Research in
Nursing PracticeB. Sunil S. De Silva
RN, BScN(OUSL), MScN(RES)(Australia)
Head/Senior LecturerDepartment of Health Sciences
The Open University of Sri Lanka
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Objectives Describe the importance of the
nursing research to practice. Identify historical aspects. Identify ethical issues. Critique research problems,
variables, literature review & hypotheses.
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Objectives… Identify different research designs,
samples & populations. Define internal & external validity. Identify different methods of data
collection & data analysis. Disseminate research findings to
develop nursing knowledge.
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Introduction to Nursing Research
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What is Research? Research – search again or to
examine carefully. Research is systematic inquiry that
uses disciplined methods to answer questions or solve problems (Polit & Beck, 2006)
The ultimate goal of research is to develop, refine, & expand a base of knowledge.
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Types of ResearchResearch
Basic/Pure research Applied research
Develop theories that
will strengthen our understanding
of the nursing process are part of basic research
Find solution to
clinical problems as part of
applied research
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Major areas of nursing research
Nursing Characteristics Patient Characteristics Nursing Administration Nursing Education Clinical Practice
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Purposes of Scientific Research…
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Research Process Conceptual phase - Think it out
Empirical phase - Go & Do it
Interpretive phase - See what it all means
Research Study Evaluation Guide based on these three phases.
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Research Process
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Historical Aspects of Nursing Research
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Historical Aspects of Nursing Research… Initiate from the time of F. Nightingale.
Recent trend to focus nursing practice than the nursing education & administration.
After 1950’s nursing research began to publish.
Future focus on health prevention, & illness prevention.
Theory development increase the body of knowledge.
Ethical Issues in
Nursing Research
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Code of ethics Many countries have developed codes
of ethics for research concerning human subjects.
It helps that the research remains ethical as well as scientific.
Recent guidelines, established in the Belmont Report (1978) ensure unbiased review.
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Belmont Report It rely on two historical documents;
The Nuremberg Code First international accepted code. Introduced informed consent.
The Declaration of Helsinki Initially develop for the doctors for clinical research. In nursing research – inform research subjects – No
personal benefits & avoid any understated suggestion.
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Basic Rights of Research Subjects Belmont Report served as model for
many of guidelines adopted by specific disciplines & outlined three primary ethical principles;
Beneficence Respect for human dignity justice
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The Principle of Beneficence It is the right of ‘Freedom from harm’
Freedom from harm/ risk of harm includes physical, emotional, legal, financial, & social harm
Freedom from exploitation/use Information do not use against them
Benefits from research should know potential benefits
Risk/Benefit Ratio Risk should be minimal
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The Principle of Respect for human dignity
The right of self-determination Voluntary decide to participate or not (at any time)
The right to full disclosure Fully informed – purpose, benefits, risks or on
going & end results.
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The Principle of justice The right to fair treatment
Fair & nondiscriminatory selections of subject Not on convenience or bias No harmful treatments for give up or refuse to
participate
The right to privacy Maintain anonymity & confidentiality
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Mechanisms for Ethical Standards Informed Consent Subject status Study purpose Type of information Nature of commitment Sponsorship Subject selection Procedures
Potential risk & benefits
Confidentiality Voluntary consent Right to withdraw Alternatives Contact information
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Mechanisms for Ethical Standards… Vulnerable Subjects
Not capable of giving informed consent. Children Mentally or emotionally disabled people Physically disabled people Peoples who are in hospitals or prisons Pregnant women
Review Boards
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Characteristic of ethical research Scientific objectivity – aware personal values & biases
Cooperation – work with ethical committees
Integrity – should not withhold any information, risks, benefits…
Equability – acknowledge the contributions
Nobility – Protect from harm
Truthfulness – Openness; purpose, procedure, methods…
Anonymity & confidentiality - Honesty – reveal scholarships, any findings…
Communication – Disseminate the findings
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Identifying Research Problems
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Sources of Research Problem Experience & interests – lead to clinical
research Existing research – published research Theory development – stem from scientific
interest External sources – pattern or trend
occurring in health care Social issues – Domestic violence
Reader – Edgar(1985),Fraleigh(1986)
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Developing a Research Question… Research problem - Broad topic of interest Problem statement - Articulate/clear the
problem to be addressed. Statement of purpose – Goal Research questions – the specific queries to
answer in addressing a research problem. Direct rewordings of statement of purpose,
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Feasible Problem Feasibility involves several factors which
the researcher needs to consider before beginning the research; Time Availability of subjects Cooperation of others Facilities & equipment Financial support Ethical considerations
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Variables
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Definition of Terms Concepts - ideas that the researcher
wants to study. Construct – narrow the focus of the study
to identify key concepts. Variable – after concepts are made
measurable, they are referred to as variables. The variables are the observable, measurable concepts which you propose to study.
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Types of Variables Independent variables
Dependent variables
Correlated variables
Extraneous variables
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Review of the Literature
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The Lit. review in a study serves several functions;
Presents theoretical frame work for the study.
Offers a critical analysis of developments related to the study’s topic.
Give credibility / trustworthiness to the study by showing that is a precedence / priority.
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Conducting the lit. review involves;
Checking for appropriate & relevant literature.
Making notes on the relevant articles located through the search.
Doing a critical analysis of each article.
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Lit. review should include the following types of literature
Relevant nursing research. Theoretical literature. General & specialty nursing literature. Methodological literature. Research literature from other disciplines. Popular lit. from sources written for general population.
