ROOSEVELT COLLEGE SYSTEM INSTITUTE OF NURSING AND HEALTH EDUCATION

SELF CORRECTION OR OBJECTIVITY THE USE OF SENSORY, EMPIRICAL (based on observation and experience) EVIDENCE

. RESEARCH Why do research? There must be a better way Purpose of Research to answer questions, whether they arise from a simple need or curiosity. 1. 2. 3. 4. Professionalism Accountability Social relevance of Nursing Research and Decision making in Nursing

Basic Aims of Scientific Inquiry: DEVELOP EXPLANATIONS OF THE WORLD [THEORIES] FIND SOLUTIONS TO PROBLEMS

I.

RESEARCH IN NURSING

Nursing research, according to the ANA Commission on Nursing Research, is research that develops knowledge about the following: Health and promotion of health over the full life span Care of persons with health problems and disabilities Nursing actions to enhance peoples ability to respond effectively to actual or potential health problems

Why do research? The value and usefulness of the scientific approach for making real world decision about nursing practice are clearer if you realize that: A. Science doesnt have to be dogmatic an mechanistic B. Science involves a process of discovery as well as process of proof C. Science requires an interpretation of acts and these interpretation can change D. Most of the principles and topics for nursing research exist in the practice of clinical nursing.

Nursing research includes investigation into: Health promotion and health restoration of individuals, families, groups, and communities Issues related to nursing education, administration, and the professions role in health policy formation

Alternative Ways of knowing: Use of trials and error combined with common sense Use of authority and tradition Use of inspiration and intuition Use of logical reasoning

The ANAs Standards of Clinical Nursing Practice states that all nurses should select nursing interventions that are substantiated by research and, further, that all nurses may participate in research activities based on their level of education, their position, and their practice setting. The nurse is expected to: Have some awareness of the process and language of research Be sensitive to issues related to protecting the rights of human subjects Participate in identifying significant researchable problems Be a discriminating consumer of research findings

Basic Assumptions that Underpin the Scientific Approach: It is better to be knowledgeable of the world than to be ignorant of it Observes of the world are able to relate observation conceptually and make meaning out of them.

Nurses who participate in research or who practice in settings where research is conducted with human subjects play an important role in safeguarding the following rights: A. Right not to be harmed subjects should be free from exposure to the possibility of injury going beyond everyday situations B. Right to full disclosure subjects should be given complete information about their participation in the study C. Right of self-determination
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SCIENTIFIC INQUIRY A process in which observable, verifiable data are systematically collected from the world through our senses to describe, explain and predicts events.

Characteristics of Scientific Inquiry that other ways of knowing dont have:

subjects should feel free from constraints, coercion, or any undue influence to participate in a study D. Right to privacy and confidentiality subjects should be able to participate in a study without worrying about later embarrassment II. RESEARCH systematic, controlled and empirical investigation that aims to develop general knowledge about natural phenomena

What is a researchable question? One that yields hard facts to help solve a problem, produce new research, add to theory, or improve nursing practice. One that provides answers that explain describes, identify, substantiate, predict or qualify.

Nursing research must be: Usable Now questions Clear

Systematic: progresses through a series of steps according to a pre-specified plan of action Controlled: involves imposing conditions on the situation so that errors are minimized and validity is maximized Empirical: evidence is on hand to support the study findings and is used as the basis for generating knowledge

Two basic components to every question: a. Stem b. Topic How to ask research questions? Start with a simple question Ask an active question

General Purposes: Description Explanation Exploration Prediction and Control

LEVELS OF QUESTIONS: Level I: There is little to no literature on either the topic or the population Purpose: to describe what is found as it exists naturally Level II: There is knowledge about the topic and about the population but the intent of the researcher is to do a statistical description of the relationships among variables Level III: There is a great deal of knowledge or theory about the topic, to test the theory through direct manipulation of variables. All level 3 questions lead to experimental designs Finding the level of knowledge according to topic: Level I: questions have one variable in one population Level II: questions have two or more variables in one population Level III: questions have cause and effect

Steps in the Research Process: 1. Identification of a problem 2. Review of related literature 3. Development of a study framework 4. Formulation of hypothesis 5. Selection of the study design 6. Selection of population, sample and setting 7. Data collection 8. Analysis and interpretation of data What is a research question? Explicit query about a problem, or issue that can be challenged, examined, and analyzed, and that will yield useful or new information. A reflection of the opinions and ideas of the researcher

Where to look for research topics? Thoughts Personal experiences Experiences Observations Previous researches Literature sources Existing theories

Elements of a research problem: 1. Review of related literature 2. The rationale for developing the question 3. The theoretical or conceptual framework VARIABLES

