research in nursing practice revision

Research in

Nursing PracticeB. Sunil S. De Silva

RN, BScN(OUSL), MScN(RES)(Australia)

Head/Senior LecturerDepartment of Health Sciences

The Open University of Sri Lanka

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Objectives Describe the importance of the

nursing research to practice. Identify historical aspects. Identify ethical issues. Critique research problems,

variables, literature review & hypotheses.


Objectives… Identify different research designs,

samples & populations. Define internal & external validity. Identify different methods of data

collection & data analysis. Disseminate research findings to

develop nursing knowledge.


Introduction to Nursing Research


What is Research? Research – search again or to

examine carefully. Research is systematic inquiry that

uses disciplined methods to answer questions or solve problems (Polit & Beck, 2006)

The ultimate goal of research is to develop, refine, & expand a base of knowledge.


Types of ResearchResearch

Basic/Pure research Applied research

Develop theories that

will strengthen our understanding

of the nursing process are part of basic research

Find solution to

clinical problems as part of

applied research


Major areas of nursing research

Nursing Characteristics Patient Characteristics Nursing Administration Nursing Education Clinical Practice


Purposes of Scientific Research…


Research Process Conceptual phase - Think it out

Empirical phase - Go & Do it

Interpretive phase - See what it all means

Research Study Evaluation Guide based on these three phases.


Research Process


Historical Aspects of Nursing Research


Historical Aspects of Nursing Research… Initiate from the time of F. Nightingale.

Recent trend to focus nursing practice than the nursing education & administration.

After 1950’s nursing research began to publish.

Future focus on health prevention, & illness prevention.

Theory development increase the body of knowledge.

Ethical Issues in

Nursing Research


Code of ethics Many countries have developed codes

of ethics for research concerning human subjects.

It helps that the research remains ethical as well as scientific.

Recent guidelines, established in the Belmont Report (1978) ensure unbiased review.


Belmont Report It rely on two historical documents;

The Nuremberg Code First international accepted code. Introduced informed consent.

The Declaration of Helsinki Initially develop for the doctors for clinical research. In nursing research – inform research subjects – No

personal benefits & avoid any understated suggestion.


Basic Rights of Research Subjects Belmont Report served as model for

many of guidelines adopted by specific disciplines & outlined three primary ethical principles;

Beneficence Respect for human dignity justice


The Principle of Beneficence It is the right of ‘Freedom from harm’

Freedom from harm/ risk of harm includes physical, emotional, legal, financial, & social harm

Freedom from exploitation/use Information do not use against them

Benefits from research should know potential benefits

Risk/Benefit Ratio Risk should be minimal


The Principle of Respect for human dignity

The right of self-determination Voluntary decide to participate or not (at any time)

The right to full disclosure Fully informed – purpose, benefits, risks or on

going & end results.


The Principle of justice The right to fair treatment

Fair & nondiscriminatory selections of subject Not on convenience or bias No harmful treatments for give up or refuse to

participate

The right to privacy Maintain anonymity & confidentiality


Mechanisms for Ethical Standards Informed Consent Subject status Study purpose Type of information Nature of commitment Sponsorship Subject selection Procedures

Potential risk & benefits

Confidentiality Voluntary consent Right to withdraw Alternatives Contact information


Mechanisms for Ethical Standards… Vulnerable Subjects

Not capable of giving informed consent. Children Mentally or emotionally disabled people Physically disabled people Peoples who are in hospitals or prisons Pregnant women

Review Boards


Characteristic of ethical research Scientific objectivity – aware personal values & biases

Cooperation – work with ethical committees

Integrity – should not withhold any information, risks, benefits…

Equability – acknowledge the contributions

Nobility – Protect from harm

Truthfulness – Openness; purpose, procedure, methods…

Anonymity & confidentiality - Honesty – reveal scholarships, any findings…

Communication – Disseminate the findings


Identifying Research Problems


Sources of Research Problem Experience & interests – lead to clinical

research Existing research – published research Theory development – stem from scientific

interest External sources – pattern or trend

occurring in health care Social issues – Domestic violence

Reader – Edgar(1985),Fraleigh(1986)


Developing a Research Question… Research problem - Broad topic of interest Problem statement - Articulate/clear the

problem to be addressed. Statement of purpose – Goal Research questions – the specific queries to

answer in addressing a research problem. Direct rewordings of statement of purpose,


Feasible Problem Feasibility involves several factors which

the researcher needs to consider before beginning the research; Time Availability of subjects Cooperation of others Facilities & equipment Financial support Ethical considerations


Variables


Definition of Terms Concepts - ideas that the researcher

wants to study. Construct – narrow the focus of the study

to identify key concepts. Variable – after concepts are made

measurable, they are referred to as variables. The variables are the observable, measurable concepts which you propose to study.

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Types of Variables Independent variables

Dependent variables

Correlated variables

Extraneous variables

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Review of the Literature


The Lit. review in a study serves several functions;

Presents theoretical frame work for the study.

Offers a critical analysis of developments related to the study’s topic.

Give credibility / trustworthiness to the study by showing that is a precedence / priority.


Conducting the lit. review involves;

Checking for appropriate & relevant literature.

Making notes on the relevant articles located through the search.

Doing a critical analysis of each article.


Lit. review should include the following types of literature

Relevant nursing research. Theoretical literature. General & specialty nursing literature. Methodological literature. Research literature from other disciplines. Popular lit. from sources written for general population.