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The Hypothesis
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Hypothesis… A hypothesis is the formal statement of the
expected relationships between two or more variables in a specified population.
Its provide specific direction for subsequent aspects of design, data collection & analysis.
Correlation, qusi-experimental & experimental studies need to include hypothesis.
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Categories of Hypothesis Different type of hypotheses depending
upon the relationships & number of variables identified in the research problem, Associative versus casual Simple versus complex Directional versus non directional Statistical versus research hypothesis.
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Associative versus casual Associative
Positive associative relationship. smoking & lung cancer
Negative associative relationship. health & illness
Casual Causal relationship – independent variable causes to
change dependent variable. prenatal education cause on a mother’s labor outcome
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Simple versus complex
Simple hypothesis – relationship between two variables (associative or causal)
Complex hypothesis – relationship among three or more variables.
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Directional vs non directional
A directional hypothesis is also an associative hypothesis, and states the direction of the predicted relationship Positive
As X increases, Y increases As X decreases, Y decreases
Negative As X increases, Y decreases As X decreases, Y increases
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Statistical/Null vs Res. hypothesis No relationship between variables. used for statistical testing & interpreting the
results of statistical analyses. simple or complex & associative or causal. It may not always be stated, but it is indirect, as it
is the opposite of the res. hypothesis. Ex; - There is no difference in measures of perceived stress
(a dependent variable) & blood pressure (a dependent variable) between subjects who do & do not participate in a program of meditation (independent variable).
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Hypothesis… An hypothesis try to answer the question posed by the
research problem.
It can be associative or casual, simple or complex, directional or non directional & research or statistical.
When testing the validity of the assumptions made from the theoretical frame work , the hypothesis bridges the theoretical & real worlds.
A hypothesis is a declarative statement about relationship between two or more variables that predicts expected outcome.
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Hypothesis… It should clear statement, contain the components
of population, variables, & predicted outcome. Two criteria used to critique are justifiable &
testable. Hypothesis…
Exploratory studies – (-) Descriptive/correlational studies – (+/- ) Res. Question
may be use Quasi-experimental/experimental - (+)
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Research Design
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Research Design… After developed research , specified variables, &
derived a hypothesis, then should determine the research design.
The ‘design’ is the structure of an investigation, through which answers to research questions are sought and outside influences are controlled (extraneous variables)
The two categories of research, qualitative & quantitative, refer both to the method of data collection & to the type of data collected.
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Two main categories of research
Qualitative
Quantitative
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Quantitative researchexperimental Nonexperimental
1. True experimental - must have three criteria;
control, manipulation & randomization
2. Quasi-experimental- randomization or control are
missing. - Most often random selection
or random assignment not possible.
• Least amount of control over extraneous variables in the study
• Describe the relationship between variables & unable to determine cause & effect.
• Correlation study - Examine the relationship between variables in a single group.
• Descriptive study - Describe each variable rather than manipulation & relationships.
• Survey design• Qualitative designs are nonexperimental & used new area of knowledge which is little is known.• Time, setting, & reasoning must be considered when determining the strength of the design.The research design chosen for the study depends on the purpose of the study
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Qualitative Nonexperimental research It is exploratory in nature & aims to
describe & explore concepts in natural settings.
Most common types; Ethnography – cultural studies Phenomenology – lived experiences Grounded theory – discover social processes.
Population and
Sample
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Basic Sampling ConceptsPopulation A population is an entire set of elements
(person, event or behavior…) Target population is the entire population
in which the researcher is interested. Accessible population is accessible to the
researcher for the study.
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Basic Sampling Concepts…Samples & Sampling Criteria Sample consists of a subset of the
elements/people. Sampling involves selecting a group of elements
to conduct a study. Sampling criteria list the essential
characteristics for membership in the target population.
Sample need to represent target population to generalize the findings.
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Probability/Random Sampling It refers to the fact that every element of the population has a probability higher than zero of being selected for a sample.
The method of equal opportunity is referred to as random sampling.
Experimental design, Survey design usually use random sampling procedure.
To achieve representative sample random sampling develop four types; simple, stratified, cluster, & systematic sampling.
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Nonprobability Sampling Elements are chosen by nonrandom
methods. Though representativeness is less, it has
been commonly used in nursing studies. There are four nonprobability sampling;
convenience, quota sampling, purposive sampling & network sampling.
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Sample Size Historically minimum sample size is 30. but
now it depends on the population. Do the power analysis for determine sample
size. Power is the capacity of the study to detect
differences or relationships that actually exist in the population.
Initial sample size will need to be larger than the calculated number as most studies lose subjects.
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Data Collection
Physiological Measurement – weight, BP…
Observational Measurement – researchers’ observations
Self-Report Measurement – interviews, questionnaires, & scales.
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Data Analysis, Discussion & Conclusions…
Data analysis depends on the type of research design & the purpose of the analysis.
Discussion & Conclusions… Interpretation of findings Limitation of the study Implication & generalizability Recommendations
Dissemination the findings to build body of knowledge in nursing.
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Summary Introduction to Nursing Research Historical Aspects of Nursing Research Ethical Issues in Nursing Research Identifying Research Problems Variable Review of the Literature The Hypothesis Research Design Population and Sample Data Collection Data Analysis, Discussion & Conclusions…
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The End
Research in
Nursing Practice