RESEARCH IN NURSING

"Research is the process of going up alleys to see

ifthey are blind."
Learning Targets
-Marston Bates

At the end of the chapter, the learner will be able

to:

Nursing research takes many forms.This

Explore the definitions of nursing research chapter shall serve both as an introduction
Differentiate rescarch in nursing and nursing and xplanation of the subject of nursing
research. The following discussions will
rescarch
deal with the definitions,nature and scope
Identify the goals of nursing research of nursing research. Then, it will proceed
Provide reasons for conducting research in to differentiate between nursing research
and research in nursing to serve as
pursing introduction to sources of topics for the
Discuss the general and specific purposes of research.It will also explain the
goals,reasons, purposes,and characteristics
nursing rescarch of nursing research.As the chapter ends, it
Critically cvaluate the scientific approach to nursing will try to show the important nurses' roles
in research and impress upon the novice
research researchers the importance of the task
Determine the characteristics of nursing ahead.

research
Classify researches in nursing
Identify the research roles of nurses
Analyze the qualities of a good nurse researcher
Assess the alternative routes to problem
solving
Chapter 1

Chapter Outline

Definitions, nature and scope of research in nursing

Rationale for conducting clinical research in nursing
Reasons for lack of clinical research in nursing
Nursing research versus research in nursing
Goals of nursing research
Purposes of nursing research
Scientific approach to nursing research
Characteristics of nursing research
Classification of nursing research
Role of nurses in research
Hallmarks and qualities of good nurse researchers
Alternative routes to problem solving

Terms to Remember

Nursing research
Clinical nursing research
Best practices
Scientific research
Empirical data
Rational problem solving

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 Research in Nursing

Definitions, Nature and Scope of Research

in Nursing
Nurses today are increasingly engaged in disciplined studies that benefit the profession and its
clients to contribute to the improvement of the entire health care system. Thousands are joining the
nursing profession daily, with many ofthem attracted to it for utilitarian reasons. Given this state of affairs,
there is need to re-emphasize that service should be the heart of the nursing profession. Emphasis on
service to humankind remains to be the greatest concern.

There are clients everyday that require the skills and care of nurses to
relieve their pain_____discomfort. Nurses are therefore obliged to provide
updated ways of addressing client concerns whether found in hospital,
community center or any health care settings. Research is an important tool to
provide the means of discovering new ways of conceptualizing and doing nursing
care. Thus, research is no longer a choice but a duty for

anyone who wishes to pursue a nursing career.

With the rise of technology, nursing has experienced profound paradigm shift. The days of trial
and error in diagnosing sickness and disease are gone. Nurses are now expected to base their
professional practice on emerging evidence from research. (Evidence based research and practice will be
discussed in chapter 2.)
Through the decades, research by nurses has been conducted. Misconceptions about research
have arisen for several reasons. Many believe that research is useless and has no place____nursing
practice. Some say that only those who are more “inclined” and 'intelligent' should do research.
Moreover, there is also the issue of funding the research. Many have been overwhelmed by the enormity
of the task because money concerns in the completion of the research project have overtaken it. Some
are generally just confused about what nursing research is.

The first question that requires an immediate answer before

3
 Chapter 1

conducting a research is “What is nursing research?”. The answer to this question somehow
clucidates the novice researcher of the practicality and scholarly investigation of a phenomenon
to fill in the gap in existing knowledge. Hopefully,the answer minimizes the mystery that
surrounds the research activity.

What is nursing research?

From an etymological context,re-search simply means 'to search again.'Generally,research

may be defined as a “methodic examination that uses regimented techniques to resolve questions or
decipher dilemmas (Boswell&&Cannon,2007).”However,in the context of nursing research, various
authors have defined the term in different ways.

Schmidt and Brown (2009) in defining the term have

underscored the importance of the systematic approach and
replicability. System and order are the key features associated with
nursing research. Research for them is also associated with theory
development.Some of the areas they have pinpointed as research
subjects are “patient outcomes, attitudes of nurses, effectiveness of
administrative policy, and teaching strategies in nursing education"

which“contributes to the development and refinement of theory.”

Polit and Beck (2008), defined research in general, as “a systematic inquiry that uses
disciplined methods to answer questions or soive problems. The ultimate goal of research is to
develop, refine, and expand a body of knowledge.” For them, research is a “systematic inquirý
designed to develop trustworthy evidence about issues of importance to the nursing profession,
including nursing practice, education, administration, and informatics.” Polit and Beck's
definition also emphasizes system and order in the pursuit of answers to questions that
encompasses the subject of nursing.
Nieswiadomy (2008) defined the tèrm nursing research as the “systematic, objective process of
analyzing phenomena of importance

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 Research in Nursing

tonursing." The termincludes“all studies concerning nursing practice, nursing education, and
nursing administration” as well as nurses. Again, there is the notion that nursiig research is
meant to explain a 'phenomena'that is related to the practice of nursing.
Burns and Grove (2007), on the other hand, stressed that the results of
nursing research must in a way change
or modify clinical nursing practice.
Nursing research for them is “a scientific process that validates and
refines existing knowledge and generates new knowledge that directly
and indirectly influences clinical nursing practice.” It is a scientific
study or investigation that is pursued to discover theories and concepts
to arrive at new facts and information and its practical application.
This information is obtained in the form of natural_____unbiased data
or empirical facts. Knowledge derived from research can directly and
indirectly influence the growth and development of professional nursing

practice.

