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Lecture Notes on Nursing Research

Prepared By: Mark Fredderick R Abejo R.N, MAN

Systematic study and assessment of nursing


problems or phenomena; finding ways to improve
nursing practice and patient care through creative
studies;initiating and evaluating change; and taking
action to make new knowledge useful in nursing.
(Vreeland, 1963 )
Includes the breadth and depth of the disciple of
nursing and the rehabilitative, therapeutic and
preventive aspects of nursing as well as the
preparation of practitioners and personnel involved
in the total nursing sphere.
NURSING RESEARCH According to NCNR, nursing research is the testing
of knowledge that can be used to guide nursing
practice. It is concerned with examining questions
Lecturer: Mark Fredderick R. Abejo RN, MAN and verifying interventions based on human
________________________________________________ experiences.

NATURE OF RESEARCH
The Goals of Nursing Research
Efficiency and effectiveness in nursing care.
Worthiness and value of the nursing
Research Definition
profession.
Derived from the old French word CERCHIER
Indentify, implementing and evaluating
meaning to seek or to search.
effective health care modalities.
The prefix re means again and signifies
Potential for providing quality care of
replication of the search, implying that the person
clients.
has to find out or to take another more careful look.
Is a scientific study or investigation that is pursued
to discover theories and concepts based on new facts Sources of Knowledge in Nursing
and information and its practical application.
Systematic collection and analysis of data to Faith, Habits and Traditions
illuminate, describe or explain new facts and Authority
relationship and for the purposes of prediction or Borrowing
explanation. Clinical / Personal Experience
An attempt to gain solutions to the problem. (Treece, Trial and Error
1986) Intuition
Refers to a problem solving process that utilizes Role Modeling
scientific and develop ideas and theories that give Logical Reasoning
meaningful answer to complex questions about Assembled Information
human beings and the environment. Disciplined Research
The Committee on Research of the Philippine
Nurses Association has come up with its own Reason for Conducting Research in Nursing
definition of research: Research is an honest,
scientific investigation undertaken for the purpose 1. Gather data or information on nursing situations or
of discovering new facts or establishing new conditions about which little knowledge is available.
relationship among facts already known which will 2. Provides scientific knowledge base from which nursing
contribute to the present body of knowledge and theories emerge and develop.
can lead to an effective solution of existing 3. Helps correct, clarify and validate perceptions and
problems. expands these.
4. Provides theoretical and scientific basis for nursing
Theory systematic, abstract explanation of some practice.
aspect of reality. 5. Defines the parameters of nursing and identifies its
Concepts building blocks of theories boundaries.
Data pieces of information obtained in the course of 6. Documents the social relevance and efficacy of nursing
investigation practice to people and health care providers.
Phenomenon an event, happening, incident and 7. Describes the characteristics of the nursing situation
observable facts. about which little knowledge is known.
8. Predicts probable outcomes of nursing decisions in
relations to client care.
Nursing Research Definition 9. Provides knowledge for purposes of problem solving and
It is defined as a formal, systematic, rigorous and decision making.
intensive process used for solutions to nursing 10. Develops and evaluates nursing theories, concepts and
problems or to discover and interpret new facts and practices these for clarity and validity of nursing actions.
trends in the clinical practice, nursing education and 11. Prevents undesirable client reactions.
nursing administration. (Waltz and Bausell, 2001) 12. Develops a considerable degree of confidence.

Introduction to Nursing Research Abejo


Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN

General and Specific Purposes of Research Types of Research

General Purposes 1. General Classification


Research in general, answer questions to solve problems.
Provide tools for observation in order to generate Basic / Pure Research
knowledge as basis for predicting and controlling the The researcher tries to find the truth about
phenomenon. Thus, a nurse can apply this knowledge in something.
practice and prescribe accurately and professionally It is done for the intellectual pleasure of
without untoward client response or reactions to nursing learning to search for knowledge for its own
interventions. (Polit and Beck, 2004 ) sake and eventually filter down the result into
real life situation.
Specific Purposes
Specifically, research aims to do the following tasks: Applied Research
Description Applied research seeks for practical application
Exploration of theoretical or abstract knowledge. The truth
Explanation is adapted to every situation.
Prediction It results from present problems or from
Control socially disorganized situations. It frequently
raises theoretical questions that must be
Research Purpose Related to Evidence- Based Practice answered by basic/ pure research.

