Week 1 PDF - Nursing Research

2/9/25 1 2 3 Week 1 Overview The aim of this session is to provide a course overview and develop an understanding of: research and the creation of nursing knowledge, the steps involved in developing and implementing a research project, research paradigms, and the role of researc...

2/9/25 1 2 3 Week 1 Overview The aim of this session is to provide a course overview and develop an understanding of: research and the creation of nursing knowledge, the steps involved in developing and implementing a research project, research paradigms, and the role of research reviews. 1.Students discover the importance of research in nursing. 2.Students identify the steps in the research process. 3.Students understand the constructivist versus positivist paradigm and how this relates to quantitative and qualitative research. 4.Students understand the common types of research reviews and where they fit within the context of research. 4 5 What is Research? Research Systematic inquiry using disciplined methods to solve problems or answer questions. Nursing research Systematic inquiry to develop knowledge about issues of importance to the nursing profession. 6 Purposes of Nursing Research 7 Roles of Nurses in Research There is a continuum of participation from producer of research, to intelligent consumer of research findings Evidence-based practice (EBP) is the use of the best clinical evidence in making patient care decisions Both consumers and producers play a key role in EBP 8 9 1  Both consumers and producers play a key role in EBP 8 Roles of Nurses in Research (Inform, Consult, Partner) 9 History of Nursing Research Florence Nightingale pioneered research (Notes on Nursing, 1859) First journal on research (Nursing Research) emerged, 1950s Clinical research becomes increasingly important, 1970s National Health Research Development Program (NHRDP) and the Medical Research Council of Canada (MRC) Canadian Institutes of Health Research (CIHR) 10 Future Directions for Nursing Research Heightened focus on evidence-based practice Greater emphasis on reviews (e.g., scoping, integrative) Increased multidisciplinary collaboration Expanded dissemination of research findings Patient-centered research (e.g., PROMs and PREMS) Consideration of cost 11 12 Nursing Research Paradigms Paradigm: a worldview; a general perspective on the complexities of the real world, with certain assumptions about reality. Key paradigms for nursing research: Ø Positivist paradigm Ø Constructivist paradigm 13 13 What is the nature of reality? Positivist assumption: Reality exists; there is a real world driven by natural causes Constructivist assumption: Reality is multiple and subjective; constructed by individuals 14 How is the inquirer related to those being studied? Positivist assumption: The inquirer is independent from those being studied Constructivist assumption: The inquirer interacts with those being studied; findings reflect this interaction 15 What is the role of values in the inquiry? Positivist assumption: Values are held in check; objectivity is sought Constructivist assumption: Subjectivity and values are inevitable and desirable 16 Key Differences in Paradigms 17 18 How is Knowledge Obtained? Research methods: the techniques used to structure a study and to gather, analyze, and interpret information Quantitative research: most often allied with the positivist tradition Qualitative research: most often allied with the constructivist tradition 19 Different Methods of Obtaining Knowledge 1 Qualitative Research Understanding the human experiences as lived 2 19 1 Qualitative Research Understanding the human experiences as lived The collection and analysis of subjective, narrative materials The use of flexible procedures that evolve in the field 2 Quantitative Research The collection and analysis of numeric information A systematic and controlled process Associated with the traditional scientific method 20 Steps in Quantitative Research 21 Qualitative Research Activities 22 Selected Key Research Terms 23 4. Research Reviews 24 What is a Research Review? Research Review is a Literature Review: Definition: “a literature review is a systematic, explicit, and reproducible method for identifying, evaluating, and synthesizing the existing body of completed and recorded work produced by researchers, scholars, and practitioners” (Fink, 2005). Key word: “systematic” ØAll reviews use a systematic approach but vary in the degree to which they are systematic according to the different roles and functions of reviews 25 Why do a Research Review? Information explosion/overload in the internet age Purposes (roles, functions): Ø Determine how work contributes to understanding an issue Ø Describe how work relates to other work Ø Identify ways to interpret and shed light on gaps Ø Identify and resolve conflicts across studies Ø Identify work done to avoid duplication 26 27 28  Ø Identify and resolve conflicts across studies Ø Identify work done to avoid duplication Ø Highlight way forward for future research 26 Systematic Approaches used in Reviews 27 Common Types of Research Reviews 28 1. Systematic Review Purpose: Seeking the best currently available answer to a specific, focused question to support decision making (clear research question is key) Follows standard scientific protocol, considered original research Features: Systematic, exhaustive, explicit methods to identify, select, critically appraise and analyze data Includes meta-analysis (if studies homogeneous), otherwise narrative 6-12 months, review team (2+, independence of reviews) Method: Cochrane Handbook for Systematic Reviews of Interventions Center for Reviews and Dissemination (University of York, England) 29 Systematic Review & Meta-Analysis 30 Meta-Analysis 31 2. Scoping Review Purpose: Examining nature and extent of literature Identifying key gaps in knowledge base Features: Often answers broad questions (e.g., “what is known about…?”) Time/scope constraints can limit completeness Minimal (or no) quality appraisal 12+ months Method: Arksey, H, & O'Malley L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. 