Nursing Research_NUSEM .pdf

Injecting Knowledge: Probing Look into Nursing Research 2. Helsinki Declaration – research should not be done in violation of human rights. Knowledge Driven Nursing Practice...

Injecting Knowledge: Probing Look into Nursing Research 2. Helsinki Declaration – research should not be done in violation of human rights. Knowledge Driven Nursing Practice 3. Belmont Report – ethics that state that the Nursing Research research must articulate (3) principles. Evidenced Based Nursing Practice Quality Improvement Beneficence – to do good. Justice – equality. Research Respect human dignity. Recerche – to search; attempt to find solutions to a Respondents | Research subjects | Participants | problem. Informants Nursing Research Person included in the study. Systematic and objective (follows a step-by-step Most commonly used are respondents. process) search for knowledge about issues and topics Basic Human Rights of Research Subject (5 R’s) related to nursing profession. Disciplines: 1. Right to informed consent – signed by legal of 1. Nursing Practice | Care age (18 years old) - nursing service; hospital - If the child is below 7 years old, parental consent 2. Nursing Education is sufficient. - academe; school 3. Nursing Administration - If the child is older than 7 years old, parental - part of nursing service; administrators consent + assent (adolescent; 12 to 17 years old 4. Nursing Informatics who freely chooses to participate) is needed. - information | documentation 2. Right not to be harm Goals for Conducting Nursing Research 3. Right to full disclosure – everything must be 1. Promote Evidenced-Based Nursing Practice (EBNP) – done to presented to the respondent. show expertise in nursing practice. 4. Right to refuse or withdraw from participation EBNP – nurses make clinical decisions based on the 5. Right to confidentiality and anonymity best research evidence in their expertise and health care preference of their patients. Confidentiality – protection of subject’s identity by the researcher. 2. Ensure credibility of the nursing profession Anonymity – no one, including the researcher 3. Document the cost effectiveness of nursing care can link the subject to the data they provide. Nursing Research Ethics: 1. Nuremberg Code – the research must be done for the good of society. - birth of informed consent  Steps in Phases in Nursing 4. Significance – effect on patient care; Nursing Research Research (C-D-E-A-D) most important criteria. 1. Problem Conceptual Phase o Gantt chart – TIMELINE 2. Purpose Illustrates start and finish dates or 3. Related Literature terminal | summary elements of 4. Hypothesis project | study. 5. Research Design Design and Planning Phase TARGET DATE 6. Sampling 7. Data Collection Empirical Phase 8. Data Organization C. Formulate Problem Statement 9. Data Analysis Analytical Phase 10. Findings (State questions | Elements | Testable) Communication Dissemination Phase 1. State as a question 11. Findings Utilization 2. Elements variables and population PROBLEM 3. Testable (quantitative) | Researchable (qualitative) The situation in need of solutions. What will be studied? A. Sources of Research Problem PURPOSE 1. Personal interest and experience – broad areas of interest Researcher intends to do on the study. of the researcher. Why the study is being done? 2. Nursing literatures A. Purposes: 3. Nursing theories 1. To promote EBNP 4. Previous researches 2. To enhanced and improved patients care o Recommendations 3. To answer a situation | to predict | to described o *Secondary Analysis Study – efficient | economical - data collection is from the previous study. 5. Social issues (related to the nursing profession) B. Justifications: 6. *Ideas from external sources (direct suggestions) 1. Goals – broad (intensions in a large places). 2. Objectives – specific things that you have to do. B. Criteria (F.I.R.S.T) 3. Reasons and Motivations 1. Feasible | Feasibility – analyzing time, money (resources), materials needed for the study. RELATED LITERATURE – related topics last 5 years 2. Interest – relevant; the researcher is willing to conduct the Written summary of the state about study. existing knowledge on a research problem. 