Treatment, Therapy or Intervention Purpose of Conducting Applied Research


Diagnosis and Assessment To solve a problem
Prognosis To make a decision
Prevention of harm To develop a new program, product,
Etiology or causation methods and procedure
Meaning and Process To evaluate program and methods.

Action Research
Paradigms for Nursing The process involves the study of certain
problem and from that experience, decisions,
Paradigms an overall belief system, a view of the world that actions and conclusion are drawn.
strives to make sense of the nature of reality and the basis of Findings are limited to settings actually
knowledge. studied.

MAJOR ASSUMPTIONS OF THE POSITIVIST AND 2. According to Level of Investigation


NATURALISTIC PARADIGMS
Exploratory Research
Allows one to study the variables pertinent to a
Positivist Naturalistic specific situation.
Paradigm Paradigm
Nature of Reality exist Reality is multiple and Descriptive Research
reality subjective The exploration and description of phenomena
Relationship Inquirer is independent Inquirer interacts with in real life situation.
bet. from those being those being research
Researcher researched
Provides an accurate account of characteristics
and those of particular individuals, situations or groups.
being
researched
The role of Values and biases are Subjectivity and value 3. According to Time Element
values in to be held in check are inevitable
inquiry Historical Research
Best method Deductive processes Inductive processes Describes what was?
for obtaining Emphasis on discrete, Emphasize on whole
evidence specific concept Focus on the subjective
Focus on objectives Flexible Descriptive Research
Verification of Insider knowledge as Describes what is?
researchers predictions internal
Fixed designed Narrative information 4. According to Duration
Outsider knowledge as Seek in depth
external understanding Longitudinal Study
Measured Focus on the product and
Seek generalization process
Follows the subjects for a long period of time
Focus on the product in order to observe change.

Introduction to Nursing Research Abejo


Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN

Cross sectional Study


Takes information one at a time and may
require subjects to recall past events or feelings.
It may contribute to a loss of accuracy and Qualitative Research
support bias. It is more often done than the A systematic, interactive, subjective approach used
longitudinal studies to describe life experiences and give them meaning.
A type of research conducted to describe and
5. According to Research Design promote understanding of human experiences.
Evolved from the behavioral and social sciences as a
Correlational Research method of understanding unique, dynamic, holistic
Involves the systematic investigation of nature of human beings.
relationship between or among variables.
This design is used to quantify the strength of Approaches in Qualitative Research
the relationships in the real world.
This design is used to quantify the strength of Phenomenological Research
the relationship between variables or in testing - Used to answer questions of meaning
a hypothesis about a specific relationship. - Begin with accumulation of evidence
when little topic is known or when
Experimental studying new topic it involves gathering of
An objective, systematic, highly controlled fresh perspective.
investigation for the purpose of predicting and - The goal of phenomenological inquiry is
controlling phenomena in nursing practice. to understand fully lived experience and
The researcher actively introduces some form perceptions.
of treatment and has greater control over - Aspects of Lived Experience involves:
extraneous variables. a. Lived Space (spatiality)
b. Live Body (corporeality)
Non Experimental c. Lived Time (temporality)
The researcher collects data without d. Live Human Relation (relationality)
introducing any treatment or making any
changes. Grounded Theory Research
Non experimental research usually includes - Method designed to inductively develop a
studies where the researchers primary interest theory based observations of selected
is understanding some human behavior in people.
naturalistic contexts. - The primary purpose of grounded theory
research is to develop a theory. The
Quasi Experimental concepts and theories discovered through
Is like experimental research because it actively this research approach are derived directly
from the data.
introduces some form of treatment or
- The following are the major premises of
manipulation of an independent variable.
grounded theory:
Unlike experimental research, however, it does
Humans act toward objects on the
not utilize randomization or control group.
basis of the meaning those objects
have for them.
Social meaning arise from social
interaction
People use interpretive processes to
Nursing Research Methodologies
handle and change meanings in
dealing with their situations.
- Fundamental characteristic of grounded
theory research is that data collection, data
Quantitative Research
analysis and sampling of participants
A formal, objective, systematic process in which
occur at the same time.
numerical data are used to obtain information about
- In depth interview and observation are the
the world.
most common data source.
This method is used to describe variables, examine
relationships among variables and determine cause Ethnographic Research
and effect interactions between variables. - A tool for studying cultures
- It has been associated with studies of
Rigor in Quantitative
primitive, foreign or remote cultures
Rigor is the striving for excellence in research
which allows the researcher to acquire
and it requires discipline, adherence to detail
new perspectives beyond his/her own
and strict accuracy.
ethnocentric perspective.
Control in Quantitative
Involves the imposing of rules by the
researcher to decrease the possibility of error.
Introduction to Nursing Research Abejo
Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN

Narrative Research
- Focus on story as the object of inquiry, to COMPARISON OF QUANTITATIVE AND
determine how individuals make sense of QUALITATIVE RESEARCH
events in their lives.
- The data can be collected as a story or Quantitative Qualitative
filed notes.
- It may be used for comparison among General Seek to confirm Seek to explore
groups, to learn about a social Framework hypotheses about phenomena
phenomenon or historical period or to phenomenon
explore a personality
Instrument use more Instrument use more
Case Study rigid style of flexible, repetitious
- Involves an in-depth description of eliciting and style of eliciting and
essential dimension and processes of the categorizing categorizing
phenomenon being studied. response to question responses to
- Are means of providing in depth, evidence questions
base discussion of clinical topics along Use highly
with practical information structured methods Use semi structured
such as methods such as in
questionnaires, depth interviews,
survey and focus groups and
COMPARISON ON PHASES OF COMPARISON OF structured participant
QUANTITATIVE AND QUALITATIVE RESEARCH observation observation

Quantitative Qualitative Analytical To quantify To describe variation


Conceptual Formulating problem Topic identification Objectives variation
Phase Review related lit. Situation appraisal To describe and
Defining framework Develop To predict causal explain relationship
Formulating hypotheses relationship
hypotheses Framework To describe
development To describe individual
Objective characteristics of a experiences
formulation population
Design / Selecting research Research plan To describe group
Planning design formulation norms
Phase Develop protocol for Question Close - ended Open ended
intervention Format
Design sampling Data Format Numerical Textual
plan Flexibility in Study design is Some aspects of the
Develop methods to Design stable from study are flexible.
safeguard rights beginning to end
Empirical Collecting data Data gathering and
Preparing data collection Participant Participant responses
analysis responses do not affect how and which
Analytical Analyze the data Data analysis and influence or questions researchers
Phase Interpreting the interpretation determine how and ask next
results Conclusion which questions
Dissemination Communicating Communicating researchers ask next Study design is
Phase findings and utilizing the repetitious, that is,
Utilizing findings in findings Study design is data collection and
practice subject to statistical research question are
assumptions and adjusted according to
conditions. what is learned.

