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NURSING RESEARCH• Is a systematic inquiry designed to
develop knowledge about issues of importance to the nursing profession, including nursing practice, education, administration, and informatics.
PURPOSE OF NURSING RESEARCH
• To test, refine and advance the knowledge on which improved education, clinical judgment, and cost-effective, safe, ethical nursing care rests.
THE ORIGIN OF NURSING RESEARCH
• FLORENCE NIGHTINGALE – viewed as the person who first elevated nursing to the status of a PROFESSION, as presented in her first book NOTES ON NURSING (1859)
• Believed in the importance of “naming nursing” by the use of observed data to support the need for health-care reforms.
• Methodical Data gathering
A Look at Nursing Education• 1923 – Committee for
the Study of Nursing Education– Studied educational
preparation of nurse teachers, administrators, public health nurses and the clinical experiences of nursing students.
– Gold Mark Report – identified many inadequacies in the educational backgrounds of the group studied and concluded that advanced educational preparation was essential.
• 1940s (WWII) – tremendous need for educated nurses– Nursing education
practices were evaluated in the study commissioned by the National Nursing Council for War Service headed by Brown
– Brown revealed numerous inadequacies in nursing education and thus, recommended that education of nurses occur in the collegiate level.
CENTER FOR NURSING RESEARCH
• 1950s– Walter Reed Army
Institute of Research – center for nursing research
– Nursing Research (journal)
EVIDENCE-BASED PRACTICE• Defined as the use of
the best clinical evidence in making patient care decisions to achieve cost-effective, high quality care based on scientific inquiry.
POSITIVIST PARADIGM
ASSUMPTION POSITIVIST PARADIGMOntologic (what is the nature of reality?)
Reality exists; there is a real world driven by real natural courses
Epistemologic (How is the inquirer related to those being researched?)
The inquirer is independent from those being researched; findings are not influenced by the researcher
Axiologic (What is the role of Values in the inquiry?)
Values and biases are to be held in check; objectivity is sought
Methodologic (How is knowledge obtained?)
Deductive process, emphasis on discrete, specific concepts; fixed design, tight controls over context, emphasis on measured, quantitative information; statistical analysis; seeks generalization
NATURALISTIC PARADIGM
ASSUMPTION NATURALISTIC PARADIGM
Ontologic (what is the nature of reality?)
Reality is multiple and subjective, mentally constructed by individuals
Epistemologic (How is the inquirer related to those being researched?)
The inquirer interacts with those being researched; findings are creation of the interactive process
Axiologic (What is the role of Values in the inquiry?)
Subjectivity and values are inevitable and desirable
Methodologic (How is knowledge obtained?)
Inductive process; emphasis on entirely of some phenomenon, holistic; emerging interpretations grounded in participants’ experiences; flexible design; context-bound; emphasis on narrative information
Qualitative analysis
RESEARCH METHODS
• Are the techniques used by researchers to structure a study and to gather and analyze information relevant to the research question.
THE SCIENTIFIC METHOD AND QUANTITATIVE
RESEARCH
• SCIENTIFIC METHOD – refers to a general set of orderly, disciplined procedures used to acquire information.
QUANTITATIVE RESEARCH• Uses deductive reasoning • Systematic • Uses control• Uses measurements• Researchers gather empirical evidence
(objective in nature)• Information gathered is usually (but not
always) quantitative/numerical• Uses statistical analysis• Cannot be used to answer moral or ethical
questions
NATURALISTIC METHODS AND QUALITATIVE
RESEARCH
• NATURALISTIC METHOD – attempt to deal with the issue of human complexity by exploring it directly.– Investigations place a heavy emphasis on
understanding the human experience as it is lived.
QUALITATIVE RESEARCH• Uses inductive reasoning• Used for theory development• Approach is flexible• Always takes place in the field• Concurrent collection and analysis of data• Gathers rich and in-depth information
(subjective in nature)• Report is written in narrative form• Involves small group of people or subjects• Cannot be used to answer moral or ethical
questions
• People who are being studied– Quantitative – subjects, study
participants, respondents– Qualitative – informants, key
informants, study participants
• Sample – composed of the people being studied
• Person who undertakes the research– Quantitative – researcher,
investigator, scientist– Qualitative – researcher,
investigator
• Research Settings – specific places where data collection occurs– Quantitative – laboratory
setting, (sometimes) field settings
• Example: Pierce and Clancy (2001) studied the effects of hypoxia on diaphragm activity in anesthetized rats.
– Qualitative – naturalistic setting/field
• Example: Carlisle (2000) studied the search for meaning in the care giving experience among informal carers of people living with HIV and AIDS. The researcher gathered in-depth information from carers in their homes and in HIV/AIDS org.