What are the basic requirements for selection? a. Knowledge on the topic b. Being interested in it Independent: cause, the variable which is thought to influence the dependent variable.
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Dependent: effect or the variable that is influenced by the researchers manipulation (control) of the independent variable. OTHER TYPES: Attribute- preexisting characteristics of the study participants, which the researcher simply observes or measures Continuous- a variable that can take on an infinite range of values along a specified continuum (ex. Height) TYPES OF NURSING RESEARCH 1. BASIC, OR PURE RESEARCH Directed to develop theories that can increase the state of knowledge 2. APPLIED RESEARCH Directed to solve problems or make decisions for what are considered practical purposes. Also directed at clinical trials aimed at developing and valuating new program, program, product, method or procedure. According to Diers: All nursing research are applied research There are 3 distinguish characteristics of a nursing problem: 1. MUST INVOLVE A DIFFERENCE THAT MATTERS IN TERMS OF ITS CONSEQUENCES IN IMPROVING PATIENT CARE 2. MUST HAVE A RELATIONSHIP TO MORE CONCEPTUAL ISSUES AND THEREFORE HAS THE POTENTIAL FOR CONTRIBUTING TO THEORY DEVELOPMENT AND OUR BODY OF SCIENTIFIC NURSING KNOWLEDGE 3. NURSES MUST HAVE ACCESS TO OR CONTROL OVER THE PHENOMENON BEING STUDIED

a researcher interested in the concept of hunger conducted his study by making college students drink through a tube from behind screen with no visual cues about what they are taking in. it is being conducted with people instead of animals but the topics of hunger and satiation are not specifically related to nursing activity Stage III. Relevant Topics and Subjects Example study to determine whether infants placed in different body positions consumed different amounts of energy it involves people as subjects and compares different positioning choices have direct concern to nursing practice Stage IV. Relevant Topics, Subjects and Trial Conditions Example: This is an example of research in nursing intervention under a special condition. Stage V. Normal Field of Conditions Stage VI. Advocacy and Adoption Research that demonstrate the applicability of primary nursing in which one nurse is totally responsible for a case load of patients.

Types of Nursing Research according to purpose or design: RESEARCH DESIGN Provides a plan, or blueprint, for answering the research question Specifies control mechanisms to be used in the study The more knowledge there is about the topic and the higher the control of variables, the stronger the design. The following are to be considered in selecting the research design: The setting for the study a) Laboratory study designed to be more highly controlled in relation to both the research environment and the extraneous variables b) Field study done in natural settings (e.g.: wards, communities, homes) or somewhere other than in a controlled laboratory setting Timing of data collection a) Looking into the past Historical descriptive studies that ask people to recall events or people from the past, or refer to written historical documents and artifacts to reconstruct the past Retrospective a phenomenon that occurs in the present is linked to a phenomenon in the past
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3. PURE / APPLIED RESEARCH Classifying types of nursing studies based on how relevant - the subjects - the content - the conditions are to the real world nursing problems and decisions Stage I. Not Directly Relevant Example: studying the mechanism of wound healing using guinea pigs not directly relevant to the practice of nursing, uses animals in testing. Stage II. Relevant Topics or Subjects Example:

Ex Post Facto essentially the same as retrospective studies (Note: In some books, ex post facto studies, considered to be the same as correlational studies, are classified into retrospective and prospective studies) Gauging the present Cross-Sectional designed to obtain a cross-section of the population at a given point in time Predicting the future Prospective a phenomenon existing in the present is linked to a phenomenon predicted to happen in the future Longitudinal designed to follow the subjects for a period of time, obtaining repeated measurements and establishing changes in the variables over time

studies the effect of a manipulated variable on another variable

METHODS: EXPERIMENTS, QUASI-EXPERIMENTS 1. True experiment Manipulation of independent variable Imposing control on at least one group (meaning, there should be at least two groups) Randomization of subjects to assigned groups 2. Quasi-experiment Manipulation of independent variable May have a non-equivalent control (comparison) group No random assignment GENERAL STEPS IN THE RESEARCH PROCESS 5 Phases: 1. Conceptual Phase 2. Design & Planning Phase 3. Empirical Phase 4. Analytic Phase 5. The Dessimination Phase

Types of Nursing Research according to purpose or design: a. Exploratory To obtain a richer familiarity with a phenomenon and clarify concepts as a basis for further research. Methods: INTERVIEWING, PARTICIPANT OBSERVATION, DOCUMENT ANALYSIS, EXPLORATORY b. Exploratory collects in-depth data on a single concept or variable Examples: 1. What are the reactions of patients to being cared for by student nurses? 2. What are the administrative characteristics of nurses? c. Descriptive to obtain complete and accurate information about the phenomenon studies known variables that have not been studied in a particular population METHODS: INTERVIEWS, QUESTIONNAIRES, DIRECT OBSERVATION, ANALYSIS OF RECORDS d. Explanatory TO PROVIDE CONCEPTUAL ANALYSES GROUNDED IN OBSERVATION OF HUMAN BEHAVIOR METHODS: INETRVIEWS, PARTICIPANT OBSERVATIONS CONSTANT COMPARATIVE ANALYSIS e. Correlational studies the relationship of two or more variables f. Experimental and quasi experimental To test hypothesis about relationship

