Bias	Any influence that may alter the outcomes of a research study
Clinical nursing research	Nursing research that has a direct impact on nursing interventions with clients
Data	Measurable bits of information collected for the purpose of analysis
Data collection	Gathering of information necessary to address the research problem
Deductive reasoning	Logical system of thinking that starts with the whole and breaks it down into its component parts
Dependent variable	A variable that is affected by the action of the independent variable
Ethics committee	Committee responsible for review of research proposals to ensure that human subjects are protected from harm
Hypothesis	Statement of a predicted relationship or difference between two or more variables. A hypothesis contains at least one independent and one dependent variable
Independent variable	A variable that causes a change in the dependent variable
Inductive reasoning	Logical system of thinking that begins with the component parts and builds them into a whole
Informed consent	An agreement by a research subject to participate voluntarily in a study after being fully informed about the study and the risks and benefits of participation
Instrument	Device or technique used to collect data in a research study, e.g., questionnaires or interviews
Literature review	A critical summary of available theoretical and research literature on the selected research topic. It places the research problem for a particular study in the context of what is currently known about the topic
Nursing research	Research usually conducted by nurses to generate knowledge that informs and develops the discipline and practice of nursing
Population	All known subjects that possess a common characteristic of interest to a researcher
Problem statement	A statement that describes the purpose of a research study, identifies key concepts and sets study limits
Qualitative research	Used to examine subjective human experiences by using non-statistical methods of analysis
Quantitative research	The systematic process used to gather and statistically analyse information that has been measured by an instrument and converted to numerical data
Reliability	Characteristic of a good instrument; the assessed degree of consistency and dependability
Research	A systematic process using both inductive and deductive reasoning to confirm and refine existing knowledge and to build new knowledge
Research design	The overall plan for collecting data in a research study
Research process	An orderly series of phrases identifying steps that allow the researcher to move from asking a question to finding an answer
Research question	Use of an interrogative format to identify the variables to be studied and possible relationships or differences between those variables
Sample	A subset of a population selected to participate in a research study
Validity	A characteristic of a good instrument; the extent of an instrument’s ability to measure what it states it will measure
Variable	A concept, characteristic or trait that varies within an identified population in a research study

(Borbasi et al 2008)

Nursing research involves a systematic search for and validation of knowledge about issues important to the nursing profession and links theory, education and practice. Nursing research is important for:

• Validating nursing as a profession

• Documenting the effectiveness of nursing interventions

• Providing a scientific knowledge base for practice

• Demonstrating accountability for the profession.

Research-based or evidence-based practice is essential if the nursing profession is to deliver safe, effective and efficient care.

The ultimate goal of nursing is to provide evidence-based care that promotes quality outcomes for clients, families, health care providers and the health care system. Burns and Grove (2004) describe evidence-based practice as involving the use of collective research findings in:

• Promoting the understanding of clients’ and families’ experiences with health and illness

• Implementing effective nursing interventions to promote client health

• Providing quality, cost-effective care within the health care system.

EVIDENCE-BASED PRACTICE

Evidence-based nursing is a clinical activity based on the belief that decisions about the delivery of care to clients should be informed by the best available and current scientific evidence (Beanland et al 2004). Another definition of evidence-based practice is that it is a process within which clinical decisions are made by practitioners using the best available research evidence, their clinical expertise and client preferences, with consideration also of available and finite resources (Schneider et al 2007). The five steps universally accepted as being necessary for evidence-based practice are presented in Clinical Interest Box 4.1. Clinical Interest Box 4.2 explains evidence-based practice.

CLINICAL INTEREST BOX 4.2 Evidence-Based Practice

What Is Evidence-Based Practice?

A process of:

• synthesising research evidence

• designing clinical practice guidelines

• implementing practice changes

• evaluating outcomes

Why Do We Need Evidence-Based Practice?

• Rapid increase in amount of information

• Rapid increase in healthcare costs

• Determination of efficient and effective healthcare practices

• Increased emphasis on performance and outcome standards

Where Is Evidence Found?

• Published research

• Systematic reviews (e.g. Cochrane Collaboration; available: http://www.cochrane.org/)^*

• Special collections of EBP resources (e.g. The Joanna Briggs Institute; available: http://www.joannabriggs.edu.au)

^* Descriptions can be found at this website, but access to systematic reviews is by subscription only.

(Brown et al 2008: 13)

THE EVOLUTION OF NURSING RESEARCH

As early as 1854, Florence Nightingale demonstrated the importance of research in the delivery of nursing care. When Nightingale arrived in the Crimea in 1854, she found the military hospital barracks overcrowded, filthy and lacking in food, drugs and essential medical supplies. Men were dying from starvation and diseases such as cholera and typhus because of these conditions. By systematically collecting, organising and reporting data, Nightingale was able to implement sanitary reforms and prove a significant reduction in mortality rates. This is considered to be the first nursing research study (Kozier et al 2007).

