1. THE RESEARCH PROCESS

2. PHASES OF NURSING RESEARCH
CONCEPTUAL PHASE
THE DESIGN AND PLANNING PHASE
THE EMPIRICAL PHASE
THE ANALYTIC PHASE
THE DISSEMINATION PHASE

4. CONCEPTUAL PHASE FORMULATING AND DELIMITING THE PROBLEM Topic
Research Problem
Problem statement – articulates the problem to be addressed and indicates the need for a study
Research Questions – are the specific queries researchers want to answer in addressing the research problem
Research Hypothesis – predictions that are tested empirically
Null hypothesis
Research or alternative hypothesis

5. Side effects of Chemotherapy
Term
Example
Topic
Side effects of Chemotherapy
Research Problem
Nausea and vomiting are common side effects among patients on chemo; interventions have been moderately successful. New interventions that can reduce or prevent these side effects need to be identified
Statement of purpose
Purpose is to test an intervention to reduce chemotherapy-induced side effects – specifically to compare the effectiveness of patient-controlled and nurse-administered antiemetic therapy
Research question
What is the relative effectiveness of patient-controlled antiemetic therapy versus nurse-controlled antiemetic therapy with regard to (a) medication consumption, and (b) control of nausea and vomiting in patients on chemotherapy?
Hypothesis
There is no difference on the effectiveness between patient-controlled and nurse-controlled antiemetic therapy with regard to medication consumption and control of nausea and vomiting of patients on chemotherapy.

6. CONCEPTUAL PHASE FORMULATING AND DELIMITING THE PROBLEM
Evaluating research problems
Significance of the problem – research problem should have the potential of contributing meaningfully to the nursing knowledge
Research ability of the Problem
Time and timing
Availability of study participants
Facilities and equipment
Money
Experience and interest of the researcher

8. CONCEPTUAL PHASE 2. REVIEWING THE LITERATURE
Done to familiarize researchers with the knowledge base
PURPOSES:
Orient of what is known and not known regarding the topic
Replication of study
Identifications of relevant theoretical and conceptual framework
Assistance in interpreting study findings and developing implications and recommendations

9. SOURCES OF LITERATURE PRIMARY SOURCES SECONDARY SOURCES
Research reports/studies
SECONDARY SOURCES
Books
Literature review summaries

10. THE DESIGN AND PLANNING PHASE
Selecting a research design
Identifying the population to be studied
Sampling plan
Methods to measure research variables
Finalizing the research study

11. RESEARCH DESIGN Based on: Time Frame Control over independent variable
Measurement of independent and dependent variables
RESEARCH DESIGN

12. TIME FRAME DESIGN FEATURES EXAMPLE CROSS-SECTIONAL
Data are collected at one point in time
Practical, easy to do, economical
Mindell and Jacobson (2000) assessed sleep patterns and the prevalence of sleep disorders during pregnancy. They compared women who were at 4 points in pregnancy: 8-12wks, 18-22wks, 25-28wks, 35-38wks. They concluded that sleep disturbance is common in late pregnancy.

13. Design of cohort study START WITH: EXPOSED NOT EXPOSED
AND
THEN FOLLOW TO SEE IF
DISEASE
DEVELOPS
DISEASE
DOES NOT
DEVELOP
DISEASE
DEVELOPS
DISEASE
DOES NOT
DEVELP
Design of cohort study

14. Design of a case-control study
THEN DETERMINE EXPOSURE HISTORY
Were not
exposed
Were not
exposed
Were exposed
Were exposed
HAVE THE DISEASE
DO NOT HAVE THE DISEASE
START WITH
Design of a case-control study

15. In A COHORT STUDY IN A CASE-CONTROL STUDY GROUPS COMPARED EXPOSED
PEOPLE
NON-EXPOSED
PEOPLE
AND
IN A CASE-CONTROL STUDY
GROUPS COMPARED
PEOPLE WITH
THE DISEASE
PEOPLE WITHOUT
THE DISEASE
AND
‘CASES ‘
‘CONTROLS’

16. In A COHORT STUDY IN A CASE-CONTROL STUDY
DETERMINE INCIDENCE RATES OF DISEASE IN:
EXPOSED
PEOPLE
NON-EXPOSED
PEOPLE
AND
IN A CASE-CONTROL STUDY
DETERMINE THE PROPORTIONS EXPOSED IN:
PEOPLE WITH
THE DISEASE
PEOPLE WITHOUT
THE DISEASE
AND
CASES
CONTROLS

17. Cohort study
Case-control study
Measure of risk
Relative risk
Odds ratio
Temporal sequence
Easy to establish
Sometimes hard
Multiple association
Possible to study associations of an exposure with several disease
Possible to study associations of a disease with several exposures or factors
Time and cost required
Long and expensive
Relatively short and inexpensive
Population size
Relatively large
Relatively small
Potential bias
Assessment of outcome
Assessment of exposure
Best when
Exposure is rare, and disease is frequent among exposed
Disease is rare, exposure is frequent among the diseased

18. Changes over time in criteria and methods
Cohort study
Case-control study
Problems
Selection of non-exposed comparison group often difficult;
Changes over time in criteria and methods
Selection of appropriate controls often difficult;
Incomplete information on exposure

19. Not Exposed Exposed B C B B C B C C Develop Disease A Develop Disease
Do not
Develop
Disease A B C
Do not
Develop
Disease A B B C B C C

20. Not Exposed To A Not Exposed To A No Disease DiseaseC C C C B B B B
Exposed to A
Not
Exposed
To A
Exposed to A
Not
Exposed
To A
No Disease
Disease
cases
Controls