Introduction to Nursing Research Abejo


Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN

CONTRAST OF QUANTITATIVE AND QUALITATIVE Links Relationships Patterns


RESEARCH APPROACHES between (causal,functional)
concepts
Element Quantitative Qualitative Logical Deductive Inductive reasoning
View of reality Reality is Reality is constructed reasoning reasoning
objective and can by the individual processes
be seen and Quality of Reliability, Trustworthiness
measured evidence validity,
View of time Reality is Reality is generalization
relatively constant continuously Parts/phases Statement of the Aim of the study
constructed of research problems
Context Reality can be Reality is embedded output Results Findings
separated from in its context Literature review Reconnaissance
context Sampling Selection
Researcher Objective, Personally involved Study framework Study simulacrum
Approach detached Main problem Central question
Population Samples that Individual cases, Specific problem Issues
Studied represent overall represented as Interview guide Aide memoir
populations, as informants. Data analysis Mode of analysis
subjects Method Design
Measures Human behavior Study the meaning
or other that individuals create
observable
phenomena Outcome Research
Observations Analyze reality as Make holistic This method examines the results of care and
definable variables observations of the measures the change in health status of clients.
total context The following are areas that require investigation
Design Preconceived and Emergent and fluid, through outcome research:
highly controlled adaptable to Clinical client response to medical and nursing
informants views interventions.
Analysis Descriptive and Analytic induction to Functional maintenance or improvement of
inferential determine meaning physical functioning
statistics Financial outcomes achieved with most
Generalization Use inference to Transfer knowledge efficient use of resources.
generalize from a from case analysis to Perceptual clients satisfaction with outcomes,
sample to a similar cases care received and providers.
defined population
Reports Objective, Interpretative reports Intervention Research
impersonal reports that reflect the Involves the investigation of the effectiveness of a
in which researchers nursing intervention in achieving the desired
researchers reconstruction of the outcome or outcomes in natural setting.
opinions are meaning of the data Intervention research should be theory driven, which
undetectable means that the theory determines the nature of the
intervention, the health professionals to deliver the
intervention, the setting where the intervention is to
be provided, the type of client to receive the
JARGONS QUANTITATIVE AND QUALITATIVE intervention and the selection and measurement of
RESEARCH APPROACHES outcome variables.

Concepts Quantitative Qualitative Components of Scientific Research


Person Study participant Study participant Order and system
contributing Control
information Respondents Informant, Key Empiricism
informant Generalization
Person Researcher, Researcher,
undertaking investigator investigator
the study Characteristics of Research
That which is Concepts Phenomena
being studied Variables Concepts It involves the gathering of new data from new sources or
Variables first-hand information.
It is directed towards the solution of a problem
Information Data (numeric Data (narrative It is characterized by carefully designed procedures
gathered value) descriptions) applying rigorous analysis
Introduction to Nursing Research Abejo
Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN

It emphasizes the development of generalizations,


Qualities of a Good
principles hypotheses and theories that may be helpful in
Researcher
predicting future occurrences.
It requires expertise
R - Research Oriented
It demands accurate observation and description of what
E - Efficient
is being studied.
S - Scientific
It strives to be logical, applying every possible test to
E - Effective
validate the procedures being employed.
A - Active
It is characterized by patient and unhurried activities.
R - Resourceful
It requires innovative approaches and determination to
C - Creative
succeed.
H - Honest
It is carefully and accurately recorded and reported.
E - Economical
R - Religous
Limitations of Research

Result of faulty planning and implementation of the The Consumer-Producer Continuum in Nursing Research
project.
The individual researcher
The scope of knowledge or information available about Consumer of Producer of
the topic and the problem under study also must be Research Research
considered.
Sources of data
The tools of measurement may be inadequate or entirely The consumers of research are nurses at one end of the
lacking. continuum whose involvement in research is indirect.
These nurses:
Reasons for Lack of Clinical Research
Identify clinical problems in nursing practice
1. Nurses tend to feel that they are too busy to care for Use library and information technology resources.
patients. Read research reports to develop new skills and
2. Unless the nurse has had academic training in theoretical search for relevant findings that affect practice.
conceptualizations, research may not seem important. Participates in journal clubs
3. Unless the importance of research is felt and recognized, Use research to solve clinical problems
nurses may not be able to identify researchable problems. Use research in clinical decisions
4. Many nurse do not have the academic training needed to
Collaborate in developing an idea for a research
feel confident in doing clinical research.
project.
5. The ethics or research tends to researchers. Fear of
Reviews a research proposal for feasibility and offer
harming a patient is also a hindrance to some researchers.
suggestion to improve the plan.
6. Unless administrators are research-oriented, the nursing
Assist in data collection
staff feels the futility of support for nursing research,
hence, there is no motivation to pursue this. Participate in research study or survey
7. Research takes time, time costs money which must be Lead a journal club or ground discussion.
budgeted. Participate in unit or service based research councils.