Waltzand Bausell (2001)defined nursing research as “a

formal, rigorous and intensive process used for solutioris to nursing
problems or to discover and interpret new facts and trends in clinical
practice, nursing education or nursing administration. It is concerned
with nurses themselves, their attitudes and behaviors in dealing with
patients and their environment, their personal_____professional
relationship with the members of the health team and the intrinsic
and extrinsic factors

affecting nursing practice.” Waltz and Bausell see nursing research as formal process, time-
consuming and relates to problem solving.

Thus, the expected outcome of research is a solution to an issue.Research is therefore a

problem solving process that utilizes scientific discovery, and which “develops ideas and theories"
that gives meaningful answers to complex situations about human beings and their environment.
In relation to nursing practice, research helps to

5
Chapter 1

establish a broader framework through which one can practice safely and judiciously. This is possible
only if nurses take time to conduct scientific investigations in all nursing situations requiring accurate
clinical judgment. Houser (2008) also described nursing research in much the way as “rigorous
guidelines to produce unbiased, trustworthy answers to questions about nursing practice.”

Research in nursing from the perspective of Treece and Treece (2008) is “a systematic
collection and analysis of data to illuminate and describe or explain new facts and relationships.” Its
goals is also to find solutions to problems. He sees it as a collection of data in a controlled situation for
purposes of “prediction or explanation”. Thus, research is concerned with the “whole of nursing."
Treece and Treece emphasize the transportability of knowledge earned in an optimum set- up to
situations which were foreseen and anticipated.

For the National Center for Nursing Research (NCNR), nursing research is "“the testing of
knowledge that can be used to guide nursing practice." This assumes an existent knowledge but which
needs to be verified for its accuracy.

The definition of nursing research provided by the Philippine Nurses Association (1963) not
only includes the viewpoint of science but also that of morals. For them,“Research is an honest,scientific
investigation undertaken for the purpose of discovering new facts which will contribute to the present
body of knowledge and can lead to an effective solution of existing problems. It involves careful or
critical thinking to revise or revalidate accepted conclusions and previously held concepts or to establish
generalizations or principles.”Therefore, research is important in providing relevant, reliable and
unbiased answers to questions for a better understanding of what nursing practice is all about.

The nursing research continuum in Figurel, is like a funnel of information where problems and
issues are tested or where interventions are checked for its accuracy.In the same way,theories are
also :efined.This creates new knowledge that is derived from the conduct of systematic research.

The increasing compiexity of care requires nurses to acquire

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 Research in Nursing

Figure 1: Nursing research continuum

specialized knowledge gained through nursing research, experiences, advanced degrees and
certification programs. Research is more than just scientific investigation directed toward building
a body ofknowiedge regarding man and his environment in a health-illness continuum.

The purpose of research is to improve health care practices and to create a strategy that
will bridge the gap between knowledge and practice. Therefore,research enhances capability of
nurses to make intelligent decisions involving clients problem based on scientific evidences and
free from erroneous judgement..

L
Chapter 1

Application: Go over the definitions of

research in nursing and list or highlight the

words that uniquely describe nursing research
for you. Explain why?
 Research in Nursing

Rationale for Conducting Clinical Nursing Research

The term clinical nursing research refers to “research designed to generate knowledge to guide
nursing practice and to improve the health and quality of life of nurses' clients" (Polit & Beck, 2008). It is
research that is undertaken to produce knowledge that will affect the conduct of nursing practice
(Nieswiadomy, 2008). This involves the care of clients at an optimum level. The studies can be
concerned with the practical details of everyday life, or intervention with the use of actual human
subjects and animal testing of a certain treatment.
The reasons for undertaking clinical research can be many and varied. Some of the more prominent
ones are:

· Nursing problems and issues which are integral to the work situation.
Personal satisfaction derived from finding better ways of providing nursing care.
No one has greater access to the client than the nurse. So who else will do research in nursing?
It could be therapeutic and enjoyable for the client to participate in clinical research.
Clinical research is a practical way for a nurse to help improve the health care of the
sick and well individuals.

Reasons for Lack of Clinical Nursing Research

Despite the many benefits of clinical research, not much of it is conducted for reasons such
as the following.

1. Nurses tend to feel that they are “too busy caring for patients.” There simply is no more time to conduct
clinical research.

2. Unless the nurse has had academic training in theoretical conceptualizations, research
inay not seem important.

9
 Chapter 1

Nursing
3. Unless the importance of research is felt and recognized, Research Research
nurses may not be able to identify researchable problems. carried out by nurses
n the clínical seiting
4. Many nurses do not have the academic training needed to
and dsigned
feel confident in doing clinical research. infonmation
provide
that wil help improve
patient carei Other
professional staff may
5. The ethical requirements of research are also participate in the difficult to
comply with and tend to scare egearch would-be researchers. The requirement to obtain
administrative-patient-relative approval for rescarch may deter some researchers. Fear of
harming a patient is also a hindrance to some researchers.

6. Unless administrators are research oriented, the nursing staff feels the futility of support for nursing
research. Thus, no motivation to pursue any form of research.

7. Research takes time and time costs money. Without sufficient funding, research may not be
conducted due to lack of resources.

Nursing Research versus Research in Nursing

The terms “nursing research” and “research in nursing" refer to research done in the course of
nursing practice. They are distinguished, however,by the subject matter of the research. While “nursing
research" refers to research done on addressing the health concerns of clients and the application of
research on their care, “research in nursing”, on the other hand,refers to studies on the particular concerns
of nurses themselves.

Some examples of nursing research are:

An exploratory study of mothering for teens with Attention Deficit Disorder.