3. Researchability | Researchable A. Steps: R – O – W 1. Read relevant literature HYPOTHESIS FORMULATION 2. Organize – synthesize Prediction of relationship | connections between VARIABLES 3. Write the literature Any characteristic of object that varies. B. Major Purpose: A. Types of Variables (IC – DECO) 1. To know what is already known and unknown on the topic 1. Independent Variables 2. To formulate framework of the study – theoretical framework (theories involve in the researcher’s study) o Presumptive Cause o Invention of Interest o Manipulated C. Sources of Related Literature: o Symbol: X 1. Abstract 2. Dependent Variables Brief summary of journal articles - conceptual framework o Presumptive Effect (structural relationship between variables) o Criterion variable Word count: 150 to 250 words. o Outcome variable o Measurable 2. Electronic sources o Symbol: Y Sites hosted by reliable organizations. Example: The study of the effect of passive Online catalogs | Online database isometric exercises on the muscle strength of Online libraries patient with traction. Online journals (e-journals) Online magazines (e-zines) IC: passive isometric exercises Cumulative Index Nursing allied Health Literature DECO: muscle strength (CINAHL) ▪ Database for nurses Population: patient with traction ▪ Contains books, articles, thesis, dissertations, and literature. 3. Uncontrolled | Extraneous | Confounding | 3. Print sources Limitations Periodicals and magazines o Variable that is uncontrolled (development Printed indexes from the library | maturation) by researcher Publications (library) o * Delimitation – limitations that are set by ▪ PNA – Philippine Nurses Association Magazine the researcher. 4. Gray Literature | Grey Nurse Anaski decides to include only nurses who have a minimum of three years’ experience as Any documents not commercially published, not indexed psychiatric nurses. Which of the following terms to and not available on major database. this? Unpublished research report. a. Concept b. Variable c. Limitation d. Delimitation After formulating and delimiting the research problem which of 2. According to prediction given the following will a priority action of Nurse Jayson? A. H1 | Alternative | Research | Scientific (H1ARS) a. Develop the theoretical of the study. o Format: Positive Statement b. Formulate the hypothesis. o Predicts expected relationship between variables. c. Plan the research design of the study. 1. Directional d. Conduct a literature search on the topic. o Predicts the exact relationship between variables. As to the observance of respecting privacy, Nurse Mel makes o Keywords show direction of sure that she did not link the identity of the respondents who relationship. answered the questionnaires. This is known as _____. o Keywords: more, less, higher, lower a. Breach of contract Example: Filipino nurses working in the USA have more professional opportunities b. Anonymity than nurses in the Philippines. c. Ethical dilemma 2. non-directional d. Confidentiality o There is a relationship, but it does not specify what it is. B. Types of Hypotheses 1. According to number of variables B. Ho | Null | Statistical (HoNS) o Simple – 1 IC and 1 DECO o Predicts NO relationship between o Complex | Multivariate – 1 IC and 2 DECO (vice versa) or variables. more. o Format: Negative statement o Testing Hypothesis Example: The study of the effect of passive isometric exercises and active exercises on the muscle strength of patients with RESEARCH DESIGN traction. Overall plan for conducting the study. IC: 1 (passive isometric exercises and active exercises) A. Types of Study (E-D-E) DECO: 1 (muscle strength) 1. Exploratory Study Population: 1 (patients with traction) o Done because there is small amount of SIMPLE knowledge on a given phenomenon. 2. Descriptive Study o Done to describe the relationship between variables.  o *NO manipulation on the independent variable One of the members of the research committee wishes to conduct a study involving an 3. Explanatory Study interdisciplinary team of colleagues. This study is o Done to search causal relationship and explain the termed as COLLABORATIVE (Action Research) relationship between variables. QUANTITATIVE RESEARCH B. Basic Classification of Research Designs: Experimental (TRUE – PRE – QUASI) 1. According to Applicability A. True Experimental | Pure Experimental a. Pure | Basic Research Research o Generate new knowledge | refine theories. o *Requisites | Elements b. Applied Research i. *Randomness | Randomization o To solve immediate problems. o Equal changes to be assigned in any group. o Eliminates bias. ii. Groups 2. According to Data Collected o Experimental group – will receive a. Quantitative – more respondents (countable/measurable) experimental treatment. b. Qualitative – lesser respondents (narrative - thematic) o Control group – comparison | comparative group [compared to Experimental group] ARM 3. According to Method iii. Manipulation a. Experimental o Variables can be manipulated. b. Non-experimental (3) Types: 1. Pre-test, post-test control group design C. Approaches: ▪ R-G-M 1. Quantitative Research ▪ Pretest is given to both groups. ▪ Experimental treatment is given to the 2. Qualitative Research Experimental group. ▪ Post-test is given to both groups Before and 3. Mixed | Triangulation After treatment. 