32  methodological framework. International Journal of Social Research Methodology, 8(1), 19-32. https://doi.org/10.1080/1364557032000119616 32 3. Realist Review Purpose: What works, for whom, under which circumstances Often used to understand how complex interventions work Features: Literature search aims for “theoretical saturation”, not exhaustivity Theory-driven, qualitative, and mixed methods approach (as alternative to conventional Cochrane-style reviews) Assesses relevance and rigour 12+ months Method: Wong, G., Greenhalgh, T., Westhorp, G., Buckingham, J., & Pawson, R. (2013). RAMESES publication standards: realist syntheses. BMC Medicine, 11(21), 1-14. https://doi.org/10.1186/1741-7015-11-21 33 4. Integrative Review Purpose: Among the broadest in reach (experimental, non-experimental research) to understand more fully a phenomenon/concern Combines theoretical and empirical literature Features: Exhaustive search to maximize number or studies/sources Studies/reports coded for quality but not necessarily excluded Creativity, critical data analysis, draws out key patterns/themes 12+ months Method: Whittemore, R., & Knafl, K. (2005). The integrative review: updated methodology. Journal of Advanced Nursing, 52(5). https://doi.org/10.1111/j.1365-2648.2005.03621.x 34 5. Qualitative Systematic Review Purpose: Looks for themes/ constructs across qualitative studies Brings together qualitative data to form new interpretation 34 Looks for themes/ constructs across qualitative studies Brings together qualitative data to form new interpretation Aim is not aggregative, instead is to broaden the understanding of a phenomenon Features: Related terms/reviews: meta-ethnography, meta-narrative, meta- synthesis May include quality appraisal (to mediate messages, not to include/exclude studies) 12+ months or less Method: No accepted (overall) methodology, frequently-cited guidance: ØNoblit, G.W., & Hare, R.D. (1988). Meta-ethnography: synthesizing qualitative studies. SAGE Publications. ØCochrane Qualitative and Implementation Methods Group 35 6. Umbrella Review Purpose: Compiles evidence where there are already multiple reviews Useful for broad conditions/problems where competing interventions have been reviewed (usually in a systematic review) Aim is overall picture of findings (not repeat searches or assess eligibility/bias) Features: Can handle heterogeneity in review evidence Studies within included reviews typically quality assessed Synthesis at review level or individual study level < 12+ months Method: Smith, V., Devane, D., Begley, C.M., & Clarke, M. (2011). Methodology in conducting a systematic review of systematic reviews of healthcare interventions. BMC Medical Research Methodology, 11(15), 1-6. https://doi.org/10.1186/1471-2288-11-15 36 SALSA Framework to Classify Review Types Simple framework to characterize types of reviews against 4 critical steps in the review process Search, AppraisaL, Synthesis, Analysis (SALSA) 36 steps in the review process Search, AppraisaL, Synthesis, Analysis (SALSA) Search: questioning & finding AppraisaL: assessing for quality Synthesis: looking for patterns Analysis: making sense of the patterns Strength and quality of each step contributes to the overall ‘signal’ emitted by the review 37 Application of SALSA Framework Scoping Review: S: broad-brush approach to finding most notable studies in field AL: minimal attempts to evaluate for quality S: rudimentary attempt to synthesize A: analysis captures quantity and distribution of literature vs Systematic Review S: exhaustive search for literature AL: checklist-driven quality assessment S: complex synthesis (textual, numerical, graphical, tabular) A: sophisticated analysis (meta-analyses, subgroup analyses, sensitivity analysis) 38 Questions 39 References Booth, A., Sutton., A., & Papaioannou, D. (2016). Systematic approaches to a successful literature review (2nd ed.) – chapter 2. Sage. https://www.researchgate.net/publication/235930866_Systematic_Ap proaches_to_a_Successful_Literature_Review Burns, L., & Wanner, A. (2018). Systematic and other reviews. https://www.plymouth.ac.uk/uploads/production/document/path/11/11 015/types_of_reviews_24-jan-18.pdf Canadian Institutes of Health Research (CIHR). (2012). CIHR’s framework for citizen engagement. https://cihr- irsc.gc.ca/e/documents/ce_framework_e.pdf  framework for citizen engagement. https://cihr- irsc.gc.ca/e/documents/ce_framework_e.pdf Fink, A. (2005). Conducting research literature reviews: from the internet to paper (2nd ed.). SAGE Publications. Grant, M.J., & Booth, A. (2009). A typology of reviews: an analysis of 14 review types and associated methodologies. Health Information and Libraries Journal, 26(2), 91-108. https://doi.org/10.1111/j.1471- 1842.2009.00848.x National Collaborating Centre for Methods and Tools (NCCMT). (2013a). Types of Reviews - What kind of review do we need [YouTube video]. https://youtu.be/ep3BRgRJ2N4?si=ErVt1bc0Mh81z7ZM NCCMT. (2013a). Forest Plots – Understanding a Meta-Analysis in 5 Minutes of Less [YouTube video]. https://youtu.be/GWLnlGN3P0M?si=lKxbDKZ-azZtRTaE Woo, K. (2019). Polit & Beck Canadian essentials of nursing research (4th ed.). Wolters Kluwer. Presentation Stock Images from Microsoft PowerPoint Acknowledgement: Dr. Kathryn Fisher