CNUR 209 Week 1 Notes - Nursing Research

**CNUR 209 Week 1** **Learning Objectives: Nursing Research and Research Literacy** - - - - - - - - - - - - - - - - - Describe how different assumptions, beliefs, and theories guide the research studies that can inform your practice.  - Understand t...

**CNUR 209 Week 1** **Learning Objectives: Nursing Research and Research Literacy** - - - - - - - - - - - - - - - - - Describe how different assumptions, beliefs, and theories guide the research studies that can inform your practice.  - Understand the difference between deductive and inductive reasoning and between quantitative, qualitative, and mixed-methods research paradigms. - Define Quantitative approaches, Qualitative approaches, and Mixed Methods. - Define world views/paradigms. - Define Constructivism and Positivism and Post-positivism and Critical Theory paradigm. - Describe the Qualitative approach (exploration, experience, understanding). - Describe the Quantitative approach (effectiveness, prediction). - Identify Qualitative & Quantitative differences  (purpose, questions, data collection,  analysis) - **Week 1 -- Introduction to Nursing Research and Research Literacy** - This list may not be complete or as detailed as might benefit you; it is intended as a base starting point as you begin to build a research vocabulary. As you do your readings, attend lectures and review content, add to your own personal list so that you can build to applying these concepts to nursing practice. - - Research - Deep logical investigation with the aim of answering questions about nursing phenomena. The goal of it is to refine, expand knowledge, benefit profession & individuals we care for. - Research literacy - - Evidence Based (or Informed) Practice - Best research evidence, clinical expertise, patient needs and values all combined together so you are able to provide the best evidence-based practice. - Result in nursing care that is - Contextually appropriate - Cost-effective - Supportive of optimal health outcomes - The evidence-Informed practice model is Similar to the nursing process (ADPIE) except thing research. - Ask (define) - Gather (search) or determine - Assess/appraise (synthesize, adapt) Plan - Act (implement) - Evaluate - Evidence Informed Decision Making - Ongoing process that incorporates evidence from research, clinical expertise, client preferences and other available resources to make nursing decisions about clients. - Decision making in nursing practice is influenced by evidence and also by individual values, client choice, theories, clinical judgement, ethics, legislation, regulation, health-care resources and practice environments. - Phenomena - Occurrences, situations, or facts that are perceptible by senses. Could be like events that are observable or measurable or experiences of and expressions of pain. - Research Mindedness - Comprehension of the significance and relationship of research to practice. It is culturing how you think about research and how you incorporate it into your practice. - Awareness of various research approaches and strategies. It's the appreciation of strengths and limitations of different research methods and critical openminded appraisal of research findings and literature. - Literature Review - Key step in the research process, as well as a separate section of a study and report/article. A systemic summary and critical evaluation of scholarly literature on a topic. Is succinct; adequately represents positive and negative findings of an area. It includes an adequate number of recourses and is a synthesis of the literature. - The overall purpose is the discover what is already known about a topic. It develops an argument and will answer a question - Synthesis - Is this good research? Where are the researchers coming from. - Primary, Secondary, Tertiary Sources - Primary- original manuscript, documents or records used in preparing a published or unpublished work. Data-based, theory, research for example, a published research study. Analyze primary source for yourself. - Secondary- published or unpublished work that relies on primary sources. It is a summary of material, critique, analysis of a theory, topic, practice. EX article about an analysis of a clinical practice. EX a journal article that is literature review only. - Tertiary- a published or unpublished work based on secondary sources. - Peer Reviewed - Another research reviews work makes a write up and sends it back so revisions can be made in order for it to be published - Paradigm - It is from the Greek word that means pattern. A set of beliefs and practices, shared by communities of researches that will guide the knowledge and development process. - Constructivist Paradigm - Constructed by individual perception. There is no absolute truth or validity, though there are individual truths for those who have them. Think the HIPI guy. Truth is relative and subjective and based on perception or some particular frame of reference. - Epistemology and paradigms- - All about the findings. - Post-Positivist Paradigm - Not all things can be understood, sensed, or