21. TIME FRAME DESIGN FEATURES LONGITUDINAL
Data are collected at two or more points in time over an extended period
TREND STUDIES
Investigations in which samples from a population are studied over time
Different samples are selected but drawn from the same population
Based on surveys
TIME FRAME

22. CONTROL OVER INDEPENDENT VARIABLE
DESIGN
FEATURES
EXPERIMENTAL
Manipulation of independent variable
Control group
randomization
QUASI -EXPERIMENTAL
No control group
No randomization
NONEXPERIMENTAL
No manipulation of independent variable

23. Is there an intervention?No
Yes
NONEXPERIMENTAL
Is there randomization? No
Yes
QUASI-EXPERIMENTAL
EXPERIMENTAL

24. MEASUREMENT OF INDEPENDENT AND DEPENDENT VARIABLES
DESIGN
FEATURES
EXAMPLE
RETROSPECTIVE
Study begins with dependent variable and looks backward for cause
Heitkemper, et. al. (2001), used a Retrospective design in their study of factors contributing to the onset of irritable bowel syndrome. They compared samples of women with and without IBS in terms of their history of sexual and physical abuse and found that abusive experiences were more prevalent among women with IBS.

25. MEASUREMENT OF INDEPENDENT AND DEPENDENT VARIABLES
DESIGN
FEATURE
EXAMPLE
PROSPECTIVE
Study begins with independent variable and looks forward for the effect
Brook, et. al. (2000) conducted a prospective study to examine clinical and cost outcomes of early versus late tracheostomy in patients who require prolonged mechanical ventilation. Early tracheostomy was found to be associated with shorter lengths of hospital stay and lower cost.

26. IDENTIFYING THE POPULATION TO BE STUDIED
POPULATION – aggregate or totality of those conforming to a set of specifications.
Nurses
Students
Children
Etc.

27. DESIGNING THE SAMPLING PLAN
SAMPLE – subset of a population
Sampling techniques:
Probability sampling
Systematic sampling
Fish bowl method
Nonprobability sampling
Purposive/Judgmental sampling
Snow ball technique
Convenience/accidental sampling

28. METHODS TO MEASURE RESEARCH VARIABLES
Different methods of data collection
Biophysiologic measurements
Self-reports
Observation
Use of a research instrument
Questionnaires
Survey forms

29. FINALIZING THE RESEARCH PLAN
Pretesting of questionnaires
Conducting a Pilot study

30. Observational Experimental Cross sectional Case control study
Study Design
General categories
Observational
Experimental
Cross sectional
Case control study
Cohort study
Community trials
Clinical Trials

31. Cross sectional Retrospective
Descriptive Studies
Future
Past
Today
Cross sectional
(Prevalence)
Retrospective
(Case Control)
Prospective
(Incidence)
Historical Prospective

32. Descriptive Study: Advantages
Cross sectional Retrospective Prospective
Quick
Cheap
Large sample
Attributes
Prevalence
Public health
Rare disease
Cheap
Uses records
Small sample
Quick
Risk factors
Complete
Risk factors
Quality data
Natural history
Incidence
Etiology

33. Cross-Sectional Study
It is also called prevalence study.
It is conduct at one point of time and try to concurrently evaluate exposure (risk factors ) and outcome (diseases) in a population.
Cross-Sectional Study

34. Questionnaire (include every information of interest)
Risk factors
Investigators
Collection of data

35. Cross-sectional Study Design
Selection of study population
-target appropriate population
-acquire a “representative” sample
-Sampling definitions
-sampling unit: person, patient, household
-Sampling frame: list of all sampling units -Sample: all sampling units chosen
rule: each unit has the same probability of being chosen

36. Sampling Simple random sampling Systematic sampling
Stratified sampling
Cluster sampling
Multistage sampling
Sampling

37. Prevalence of Metabolic Syndrome:8814 US Adults Age 20+
NHANES , JAMA

38. Prevalence of Cardiovascular Disease in Women with Diabetes NHIS 1997-9
MMWR :948-54

39. Cross-sectional Studies Analysis:
Study sample
Cross-sectional collection of data
Exposed
w/disease
“a”
Exposed
w/o disease
“b”
No exposure
w/disease
“c”
No exposure
w/o disease
“d”

40. Cross-sectional Studies Analysis:
Study sample
Cross-sectional collection of data
Exposed
w/disease
“a”
Exposed
w/o disease
“b”
No exposure
w/disease
“c”
No exposure
w/o disease
“d”
Dis no dis
Compare prevalence in exposed to prevalence in non-exposed
Exp
no exp a b
Prevalence ratio = a / a+b c / c+d c d

41. Cross-sectional Studies
Common methods of Analysis:
-t-tests
-rate comparisons
-categorical data analysis
descriptive analysis
comparisons can be by
age, sex, or date, year

47. 3ed stage – working up of material
The stages of statistic investigation
1st stage – composition of the program and plan of investigation
5th stage – putting into practice
4th stage – analysis of material, conclusions, proposals
2nd stage – collection of material
3ed stage – working up of material

50. DATA COLLECTION
DATA ENCODING
EMPIRICAL PHASE

51. THE ANALYTIC PHASE DATA ANALYSIS
Statistical analysis
DATA INTERPRETATION – is the process of making sense of the results and examining their implications
CONCLUSION AND RECOMMENDATION
THE ANALYTIC PHASE

53. DISSEMINATION PHASE RESEARCH REPORT UTILIZATION OF FINDINGS
Research Abstract
Research published in journals
Term papers, theses, dissertations
UTILIZATION OF FINDINGS
Application to nursing practice and nursing education
DISSEMINATION PHASE