Development of a nursometric (nursing measurement)

10
 Research in Nursing

instrument for use in quantifying diet change patterns among

women____their 40's.

Disengagement behaviors of adult children toward their elderly parents.

Some examples of research in nursing, are:
Job satisfaction and acculturation of Filipino nurses in Australia.
Performance of nursing graduates from Manila and other regions in the licensure exams in
2009-2011.
Leadership and management styles of nurse leaders____selected Metro Manila hospitals.

Having a good grasp of the difference between research in nursing and nursing research is a useful
general guide to a researcher in the choice of topics to study. The range of topics and issues in nursing research
has expanded remarkably in the past three decades or so. This has provided nurses with an extensive
knowledge base to use in their practice. Nonetheless, there is still a need to continuously delve into the issues
of nursing research.
Research in nursing, on the other hand, requires a broader study of the nursing profession, its
concepts, theories, principles_____policies or guidelines inherent in the practice of nursing. It also dwells
on historical, ethical, legal and moral standards as well as the duties and responsibilities of a nurse
practitioner and the implications of these to individual clients and to society.
Many first-time researchers believe that it is easier to do research in nursing. Later on, they find out
that what is more important____the choice of study s interest in the choice of research problem. Interest helps
motivate the researcher. This same interest is what also sustains the researcher throughout the toughest times
in research making. Both fields, reserch in nursing and nursing research are worthy of one's time and effort.

11
 Chapter 1

Goals of Nursing Research

The goal of nursing science is to strengthen

the body of abstract knowledge through continuous
scientific researches and logical analysis capable
of being translated to nursing practice.

Research serves the need of nurses for direction in helping address today's problems of
sustaining human life in the face of technological changes that threaten that life. Among other
things, effective research can help nurses thoroughly understand what their clients are experiencing
when contemplating nursing care interventions to alleviate their problems.

The most relevant aspects of health care delivery to practicing nurses relate to nursing care
management particularly on discharge planning, nutrition counseling, spiritual ministry and patient
teaching. Research on these areas would inform the nurse practitioner of the viability of one's
continued practice.

Nursing research is therefore an invaluable aid in the promotion and maintenance of health,
prevention and cure of illness, the habilitation and rehabilitation of the disabled and the handicapped
whose life depends on others for survival.

As a basic tool for knowledge acquisition in nursing, research has at least four (4) specific goals:

Efficiency and effectiveness in nursing care

Worth and value of the nursing profession to society

·Identification,implementation and evaluation of effective health care modalities

·Provision of quality care to clients

1.Provide Efficient and Effective Nursing Care

The primary reason for conducting nursing research is to foster optimum care for clients. The
nursing profession exists primarily for

12
 Research in Nursing

service to society based on accurate knowledge.

With nurses as principal investigators, research

can help identify clinical problems, their causes, and
can help identify clinical problems, their causes, and
accurate diagnoses, devise nursing care interventions
and evaluate nursing care outcomes. When findings
of their research serve as the basis of their knowledge,
nurses are then able to describe, explain, predict and
control phenomena related to the health care of clients, and are able to
implement nursing care safely and accurately.

2. Promote the Worth and Value of the Nursing Profession to Society

Health care is indispensable to man's survival, and nursing care is one of its major components.
To enable nurses to deliver quality care is to make use of the most recent findings that provide proof or
evidence to validate and justify the appropriateness and adequacy of nursing care.

Nursing research provide evidenced-based data which is concerned with the promotion of
health in the growth and development process, the prevention of diseases and the habilitation or
rehabilitation of clients for a more meaningful and productive life. Through continued research, nursing as
a profession is elevated to a status where its practice is based on sound knowledge. Caring and curing are
two (2) identifiable gains derived from quality nursing care based on research evidenced. Thus, society can
look at nurses as worthy contributors to the existence of life.

3.Identify,Implement and Evaluate Effective Health Care Modalities

Nursing research enables nurses to cautiously assess individuals and groups as basis for planning
accurate nursing interventions. Factors such as the biological, physiological, social, behavioral, spiritual
and environmental components that influence health and disease in man's stages of development have
become the basis for nursing research which ultimately lead to more effective methods of care and
treatment.
Chapter 1

Through a continued systematic review of researches made on specific modalities and its
advantages and disadvantages in various situations, one would be more confident to adopt a practice
that is based on logical and accurate investigation.

4. Utilize Clinical Nursing Research as evidence-based data to provide Quality Care to Clients

Caring of clients who come for health checks is not only measured through the number of
clients attended to but also on the quality of care given to them. Clinical nursing research is thus
concerned with the following tasks:

a. Systematic study of nursing problems or phenomena using the nursing process of assessing,
planning, implementing and evaluating nursing care;

b. Improving nursing practice and patient care through creative and

scientific studies, knowledge of health and the promotion of health
throughout one's lifespan;

c. Identifying nursing interventions that can help individuals respond

efficiently and effectively to actual or potential health problems; and

d. Initiating and assessing change as a result of nursing care to clients, and incisive efforts to make
this new knowledge useful in nursing practice.

These four goals of nursing research are starting points to motivate students and nurse
practitioners to undertake research. As stated, it can serve as principles to guide the practice of
nurses. It will constantly encourage one to ask and question the intervention adopted in
practice. Is this really the best and viable intervention? Does this contribute to efficient and
effective practice of nursing? With a few of these questions, the goals of nursing research would
be achieved.