placed into a cause-and-effect relationship. The senses provide us with an imperfect understanding of the external/ material world. Imperfect but still the most objective way we have. SCIENCE DUDE. - Epistemology and paradigms- - Researches are naturally biased and objectivity is the ultimate goal. Encourages triangulation and replication of finding - Critical Social Paradigm - Research with the goal to make a difference and help people. Reality is constructed by those with the most power at particular points in history. They believe that reality is plastic (or changeable) and at all times imperfectly understood. Over time, reality is shaped by numerous, social, political, economic, and cultural forces. Imperfectly shaped sources stories become accepted reality. - Ontology - Study of being. Questions that can be asked for this are.... What can be said to exist? Into what categories can existing things be sorted? - Epistemology - Addresses the issue of the truth.. What is knowledge? How do we know what we know? What is the scope of knowledge? Do I need to touch it feel it or be able to measure it. How do I research it - Methodology - Discipline-specific principles, rules, and procedures that guide research process. Procedure in order to study it like the road map. - Context - Personal, social, and political environment in which a phenomenon of interest occurs - Aim of Inquiry - Goals or specific objectives of the research. Need to look at research with a critical eye. - Deductive Research Approach - Generally is a quantitative approach. This is what we learned in high school - Theory - Hypothesis - Observation - Confirmation - Inductive Research Approach - Generally a qualitative approach - Observation - Pattern - Tentative hypothesis - Theory - Qualitative Research Approach - Think meaning, experience, understanding. Small samples, interview thematic analysis, description. - Quantitative Research Approach - Think cause and effect, relationships, differences, prediction. Large samples (if possible), interventions, statistics - Mixed Method Research Approach - Qualitative and quantitative. They have multiple objectives, multiple foci, somewhat predictable, common sense and what pragmatic "what works". It has multiple contexts. There is a mixture of data collected in multiple forms. The analysis is both qualitative and quantitative and there is potential for both of these in the results. The final report includes both qualitative and quantitative research. **CNUR 209 Week 2** **Learning Objectives: Overview of the Research Process** - - - - - - - - - - - - - - - - - - - - - - **CNUR 209 Terminology List** - **Week 2 -- Overview of the Research Process, Critical Reading, Sample & Setting** - This list may not be complete or as detailed as might benefit you; it is intended as a base starting point as you begin to build a research vocabulary. As you do your readings, attend lectures and review content, add to your own personal list so that you can build to applying these concepts to nursing practice. Quantitative -- so think cause and effect relationships, differences, prediction. They have large samples , interventions, statistics It comes from a grounding qualitative research project and expands on it. Qualitative research question- think meaning, experience, understanding. These are small samples, interviews, thematic analysis description to have deep thinking and consideration on the topic - Researcher(s) -- Names, titles, backgrounds, affiliations - - Abstract - Brief comprehensive summary of a study at the beginning of an article. - Phenomenon of study or research problem - Occurrences, circumstances, or facts that are perceptible by the senses. - Purpose/Aim/Objective - Aims or objectors the investigator hopes to achieve with the research. - Literature Review - An extensive, systematic, and critical review of the most important published scholarly literature on a particular topic. In most cases , the literature review is not considered exhaustive - Theoretical Framework/Conceptual Framework - A structure for concepts, theories, or both used to construct a map for the study based on a philosophical or theorized belief or understanding or why the phenomenon under study exists (theoretical framework) - Conceptual framework is a structure of concepts, theories, or both used to construct a map for the study. - Hypothesis/Research Questions - Very quantitative approach to research because they are making an educated guess of what will happen - Formal statement of the expected relationship between two or more variables in a specified population that suggests an answer to the research question, statement that predicts the outcomes of a study - Similar to PICOT research question but states the expected relationship P=populations - What's important about hypothesis is that you are stating the expected relationship and the outcome of the study. - Design - Sample - Subset of sampling units, or elements from a population - Ethical/Legal Issues - Instruments/Measures - Validity & Reliability - Data Collection Procedure - Data Analysis - Process of manipulating