Steps in Research Process 1. Formulating & Delimiting the problem 2. Review of Related Literature 3. Defining the Theoretical Framework 4. Formulating Hypothesis and Defining variables 5. Selecting Research Design 6. Identifying the Population to be Studied 7. Specifying Methods to Measure the Research Variables 8. Designing the Sampling Plan 9. Finalizing and Reviewing the Research Plan 10. Conducting the Pilot Study and Making Revisions 11. Collecting Data 12. Preparing Data for Analysis 13. Analyzing Data 14. Interpreting Results 15. Communicating the findings 16. Utilizing the findings Phase I: THE CONCEPTUAL PHASE Includes thinking, reading, conceptualizing, reconceptualizing, theorizing, and reviewing ideas with colleagues or advisers. The researcher calls on such skills as creativity, deductive reasoning, insight, and firm grounding on previous research on the topic of interest. Step 1: Formulating and Delimiting the Problem In developing a research question, nurse researchers must consider the following: a. Substantive dimensions (e.g. Is this research question of theoretical or clinical significance?)
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b. Methodological dimensions (e.g. How can this question be best studied?) c. Practical dimensions (e.g. Are adequate resources available to conduct a study?) d. Ethical dimensions (e.g. Can this question be studied in a manner consistent with guidelines for the protection of subjects?) How to state a research problem stated in the form of a question an explicit query of about a problem or issue that can be challenged, examined, analyzed and will yield useful new information. Defining the purpose of research The researchers statement on why the question is important and what use the answer will serve

Experimental Research - Researcher actively introduces some form of intervention Non-experimental Research - Researcher collects data without trying to make any changes or introduce any treatment. Step 6: Identifying the Population to be studied Population - group to be studied Sample - those elements of a population from whom data will be actually collected and from whom generalizations from the population will be made. Selecting the population and sample: Arises from the need to specify the group to which the results of a study can be applied Population refers to the aggregate or totality of all the objects, subjects, or members that conform to a set of specifications. Sample selection: a) Randomness the distribution of distinguishing characteristics in the sample should approximate that in the population as closely as possible b) Accessibility refers to whether the researcher can reasonably expect to find enough elements or units of the population c) Generalizability d) Representative Types of data to be collected: 1. Qualitative study data collected have names or labels 2. Quantitative data data collected reflects the measurement (numerical) of variables or attributes Issues of control: a. Internal validity the extent to which the results of the study can actually be attributed to the action of the independent variable and not to any other; the degree to which unwanted influences* are controlled a.1 Extraneous variables interferes with the action of the variables being studied a.2 Bias influencing the outcome of a study in any way, even unconsciously a.3 Hawthorne effect the subjects awareness of being studied affects their responses b. External validity the degree to which the findings of the study are generalizable to the population; depends on the degree to which the sample represents the population Step 7: Specifying Methods to Measure the Research Variables Research variables are first identified to clarify exactly the meaning of each before selecting an appropriate method of collecting the data.

Step 2: Reviewing Related Literature Provides the researcher with ideas for defining concepts and instruments Provides full awareness of the facts, issues, prior findings, theories and instruments, that may be related to the study question. Provides a foundation upon which to base new knowledge and generally is conducted well before any data are collected in a quantitative study Familiarization with previous studies can be useful in suggesting research topics or in identifying aspects of a problem. Step 3: Defining the Theoretical Framework Previous theory is used as a basis for generating predictions that can be tested through empirical research Step 4: Formulating Hypothesis and Defining Variables A statement of the researcher's expectations about relationships between the variables under investigation A prediction of expected outcomes States the relationships that the researcher expects to find as a result of the study Hypotheses are statements of the relationship between two or more variables or concepts. Variables should be operationally defined Phase II: THE DESIGN AND PLANNING PHASES The investigator decides on the method to be used to address research questions and plans for the actual collection of data. Step 5: Selecting the Research Design Research design is a well-thought-out, systematic and even controlled plan for finding answers to study questions.