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 Research in Nursing

Reasons for Conducting Research in Nursing

Conducting research in nursing is an

integralpart
integral partof
ofthe
theprofession's
profession'sobligation
obligationto
to Research
Researchcan
canenhance
enhance
promote excellence in practice. All nurses, the nurse's ability to think
having developed a specific theoretical criticaliy_at conceptual
perspective from their particular body and scliolarly levels.
of knowledge, have a responsibility to
continually extend and test that knowledge
in order to improve the quality of nursing practice. The process of
systematic inquiry they use in their research depends on the degree
to which their education has prepared them for such research. Some
nurses in fact are engaged primarily in the role of nurse researcher.
Research in nursing is vital to the well being of mankind due to its valuable tasks, as follows:

1. Gathers data or information on nursing situations or conditions about which little

knowledge is available. Information is important in designing appropriate nursing
interventions and can serve as basis for qualifying the extent of nursing care needed in the
solution of clients' problems.
2. Provides scientific knowledge base from which nursing theories emerge and develop. Research findings
are evidenced-based data leading to the development of nursing theories and serve as bases to guide
nursing practice and future researches.

3. Helps correct, clarify, validate and expand perceptions. Knowledge is never absolute
and must be continuously tested and validated through research. The value of a specific
body of knowledge may either increase or diminish through research depending on the
extent of its use by a professional discipline.

4. Provides theoretical and scientific basis for nursing practice. Theories derived from research
findings help improve and justify nursing practice. They can firm up the credibility of the nursing
profession and even define the accountability of nursing practice. Theories documents the legal
and moral implications and cost
Chapter 1

effectiveness of nursing care.

5. Defines parameters of nursing and identifies its boundaries.

Research clarifies the scope and limitations

of nursing practice. It is concerned with

“what it is” and “what it is not.” It focuses

on expanding knowledge and use of the

nursing process in clinical situations to

clarify extent of authority, responsibility and

accountability (ARA) of nurses. To do this,
requires a thorough assessment, planning,
nursing action or intervention, evaluation
and documentation of care.

6. Documents the social relevance and efficacy of nursing practice to people and health
care providers. Research enables nurses to verify the strengths and weaknesses of certain
modalities of care and their implications____the process of meeting the needs and problems
of people.

7. Describes the characteristics of the nursing situation about which little is known.More issues
and concerns about nursing care arise as new, untested technology becomes available. These
unknown elements limit the ability of nurses to respond intelligently to nursing situations, and it is
through research that the nurse is able to eventually address these concerns.

8. Predicts probable outcomes of nursing decisions in relation to client care.Research makes it easy
for nurses to forecast the effects or consequences of nursing actions and its potential problems and
helps anticipate shortfalls.

9. Provides knowledge for purposes of problem solving and decision making. Knowledge that
relates to economic, social, political, cultural and technological phenomena may have serious
implications on health care and nursing practices as it is used in deciding better ways of solving
health problems. Research clarifies and validates this knowledge for accurate decisions and
actions. Examples are population explosion, drug addiction, and teenage pregnancy, among others.

16
 Research in Nursing

10.Develops and evaluates nursing theories and concepts and practices these for
clarity and validity of nursing actions. Research helps knowledge grow and develop. It
either revises existing knowledge paradigms or replaces it with new paradigms
altogether based on current research findings.
11.Prevents undesirable client reactions. Research predicts outcomes and potential
problems of clients. This requires balancing of phenomena that generates positive results
and control undesirable outcomes; and
12.Develops considerable degree of confidence. Professional undertakings are intended to achieve
desired client behaviors. Adequate knowledge sustains self-confidence of a nurse that makes work
easier and lighter. The nurse is therefore unburdened with uncertainties and doubtful consequences
ofactions that predisposes nurses to unsafe health care practice.

Purposes of Nursing Research

Research in general answers

questions to solve problems. Research Rescarch predicts
provides tools for observation to generate outcome and
knowledge as basis for predicting and potential problems
controlling phenomenon. Thus, a nurse of clients.
can apply this knowledge in practice and
prescribe accurately and professionally
without untoward client response or reactions to nursing interventions
(Polit & Beck, 2008).

Nursing interventions are borne out of researches conducted. Best practices in nursing are
perpetuated. Best practices are those that “produce the most desirable patient outcomes through
scientific data (Boswell & Cannon,2007).”Burns and Grove (2007) cited an example regarding client
consumption of oxygen. The sense might be that getting a patient up to the bedside commode
results in more oxygen consumption than when a patient uses a bedpan. However,research

17
Chapter 1

has shown this to be inaccurate since oxygen consumption do not differ as to whether the patient uses
a commode or a bedpan. Thus, reality can be tested through scientific inquiry,which leads to best
practice solutions.

Specifically,nursing research aims to do the following tasks:

1.Identification

Nursing research assesses situations that need clarification

and solutions. Before anything else can be done, there is awareness
that a problem or issue exists. This requires from the nurse a quick
identification of the cause of the problem.

2.Description

Research aims at describing a phenomenon that relates to the nursing profession. It also
observes, defines and documents nursing situations inquiry. Nursing research also determine the
relationship between and among the variables investigated.
Example:

Nursing care refers to the set of services rendered by professional and non-professional nursing personnel to respond to the
health needs and problems of individuals, families, groups and communities intended to bring them comfort and relief.

3.Exploration

Research explores the phenomenon by observing

and recording events and situations occurring in that
phenomenon. It answers “what” questions on the
phenomenon searching for illustrative examples in
order to become familiar with the phenomenon and
understand it more precisely and accurately.

Examples:

What factors influence,affect or relate to the adjustment of client to hospitalization?

18
 Research in Nursing

What do insulin-dependent patients want to know about their ailment?

What factors relate to patient stress level?

