NSRCH01

CESARIA A. YALONG, RN, MAN

objectives
At the end of the lesson, the students will be able to: y Formulate their own definition of research and nursing research y Describe the characteristics of research and the researcher y Explain the importance/purpose of nursing research/ roles of nurses in research y Trace the history of nursing research

.A - WHAT is Research? 1. Research 2. Nursing research

B. Importance of research in nursing C. Roles of nurses in research D. Purposes of nursing research E. Evolution/ History of nursing research F. Future directions for nursing research

WHAT IS RESEARCH?

RESEARCH
French word . CERCHIER == To search Prefix re === again Search again & again Examine Carefully

Diligent, Systematic inquiry or study

To validate & refine existing Knowledge and Develop new knowledge

NURSING RESEARCH?

Various definition:
y A systematic search for and validation of knowledge

about issues of importance to the nursing profession (Polit and Hungler, 1999).
y Concerned with knowledge that directly and indirectly

influences clinical nursing practice (Burns and Grove, 1997).

NURSING RESEARCH
A systematic process that validates & refines knowledge and generates new existing knowledge

that directly and indirectly influence nursing practice

NURSING RESEARCH
development of knowledge about...

health & promotion of health over the full life span, care of persons with health problems & disabilities, & nursing actions to enhance the ability of individuals to respond effectively to actual or potential problems (ANA, 1981)

3 MAJOR AREAS OF CONCERN IN NURSING RESEARCH: 1. nursing education 2. practice of nursing 3. nursing service

B - The importance of research in nursing

the primary task of nursing research is the development and refinement of nursing theories which serve as guides to nursing practice and which can be organized into a body of scientific nursing knowledge (Rozella Schlotfeldt, 1960)

11 Characteristics of Research
1. Directed towards the solution of a problem. 2. Emphasizes the develop-

ment of generalizations, principles and theories that may be helpful in predicting future occurrences.

3. It involves the gathering of new and existing data from new sources or first-hand
information y Research is original work.

4. Analytical.
- Collect data-> Rigorous analysis/interpretation
y critical analysis of all the data used so that there is no error

in their interpretation.
y careful examination of detailed components of the object

of study. y uses published research to bolster that insight.

5. Requires expertise y Research is done by an expert. y The researcher uses valid and carefully designed procedures, valid data gathering instruments, and valid data. 6. It is empirical. All procedures employed and the data gathered are perceived in the same manner by all observers.

7. Strives to be logical- apply every possible test to validate the procedures being employed <- researcher has confidence in the results. y Research is objective, unbiased, and logical. y All findings and conclusions are logically based on empirical data and no effort is made to alter the results of the research. 8. Honest and characterized by patient & unhurried activities. y Research is patient and unhurried activity. y This to ensure accuracy.

9. Can be replicated. - Reproducibility: Is your experiment/thesis designed flawlessly with clear procedures so that others can test your findings? 10 Requires innovative approaches. - uses or shows new methods, ideas, etc 11. Carefully recorded and reported - to other persons interested in the problem.

y Values Derived in Research y y Critical thinking y Creativity and innovativeness y Intellectual integrity y Patience and perseverance y Widening of perspective y Advancement of moral/social responsibility y Objectivity/adherence to truth y

y Difficulties encountered in Research y y Recognizing problems y Duplication y Indifference to Research y Lack of facilities and materials y Financial difficulties y Lack of adequate and expert research

consultants y Others (technical, know-how, vocabulary, uncooperative subjects/respondents, etc.)

y

C - ROLES OF NURSES IN RESEARCH

P R R I D E S A C C U

1. PRINCIPAL INVESTIGATOR- leader of research team 2. RESEARCH ASSISTANT- trained in a specific method of data collection 3. RESEARCH COORDINATOR- helps run the daily operations of the study

4. IDENTIFIER 5. DATA COLLECTOR- MEMBER - collect data from clients for another person s research project 6. EVALUATOR/CRITIC- assesses quality of a scientific research document for publication, securing support funds, fulfillment of university requirements or obtaining permission for oral presentation

7. SUBJECT or PARTICIPANT- a person who has decided to take part in the research by signing a consent form and by providing target information with the aid of appropriate research instruments 8. ADVISER/ CONSULTANT- shares his knowledge to the investigator/researcher/research team and offers guidance in the proper conduct of the study 9. CLIENT / PATIENT ADVOCATE- protects the rights of the healthcare provider s client and speaks on his behalf if he happens to be a subject in a research investigation conducted in a clinical setting.