BUILDING BLOCKS OF A STUDY
• Phenomena – occurrence or events
• Concept – abstract ideas– Examples of phenomena and concepts: pain,
coping, and grief
• Constructs – abstractions that are systematically invented by a researcher– Example: self-care
THEORIES AND CONCEPTUAL FRAMEWORKS
• Theory – systematic, abstract explanation of some aspect of reality– Example: Nightingale’s Environmental Nursing Theory
• Conceptual Frameworks/Models – interrelated concepts or abstractions assembled together in a rational scheme by virtue of their relevance to a common theme.– Example: Betty Neuman's Health Care Systems Model
VARIABLES• Are something that varies
– Examples: weight, body temperature, income, anxiety level, etc
• Are central building blocks of a quantitative study
• Constant – opposite of variables
• Independent variable – presumed cause• Dependent variable – presumed effect
• Independent and dependent variables are used to indicate direction of influence rather than causal link.– The effect of initial bath timing on the
temperature of newborns– The effect of sautéed garlic on the blood
pressure of elderly patients– The relationship between teacher’s qualification
and student education
– Quantitative data – numerical• Example: Thinking about the past week, how
depressed would you say you have been on a scale from 0-10, where 0 means “not at all” and 10 means “the most possible.”
– Subject 1 – 9– Subject 2 – 0– Subject 3 - 4
– Qualitative data – narrative descriptions• Example: tell me about how you’ve been feeling
lately. Have you felt sad or depressed at all, or have you generally been in good spirits?
– Participant – I’ve had a few ups and downs in the past week, but basically things are pretty even keel. I don’t have too many complaints.
• Reliability – refers to the accuracy and consistency of information obtained in the study
• Generalizability – asses the extent to which the findings can be applied to other groups and settings.
• Validity – complex concept that broadly concerns the soundness of the study’s evidence.– If methods used in
the study are really measuring the concept/s that they have to measure.
• Dependability – in qualitative studies, refers to evidence that is consistent and stable
• Confirmability – is similar to objectivity; it is the degree to which study results are derived from characteristics of participants and study context.
• Credibility – is achieved to the extent that the research method engender confidence in the truth of the data and in the researcher’s interpretations of the data.
RESEARCH CONTROL• Involve holding
constant other influences on the dependent variable so that the true relationship between the dependent and independent variables can be understood.
• Attempts to eliminate contaminating factors that might cloud the relationship between the variables of central interest.
– Example: Effect of sautéed garlic on the blood pressure of elderly patients – get subjects who are of almost the same age and engage in the same type of activities.
RANDOMNESS• A powerful tool in quantitative studies to
eliminate biases.
• Is not considered in qualitative studies
KEY TERMS USED IN QUANTITATIVE AND QUALITATIVE RESEARCH
CONCEPT QUANTITATIVE TERM QUALITATIVE TERM
Person Contributing Information
Subject, Study Participant, Respondent
Study participant, informant, key informant
Person undertaking the study
Researcher, investigator, scientist
Researcher, investigator
Being investigated Concepts, constructs, variables
Phenomena, concepts
System of organizing concepts
Theory, theoretical and conceptual framework,
Theory, conceptual framework
Information gathered Data (numerical) Data (narrative descriptions)
Connections bet. concepts
Relationships (cause-and-effect, functional)
Patterns of association
Quality of evidence Reliability, Validity, Generalizability, Objectivity
Dependability, Credibility, Transferability, Confirmability
MAJOR CLASSES OF QUANTITATIVE RESEARCH
• EXPERIMENTAL RESEARCH – type of research wherein researchers actively introduce an intervention or treatment.– Explicitly designed to test causal
relationships– Offer the possibility of greater control
EXPERIMENTAL RESEARCHExample:
A researcher gave bran flakes to one group of subjects and prune juice to another to evaluate which method facilitated more effective elimination.
MAJOR CLASSES OF QUANTITATIVE RESEARCH
• NONEXPERIMENTAL RESEARCH – type of research wherein researchers collect data without making changes or introducing treatment.
NONEXPERIMENTAL RESEARCH
Example: A researcher compared elimination patterns of two groups of people whose regular eating patterns differed – some normally took food that stimulated bowel elimination and others did not – there is no intervention.
MAJOR CLASSES OF QUALITATIVE RESEARCH
• GROUNDED THEORY – seeks to describe and understand the key social, psychological, and structural processes that occur in social setting– Focus is on a developing social experience – the
social or psychological stages and phases that characterize a particular event of episode.
GROUNDED THEORYHauck and Irurita (2002) conducted a grounded theory study to explain the maternal process of managing late stages of breastfeeding and weaning the child from the breast.
MAJOR CLASSES OF QUALITATIVE RESEARCH
• PHENOMENOLOGY – concerned with the lived experiences of humans– An approach to thinking about what life
experiences or people are like and what they mean.
– Answers the question: What is the meaning of the phenomena to those who experience it?
PHENOMENOLOGYExample: Sundin, Norberg, and Jansson (2001) conducted a phenomenological study to illuminate the lived experiences of care providers who were highly skilled communicators in their relationship with patients with stroke and aphasia.
MAJOR CLASSES OF QUALITATIVE RESEARCH
• ETHNOGRAPHY – provides a framework for studying the meaning, patterns, and experiences of a defined cultural group in a holistic fashion.
– Ethnographers typically engage in fieldwork and often participate to the extent possible in the life of the culture under study
– Aim is to learn from members of a cultural group.