Does a patient's age and sex play any role in his recovery?

Is the patient's stress caused by the behavior of the nursing staff?

What is the best way to contain the HINI virus from spreading in a school setting?

4.Explanation

Research seeks clarification of a prevailing situation to answer questions that ask “why” a
phenomenon occurred. “Why does this happen?” What could have happened if...?”

Research generally calls upon existing theories for clarifying, explaining and integrating
ideas and for determining the reasons for existence of a particular phenomenon.
Examples:
Why do older patients need more time than younger patients to recover?
Why is care of chronically ill patients done more effectively at home than in a hospital?
Why do younger cbildren need more parenting than older children?
Why is there high incidence of Dengue infection in highly urbanized areas?

5.Prediction and Control

Research anticipates possible psychological and physiological

reactions to nursing interventions. Research provides a basis for
decisions by eliminating barriers and sourcing ways and strategies
that would bring about effective client care outcomes.

Prediction. Research projects situations or events that could arise

from research investigation.

Control. Research puts up a barrier to hinder or minimize the effects of anticipated outcomes or
reactions.
Example:
The incidence of Down Syndrome in infants is expected to increase with the age of the mother.

Predict. Projection of a greater risk for a 40 year old woman as compared to a 25

year old woman in bearing a child with Down Syndrome

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 Chapter 1

There is partial control of the outcome by educating women on

Control.
the risks of child bearing and potential maternal and fetal threats.
Likewise, offering amniocentesis or other therapeutic means to
minimize or eliminate these threats to women over 35 years old.

Control also refers to nursing actions or interventions that respond to client needs in
order to prevent and eliminate potential health problems.

More examples:

Identify what is predicted and the possible control measures to prevent undesirable outcomes.

Smoking can cause lung cancer.

Multiple sexual partners can lead to cervical cancer.

Homosexual activities predispose one to Autoimmune Deficiency Syndrome.

Touch and auditory stimulation improve the heartbeat rate response of premature infants.

Academic and clinical performance of nursing students directly relate to their Intelligence and Emotional Quotient.

Severe Acute Respiratory Syndrome (SARS) leads to multiple organ failure and respiratory arrest.

Scientific Approach to Nursing Research

Research as a human activity seeks to harness the intellectual capabilities of the individual to
discover, interpret, and develop ways to advance knowledge in various fields. Scientific research uses
scientific methods to seek the truth of a matter. It provides scientific information and theories to explain
the problem. Its ultimate goal is the practical application of research findings.

Scientific research makes use of empirical data gathered through the five senses. It is
skeptical of research findings that cannot be verified by what one sees, hear, taste, smell or touch.
Nursing as an art and science seeks to promote the health and welfare of clients to provide a
systematic and wholistic care. Nursing research uses the scientific

20
 Research in Nursing

approach to obtain knowledge that can be generalized across similar clients suffering the same
disease albeit in different situations. Thus, nursing research is concerned with the ability to
generalize research findings.

Characteristics of Research

The scientific approach to nursing

research has certain characteristics. The consists in seeing
researcher seeks information in terms of
data through a systematic, orderly and
objective process. Research situations are
controlled to minimize bias. The personal thought."
opinion of the researcher must not influence
the findings of the study and neither does it
predict results in the early stages of the study. The scientific method
is conceived to be the most objective, systematic way of obtaining
knowledge.

1. Orderly and Systematic

The researcher undertakes the investigation systematically____an ordered sequence of steps as
follows:
a. Identify the Problem. This refers to what will be investigated and what areas of concern will
be the focus of the inquiry.
b. Determine the Purpose of the Study. This is concerned with why the phenomenon is being
ivestigated and what its goals and objectives are.
c. Review of Related Literature. This refers to previous knowledge and results of
research studies that serves as basis for the current research.
d. Theoretical/Conceptual Framework. This explains the relationship of the variables
investigated.
e. Study Assumptions. These are statements presumed to be true but have not been
proven so.

21
Chapter 1

f.Acknowledge the Limitations of the Study.These are uncontrolled variables that

could affect research results and limit the generalizability of findings.

g. Formulate the Null Hypotheses. These are statements in null form to be

statistically tested to prove extent of differences or relationships between two or more
variables.
h. Define Study Variables. Factors such as people, status, situations,
policies and practices that are the focus of the study are defined to create a clear
interpretation of meaning to the researcher and the reader.

i Choice of Research Design.The overall pattern of how the study will be conducted,
particularly the research methods and techniques to be used.

j. Identify the Target Population. The target group are individuals, organizations or
institutions which constitute the focus of research.

k. Choose the Study Samples. This points to the particular number, percentage or proportion
of the population selected as respondents or study participants based on a particular set of criteria.

j Conduct the Field Test.This is the dry-run of the study on a selected group of individuals or
institution(s) to determine the validity, soundness of structure and reliability of instruments used.

2. Control
The researcher identifies and eliminates specific constraints or limitations to ensure precise
and valid results. This will enable the researcher to justify and validate conclusions drawn from the
investigation.
In research, controlled subjects or controlled procedures permit comparison with
experimental-results. The first controlled clinical

22
 Research in Nursing

research was probably done in 1875 by the British naval

surgeonJames
surgeon JamesLind.
Lind.While
Whilehe
hewas
wason
onboard
boardthe
theHMS
HMS
Salisbury, he gave sailors with scurvy either oranges
or lemons or cider or vinegar or nutmeg (or another
treatment). After just six days, he discovered that the
citrus-consuming sailors had recovered frm scurvy while
the sailors who had been given the other treatments
remained sick. Nevertheless, more years passed before this treatment
was widely adopted.

