1 NURS 320 Nursing Research Research and Evidence-Based Nursing Practice

2 Read Fawcett and Garity, Chapter 1 Read Fawcett and Garity, Chapter 1

3 What is Research? Research is a formal, systematic, and rigorous process of inquiry used to generate new theories and test existing theories Research is a formal, systematic, and rigorous process of inquiry used to generate new theories and test existing theories

4 What is Research? A project that is NOT designed to generate or test a theory is, at best, a hobby, not research! A project that is NOT designed to generate or test a theory is, at best, a hobby, not research! Thus, research is no more or less than the vehicle for THEORY DEVELOPMENT Thus, research is no more or less than the vehicle for THEORY DEVELOPMENT

5 What is a Theory? A theory is one or more relatively concrete and specific concepts, the propositions that narrowly describe those concepts, and the propositions that state relatively concrete and specific relations between two or more of the concepts A theory is one or more relatively concrete and specific concepts, the propositions that narrowly describe those concepts, and the propositions that state relatively concrete and specific relations between two or more of the concepts A concept is an idea expressed in wordsA concept is an idea expressed in words A proposition is a statement about one or more conceptsA proposition is a statement about one or more concepts

6 What is NURSING Research? Nursing research is a formal, systematic, and rigorous process of inquiry used to generate new theories and test existing theories about the health-related experiences of human beings within their environments and about the actions and processes that nurses use in practice Nursing research is a formal, systematic, and rigorous process of inquiry used to generate new theories and test existing theories about the health-related experiences of human beings within their environments and about the actions and processes that nurses use in practice

7 Why Should Nursing Research Be Conducted? Why do YOU think nursing research should be conducted? Why do YOU think nursing research should be conducted? “So what?” topics“So what?” topics Great topicsGreat topics

8 What is Evidence-Based Nursing Practice? Evidence-based nursing practice is the deliberate and critical use of theories about human beings’ health-related experiences to guide actions associated with each step of the nursing process Evidence-based nursing practice is the deliberate and critical use of theories about human beings’ health-related experiences to guide actions associated with each step of the nursing process

9 Nursing Practice Process and Nursing Research Process Practice is research Practice is research Research is practice Research is practice

10 Parallel Between the Nursing Practice Process and the Nursing Research Process Nursing Practice Process Nursing Research Process AssessmentStatement of the problem PlanningResearch methods ImplementationConduct of the research Evaluation Documentation Interpretation of results Research report

11 Evidence-Based Nursing Practice Theories are the BEST evidence for practice Theories are the BEST evidence for practice However, other sources of knowledge sometimes are used as evidenceHowever, other sources of knowledge sometimes are used as evidence Four methods of knowing Four methods of knowing

12 Methods of Knowing Used as Evidence: Tenacity Method and Description Limitations Tenacity “We’ve always done it that way; it’s the custom.” “It’s the traditional way to do it here.” Ignores contradictory evidence and opinions No way to decide between conflicting opinions. Unanticipated negative outcomes.

13 Methods of Knowing Used as Evidence: Authority Method and Description Limitations Authority “The textbook tells us to do it that way.” “My teacher told me to do it this way.” Authoritative sources are not infallible. No way to decide which authoritative source is correct.

14 Methods of Knowing Used as Evidence: A Priori Method and Description Limitations A priori “It seems reasonable.” One person’s idea of reasonable is not the same as another’s. No way to decide whether reasonableness depends on the current way of thinking or previous education.

15 Theory is the BEST Evidence Method and Description Limitations Theory “The theory guides me to do it.” Must be developed through rigorous inquiry. Theories can be false.

16 Theory is the BEST Evidence Five types of nursing theories have been identified Five types of nursing theories have been identified CarperCarper Chinn and Kramer Chinn and Kramer WhiteWhite

17 Five Types of Theory for Evidence-Based Nursing Practice: Empirical Theories Description Mode of Inquiry Examples The science of nursing Publicly verifiable, factual descriptions, explanations, or predictions based on subjective or objective group data Empirical research Scientific data

18 Five Types of Theory for Evidence-Based Nursing Practice: Three Types of Empirical Theories and Research Description Mode of Inquiry Examples Descriptive theories Descriptive research Descriptions of people’s health experiences

19 Five Types of Theory for Evidence-Based Nursing Practice: Three Types of Empirical Theories and Research Description Mode of Inquiry Examples Explanatory theories Correlational research Explanations of factors that influence health experiences

20 Five Types of Theory for Evidence-Based Nursing Practice: Three Types of Empirical Theories and Research Description Mode of Inquiry Examples Predictive theories Experimental research Outcomes of nursing interventions

21 Empirical Theories Think about your own nursing practice Think about your own nursing practice How do you know what to expect in a clinical situation?How do you know what to expect in a clinical situation? How do you know how a nursing intervention “works”?How do you know how a nursing intervention “works”? How do you know what your own best practices are?How do you know what your own best practices are? How do you know how to get desired outcomes?How do you know how to get desired outcomes?

