supports nursing research.
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Evidence-Based Practice
Level of Evidence• Four levels of evidence designate the
amount of research support generated to support a particular strategy in care.
• Best Practice Information Sheets allow reviewers to evaluate and draw conclusions based on the prescribed level of evidence.
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Research Designs, Methods, and Methodologies in Nursing
The two main research paradigms in nursing are quantitative and qualitative.
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Research Designs, Methods, and Methodologies in Nursing
Quantitative Research Design• Draws conclusions about some procedure.• Uses statistical methods.• Uses deductive reasoning, logic, and
measurable aspects of experience.
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Quantitative Research Design Methods
Descriptive, exploratory, survey Historical review Cross-sectional, longitudinal Retrospective, prospective Correlational Quasi-experimental, experimental
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Quantitative Research
Descriptive Studies • Describe a phenomenon of interest (clinical
observation).
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Quantitative Research
Exploratory Studies • Describe in detail the phenomena and try to
identify contributing factors.
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Quantitative Research
Survey Method • Surveying a group of individuals for
responses to certain questions.
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Quantitative Research
A nurse researcher gives directions to research assistants when she is training to implement her survey method of research.
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Quantitative Research
Historical Research • Systematic data collection relating to past
events.• Places concepts in perspective.• Establishes parameters for continued
research in a specialized area.
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Quantitative Research
Cross-Section Studies • Data collected at one specific measurement
point about a single event.• A relatively large number of individuals is
sampled in a short period of time.
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Quantitative Research
Longitudinal Studies • Data collection on the same subjects studied
over time. • Data is collected on a number of variables.
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Quantitative Research
Retrospective Studies • Review existing data from medical
records/hospital charts.• A carefully conducted retrospective study
can provide the research questions for a prospective study.
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Quantitative Research
Prospective Studies • Actively follow subjects over the period of
the study.• The researcher is able to control all
information collected.
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Quantitative Research
Correlational Designs • Investigate the correlation (relationship) of
one variable to another.• Useful for studying the relationships among
large numbers of variables associated with “human research.”
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Quantitative Research
Quasi-Experimental Design • A modified experiment exposing all subjects
to the independent variable.• Less robust than a true experimental design.
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Quantitative Research
Experimental design • Tests an “independent variable” against a
“dependent variable.”• Subjects are randomized to a treatment
group or a control group.• “Gold standard” in research design.
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Research Designs, Methods, and Methodologies in Nursing
Qualitative Research Design• The systematic collection and consideration
of data relating to humans’ interactions in and with the world.
• Frequently involves interview data.• Provides a more holistic approach that is
conducted in natural settings.
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Methods of Qualitative Research
Biographical Case Study Method Ethnography Ethnomethodology Grounded Theory Phenomenology
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Qualitative Research
Biographical Method• Involves writing about people’s lives.• Sources of data include historical
documents: artifacts, diaries, letters, personal stories, related historical facts.
• Data analysis involves sorting and relating all the information gathered.
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Qualitative Research
Case Study Method • May refer to a single case, subject, group, or
institution.• Multidimensional approach using a variety of
data-collection strategies.
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Qualitative Research
Ethnography• Longitudinal, descriptive research approach
used by anthropologists to describe behaviors of a culture.
• Data sources include observation of participant behavior, interviews, artifacts.
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Qualitative Research
Ethnomethodology• Interpretive descriptions of how people make
sense of their social world.
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Qualitative Research
Grounded Theory• Field research used in hospitals, nursing
homes, clinics.• Investigates social and decision-making
processes of clients.• Involves theoretical sampling until data
saturation is reached.
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Qualitative Research
Phenomenology• Approach uses a variety of distinctive, yet
related, philosophical approaches.• Begins in profound reflection on the
phenomenon to be studied.• Multiple sources of data collection.• Requires intense reflection to understand its
meaning.
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Literature Review
The process by which published and unpublished materials are selected to develop support for the research project. • Computerized literature search• Conference abstracts• Published and unpublished materials
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Developing a Research Proposal
Identification of the research question Statement of the problem Research design Implications for nursing
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Writing and Publishing Research Studies
Identification of the most appropriate journal for disseminating the results of the study.
Specific criteria for publication includes submission of an abstract and manuscript.
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Implementing Research into Nursing Practice
Publication of findings Forums for presenting findings Applying legal and ethical principles Gaining support from management Making changes in nursing practice
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Legal Aspects of Research
Protection of subjects in all research studies is mandatory.
Informed consent is the primary method for ensuring subjects are protected.
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Legal Aspects of Research
The subject’s rights that are protected in informed consent are:• Protection from harm• Full disclosure of information• Freedom to participate or not• Privacy and confidentiality respected
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Legal Aspects of Research
The Institutional Review Board provides a structure for research to be implemented in both a legal and an ethical environment.
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Legal Aspects of Research
Informed Consent for Vulnerable Clients• Confused elderly, unconscious, underage
clients• Consent by proxy
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Nursing Research in the Year 2003 and Beyond
Future changes in nursing research include collaboration and development of teams of researchers using distance learning technology.