3. Empirical
The researcheruses results ofexperiences and observations rooted in objective reality as
sources of knowledge. Knowledge gained through empiricism consists of concepts, processes and other
phenomena which are learned through the use of human senses (Polit & Beck, 2008).
Research data must be objective,
precise, verifiable and replicable. This drmen liked shopping,
means that others may use the results of theyd call it research
the study for professional advancement and Ginthia Netms
as basis for future research. The research
process and techniques used are themselves transmittable enabling
others to replicate them and assess their validity and reliability.

4. Generalization
Generalization is the stage where the findings of the study are deemed to have applicability to
the entire population. Generalization is based on the results obtained on the sample of
cases_____instances having common traits and characteristics as the universe. It is the criterion used in
quantitative study to assess the extent to which study findings can be applied to other groups and
settings.

5.Intensive
In-depth approach is used to ensure that all the possible loopholes in the study are
covered. This is done by carefully selecting the population and sample, formulating the method
by which data would be gathered and analyzed, including the appropriate statistical tools to be
used.
Chapter 1

Points to Remember!

The researcher must reject the notion that conducting

a research is merely copying of information in one form

Classifications of Nursing Research

There are a variety of terms to describe scientific research conducted by nurses. The
categories change according to the approach used, measurement and analysis of data, time frame
of the study, motive or objective of research and the research environment.

Briefly,as shown in Figure 2,research is classified according to approach when the research
adopts a purely experimental or non- experimental or quasi-experimental method. Research can also
be classified according to the measurement and data analysis used. As such it can either be
quantitative, qualitative or mixed method of research.

Nursing research may be longitudinal or prospective or cross- sectional and retrospective

depending on the time frame used.According to the motive or objective of the research, it can be basic
research or applied research. Finally, according to research environment, it may be conducted____the
field or in the clinical area or in the laboratory. These classifications though are not mutually exclusive.

Role of Nurses in Research

Novice researchers will assume several roles as research is conducted depending on the nature of
the study, the capacity of the researcher and the assignment of the teacher or supervisor. They may wear
the hat of a principal investigator, a member of the team, evaluator, consumer, client advocate, and even
as subjects of the study.

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 Research in Nursing

Figure 2: Classification of Nursing Research

1. As Principal Investigators.
Nurses need special research preparation and training to conduct a scientific study. As
principal investigators, they need to thoroughly read the literature on the chosen topic or problem.
2. As Member of a Research Team.
Anurse maybe the data collector to conduct an experimental investigation which is all
considered as part of one's normal workload. Sometimes, it is better to be part of a team to help lighten
the load of researching but definitely the responsibility attached as a researcher is never diminished.
3. As Evaluator of Research Findings.
A nurse must determine the usefulness of research findings in the practice ofnursing and
continuouslyrelate these findings to actual situation which in turn may lead to another investigation. To
become an evaluator requires the conduct of research through one's own efforts. This ensures that the
evaluator knows what to look out for. The evaluator may be a referee of a research paper or a panelist
in a forum where a research is presented for critiquing.

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Chapter 1

4. As Consumers of Research Findings.

Nursesareresearchusersandbeneficiaries and are apt to put

these findings into use in their practice. However, this must be judiciously
done to prove reliability of research findings. The nurse must be a voracious
consumer of research findings for an enlightened practice.

5. As Client Advocates in a Research Study.

Nurses must explain thoroughly t clients who are involved in the study the nature of
the research and answer their questions satisfactorily.The welfare of the clients must____a priority
in the conduct of the research.The ethics of research must always prevail.

6. As Subjects of Research.
Nurses may also be study respondents who will provide data for the research,intended
to change and or improve nursing practice. They themselves can become subjects of a research too.
As nurses, they can provide insights about the profession and its education in general.

Hallmarks and Qualities of Good Nurse Researchers

What makes a good nurse researcher? This is a question worth pondering about. The following
are qualities and characteristics of good nurse researchers, such as honesty, credibility, accuracy in data
collection, organized and systematic,logical, self-awareness, imaginative and curious, persistent, good
interpersonal relationships, informed and updated on current events are just but few of the hallmarks of
a good nurse researcher.

1. Honest and Credible

A nurse is a researcher of truth and a model of values that reconcile every piece of
discovery. Accuracy of the details of the research work is of little worth if the researcher's honesty and
credibility is in question.

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 Research in Nursing

2 Accurate____Data Collection

A nurse researcher must observe the protocol in gathering accrate and precise data.
One gives proper attention to the variables examined and takes note of small differences instead of
skipping or ignoring them. Doing this regularly helps the researcher avoid mistakes or
errors____data interpretation.

3. Organized and Systematic

A nurse researcher 13 organized,
orderly and systematic. Any aspect of research
data must be noted down, compared, verified,
indexed, grouped, sequenced and recopied.
If this is constantly practiced, this prevents
errors and minimizes tension. This also calls
for the nurse researchers to be calm, patient and
persevering.

4. Logical

A nurse researcher is ready to learn the art of reasoning using the

complex nature of research process. This involves understanding of the phenomenon and
organizing data derived from that phenomenon, using intellectual faculties and formal
systems of thought either through inductive or deductive reasoning.

5. Self-Awareness

Anurse researcher knows and understands her capabilities and limitations.

Assumptions must be clear and personal judgment of a phenomenon under study must be
avoided unless supported by factual data.