22 Five Types of Theory for Evidence-Based Nursing Practice: Aesthetic Theories Description Mode of Inquiry Examples The art of nursing Expressions of the nurse’s perception of what is significant in the individual patient’s behavior Performance of nursing actions in an artful manner Envisioning possibilities Rehearsing nursing art and acts and observing or performing nursing art Philosophical essays Works of art Aesthetic criticism

23 Aesthetic Theories Think about your own nursing practice Think about your own nursing practice How do you express your aesthetic knowing?How do you express your aesthetic knowing? Have you ever written a poem or story that expressed your aesthetic knowing about a particular situation with a patient?Have you ever written a poem or story that expressed your aesthetic knowing about a particular situation with a patient? Have you ever danced in a way that expressed your aesthetic knowing about a particular situation with a patient?Have you ever danced in a way that expressed your aesthetic knowing about a particular situation with a patient? Have you ever made a painting or drawing that expressed your aesthetic knowing about a particular situation with a patient?Have you ever made a painting or drawing that expressed your aesthetic knowing about a particular situation with a patient?

24 Five Types of Theory for Evidence-Based Nursing Practice: Ethical Theories Description Mode of Inquiry Examples The ethics of nursing Descriptions of moral obligations, moral and nonmoral values, and desired ends Identification, analysis, and clarification of beliefs and values Dialogue about and justification of beliefs and values Standards of practice Codes of ethics Philosophies of nursing

25 Ethical Theories Think about your own nursing practice Think about your own nursing practice How do you know what is the right thing to do in nursing practice?How do you know what is the right thing to do in nursing practice? How do you know what is the right thing to do in nursing research?How do you know what is the right thing to do in nursing research? How do you know when you are acting responsibly?How do you know when you are acting responsibly? How do you know what you should do in nursing practice?How do you know what you should do in nursing practice?

26 Five Types of Theory for Evidence-Based Nursing Practice: Theories of Personal Knowing Description Mode of Inquiry Examples The interpersonal relationships of nursing Expressions of the quality and authenticity of the interpersonal process between each nurse and each patient Opening, centering, thinking, listening, and reflecting Essays Nurses’ autobiographic al stories

27 Theories of Personal Knowing Think about your own nursing practice Think about your own nursing practice How do you express yourself in an authentic manner to patients?How do you express yourself in an authentic manner to patients? How do you let patients know that you care about them as individuals?How do you let patients know that you care about them as individuals? What strategies do you use to engage in therapeutic relationships with patients?What strategies do you use to engage in therapeutic relationships with patients? How do you know that your relationship with a particular patient is therapeutic?How do you know that your relationship with a particular patient is therapeutic?

28 Five Types of Theory for Evidence-Based Nursing Practice: Sociopolitical Theories Description Mode of Inquiry Examples The politics and policies of nursing Descriptions and expressions of the context or cultural location for nurse-patient interactions and the broader context in which nursing and healthcare take place Critiques of situations Critiques of alternate constructions of reality Hearing and attending to all relevant voices Written or oral criticism Written or oral documentation of voices heard and acknowledged

29 Sociopolitical Theories Think about your own nursing practice Think about your own nursing practice Who are the stakeholders in your particular work environment?Who are the stakeholders in your particular work environment? Who are the stakeholders for nursing practice as a whole?Who are the stakeholders for nursing practice as a whole? Who are the stakeholders in the educational program in which you currently are enrolled?Who are the stakeholders in the educational program in which you currently are enrolled? Who are the stakeholders for the entire discipline of nursing?Who are the stakeholders for the entire discipline of nursing?

30 Sociopolitical Theories Think about your own nursing practice Think about your own nursing practice How do you, as a nurse, hear and attend to all relevant voices?How do you, as a nurse, hear and attend to all relevant voices? What strategies do you use to encourage stakeholders to express their views? What strategies do you use to encourage stakeholders to express their views? What strategies do you use to share diverse views among stakeholders? What strategies do you use to share diverse views among stakeholders?

31 Contributions of Five Types of Theories to Evidence-Based Nursing Practice Each type of theory is needed as evidence for practice Each type of theory is needed as evidence for practice Inquiry addressing each type of theory contributes different but equally valuable evidence for nursing practice Inquiry addressing each type of theory contributes different but equally valuable evidence for nursing practice

32 Evidence-Based Nursing Practice Evidence is needed to support actions associated with each step of the nursing process Evidence is needed to support actions associated with each step of the nursing process AssessmentAssessment PlanningPlanning ImplementationImplementation EvaluationEvaluation

33 NURS 320 Nursing Research: Major Points for this Session Research = Theory Development Research = Theory Development Theory = Evidence Theory = Evidence Practice = Research Practice = Research

34 NURS 320 Nursing Research: Major Points for this Session Definition of research Definition of research Definition of theory Definition of theory Definition of nursing research Definition of nursing research Definition of evidence-based nursing practice Definition of evidence-based nursing practice

35 NURS 320 Nursing Research: Major Points for this Session Sources of evidence for evidence-based Sources of evidence for evidence-based nursing practice nursing practice TenacityTenacity AuthorityAuthority A prioriA priori TheoryTheory

36 NURS 320 Nursing Research: Major Points for this Session Theory is the best source of evidence for Theory is the best source of evidence for evidence-based nursing practice evidence-based nursing practice Five types of theoriesFive types of theories Empirical Empirical Aesthetic Aesthetic Ethical Ethical Personal knowing Personal knowing Sociopolitical knowing Sociopolitical knowing

37 Research and Evidence-Based Nursing Practice Questions? Questions? Comments? Comments? Concerns? Concerns?

38 NURS 320 Nursing Research: Next Session Conceptual-theoretical-empirical (C-T-E) structures for nursing research Conceptual-theoretical-empirical (C-T-E) structures for nursing research Contents of research report Contents of research report Framework for evaluating C-T-E structures for research Framework for evaluating C-T-E structures for research