the data so that it can be used to answer the research question - Results/Findings - Tables, Figures - Implications/Significance/Recommendations - Recommendations is an investigators suggestions for the application of a studies results to practice theory and future research - Limitations - Weakness of a study - Reference Theoretical Framework - Variables - Attribute or property in which organisms vary (people, events, objects) - Variables can change depending on the study - Characteristic or quality that can take on different values - There can be multiple DVs and IVs - Qualities, properties, or characteristics of people, things, or situations that are manipulated (changed through interventions) or measured in research - Variables are measurable with instruments and/or intensity scales. - Concrete Variables - Temperature, weight - See touch hear and measure - Abstract Variables - Concept things - Creativity, empathy - Independent variables - Stimulus or activity manipulated or varied by the research to cause an effect on depend variables. It is **also called the treatment or experimental variable**. It causes the dependant variable to change. - The dependant variable does not change it is controlled by the researcher - So basically it is that variable that the researcher is controlling. - It is known as the X factor because it is the one that is changing the study. It may be manipulated or it may not be manipulated.. - Dependent variables - Outcome or response the researcher wants to predict or explain. Changes in the dependent variable are presumed to be caused by the dependant variable. - Also known as the Y factor- it is the object of the study. It is not directly changed by research. - Research variables or concepts - Extraneous variables - They can interfere with obtaining clear understanding of relational or causal dynamics in the study. They may interfere with the hypothesized relationships between variables. They can be recognized or unrecognized and controlled or uncontrolled. If the variable is not recognized until the study is in process or cannot be controlled, it is called a confounding variable.. - An environmental variable is an uncontrolled variable relating to the setting (maybe it's the temperature in the room or a thunderstorm that rolls in). These occur in all research studies. The influence of extraneous variables can be decreased through sample selection and the use of defined research settings. - Demographic variables - Contain characteristics of subjects. May include age, education, gender, ethnic origin, income, medical diagnosis, geographic location, etc. - Demographic data are analyzed to develop sample characteristics. - They can be analyzed all on their own - There will be a paragraph in this study we talked to 12 individuals who all live in an urban area. - Run into both types of study quantitave and qualative - Conceptual Definition - Abstract, theoretical meaning - EX Hospital stay - Time during which a person is a registered patient at a hospital - EX Ambulation - To walk from place to place, move about - Operational Definition - Procedures and tools required to measure the variable - Way of defining a variable that makes it measurable or manipulable in real world - Researchers need to make them measurable and real - Ex hospital stay, - Sum of days as a registered patient, beginning with admission day and concluding with dismissal day - Ex ambulation - Taking four steps without assistance - Associative/Correlational Hypothesis - Associative is the relationship between variables - Examples, - There is a relationship between social distance in families and burden of caregiving for chronically ill adults (correlational). This is correctional hypothesis because the researcher is examining a relationship between two variables - Causal hypothesis - Cause-and-effect relationship between variables - Simple hypothesis - Relationship between two variables - Example, - Rates of use of health care facilities by cultural minorities are higher in facilities with bilingual health care staff (simple). This is a simple hypothesis because the researcher is examining the rates and not seeking a relationship. - Complex hypothesis - Relationship between three or more variables - Non-directional hypothesis - States that the relationship exists, but not the direction. Relationship exists between variables, but hypothesis does not predict nature of relationship. - Ex, - There will be a difference in fatigue between two groups of caregivers of preterm infants (i.e., infants on versus not on apnea monitors) during three time periods (i.e., prior to discharge, 1 week postdischarge, and 1 month postdischarge). (non-directional) - There will be a significant difference in menopausal hot flashes between conditions of fasting and experimentally sustained (130--140 mg/dL) blood glucose concentrations. (non-directional) - Directional hypothesis - States which way the relationship should exist - Ex, as X increases, Y decreases, as X increases, Y increases - Nature (positive or negative) of interaction between two or more variables is stated - These are developed from theoretical framework, literature or clinical practice. - Example, - There will be a positive relationship between phase-specific telephone counselling and emotional adjustment in women with breast cancer and their partners. (directional) - There will be a greater decrease in stated anxiety scores for patients receiving structured informational videos prior to abdominal or chest tube removal than for patients receiving standard information. (directional) - Null hypothesis - States there is no difference or relationship between variables, also statistical hypothesis - Null (HO) statistical hypothesis - No relationship exists between X and Y - Example, - There is no difference between attitudes of men and women toward caring for people with AIDS (null). It is null because the researcher is stating there is no relationship between the variables. - Research hypothesis - States what researcher thinks is true, there is a relationship between two or more variables - Research alternative hypothesis (H1 or Ha) - Testable hypothesis - Stated without the phrase \*there is no significant difference\* - This should be testable in the real world. Variables are measurable or able to be manipulated. Relationship between variables is either supported or not supported. - Causal link between independent and dependant variables is evaluated using statistical tests. - Feasibility - Time, money, expertise, access to subjects, facilities and equipment. - Is it ethical? - Population - Defined set that has certain specified properties - All elements that meet certain criteria for inclusion in study - a well-defined set that has certain properties/characteristics - Example: all female identifying students in higher education - EX, all female identifying students in higher education - Descriptor examples, - Gender - Age - Marital status - Socioeconomic status - Religion - Ethnicity, education, health status, diagnosis, co-morbidities - Target population - A population or group of individuals who meet the sampling criteria and about whom the researcher hope to make generalizations. An entire set of individuals or elements who meet the sampling criteria - **Accessible population** - **Population that meets the population criteria and is available.** - **The portion of the target population to which the researcher has reasonable access** - Sample - A subset of sampling units or elements, form a population - Defines the selected group of people or elements from which data are collected for a study. - EX, female identifying students in three state universities in the Southwest - Sampling - How researchers choses what is included in the variable - Process in which representative units of a population are selected for study in a research investigation - The desired sample size is determined (prior to recruitment and data collection) by statistical calculations for quantitative research. - Probability sampling is the *ideal* - Inclusion criteria - Individual must satisfy to participate in a study - Characteristics that the subject or element must possess to be part of the target population - Examples: - Between the ages of 18 and 45 - Ability to speak English - Admitted for gallbladder surgery - Diagnosed with diabetes within past month - Exclusion criteria - Criteria used to exclude individuals from participating in a study - Characteristics that can cause a person or element to be excluded from the target population - Examples: - Diagnosis of mental illness - Less than 18 years of age - Diagnosis of cognitive dysfunction - Unable to read or speak English - Subject or participant - Representativeness - A representative sample is one whose key characteristics closely approximate those of the population - The more heterogeneous the sample, the more difficult to interpret results and generalize - (more variation, more reasons for statistical differences) - Sampling error - Tendency for statistics to fluctuate from one sampling error to another - **Systematic variation/bias** - **Self-selection** - Homogeneous sample - Having limited variation in attributes or characteristics - Heterogeneous sample - Dissimilarities of a sample group, which inhibit the researchers ability to interpret the findings meaningfully and make generalizations - Represents a braod range of values - Used when a narrow focus is not desirable - Nonprobability sampling - A selection technique in which elements are chosen by nonrandom methods. - Probability sampling - A selection technique in which some form of random selection is used when the sample units are chosen. - Simple random (random number table) - Stratified random (proportional, subgroups) - Multistage (cluster, smaller & smaller subgroups) - Systematic (fixed intervals) - Simple random sampling - A probability sampling strategy in which the population is defined, a sampling frame is listed, and a subset from which the sample will be chosen is selected; members are randomly selected - Laborious, controlled - Need to know the entire population - E.g., numbered list of all Canadian cancer specialty hospitals - Stratified