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Chapter 1

6. Imaginative and Curious

A nurse rescarcher must have perceptive

imagination to arrive
imagination at better
to arrive ways
at better of of
ways
understanding and analyzing data which
challenge previous ways of thinking. Curiosity CURIOUS
to seck more explanations for nursing problems

has increascd the need for better research, thus, providing

a remarkable growth of knowledge in nursing. While curiosity
enhances imagination, an ounce of curiosity will help the nurse
researcher in her nursing care activities.

7. Persistent with Barriers

A nurse researcher is ready to face challenges of hard work and the complex
nature of research. The researcher must quickly learn to cope with the different
fcrms of stress that are encountered in doing research, while at the same time
maintaining confidence and optimism.

8. Establishes Good Relationships with Respondents and Other Researchers

A nurse researcher must have genuine interest in people who will provide the needed
assistance and research data. The researcher may need extra effort in seeking the help of research
assistantsaswellasencouragingchosen respondents toparticipate in the study. The researcher may
have to offer monetary or other forms of incentives if research is time consuming or demanding.

9. Updated and Informed of Present Issues and Events

A nurse researcher must have a wellspring of sources of information and knowledge

that can thoroughly provide all the possible issues surrounding a particular research problem as well
as those which may already have been resolved. Research is not done in a vacuum where there are
no current or past events surrounding the problem. As such, a researcher is better informed of all
the circumstances regarding a research problem
 Research in Nursing

of interest. Thus, research-based and updated information can justify significantly the
validity and reliability of information being disseminated.

Alternative Routes to Problem Solving

There are as many alternative solutions to problems as there are approaches to that problem
besides the scientific approach.
1. Ignore or Redefine the Problem

Determine the background of the problem or redefine it in order to identify responsibility

for its solution.
Problems:
Nurses who abuse sick leaves
Deteriorating nursing service
Strained relationships of nurses with other health workers

2.Faith, Habit or Traditional Practice

Questions are answered and problems are often solved

using traditional techniques. Nurses tend to practice nursing
procedures to which they have always been exposed.

However, there is a need for change. All fields of human

endeavor including nursing keep on changing because of
scientific researches and advancements in health care
technology. It is believed that it takes weeks, months or years to
replace an old habit. But in case of nursing practice, it will take
more than two weeks to institute new ways of doing things.

3. Authority

Solving problems and making decisions are often done in a manner consistent with authoritative
practice. This is appropriate for situations
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 Chapter 1

in which there are standards set by the authoritative sources.Florence

Nightingale was an example of an authoritative source in nursing

practice. Her profound ideas in health care involves the

beneficial effects of hygiene and fresh air which are now

assumed as the universal principle of life.

However, such practice may offer limited solutions to a problem when knowledge
of authorities concerned is based only on experiences not on scientific research.

4. Human experience
In such a paradigm, problems are solved based on methods applied to similar prior problems.
What ultimately limits this method is the reality that no two problems are the same; several factors
of change may_____often do require new solutions. Scientific research becomes necessary to detect
patterns and consistently recurring events.

5. Trial and Error

With trial and error, problems are solved without rationalization but only
through guess work. In the clinical setting, professional judgment is crucial
because human life is at stake. While guess work is practical and easy, it is usually
fallible and prone to errors.

6. Logical Reasoning

Problems are solved through rationalization or logical thought process. Rationalization is an

important aspect of any scientific inquiry but nonetheless has its limits because validity of both inductive
and deductive reasoning depends on the availability and accuracy of facts. Reasoning without sufficient
facts as their basis is uninformed and can therefore be dangerous.

7.Common Sense

This operates on superficial knowledge of facts instead of the application of a systematic body
of knowledge. This is limited and

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 Research in Nursing

deficient because solutions could be transitory and unsubstantial.

8. Problem Solving and the Nursing Process
A problem is a gap between “What is" and “what should be”; the difference of “what is
expected” and “what is reality".
Solutions to problems are sought, using the rational problem solving approach. This is a

scientific process of identifying the problem and finding ways of solving______problem.

Theories, principles and concepts used in problem solving come from a body of knowledge
specific to a particular discipline. In nursing, the technique used in problem solving is the nursing process.
The similarities between rational problem solving and the nursing process lies on the fact that
both start with a particular concern or problem followed by gathering of information, designing of
alternative solutions, the making of the decision, the implementation of that decision and subsequent
evaluation of results.
Table 1: The steps below illustrate how rational problem-solving and the nursing process
compare (Bush, 1995).

PROBLEM SOLVING NURSING PROCESS

a. Identify the problem a. Client Assessment

b. Gather information b. Nursing Diagnosis

c. Generate alternative c.Plan of Action
solutions
d.Consider outcomes d. Goal and Objective
Setting.
e. Choice of solution e. Alternative Nursing
Actions

f. Implement Solution f.Implementation

g.Evaluate results g.Evaluation

The difference in the two processes lies in these areas of concern as shown in figure 3.

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Chapter 1

Figure 3: Difference in the Rational Problem Solving Process and the Nursing Process

The possible solutions and outcomes are the results of creative process of both the nurse and
the client dealing with the as-yet unsolved problem, the clients', complaints, history, results of physical
examinations (PE) and review of systems (ROS) laboratory test and other diagnostic procedure.
Consequently, nursing diagnosis and plan of care are made based on an overall assessment. And
finally, nursing actions and evaluations are done considering the mental, physical, social and
environmental factors.

9. Research and Problem Solving

As a scientific inquiry, research seeks solutions to a problem, using relevant research findings
and the results of a situational analysis that pinpoints the immediate and root causes of the problem.
This could relate to people, socio-economic situations, and prevailing policies and practices.