Research was slow to develop in nursing, with little formal research carried out by nurses until the late 1940s. Nursing schools evolved from military and religious roots and stressed order and obedience. Training was viewed as an apprenticeship, with long hours, and nurses had little say in their own training or work. Only when nursing began to move towards advanced education and affiliation with university settings did nursing research begin to emerge. This move began in the USA. In the 1960s and 1970s the number of nurses with advanced degrees and research skills increased and the push for doctoral preparation in nursing began. Nurses began to turn to nursing care and clinical practice to provide questions for research. Nursing theories evolved that attempted to describe and explain the practice of nursing and these theories began to be tested by nurse researchers. Practice-related research flourished and by the end of the 1970s two new research journals were launched in the USA to handle the nursing research explosion (Borbasi et al 2004).

In Australia and New Zealand, nursing research awareness remained relatively low until nursing moved into the tertiary education sector in the 1970s and 1980s. This move was accompanied by a major increase in the level of research activity, which was directed at educational, disciplinary or professional issues, and research into other disciplinary areas of relevance to nursing. It is only recently that research education delivered to nurses in Australia and New Zealand has begun to prepare nurses to understand the relationship between research evidence and nursing practice, and how to go about incorporating research findings into practice (Crisp & Taylor 2005). Some ideas that have been tested and demonstrated to be useful in practice are: moist wound healing; pressure-relieving devices for the prevention of pressure ulcers; client information to improve self care and healthy lifestyles; communication with people who are dying; and nutritional support of older people in hospital (Brown et al 2008).

THE FUTURE OF NURSING RESEARCH

The value of research studies that increase understanding of clinical phenomena and provide direction for defining programs of research is well recognised and flourishing in Australia and New Zealand. Nurse researchers and nurse leaders are visibly involved at the national level, participating in policy making, representing nursing on expert panels and organisations such as the National Health and Medical Research Council (NHMRC) and lobbying for funding (Beanland et al 2004).

Magnet Hospitals are emerging in both Australia and New Zealand. The concept of a ‘Magnet Hospital’ is to develop and sustain an environment where nursing- and midwifery-related evidence-based practice and practice change are more likely to occur. Magnet Hospitals aim to provide a commitment to staff development and training, effective systems for implementing and evaluating quality-based treatment and care, and sustainable long term resourcing (Schneider et al 2007).

Borbasi et al (2004) state that, with the development of a national organisation for nursing research, research priorities in the 21st century are likely to be directed at nursing practice and that there will be an increased emphasis on building on the results of completed studies. They also believe that there will also be a greater emphasis on finding ways to utilise the results of nursing research in the course of day-to-day practice.

RESEARCH METHODS

Nursing research focuses on the full range of human experiences and responses and is directed towards helping well individuals improve their health status and stay healthy, as well as assisting clients who are sick or disabled by an illness to maintain or improve their health (Crisp & Taylor 2005).

The major factor that affects whether a nursing researcher uses systematic, controlled methods for studying events or problems is the extent to which he or she wishes to study the way that characteristics or variables (see Table 4.1) are different, or the way that one variable is predictive of (causally associated with) another. These studies are well organised and follow a specific procedure to enable other researchers to reproduce the study or examine the evidence and achieve the same outcomes. To guide the design of a research study, nurse researchers may create a hypothesis or statement about what they expect to see before conducting the study (Crisp & Taylor 2005).

Nurse researchers use many methods because nurses are interested in acquiring knowledge about a wide range of human needs and responses to health problems. For example, a different research method may be used by a nursing researcher interested in developing a deeper understanding of a phenomenon and how it may be experienced by clients, such as helping women deal with the consequences of incontinence after childbirth. Most methods used are either quantitative or qualitative in nature (Crisp & Taylor 2005).

QUANTITATIVE METHODS

Quantitative research methods involve the use of numbers and statistical analysis. This is a process used to gather and analyse information that has been measured by an ‘instrument’, such as a questionnaire, and converted to numerical data. Quantitative nursing research is the investigation of nursing phenomena that lend themselves to a precise measurement, such as pain severity, rate of wound healing, etc (Crisp & Taylor 2005). Box 4.1 describes different ways of using quantitative methods.

Box 4.1 Types of research that use quantitative methods

CORRELATIONAL RESEARCH

Studies that explore the patterns of interrelationships among variables of interest, without any active intervention by the researcher. Correlational methods are used in testing predictive relationships among variables, for testing models or theories that seek to explain complex patterns of relationships, and for testing the most effective and efficient means of achieving positive health outcomes.

