Presentation on theme: "NURSING RESEARCH Is a systematic inquiry designed to develop knowledge about issues of importance to the nursing profession, including nursing practice,"— Presentation transcript:
5THE ORIGIN OF NURSING RESEARCH FLORENCE NIGHTINGALE – viewed as the person who first elevated nursing to the status of a PROFESSION, as presented in her first book NOTES ON NURSING (1859)Believed in the importance of “naming nursing” by the use of observed data to support the need for health-care reforms.Methodical Data gathering
6A Look at Nursing Education 1923 – Committee for the Study of Nursing EducationStudied educational preparation of nurse teachers, administrators, public health nurses and the clinical experiences of nursing students.
7Gold Mark Report – identified many inadequacies in the educational backgrounds of the group studied and concluded that advanced educational preparation was essential.
81940s (WWII) – tremendous need for educated nurses Nursing education practices were evaluated in the study commissioned by the National Nursing Council for War Service headed by BrownBrown revealed numerous inadequacies in nursing education and thus, recommended that education of nurses occur in the collegiate level.
9CENTER FOR NURSING RESEARCH Walter Reed Army Institute of Research – center for nursing researchNursing Research (journal)
10SOURCE FOR NATIONAL DATA 1986National Center for Nursing Research
11EVIDENCE-BASED PRACTICE Defined as the use of the best clinical evidence in making patient care decisions to achieve cost-effective, high quality care based on scientific inquiry.
12PARADIGMS AND METHODS: QUANTITATIVE AND QUALITATIVE RESEARCH
13POSITIVIST PARADIGM ASSUMPTION POSITIVIST PARADIGM Ontologic (what is the nature of reality?)Reality exists; there is a real world driven by real natural coursesEpistemologic (How is the inquirer related to those being researched?)The inquirer is independent from those being researched; findings are not influenced by the researcherAxiologic (What is the role of Values in the inquiry?)Values and biases are to be held in check; objectivity is soughtMethodologic (How is knowledge obtained?)Deductive process, emphasis on discrete, specific concepts; fixed design, tight controls over context, emphasis on measured, quantitative information; statistical analysis; seeks generalization
14NATURALISTIC PARADIGM ASSUMPTIONNATURALISTIC PARADIGMOntologic (what is the nature of reality?)Reality is multiple and subjective, mentally constructed by individualsEpistemologic (How is the inquirer related to those being researched?)The inquirer interacts with those being researched; findings are creation of the interactive processAxiologic (What is the role of Values in the inquiry?)Subjectivity and values are inevitable and desirableMethodologic (How is knowledge obtained?)Inductive process; emphasis on entirely of some phenomenon, holistic; emerging interpretations grounded in participants’ experiences; flexible design; context-bound; emphasis on narrative informationQualitative analysis
15RESEARCH METHODSAre the techniques used by researchers to structure a study and to gather and analyze information relevant to the research question.
16THE SCIENTIFIC METHOD AND QUANTITATIVE RESEARCH SCIENTIFIC METHOD – refers to a general set of orderly, disciplined procedures used to acquire information.
17QUANTITATIVE RESEARCH Uses deductive reasoningSystematicUses controlUses measurementsResearchers gather empirical evidence (objective in nature)Information gathered is usually (but not always) quantitative/numericalUses statistical analysisCannot be used to answer moral or ethical questions
18NATURALISTIC METHODS AND QUALITATIVE RESEARCH NATURALISTIC METHOD – attempt to deal with the issue of human complexity by exploring it directly.Investigations place a heavy emphasis on understanding the human experience as it is lived.
19QUALITATIVE RESEARCH Uses inductive reasoning Used for theory developmentApproach is flexibleAlways takes place in the fieldConcurrent collection and analysis of dataGathers rich and in-depth information (subjective in nature)Report is written in narrative formInvolves small group of people or subjectsCannot be used to answer moral or ethical questions
20KEY CONCEPTS AND TERMS IN QUANTITATIVE AND QUALITATIVE RESEARCH
21People who are being studied Quantitative – subjects, study participants, respondentsQualitative – informants, key informants, study participantsSample – composed of the people being studiedPerson who undertakes the researchQuantitative – researcher, investigator, scientistQualitative – researcher, investigator
22Research Settings – specific places where data collection occurs Quantitative – laboratory setting, (sometimes) field settingsExample: Pierce and Clancy (2001) studied the effects of hypoxia on diaphragm activity in anesthetized rats.Qualitative – naturalistic setting/fieldExample: Carlisle (2000) studied the search for meaning in the care giving experience among informal carers of people living with HIV and AIDS. The researcher gathered in-depth information from carers in their homes and in HIV/AIDS org.