4. Outcome Research – understanding end result A (EG) B (CG) 5. Action Research – to facilitate change Pre-test o Ex: COPAR ET Post-test 2. Post-test only control group design C. Quasi Experimental ▪ R-G-M o Handpicked respondents ▪ NO Pretest is given. (2) Types: ▪ Experimental treatment is given to the experimental group. ▪ Post-test is given to both groups After treatment. 1. Non-equivalent control group design A (EG) B (CG) ▪ Similar to pretest, post-test Pre-test 2. Times series design | Interrupted Time Series ET Design Post-test ▪ Experimental treatment is done between series of observations. 3. Solomon for group design ▪ R-G-M Non-Experimental (Co-Co-Me-Su) ▪ Combination of pre-test, post-test and post-test only A. Correlational ▪ Pretest is given to (1) Experimental group and (1) Control group. ▪ Seeks relationship between variables. ▪ Experimental treatment is given to the Experimental ▪ Keywords: correlation, relationship, groups (2) association ▪ Post-test is given to four groups. ▪ Positive relationship – direct relationship ▪ Negative relationship – inverse relationship A (1EG) B (1CG) C (2EG) D (2CG) Pre-test ▪ Perfect negative correlation – 1.00 ▪ Perfect positive correlation 1.00 ET ▪ No relationship.00 Post-test ▪ Pearson Product Moment Correlation (Pearson R) B. Pre-experimental o Weakest type of design ▪ Spearman’s rho o NO randomization o NO comparison | NO arm o Single Group | ONE group B. Comparative (2) Types: ▪ Comparison of groups on the same variable of interest. 1. One shot case study ▪ Keywords: compare, difference o A single group is exposed to experimental treatment and ▪ Retrospective study | Ex-post favto observed for results. Identify the effect to identify the cause. Ex-po facto (after the fact-event) 2. One group pre-test, post test o Comparison of group before and after treatment. ▪ Prospective study Identifying the cause to identify the effect. C. Methodological 5. * Grounded Theory – discovered by Glaser and Strauss (sociologist) ▪ Development, testing and evaluation of research instruments or methods or tools. Involves study of social processes and social structures. D. Survey Which of the following research designs is most ▪ Public opinion – portion | part of a certain population appropriate for this study if the aim is to find a ▪ Describing the characteristic of the population relationship between two variables in the study? ▪ Phil: Answer: Correlational ▪ Census – Inclusion of the general population (every 5 years) ▪ Agency: PSA – Philippine Statistical Authority Nurse Geb reminded the committee members that bias is an influence that distorts study results. In quantitative research, which will eliminate bias? QUALITATIVE RESEARCH (C-H-E-P-G) Answer: Randomness 1. Case Study – in depth extensive investigation of single entity or small group SAMPLING 2. Historical (Relic Study) - synthesis of data from the past Process of selecting a portion to represent Theories – Hierarchy of needs (Maslows) a general population. 3. Ethnographic – study meaning and patterns of a defined A. Population – the complete set of individuals; culture. entire aggregation. Best method: Participant observer ▪ Target – the group of people that you want Interview key informant. to include in the study; group of the Data saturation (more than once) researchers wishes to generalize findings. 4. Phenomenological – discovered by Edmund Husserl ▪ Accessible population – available group Study live | life experience of a certain person | informants. ▪ Sample – subgroup chosen to represent Descriptive – describing experiences. the general population. The process of Interpretative | Hermeneutics - interpreting feelings and getting the sample is sampling. living experience. Methods: Element – single entity i. In depth conversation – respondents (main source of ▪ Representativeness information) 1st person. Vital characteristic of sample ii. Focus group discussion – person with similar patterns iii. Interview B. Types of Sampling iv. * Bracketing – the researcher set aside own feelings on a 1. Slovin’s Formula – used to determine given phenomenon. appropriate sample size. Formula: n = 𝟏+𝑵𝒆𝟐 𝑵 Example: N = 500 n = sample size N = Population size n = 50 K = every 10th of population e = error of tolerance (margin of error – 5%) Example: Barangay Rewards has a population of 1,000. How many samples should Nurse Jay secure for his study? c. Stratified – division into category strata. 