DESCRIPTIVE RESEARCH

Studies in which the aim is to accurately portray characteristics of individuals, situations or groups and the frequency with which certain events or characteristics occur. The major goal of this form of research is simply to describe what is seen in order to identify variables that may be of interest in future investigations.

EXPERIMENTAL OR QUASI-EXPERIMENTAL RESEARCH

Studies in which the investigator controls the independent variable and randomly assigns subjects to different conditions. The major goal of this research is to determine causal relationships among the variables through a controlled investigation in which only the independent variable can be the cause of changes in the dependent variable.

EXPLORATORY RESEARCH

Studies designed to develop or refine the dimensions of phenomena or to develop or refine a hypothesis about the relationships among phenomena. The major goal of this research is to explore what is seen in order to identify relationships among variables that might be of interest in future investigations.

EVALUATION RESEARCH

Studies that test how well a program, practice or policy is working. The major goal of this form of research is determining the success of a program. This type of research can determine specifically why a program was successful. When programs are unsuccessful, evaluation research can assist in identifying problems with the program, why it was not successful or even barriers to implementation of programs.

SURVEY RESEARCH

Studies designed to obtain information from populations regarding prevalence, distribution and interrelation of variables within the study population. They may be conducted for the general purposes of obtaining information about practices, opinions, attitudes and other characteristics of individuals. The major goal of this form of research is simple description or the accumulation of a large amount of data to describe the population being studied, as well as the topic of study.

(Crisp & Taylor 2005)

In quantitative research, the researcher changes one set of variables and observes the outcome or its influence on other variables. Variables are changeable qualities, such as characteristics of people or situations that can change or vary for many reasons. Temperature, pulse, respiration, blood pressure, height and weight are examples of variables.

The variable that the researcher controls or manipulates is called the independent variable. The variable that varies or changes because of this is called the dependent variable. For example, consider the statement: ‘Sitting upright in bed does not make breathing easy in a client with asthma’. The independent variable relates to sitting the client in different positions, such as lying flat, semi-recumbent, lateral and upright positions. This is the variable the researcher can manipulate to study its influence on the dependent variable. The dependent variable is the measurement of breathing.

QUALITATIVE METHODS

Qualitative research is used to describe information obtained in a non-numerical form, such as data obtained from interviews. Qualitative nursing research is the investigation of phenomena that are not easily quantified or categorised, in which inductive reasoning is used to develop generalisations or theories from specific observations or interviews (Crisp & Taylor 2005). See Box 4.2 for the different ways of using qualitative methods.

Box 4.2 Types of research that use qualitative methods

(Crisp & Taylor 2005)

ACTION RESEARCH

Studies that attempt to make qualitative research more humanistic, holistic and relevant to the lives of human beings. The major goal of this research is working in collaboration with participants in a manner that brings about desired change(s).

CRITICAL SOCIAL RESEARCH

Studies that empower individuals involved in this research by attempting to confront unjust power structures within a specific context or society. The major goal of this research is the challenging of dominant constructions of reality and the societal structures that maintain the status quo and determine allocation of power and resources.

DESCRIPTIVE RESEARCH

Studies in which the objective is to accurately portray characteristics of individuals, situations or groups and the frequency with which certain events or characteristics occur. The major goal of this research is to describe what is seen in order to detect phenomena that might be of interest in future research.

EXPLORATORY RESEARCH

Studies designed to develop or refine the dimensions of phenomena or to develop or refine a hypothesis about the relationships among phenomena. The major goal of this research is to explore what is seen in order to identify relationships among phenomena that might be of interest in future research.

HISTORICAL RESEARCH

Systematic studies designed to establish facts and relationships concerning past events. The major goal of this research may be either a descriptive account of what occurred and the facts surrounding the event(s), or a critical approach may be taken in which the researchers challenge the dominant interpretations of facts.

INTERPRETATIVE RESEARCH

Studies in which human experience is investigated to generate deeper understanding of the phenomena of interest. The major goal of this research is the exploration of the numerous ways human beings experience the complex world in which they live.

Qualitative researchers may wish to examine individual lives and their stories and behaviour, organisations and their functioning, or cultures and their interactions and social movement. As the study methodology embraces the examination of subjective phenomena, these findings are only considered to be representative of a particular person or group of people, and in a particular setting, and not reflective of other people or other settings (Borbasi et al 2004).

There are strengths in both quantitative and qualitative approaches. The quantitative approach can support a theory or argue to disprove it, and can be very useful, for example, when hospitals or governments want to introduce policy changes. The qualitative approach, by contrast, has a human focus and allows researchers to know their subjects and collect information about attitudes and satisfaction levels that are vital to improve care provided by nurses.