10. CO-INVESTIGATOR- member of the research team with the responsibility of helping the principal investigator and other member of the team in the proper conduct of the study. 11. USER/CONSUMER OF RESEARCH FINDINGS - Promoter of better quality care of clients by utilizing evidence-based best practice

1. 7 Characteristics of Nurse Researcher 2. Evolution of Nursing Research 3. 6 Purposes of Nursing Research 4. Types of research a. Experimental True experimental, Quasiexperimental, Pre-experimental ( TPQ) b. Non-experimental b.1. Pure or basic research b. 2. Applied research- Descriptive, Developmental, Ex Post Facto, Action, Correlational, Cause and Field, Historical ( DDEACH) 3. Sources of Evidence for Nursing Practice 4. Paradigm for Nursing Research

ASSIGNMENT
1. Trace the Evolution of Nursing Research starting from the time of Florence Nightingale. 2. Place in a short coupon bond ( maximum of 5 pages and of any color) 3. Submit next Monday 4. Criteria of grading= 20 pts. a. Content------------ 10 pts. b. Organization----- 5 pts. c. Creativity----------5 pts

7 CHARACTERISTICS OF NURSE RESEARCHERS(C3H2AP)

y C- Curiosity ------ eager to seek information undertake inquiry and serious thinking about situations and problems affecting nurses and nursing. y C- Creative Thinking -----ability to go beyond what already exist & develop various ways of doing things y C- Critical Thinking ----- Ability to relate study to a known theory Clinical expertise and a working knowledge of the scientific problem-solving technique help to a great extent in formalizing the study.

y H- Honesty

----Intellectual honesty==collecting, analyzing and reporting data y Intellectual honesty Researchers are honest in collecting, analyzing, and reporting data

Characteristics of Nurse Researchers- (C3H2AP)

y H- Humour

----sense of humour as to accept inadequacies in the study as basis for improvements

y A- Ability to relate their study to a known Theory y P- Patience and discipline to see the study through

--- long hour of digging up, sorting, rewriting manuscripts until the study becomes an integrated whole

D - EVOLUTION OF NURSING RESEARCH

Florence Nightingale in 1859 ---- focus: significance of a healthy environment in the promotion of the patient s physical and well-being

Evolution of nursing research

Nursing Research in 1900-1950 1st publication of American Journal of Nursing, research emphasis is on the organization and delivery of nursing of nursing services Nursing Research in 1950 and 1960
research emerged as high priority with support from nursing leaders HENDERSON & ABDELLAH. Research was introduced & the steps in baccalaureate level by nursing schools

Evolution of nursing research

Nursing Research in 1970 - researches was on the improvement of nursing practice; new journals were published (Advances in Nursing Sciences, Image, Research in Nursing & Health, Western Journal of Nursing research); Nursing Research in 1980 - focus was on the conduct of clinical nursing research. Many clinical journals published like cancer nursing, CV nursing, etc. NCNR (national center for nursing research) created in 1985.

Evolution of nursing research

Research in 1990 (Present and Future) NCNR renamed NINR( national institute for nursing research) under Dr. Hinshaw; outcomes research has come out as an important methodology.

y thurs

P I E C E D 1. P- Prediction provides knowledge to estimate effects of a given situation, or a prevailing condition. Examples: (1) What are the effect of health behaviours like balanced diet, regular exercises, and no smoking on health status and longevity? (2) What are the effects of prolonged bed rest on the hospitalized patient s recovery?

E - 6 PURPOSES OF NURSING RESEARCH

Purposes of nursing research

2. I- Identification Identifying or naming an unknown phenomenon in relation to the practice; defining or conceptualizing under inquiry. Example: People with diabetes investigation aimed at discovering the basic social problems affecting their adherence to health care directives.

Purposes of nursing research

3. Exploration NOT only simply observing and describing it, exploratory research investigates the full nature of the phenomenon, the manner in which it is manifested, and the factors to which it is related Provides insights. It asks the question WHAT in order to investigate the causes or full nature of an existing particular question.

Examples: (1) What factors diminish or increase a patient s stress? (2) How is a patient s stress related to the behaviours of the nursing staff? (3) To what extent stress relates to the patient s cultural backgrounds?

Purposes of nursing research

4. C- Control

The manipulation of a given situation to produce the desired outcome . Follows prediction of the outcome of a given situation. It provides a barrier to hinder or minimize the effects of a predicted outcome. Prediction and control combined in nursing research may specify psychological and physiological reactions possible to nursing intervention.

Example: Research has shown that the incidence of Down Syndrome in infant increases with the age of the mother. ---We can predict that a woman aged 40 yrs old is at higher risk for bearing a child with Down Syndrome than a women aged 25 years. --- We can partially control the outcome by educating women about the risks and offering amniocentesis to women older than 35 years of age.