The producers of research at the other end of the


Characteristics of the Good Nurse Researcher continuum are the nurses who actively participate in:

Honest and Credible Designing and implementing studies


Intellectual Curiosity Conducting studies
Accurate in his/her data Disseminating research findings
Organized and Systematic Appraising the clinical relevance of research
Prudence findings.
Logic Provides leadership for integrating findings in
Self- Awareness clinical practice.
Healthy Criticism
Intellectual Honestly Nursing Research Guidelines for the Investigative
Good Relationship with his/her respondents Function of Nurses

1. Associate Degree in Nursing


Demonstrates awareness of the value or relevance of
research in nursing
Assists in identifying problem areas in nursing
practice.
Assists in collection of data within an established
structured format.
Introduction to Nursing Research Abejo
Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN

2. Baccalaureate Degree in Nursing


Reads, interprets and evaluates research for Ethics in research requires honesty and accuracy of
applicability to nursing practice. data. The researcher must guarantee factual and
Identifies nursing problems that need to be evidenced based data. There should be no
investigated and participates in the implementation plagiarism such as presenting the ideas or words of
of scientific studies. another as ones own, nor distort or fabricate data for
Uses nursing practice as a means of gathering data purposes of completing the research on time.
and refining and extending practice. The Philippine Copyright Law (R.A No. 8293 )
Applies established findings of nursing and other protects the intellectual property rights of authors and
health related research to nursing practice. artist .
Shares research findings with colleagues.

3. Masters Degree in Nursing


Analyzes and reformulates nursing practice
problems so that scientific knowledge and scientific
methods can be used to find solutions.
Provides expertise in clinical problems by providing
knowledge about the way clinical services are
delivered which enhances quality and clinical
relevance of nursing.
Facilitates investigation of problems in clinical
settings by contributing to a climate of supportive
investigative activities, collaborating with others in
investigations and enhancing nurses access to
clients and data.
Investigates for the purpose of monitoring the
quality of nursing practice in a clinical setting.
Assists others in applying scientific knowledge in
nursing practice.

4. Doctorate Degree in Nursing or Related Discipline

Provides leadership for the integration of scientific


knowledge with others types of knowledge for the
advancement of practice.
Conducts investigations to evaluate the contributions
of nursing activities to the well-being of clients.
Develops methods to monitor the quality of nursing
practice in a clinical setting and to evaluate
contributions of nursing activities to the well-being
of clients.

Role of Nurses in Research

As Principal Investigators _________________________________________


As Member of a Research Team
As Evaluator of Research Findings References:
As Consumers of Research Findings
1. Venzon. 2004. Introduction to Nursing Research: Quest for Quality
As Client Advocate in a Research Study Nursing, 1st ed. Philippines: C&E Publishing Inc.
As Subject of Research 2. Barrientos-Tan. 2006. A Research Guide in Nursing Education, 3rd
ed. Philippines: Visual Print Enterprises.
3. Reyes & Layug. 2009. Comprehensive Reviewer for the Nurse
Ethics in Research Licensure Exam, Philippines: East West Educational Specialists,
C&E Publishing Inc.
Informed Consent 4. Brink & Wood. 2001. Basic Steps in Planning Nursing Research,
Beneficence and Non-maleficence 5th ed. Philippines: Jones and Bartlett Publisher Inc.
5. Burns & Grove. 2007. Understanding Nursing Research : Building
- Freedom from any Physical and Psychological Harm an Evidence-Based Practice, 4th ed. China; Elsevier, Health
- Freedom from Exploitation Sciences.
Respect for Human Dignity 6. LoBiondo-Wood & Haber. 2006. Nursing Research: Methods and
- The right to self determination Critical Appraisal for Evidence-Based Practice, 6th ed. USA: Mosby
Inc.
- The right to full disclosure 7. Polit & Beck. 2008. Nursing Research: Generating and Assessing
- Anonymity and Confidentiality Evidence for Nursing Practice, 8th ed. Philadelphia: Lippincott
Justice and Fairness Williams & Wilkins.

Introduction to Nursing Research Abejo