Untitled Quiz

Research Methods - NURS 3030

• Course overview for nursing research and evidence-based practice (EBP)
• 2024 course

Objectives

• At the end of the session, students will be able to:
  • Describe benefits of nursing research and evidence-based practice (EBP)
  • Discuss the sources of nursing knowledge
  • Identify the purposes of nursing research
  • Explain common terms and concepts related to research

Research... Why???

• Image displays words related to anxiety as a potential research subject

What is Research?

• Systematic inquiry to answer questions and/or solve problems
• Goal: Develop, refine, and expand knowledge

What is Nursing Research?

• Systematic inquiry to develop evidence about issues relevant to the nursing profession (practice, education, administration)
• Develops evidence-based practice (EBP) to influence education, practice, and administration

Nursing Research:

• Systematic inquiry designed to develop evidence about issues of importance to the nursing profession, including nursing practice, education, and administration
• Scientific process that validates and refines existing knowledge and generates new knowledge directly and indirectly influencing clinical nursing practice

Research & Evidence-Based Practice

• Evidence-based practice (EBP): using best clinical evidence in making patient care decisions
• Nursing decisions need to be based on evidence
  • Wearing Personal Protective Equipment (PPE)
  • Handwashing
  • Q2h turnings & repositioning
  • Administering supplemental oxygen (O2) to patients with Chronic Obstructive Pulmonary Disease (COPD)
• Recent clinical practice changes reflect the impact of research

Role of Nurses in Research

• Consumer: Read and critically appraise evidence, identifying problems/data collection
• Producer: Critically appraise evidence for practice, implement best evidence in practice, and develop research projects, collaborate for research
  • BScN: Read & critically appraise evidence for practice
  • MSc: Critically appraise evidence, implement best evidence, and develop research projects. Collaborates for research.
  • PhD: Major role in conducting nursing research (primary investigator). Contributes to knowledge generation in nursing.

Knowledge Sources for Nursing Practice

• Tradition: "We've always done it this way"
• Authority & Experts: Specialized knowledge (e.g., Dr. Benjamin Spock's views on infant positioning)
• Trial & Error/Clinical Experience: "If it works, we'll use it"
• Assembled Information: Quality improvement data, best practice guidelines (BPGs)
• Scientific Research: Most objective source of evidence-based nursing knowledge (e.g., CINAHL, collaboration with other healthcare professionals)
• Logical Reasoning

Knowledge Sources - Logical Reasoning

• Deductive: Developing specific predictions from general principles
  • All nursing students must complete a research methods course. You are a nursing student, therefore you are doing NURS 3030.
• Inductive: Developing generalizations from specific observations
  • Headache, fractures, and cancer are all altered states of health and stressful. Therefore, all altered states of health are stressful.

Overview of Nursing Research

• Florence Nightingale: "Notes on Nursing" (1859) - focus on environmental factors for well-being
• 1900s-1970s: Development of nursing journals; mainly focus on nursing education; focus shifts to clinical research in 1970s.
• International/Regional Agencies: Support nursing research (WHO, PAHO, NIH/NINR, CARPHA)
• 21st Century Priorities:
  • Patient-centered care
  • Reducing health disparities
  • Reducing non-communicable diseases (NCDs), obesity, and infection control

Future Directions for Nursing Research

• Heightened focus on evidence-based practice (replication and multisite studies)
• Greater stress on systematic reviews
• Expanded local research in health care settings
• More multidisciplinary collaboration
• Expanded dissemination of research findings
• Greater focus on cultural issues and health disparities

Benefits of Nursing Research

• Promotes lifelong professional development of the discipline of nursing
• Helps implement changes to provide excellence in nursing care
• Supports the fact that nursing is a professional discipline
• Documents the cost-effectiveness of nursing care
• Improves clinical expertise and personal knowledge
• Basis for Evidence-Based Practice (EBP)

Nursing Research: Basis for Evidence-Based Practice (EBP)

• Contributes to improved patient/family/community outcomes and decision-making
• Nurses use research to shape health policy in direct care, within organizations, and at local, regional, and international levels
• Nurses conduct research and teach about research in practice
• Serves as a catalyst for changes in nursing practice (e.g., kangaroo care, use of papaya for wound dressings)
• Enhances cost-effective, positive outcomes for patients
• Provides professional growth for nurses

Summary: Benefits of Nursing Research & EBP

• Improved patient outcomes
• Enhanced quality of care
• Increased nurse satisfaction
• Better healthcare policies

Kangaroo Care

• Image depiction of kangaroo care

Purpose of Research

• "Why" students or personnel might conduct research:
  • Class assignment
  • Curiosity
  • Boss's instructions

Goals of Scientific Research

• Describe behavior
• Predict behavior
• Determine cause of behavior
• Explain behavior

Purpose of Research - cont'd

• Identification
• Description (of a social phenomenon)
• Exploration (of a new topic)
• Explanation (of why an event occurred)
• Prediction and Control

Purpose of Research - cont'd

• Identification: answers qualitative research questions only ("What is...?"). Researcher describes, classifies, and analyzes. Qualitative researchers observe, describe, and classify nature/dimensions of phenomena. Quantitative investigates prevalence, size, measurable aspects.
• Description: describes phenomena of interest related to nursing. Researcher observes, describes, and classifies. Qualitative research describes the nature, dimensions, and meaning of the phenomenon; quantitative research focuses on prevalence, size, and measurable aspects.
• Exploration: explores dimensions of a phenomenon of interest; how it manifests, other related factors, especially useful when a new area/topic is investigated. Answers both qualitative and quantitative research questions.
• Explanation: designed to get answers to the "why" of specific natural phenomena; attempts to offer an understanding of the underlying causes. Generally linked to theories and answered using both qualitative and quantitative research.
• Prediction and Control: predictions made to control phenomena based on findings from scientific investigations. Answers quantitative research questions only.