Amniocentesis (also referred to as amniotic fluid test or AFT), is a procedure used in prenatal diagnosis of chromosomal abnormalities and fetal infections , in which a small amount of amniotic fluid, which contains fetal tissues, is extracted from the amnion or amniotic sac surrounding a developing fetus, and the fetal DNA is examined for genetic abnormalities.

Down syndrome (DS), also called Trisomy 21, is a condition in which extra genetic material causes delays in the way a child develops, both mentally and physically. It affects about 1 in every 800 babies. Normally, at the time of conception a baby inherits genetic information from its parents in the form of 46 chromosomes: 23 from the mother and 23 from the father. In most cases of Down syndrome, a child gets an extra chromosome 21 for a total of 47 chromosomes instead of 46. It's this extra genetic material that causes the physical features and developmental delays associated with DS.

Purposes of nursing research

5. E- Explanation - Attempts to provide understanding of the underlying causes or full nature of a phenomenon.
- Offers understanding, clarification, and

information

WHY a certain phenomenon occurs. Examples: (1) Why do patients in the ICU need to feel safe? or Why is it significant to provide for the psychological needs of patients in the ICU?

Purposes of nursing research

6. D- Description Describing a phenomenon affecting the nursing profession. Nurse researcher observes, count, delineate, and classify. It provides new information. Examples: (1) Describing varied phenomena such as: patients stress and coping, pain management, adaptation processes, health beliefs and practices, rehabilitation success and nursing care. (2) Describing quantitative changes in psychological and psychosocial resources six months after kidney transplantation. (3) Describing the experience of waiting in a critical care room.

SOURCES OF NURSING KNOWLEDGE yCustoms and Traditions yAuthority yTrial and error as means of discovering knowledge/Staff Development and Experience yDisciplined research

SOURCES OF EVIDENCE FOR NURSING PRACTICE

1. Custom and Tradition

handling down knowledge from one generation to another and leads to actions that occur because we ve always done it that way 2. Authority experts or authorities in a given field often provide knowledge for other people.

3. Clinical Experience 4. Trial and error - alternatives are tried successively until a solution to a problem is found 5. Logical Reasoning - Combines experience, intellectual faculties, and formal system of thought.

G - RESEARCH PRIORITIES IN THE FUTURE 1. Promotion of evidence-based practice aim: Provide the best possible care based on the best available research 2. Increased multidisciplinary collaboration 3. Greater focus on outcomes research aim: assessing and document the effectiveness of health care services 4. Use of multiple, confirmatory strategies 5. Expanded dissemination of research findings 6. Increased visibility of nursing research

yII

PARADIGMS OF RESEARCH yA. positivisms yScientific yPost positivism yB. naturalistic/ constructivism yC. participatory/ advocacy yD. pragmatism

The design of a research study begins with the selection of a topic and a paradigm.

PARADIGMS FOR NURSING RESEARCH

A world view: basic set of beliefs that

guide action (Guba, 1990: 17)

A general perspective on the complexities of the real world, with certain assumption about reality

PARADIGM
y A diagrammatic representation of a conceptual

framework

y It provides a conceptual framework for seeing and

making sense of the social world; y to be located in a particular paradigm is to view the world in a particular way.

The significance of paradigms is that they shape how we perceive the world and are reinforced by those around us, the community of practitioners.

y For the researcher it is important to recognise their

paradigm, it allows them to identify their role in the research process, determine the course of any research project and distinguish other perspectives.

y Therefore, paradigms are never right or wrong but

merely different ways of looking at society. In that respect, they are to be judged as useful or useless in specific situations only.

A PARADIGM ENCOMPASSES FOUR ELEMENTS/ CATEGORIES

Epistemology, - Ontology - Axiology and - Methodology
-

y Epistomology asks How do we know the world? What

is the relationship between the inquirer and the known? Source of Data: Subject or Participant (reciprocity)

y Epistemology: what is the relationship between the

inquirer and the known: "epistemology is the branch of philosophy that studies the nature of knowledge and the process by which knowledge is acquired and validated" (Gall, Borg, & Gall, 1996)
reality. What is there that can be known about the form and nature of reality? Single or multiple

y Ontology raises basic questions about the nature of

y Denzin and Lincoln (2001) listed three categories of those

beliefs: y Ontology: what kind of being is the human being. y Ontology deals with the question of what is real.

y Ontology raises basic questions about the nature of

reality. What is there that can be known about the form and nature of reality? Single or multiple

y Denzin and Lincoln (2001) listed three categories of

those beliefs: y Ontology: what kind of being is the human being. y Ontology deals with the question of what is real.