THE RESEARCH PROCESS

There are several steps in conducting either quantitative or qualitative research.

STEP 1. THE RESEARCH PROBLEM

The research problem is refined through a process that proceeds from identifying a general idea of interest to defining a specific topic. A preliminary literature review reveals related factors that appear critical to the research topic. The significance of the research problem must be identified in terms of its potential contribution to clients, nurses and the medical community (Beanland et al 2004). Choosing the topic of interest may develop from:

• Discussing an issue of common interest with a colleague

• Reading about an issue in a journal, text or newspaper

• An aspect of practice being introduced for the first time

• An aspect of practice that may have been observed but needs to be validated

• Areas of work that may need to change

• Wanting to repeat a study that has already been conducted, to check the results.

STEP 2. THE PURPOSE

The purpose of the study states the aims or goals that the investigator hopes to achieve with the research. It also suggests the way in which the researcher sought to study the problem.

STEP 3. LITERATURE REVIEW

The overall purpose of conducting a review of the literature is to develop a strong knowledge base to carry out research and other consumer research activities in the educational and clinical practice settings. It is a broad, comprehensive, in-depth, systematic and critical review of scholarly publications, unpublished scholarly print materials, audiovisual materials and personal communications (Beanland et al 2004).

The literature review provides a way of checking what has already been studied in relation to the proposed study. It can also provide an understanding of the procedures, methods of analysis and variables that can influence the study (see Box 4.3).

Box 4.3 Overall purpose of a literature review

• Determines what is known and not known about a subject, concept or problem.

• Determines gaps, consistencies and inconsistencies in the literature about a subject, concept or problem.

• Discovers unanswered questions about a subject, concept or problem.

• Discovers conceptual traditions used to examine problems.

• Uncovers a new practice intervention(s) or provides evidence for current practice intervention(s).

• Generates useful research questions and hypotheses for the discipline.

• Describes the strengths and weaknesses of designs or methods of enquiry and instruments used in earlier works.

• Determines an appropriate research design or method (instruments, data collection and analysis methods) for answering the research question(s).

• Determines the need for replication of a well-designed study or refinement of a study.

• Promotes development of new or revised practice protocols, policies and projects or activities related to nursing practice and to the discipline.

(Schneider et al 2007)

How to search successfully for information

To conduct a successful search for information about a particular subject, the researcher needs to define the topic of interest, select appropriate search resources and selectively review and evaluate the materials produced by a search (Borbasi et al 2004). A search is conducted using indexes, abstracts and catalogues to find information about specific subjects. Books tend to give standard accepted information and practices. They provide good baseline data on a subject. Journals, however, provide more current information than books. They report changing trends and practices.

Several electronic indexes are used for nursing journals (Box 4.4), including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Index Medicus (a comprehensive index of peer-reviewed medical journals compiled by the US National Library of Medicine) and its online counterpart, MEDLINE (Medical Literature Analysis and Retrieval System [MEDLARS] online). Each index has a primary area of focus and advantages and limits. Electronic databases operate with a special vocabulary. However, the computer helps the researcher to define the preferred terms to use in a search. It is important to make the search as precise as possible; if there are several key terms, they should be used. Other limits such as gender, age and/or time factors, should also be set. Ask for assistance from the librarian if there is difficulty finding information. Many professional information sources are also available on the internet, where there is access to a wide variety of databases, client and nursing education resources, as well as some nursing journals (see Online Resources at the end of this chapter).

Tags: Tabbners Nursing Care Theory and Practice

Feb 12, 2017 | Posted by admin in NURSING | Comments Off

Nurse Key

Fastest Nurse Insight Engine

NURSING RESEARCH

NURSING RESEARCH

EVIDENCE-BASED PRACTICE

THE EVOLUTION OF NURSING RESEARCH

THE FUTURE OF NURSING RESEARCH

RESEARCH METHODS

QUANTITATIVE METHODS

CORRELATIONAL RESEARCH

DESCRIPTIVE RESEARCH

EXPERIMENTAL OR QUASI-EXPERIMENTAL RESEARCH

EXPLORATORY RESEARCH

EVALUATION RESEARCH

SURVEY RESEARCH

QUALITATIVE METHODS

ACTION RESEARCH

CRITICAL SOCIAL RESEARCH

DESCRIPTIVE RESEARCH

EXPLORATORY RESEARCH

HISTORICAL RESEARCH

INTERPRETATIVE RESEARCH

THE RESEARCH PROCESS

STEP 1. THE RESEARCH PROBLEM

STEP 2. THE PURPOSE

STEP 3. LITERATURE REVIEW

How to search successfully for information

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