23BUILDING BLOCKS OF A STUDY Phenomena – occurrence or eventsConcept – abstract ideasExamples of phenomena and concepts: pain, coping, and griefConstructs – abstractions that are systematically invented by a researcherExample: self-care
24THEORIES AND CONCEPTUAL FRAMEWORKS Theory – systematic, abstract explanation of some aspect of realityExample: Nightingale’s Environmental Nursing TheoryConceptual Frameworks/Models – interrelated concepts or abstractions assembled together in a rational scheme by virtue of their relevance to a common theme.Example: Betty Neuman's Health Care Systems Model
28Independent variable – presumed cause Dependent variable – presumed effectIndependent and dependent variables are used to indicate direction of influence rather than causal link.The effect of initial bath timing on the temperature of newbornsThe effect of sautéed garlic on the blood pressure of elderly patientsThe relationship between teacher’s qualification and student education
29RESEARCH DATAPieces of information obtained in the course of investigation
30Quantitative data – numerical Example: Thinking about the past week, how depressed would you say you have been on a scale from 0-10, where 0 means “not at all” and 10 means “the most possible.”Subject 1 – 9Subject 2 – 0Subject 3 - 4Qualitative data – narrative descriptionsExample: tell me about how you’ve been feeling lately. Have you felt sad or depressed at all, or have you generally been in good spirits?Participant – I’ve had a few ups and downs in the past week, but basically things are pretty even keel. I don’t have too many complaints.
32Reliability – refers to the accuracy and consistency of information obtained in the study Generalizability – asses the extent to which the findings can be applied to other groups and settings.
33Validity – complex concept that broadly concerns the soundness of the study’s evidence. If methods used in the study are really measuring the concept/s that they have to measure.
34Dependability – in qualitative studies, refers to evidence that is consistent and stable Confirmability – is similar to objectivity; it is the degree to which study results are derived from characteristics of participants and study context.Credibility – is achieved to the extent that the research method engender confidence in the truth of the data and in the researcher’s interpretations of the data.
35Transferability – the extent to which qualitative findings can be transferred to other settings.
36RESEARCH CONTROLInvolve holding constant other influences on the dependent variable so that the true relationship between the dependent and independent variables can be understood.
37Attempts to eliminate contaminating factors that might cloud the relationship between the variables of central interest.Example: Effect of sautéed garlic on the blood pressure of elderly patients – get subjects who are of almost the same age and engage in the same type of activities.
38RANDOMNESSA powerful tool in quantitative studies to eliminate biases.Is not considered in qualitative studies
39KEY TERMS USED IN QUANTITATIVE AND QUALITATIVE RESEARCH CONCEPTQUANTITATIVE TERMQUALITATIVE TERMPerson Contributing InformationSubject, Study Participant, RespondentStudy participant, informant, key informantPerson undertaking the studyResearcher, investigator, scientistResearcher, investigatorBeing investigatedConcepts, constructs, variablesPhenomena, conceptsSystem of organizing conceptsTheory, theoretical and conceptual framework,Theory, conceptual frameworkInformation gatheredData (numerical)Data (narrative descriptions)Connections bet. conceptsRelationships (cause-and-effect, functional)Patterns of associationQuality of evidenceReliability, Validity, Generalizability, ObjectivityDependability, Credibility, Transferability, Confirmability
40MAJOR CLASSES OF QUANTITATIVE RESEARCH EXPERIMENTAL RESEARCH – type of research wherein researchers actively introduce an intervention or treatment.Explicitly designed to test causal relationshipsOffer the possibility of greater control
41EXPERIMENTAL RESEARCH Example:A researcher gave bran flakes to one group of subjects and prune juice to another to evaluate which method facilitated more effective elimination.
42MAJOR CLASSES OF QUANTITATIVE RESEARCH NONEXPERIMENTAL RESEARCH – type of research wherein researchers collect data without making changes or introducing treatment.
43NONEXPERIMENTAL RESEARCH Example: A researcher compared elimination patterns of two groups of people whose regular eating patterns differed – some normally took food that stimulated bowel elimination and others did not – there is no intervention.
44MAJOR CLASSES OF QUALITATIVE RESEARCH GROUNDED THEORY – seeks to describe and understand the key social, psychological, and structural processes that occur in social settingFocus is on a developing social experience – the social or psychological stages and phases that characterize a particular event of episode.
45GROUNDED THEORYHauck and Irurita (2002) conducted a grounded theory study to explain the maternal process of managing late stages of breastfeeding and weaning the child from the breast.
46MAJOR CLASSES OF QUALITATIVE RESEARCH PHENOMENOLOGY – concerned with the lived experiences of humansAn approach to thinking about what life experiences or people are like and what they mean.Answers the question: What is the meaning of the phenomena to those who experience it?
47PHENOMENOLOGYExample: Sundin, Norberg, and Jansson (2001) conducted a phenomenological study to illuminate the lived experiences of care providers who were highly skilled communicators in their relationship with patients with stroke and aphasia.
48MAJOR CLASSES OF QUALITATIVE RESEARCH ETHNOGRAPHY – provides a framework for studying the meaning, patterns, and experiences of a defined cultural group in a holistic fashion.
49Ethnographers typically engage in fieldwork and often participate to the extent possible in the life of the culture under studyAim is to learn from members of a cultural group.
50ETHNOGRAPHYExample: Powers (2001) undertook an ethnographic analysis of a nursing home residence focusing on the ethical issues of daily living affecting nursing home residents with dementia.