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Data Collection Approaches: 1. Biophysiologic Measure 1.a Self-reports: Subjects are asked about their feelings, behaviors, attitudes, and personal traits. 1.b Observation: Researcher collects data by noting people's behavior as well as the relevant aspects of it. Step 8: Designing the Sampling Plan A sample refers to the small fraction of the population. It is more practical to use a sample in order to minimize cost rather than collecting data from a population. Selected sample may not adequately reflect the behaviors, traits, symptoms, or beliefs of the population. Types of sampling method: a. Probability sampling use of random selection process to select elements of a population b. Simple random sampling is a type of probability sampling that ensures that each element of the population has an equal and an independent chance of being chosen. (use table of numbers or assign numbers) c. Stratified random sampling divide population into strata (age, gender, educational background), determine the number of cases desired in each stratum, random sample the groups. d. Cluster random sampling groups, rather than people are selected from the population. Successive steps of selection are done (state, country, city) then samples are randomly selected from clusters. e. Systematic random sampling involves selecting the kth element in the population. Uses sampling interval. Types of Nonprobability sampling: a. Convenience sampling accidental, incidental sampling; choosing readily available subjects/ respondents for study b. Snowball sampling- involves the assistance of the study subjects to get other subjects. C. Quota sampling divides the group into strata then use convenience sampling to select respondents/ subjects. d. Purposive sampling- handpicking of subjects who are representatives of the whole population. SAMPLE SIZE between 30 500, statistically accepted accdg to Roscoe (1975). Step 9: Finalizing and Reviewing the Research Plan To generate support for financial resource To ensure that the plan does not violate ethical principles

Step 10: Conducting the Pilot Study and Making Revisions Provides the strengths and weaknesses of your larger projects intended design, sample size and data collection instrument. Done to assess the adequacy of the data collection plan Carried out as much as the major study so that any detected weakness will be truly representative of inadequacies inherent in the major study. Pilot subjects should be chosen from the same population as subjects for the major study. Revisions and refinements are done after the pilot study to reduce or eliminate problems encountered. Second trial is advisable if extensive revisions are required. Phase III: THE EMPIRICAL PHASE Involves the collection of research data and the preparation of those data for analysis Step 11: Collecting the Data Data sources: people, documents, laboratory materials. Data collection instruments: interviews, questionnaires, physiological test, and psychological tests Enough materials should be available to complete the study. Participants should be informed on the schedule of the activities. Research personnel, e.g. interviewers, should be conscientious in keeping their appointments. Suitable system of maintaining confidentiality of information should be implemented.

Analyzing the data: Taking the data that have been collected apart and reorganizing them so that the researcher can make some sense of them in relation to the study question, research objectives or study hypothesis. Step 12: Preparing the Data for Analysis Questionnaires should be checked for the completeness of answers. Coding should be done. It is the process of translating verbal data into categories or numeric form. Research information should be transferred from written documents to the computer files for analysis.

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Phase IV: THE ANALYTIC PHASE Step 13: Analyzing the Data Data are processed and analyzed in an orderly, coherent fashion to determine the relationship among the variables. Quantitative information is generally analyzed through statistical procedures. Classification of statistics: a. Descriptive allows researcher to examine the characteristics, behaviors, and experiences of study participants b. Inferential helps the researcher determine the likelihood that the sample that is chosen is actually a representative of the population Statistical Techniques: 1. Measure to condense data Frequency distribution - all values are listed and the number of times each one appears is recorded, values may be listed from highest to lowest 2. Measures of central tendency Mode value that occurs most often in a set of data under consideration Median middle score or value in the data. Mean average sum of values divided by the total number of values 3. Measures of variability Describe how values are spread out in a given set of values Range the distance between the highest and the lowest value in a group of values. Percentile datum point below which lies a certain percentage of the values in frequency distribution Standard Deviation measurement that indicates the average deviation or deviation of all values in a set of values from the mean of value of those data. - Used in testing the hypothesis t-Test Used to analyze difference between two means 2 Chi-square Test (X ) Used to assess whether a relationship exists between two nominal-level variables Analysis of Variance (ANOVA) Tests mean differences among 3 or more groups by comparing the variability within groups Analysis of Covariance (ANCOVA) Tests mean differences among groups on a dependent variable, while controlling for one or more extraneous variable (covariates) Spearman Rank-Order Correlation Coefficient

Tests an association between two ranked variables

Step 14: Interpreting the Results Interpretation is the process of making sense of the results and examining the implications of the findings within the broader context. It provides the answer to the questions posed in the first phase of the project. Begins with an attempt to explain the findings, within the context of the theoretical framework, prior knowledge in the area, and the limitations of the study. Phase V: THE DESIMINATION PHASE Step 15: Communicating the Findings Research report in the form of term papers, dissertations, journal articles, papers for presentation at professional conferences, books, etc. is prepared to present the results to others. Step 16: Utilizing the Findings Recommendations as to how the results of the study can be incorporated into the practice of nursing Disseminating findings to practicing nurses.

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