The following steps in Figure 4 indicate why problem solving is parallel to research (Bush,
1995):

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 Research in Nursing

Figure 4: Parallelism between Problem Solving & Research

There are many similarities between the two. Both follow the same process except that research

has a broader application than that of simple problem solving that is limited to the specific

issue____question.

www.nursfoon.comm

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Chapter 1

Summary of Key Concepts

Research is a “methodic examination that uses regimented techniques to resolve questions

or decipher dilemmas

A problem is a gap between “what is" and “what should be"; the difference of
“what is expected" and “what is reality".

·Nursing interventions are borne out of researches conducted. Best practices in

nursing are perpetuated such that it will “produce the most desirable patient
outcomes through scientific data.”

Qualities and characteristics of good nurse researchers, include

honesty,credibility,accuracy in data collection, organized and systematic, logical, self-
awareness, imaginative and curious, persistent, gcod interpersonal relationships,
informed and updated on current events

Novice researchers assume several roles such as a principal investigator, a member of

research team, evaluator, consumer, client advocate, and even as subjects of the study.

Theories, principles and concepts used in problem solving come from a body of
knowledge specific to a particular discipline. In nursing, the technique used in problem
solving is the nursing process, management process and research process.

A nurse researcher must have a wellspring of sources of information and knowledge that
can thoroughly provide all the possible issues surrounding a particular research problem as
well as those which may already have been resolved.
 Research in Nursing

Application: Go to the library and examine the

titles of theses and dissertations. Identify at
least 5 titles in nursing research and research in
nursing.

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Chapter 1

A.Knowledge Assessment

Answer the following as best as you can.

Write your answers on the space provided.

1. Describe research as a scientific approach.

2. Cite a researchable problem and explain the criteria of your

choice.

3. Differentiate research process from problem solving process.

4. List other approaches in problem solving besides research.

5. Explain briefly the nature and scope of nursing research.

6. Discuss the relevance of research to the nursing profession,

specific to:
a. nursing service c. nursing research
b. nursing education d. nursing management
a. nursing service c. nursing research
7 Explain why there is an increasingly greater demand for research studies in nursing
b. nursing education d. nursing management
today.
7 Explain why there is an increasingly greater demand for
8. Describe the role of nurses in research.
research studies in nursing today.
9. Explain the hallmarks of a good nurse researcher.
8. Describe the role of nurses in research.
10.What are best research practices?
9. Explain the hallmarks of a good nurse researcher.

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Chapter 1
Chapter 1

Chapter 1
B.Practice Test.
Encircle the letter that corresponds to your
B.Practice Test.
choice.
1. It refers to studies on the particular
concerns of nurses.
a. nursing research
1. It refers to studies on the particular concerns of
b. research in nursing
nurses.
c. clinical nursing research
a. nursing research
d. none of the above
b. research in nursing
2. Clinical research
c. clinical nursing is pursued for the following reasons except:
research
a. none
d. nursing
of theproblems
above and issues are integral to the work
situation
2. Clinical research is pursued for the following reasons except:
b. no one has greater access to the client than the nurse
a. nursing problems and issues are integral to the work situation
c. practical way to help improve health care
b. no one has greater access to the client than the nurse
d. Staffing is not an obstacle
c. practical way to help improve health care
3. It
d. Staffing is an
is not research
obstacleundertaken to produce knowledge that will
affect the conduct of nursing practice.
3. It is research undertaken to produce knowledge that will affect the conduct of nursing practice.
a. nursing research
a. nursing research
b. research in nursing
b. research in nursing
c. clinical nursing research
c. clinical nursing research
d.d. none
none of above
of the the above
4.The following are characteristics of research except:
4.The following are characteristics of research except:
a. systematic and orderly
a. systematic and orderly
b. controlled
b. controlled
c. empirical
c. empirical
d. honest
d. honest
5. The following are the principal roles of a nurse researcher
5. Theexcept:
following are the principal roles of a nurse researcher except:
a. evaluator
a. evaluator
b. investigator
b. investigator
c. subject
c. subject
d. fence-sitter
d. fence-sitter

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 Research in Nursing

B. Practice Test.

B.6.Practice
Scientific
Test.research focuses on the generation
of empirical
6. Scientific research data gathered
focuses on thethrough.
generation of empirical data
a. Five
gathered through.senses
b. Objective data
b. Objective data
c. Subjective data
c.d.Subjective data
Combined data
d. Combined data

7. Research carried out by nurses in the clinical setting anddesigned to provide

7. Research carried out by nurses in the clinical setting and designed to provide information that will help
improve client care.
b. epidemiological research
information that will help improve clientcare.
C. pathological research
d. a. clinical
patient research
research
b. epidemiological
8. If research research
is classified according to approach, it should consist of the following except:
C. pathological research
b. non-experimental
d. patient research
c. cross-sectional
d. quasi-experimental
8. If research is classified according to approach, it should consistof the following
9. Experimental research means that all sources of data must come from:
b. subjective reality
c. theoretical framework
except:
d. conceptual framework
a. experimental
10. Rational problem solving and the nursing process are similar in a sense that they start with:
b. non-experimental
a.c.making a decision
cross-sectional
b.d.gathering
quasi-experimental
of information
c. identifying a particular concern or problem
9. d.
Experimental research
implementing means that all sources of data must comefrom:
a decision
a. objective reality
b. subjective reality
c. theoretical framework
d. conceptual framework

10. Rational problem solving and the nursing process are similar ina sense that they

start with:

a. making a decision
b. gathering of information

c. identifying a particular concern or problemd. implementing a decision

39