y Axiology- values: objectivity vs. Subjectivity: Bias y axiology deals with the issues about value. y Specific assumptions about research include the role

of value in research, how to avoid value from influencing research, and how best to use research products (Baptiste, 2000). y Methodology focuses on how we gain knowledge about the world. How can the inquirer (would-beknower) go about finding out whatever he or she believes can be known?: Data obtained
y Methodology: how do we know the world, or gain

knowledge of it?

ontology
y Norman Blaikie offers a fuller definition,

suggesting that ontological claims are claims and assumptions that are made about the nature of social reality, claims about what exists, what it looks like, what units make it up and how these units interact with each other.
y In short, ontological assumptions are concerned

with what we believe constitutes social reality (Blaikie, 2000, p. 8)

y Epistemology, one of the core branches of

philosophy, is concerned with the theory of knowledge, especially in regard to its methods, validation and the possible ways of gaining knowledge of social reality, whatever it is understood to be.

Epistemologic How is the inquirer related to those being researched? Inquirer is independent from those being researched; findings are not influenced by the researcher Inquirer interacts with those being researched;

findings are the creation of the interactive process

Axiologic What is the role of values in the inquiry? Values & biases are to be held in check; objectivity is sought. Subjectivity and values are inevitable and desirable

ASSUMPTION

POSITIVIST PARADIGM

NATURALISTIC PARADIGM

Ont l ic ( at is t e at re f eality?) Epistemologic How is the inquirer related to those being researched?

Reality exists, there is a real world driven by real natural causes

The inquirer is independent from those being researched; findings are not influenced by the researcher

Reality is multiple and subjective, mentally constructed by individuals The inquirer interacts with those being researched; findings are the creation of the interactive process

Axiologic Values and What is the role biases are to be of values in the held in check; inquiry?

objectivity is sought.

Subjectivity and values are inevitable and desirable

Methodologic Deductive processes

How is the evidence best obtained?

Inductive processes

Emphasis on discrete, Emphasis on entirety of some specific concepts phenomenon, holistic. Focus on the objective and Focus on the subjective and quantifiable nonquantifiable Verifications of researchers prediction Outsider knowledgeresearcher is external separate Fixed pre-specified design Measured, Quantitative Information;statistical analysis Seeks generalization Focus on the product Narrative information, qualitative analysis Seeks indepth understanding Focus on the product and the process Emerging insights grounded in participant s experiences. Insider knowledge-researcher is internal, part of the process Flexible, emergent design

4 different worldviews
y1. Positivism/Postpositivism y2. Constructivism/ Naturalism y3. Advocacy/Participatory y4. Pragmatism

FOUR WORLDVIEWS USED IN RESEARCH

Postpositivism Constructivism Advocacy and Participatory - Determination - Understanding - Political - Reductionism - Multiple - Empowerment - Empirical participant and observation meanings issue oriented and - Social and - Collaborative measurement historical - Change - Theory construction oriented verification - Theory generation
Source: Creswell (2003)

Pragmatism - Consequences of actions - Problem centered - Pluralistic - Real-world practice oriented

Types of Research according to General Classification

A. Quantitative Research Types: 1. Descriptive Research 2. Correlational research 3. Quasi-experimental 4. Expereimental B. Qualitative Research Types: 1. Phenomenological 2. Grounded theory 3. Ethnographic 4. Historical

Quantitative Research - Is a formal, objective, systematic process in which numerical data are used to obtain information about the world Qualitative Research - Systematic subjective approach to describe life experiences and give meaning
- Used to describe and promote understanding of

human experinces such as pain, caring, powerlessness and comfort.

Comparison of Research Approaches

Quantitati y Objectivity val e y One reality y e cti n, c ntr l, and predicti n y Meas rable y arts e al t e le
y y y

eport statistical analyses esearc er separate eneralization

Qualitative y Subjectivity valued y Multiple realities y Discovery, description, and understanding y Interpretive y Whole is greater than the parts y Report rich narrative y Researcher part of the process y Uniqueness

A. Quantitative Research Types: 1. Descriptive Research 2. Correlational research 3. Quasi-experimental 4. Expereimental

Purposes of Nursing Research

I 1. I 3. D 4. E 5. E 6. C 7. P D E E C P dentification ..escription ..xploration ..xplanation ..ontrol .rediction

Purposes of Nursing Research

1. Identification

Naming an unknown phenomenon in relation to the nursing practice Example : People with diabetes and hypertension investigation discovering the basic social problems affecting their adherence to health care directives.