random sampling - A probability sampling strategy in which the population is divided into strata or subgroups; members of each strata are homogeneous with regard to certain characteristics. An appropriate number of elements from each subgroup are randomly selected on the basis of their proportion in the population - Increases the representativeness of the sample based on the target population. Control group: Used in studies with random sampling - Comparison group: Not randomly determined - Multistage sampling - A sampling method that involves successive random sampling of units that progresses from large to small and meets sample eligibility criteria. Also known as cluster sampling - Systematic sampling - A probability sampling strategy that involves the selection of participants randomly drawn from a population list at fixed intervals - Convenience sampling - A nonprobability sampling strategy in which the most readily accessible persons or objects serve as participants of a study - Quota sampling - A nonprobability sampling strategy that identifies a specific strata of the population and represents the strata proportionately in the sample - Purposive sampling - Strategy where the researchers knowledge of the population and its elements is used to select the participants. - Also called *judgmental* or *selective* *sampling* - Efforts are made to include typical or atypical subjects. - Sampling is based on the researcher's judgment. - Group consists of particular people who can illuminate the phenomenon they want to study. Effective pretesting of newly developed instruments with a purposive sample of ***diverse types of people.*** Validation of a scale or test with a ***known-groups*** technique. Collection of exploratory data in relation to an **unusual or highly specific** population. **particularly when the total target population remains *unknown* to the researchers** - Collection of descriptive data. seek to describe the lived experience of a particular phenomenon (e.g., postpartum depression, caring, hope, or surviving childhood sexual abuse). Focus of the study population relates to a specific diagnosis (e.g., type I diabetes, multiple sclerosis) condition (e.g., legal blindness, terminal illness. demographic characteristic (e.g., same-sex twins) - May look for typical cases, exceptional casesEspecially ethnographic---e.g., key informants, stakeholders - Matching sampling - Special sampling strategy used to construct an equivalent comparison sample group by filling it with participants who are similar to each subject in another sample group in terms of pre-established variables, such as age and gender - Network or snowball effect sampling - Strategy used for finding samples that are difficult to locate. It entails the use of social networks and the facts that friends tend to have characteristics in common. Participants who meet the eligibility criteria are asked for assistance in getting in touch with other who meet the same criteria. - Theoretical sampling - In the grounded theory method, the sampling method used to select experiences that will help the researcher test ideas and gather complete information about developing concepts - Used in grounded theory research - Data are gathered from any individual or group that can provide relevant data for theory generation. - The sample is saturated when the data collection is complete based on the researchers' expectations. - Diversity in the sample is encouraged. - Generalization - The extent to which data can be inferred to be representative of similar phenomena in a population. - Inappropriate generalization is when samples cannot be generalized beyond their sampling criteria. - **Random variation** - **Sampling error is the difference between the population mean the mean of the sample** - **Random variation is the expected difference in values that occurs when different subjects from the same sample are examined. Difference is random because some values will be higher and others lower than the average population values.** - **Refusal & Acceptance Rate** - **Refusal rate: Percentage of subjects who declined to participate in the study** - **80 subjects approached and 4 refused** - **4 ÷ 80 = 0.05 = 5% refusal rate** - **Acceptance rate: Percentage of subjects who consented to be in the study** - **80 subjects approached and 76 accepted** - **76 ÷ 80 = 0.95 = 95% acceptance rate** - **Sample attrition & retention** - **Sample attrition: Withdrawal or loss of subjects from a study** - **Attrition rate = number of subjects withdrawing ÷ number of study subjects × 100** - **Sample retention: Number of subjects who remain in and complete a study** - Effect size - Measurement of the magnitude of a treatment effect, how large a difference is observed between the groups. - Power analysis - The conditional prior probability that the researcher will make a correct decision to reject the null hypothesis when it is actually false - Ability to detect differences in the population or capacity to correctly reject a null hypothesis - Standard power of 0.8 - Level of significance - Alpha = 0.05, 0.01, 0.001