The Hypothesis


Hypothesis… A hypothesis is the formal statement of the

expected relationships between two or more variables in a specified population.

Its provide specific direction for subsequent aspects of design, data collection & analysis.

Correlation, qusi-experimental & experimental studies need to include hypothesis.


Categories of Hypothesis Different type of hypotheses depending

upon the relationships & number of variables identified in the research problem, Associative versus casual Simple versus complex Directional versus non directional Statistical versus research hypothesis.


Associative versus casual Associative

Positive associative relationship. smoking & lung cancer

Negative associative relationship. health & illness

Casual Causal relationship – independent variable causes to

change dependent variable. prenatal education cause on a mother’s labor outcome


Simple versus complex

Simple hypothesis – relationship between two variables (associative or causal)

Complex hypothesis – relationship among three or more variables.


Directional vs non directional

A directional hypothesis is also an associative hypothesis, and states the direction of the predicted relationship Positive

As X increases, Y increases As X decreases, Y decreases

Negative As X increases, Y decreases As X decreases, Y increases


Statistical/Null vs Res. hypothesis No relationship between variables. used for statistical testing & interpreting the

results of statistical analyses. simple or complex & associative or causal. It may not always be stated, but it is indirect, as it

is the opposite of the res. hypothesis. Ex; - There is no difference in measures of perceived stress

(a dependent variable) & blood pressure (a dependent variable) between subjects who do & do not participate in a program of meditation (independent variable).


Hypothesis… An hypothesis try to answer the question posed by the

research problem.

It can be associative or casual, simple or complex, directional or non directional & research or statistical.

When testing the validity of the assumptions made from the theoretical frame work , the hypothesis bridges the theoretical & real worlds.

A hypothesis is a declarative statement about relationship between two or more variables that predicts expected outcome.


Hypothesis… It should clear statement, contain the components

of population, variables, & predicted outcome. Two criteria used to critique are justifiable &

testable. Hypothesis…

Exploratory studies – (-) Descriptive/correlational studies – (+/- ) Res. Question

may be use Quasi-experimental/experimental - (+)


Research Design


Research Design… After developed research , specified variables, &

derived a hypothesis, then should determine the research design.

The ‘design’ is the structure of an investigation, through which answers to research questions are sought and outside influences are controlled (extraneous variables)

The two categories of research, qualitative & quantitative, refer both to the method of data collection & to the type of data collected.


Two main categories of research

Qualitative

Quantitative


Quantitative researchexperimental Nonexperimental

1. True experimental - must have three criteria;

control, manipulation & randomization

2. Quasi-experimental- randomization or control are

missing. - Most often random selection

or random assignment not possible.

• Least amount of control over extraneous variables in the study

• Describe the relationship between variables & unable to determine cause & effect.

• Correlation study - Examine the relationship between variables in a single group.

• Descriptive study - Describe each variable rather than manipulation & relationships.

• Survey design• Qualitative designs are nonexperimental & used new area of knowledge which is little is known.• Time, setting, & reasoning must be considered when determining the strength of the design.The research design chosen for the study depends on the purpose of the study


Qualitative Nonexperimental research It is exploratory in nature & aims to

describe & explore concepts in natural settings.

Most common types; Ethnography – cultural studies Phenomenology – lived experiences Grounded theory – discover social processes.

Population and

Sample


Basic Sampling ConceptsPopulation A population is an entire set of elements

(person, event or behavior…) Target population is the entire population

in which the researcher is interested. Accessible population is accessible to the

researcher for the study.


Basic Sampling Concepts…Samples & Sampling Criteria Sample consists of a subset of the

elements/people. Sampling involves selecting a group of elements

to conduct a study. Sampling criteria list the essential

characteristics for membership in the target population.

Sample need to represent target population to generalize the findings.


Probability/Random Sampling It refers to the fact that every element of the population has a probability higher than zero of being selected for a sample.

The method of equal opportunity is referred to as random sampling.

Experimental design, Survey design usually use random sampling procedure.

To achieve representative sample random sampling develop four types; simple, stratified, cluster, & systematic sampling.


Nonprobability Sampling Elements are chosen by nonrandom

methods. Though representativeness is less, it has

been commonly used in nursing studies. There are four nonprobability sampling;

convenience, quota sampling, purposive sampling & network sampling.


Sample Size Historically minimum sample size is 30. but

now it depends on the population. Do the power analysis for determine sample

size. Power is the capacity of the study to detect

differences or relationships that actually exist in the population.

Initial sample size will need to be larger than the calculated number as most studies lose subjects.

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Data Collection

Physiological Measurement – weight, BP…

Observational Measurement – researchers’ observations

Self-Report Measurement – interviews, questionnaires, & scales.

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Data Analysis, Discussion & Conclusions…

Data analysis depends on the type of research design & the purpose of the analysis.

Discussion & Conclusions… Interpretation of findings Limitation of the study Implication & generalizability Recommendations

Dissemination the findings to build body of knowledge in nursing.


Summary Introduction to Nursing Research Historical Aspects of Nursing Research Ethical Issues in Nursing Research Identifying Research Problems Variable Review of the Literature The Hypothesis Research Design Population and Sample Data Collection Data Analysis, Discussion & Conclusions…


The End

Research in

Nursing Practice

research in nursing practice revision

Healthcare