Purpose of Research - cont'd

• Types of Questions (qualitative vs quantitative)

Scientific Process: Characteristics

• Logical Order and Systematic: process follows a logical sequential plan.
• Control: involves imposing conditions to minimize biases and maximize validity (biases produce distortion, errors in study results). Validity refers to the soundness of the study's evidence.

Scientific Research Process: Characteristics

• Empirical Evidence: gathered directly or indirectly through the human senses. Imposes a certain degree of objectivity on the research situation.
• Generalization: ability to transfer findings from the specific to more general settings

Scientific Research Process: Characteristics - cont'd

• Purposiveness: research should display purposiveness. Objectivity: fixed answers. Replicability: can be tested again. Reliability: degree of consistency. Validity/rigor: measures what is intended to measure.

The Scientific Research Process: Limitations

• Moral or Ethical Issues: the scientific process cannot answer moral or ethical questions (e.g., euthanasia).
• Measurement Problems: accurate measures of psychological phenomena (e.g., anxiety, pain, self-confidence) may not have been developed.
• Human Complexity: human beings are complex in personality, mental capacities, and values; traditional scientific approaches may not fully capture the complexity.
• General Limitations: every research study may have specific faults (e.g., questionnaires return rates.)

Common Terms & Concepts

• Research: systematic inquiry using orderly, logical methods to answer questions/solve problems
• Research Utilization: process of synthesizing, disseminating, and using research-generated to make an impact on or change existing nursing practice
• Assumption: Something that one assumes to be the case, even without proof.
  • Example: You are lazy if you are fat

Common Terms & Concepts - cont'd

• Evidence-based practice (EBP): practice guided by scientific practice. Goal to provide evidence-based care of quality outcomes for patients, their families, and the healthcare system; conscious use of current best evidence to make clinical decisions about patient care. EBP integrates the best research evidence with clinical expertise, patient needs and values.
• Systematic Review: rigorous synthesis of research findings using a systematic sampling and data collection and protocol.
• Meta-Analysis: technique for quantitatively integrating the results of multiple studies addressing the same research question.
• Randomized Controlled Trial (RCT): full experimental test of an intervention involving random assignment to treatment groups.
• Hypothesis: Predicts the likely relationship between two or more variables; written as a statement; can be simple or complex; directional or non-directional. Research hypothesis. Must be worded to be rejected or accepted. Hypotheses should flow from literature review and theory/research gaps.. To replicate a study. Clear wording minimizes bias.
• Null Hypothesis (H₀): attempts to disprove or nullify; often a statistical hypothesis.
• Alternative Hypothesis: what researcher actually believes. Statement of expected relationship between variables; often a research, substantive, declarative or scientific hypothesis.

Common Terms & Concepts - cont'd

• Theory: systematic, abstract explanation of an aspect of reality.
• Concepts: building blocks of theories
• Data: pieces of information obtained during investigation
• Phenomenon: an event, happening, incident, and observable fact

Types of Evidence & Evidence Hierarchies

• Levels I-VII of evidence based on strength of evidence. Level I is strongest. Level VII is opinions of authorities and expert committees

Examples of EBP Interventions

• Problems Identified*
• Coronary heart disease
• Gastroenteritis
• Communicable disease
• Dental health
• Motor vehicle safety
• Lung cancer
• Interventions (EBP)*
• Diet and lifestyle changes
• Oral rehydration therapy
• Immunization
• Salt fluoridation
• Seatbelt legislation
• Tobacco control

Common Terms: Quantitative Research

• Investigation of phenomena precisely measured and quantified (using numbers).
• Rigorous and controlled research design.
• Collects and manipulates numerical data to confirm or reject a hypothesis.
• Used to explain causal relationships between variables.
• Provides breadth of population information; researcher samples large numbers of people.

Common Terms: Qualitative Research

• Investigation of phenomena using holistic or in-depth analysis of rich narrative material.
• Flexible research design suitable for exploring perceptions, attitudes, and motivations.
• Subjective approach involving researcher active participation in the research process
• Use of verbatim quotes to illustrate points (subject-to-life illustrations). Relies on moderator skills; samples are likely small.
• Techniques include group discussions, workshop sessions, paired interviews, and individual in-depth interviews.

Common Terms

• Pilot Study: small-scale trial run to assess feasibility of larger-scale study.
• Validity: degree to which an instrument measures what it intends to measure.
• Reliability: degree to which measurement is free from error; accurate and consistent.

References

• Provides information about the course readings and resources.