𝟏𝟎𝟎𝟎 𝟏𝟎𝟎𝟎 𝟏𝟎𝟎𝟎 𝟏𝟎𝟎𝟎 n = 𝟏+𝟏𝟎𝟎𝟎(𝟎.𝟎𝟓)𝟐 = 𝟏+𝟏𝟎𝟎𝟎 (𝟎.𝟎𝟎𝟐𝟓) = 𝟏+𝟐.𝟓 = = 286 Strata – levels 𝟑.𝟓 Random d. Cluster | Multistage – getting sample from a Population: 5,200 large group according to geographic location. 𝟓,𝟐𝟎𝟎 𝟓𝟐𝟎𝟎 𝟓𝟐𝟎𝟎 n = 𝟏+𝟓𝟐𝟎𝟎(𝟎.𝟎𝟓)𝟐 = 𝟏+𝟓𝟐𝟎𝟎(𝟎.𝟎𝟎𝟐𝟓) = 𝟏𝟒 = 371 3. Non-probability Sampling Method – involves non-random selection Population: 4,112 a. Convenience | Accidental | Incidental 𝟒𝟏𝟏𝟐 𝟒𝟏𝟏𝟐 𝟒𝟏𝟏𝟐 n = 𝟏+𝟒𝟏𝟏𝟐(𝟎.𝟎𝟓)𝟐 = 𝟏+𝟒𝟏𝟏𝟐(𝟎.𝟎𝟎𝟐𝟓) = 𝟏𝟎.𝟐𝟖 = 400 Getting readily available subjects Least time consuming. Stopping people on street 2. Probability Sampling Method (S-S-S-C) – involves random b. Purposive | Judgmental selection Conscious selection a. Simple random Handpicking subjects they wanted. Equal chances of selection c. Quota – similar to Stratified; divided into Most reliable and unbiased category strata but handpicked. Fishbowl method Bingo d. Snowball | Network | Chain Sampling Lottery Draw lots Referral * Table of random numbers b. Systematic Timeframe for Studying the Samples Getting every TH of the population | sampling frame (list of a. Longitudinal Study – the researcher follows the population) participant over a period of time. 𝑵 Formula: K = 𝒏 Cohort Study – focus on subgroup of population. K = interval width b. Cross-sectional Study – collect data from many N = population size individuals at a single point of time. n = sample size * Pilot Study – small version | trial version Respondents a. Overt – with full awareness Purpose: to avoid large scale problem b. Covert – not aware 4. *Biophysiologic Measure – most accurate way DATA COLLECTION of obtaining data. A. Factors to consider in collecting data Physical data – In Vivo (ex: vital signs) 1. Practicality – cost of instrument Physiological data – In Vitro (ex: labs) EXTRACTION 2. *Reliability – consistent, accurate, stable *Empirical Evidences – using senses (visual, *Teamwork – TEAM APPROACH (to be successful in a task) hearing, touch, smell, taste) integrating knowledge, expertise, and experience. 5. *Likert Scale – summated rating scale towards safe, timely, efficient, effective, and equitable actions. Degree of agreement to disagreement Degree of favorability (strongly agree, agree, 3. Validity – soundness of the study; measures what is supposed strongly disagree) to measure. 6. Semantic Scale | Differential – bipolar rating 4. *Generalizability – the results can be applied to any person | any setting. Respondents indicate reaction to phenomenon 5. Confirmability – the information is obtained from the subject. Yes or No Agree or Disagree True or False B. Research Instrument – formal tool or device Like or Dislike 1. Questionnaire – most common instrument 7. *Delphi Technique – consulting to experts pen and paper self-report method open-ended – narrative DATA ORGANIZATION closed ended – YES OR NO A. Levels of Measurement (N-O-R-I) cafeteria question – set of answers | statements to be selected. 1. Nominal – lowest form | NOMINATE DATA 2. Interview – 2nd most common instrument Data are categorized | named face to face Examples: gender, political affiliation, race, hair virtual color, age a. Unstructured – with topic 2. Ordinal – second level of data organization wherein you arrange or rank the data according b. Structured – with list of questions to their scores c. Semi-structured – with topic guide (list of questions) Examples: scores, educational attainment 3. Observation – gather direct information of behavior 3. Ratio – using real numbers with natural or absolute zero 4. Calculate level of significance Examples: weight, height, bank account, crime rate *If the p-value is greater than 0.05 – accept the null (there is no) HO 4. Interval – equidistance *If the p-value is less than 0.05 – reject the null Examples: temperature (38.2, 38.4, 38.6) (there is) – H1 5. Check for statistical test DATA ANALYSIS – descriptive statistics a. TTest – (2) groups / means Described, organized, summarized data b. ANOVA – Ftest (3) groups a. Measures of central tendency (3m): c. Chi Square – compare actual and expected Mean – average of all values (add divided by total scores) value. Median – middle score (arrange the score from lowest to 6. Calculate the statistical test highest) Mode – frequently appearing score. * If T1| F1| X2 is greater than critical value, reject the null b. Measure of Variability * If T1| F1| X2 is less than critical value, accept 1. Range the null Extreme scores R = HS – LS FINDINGS COMMUNICATION AND FINDINGS 2. Standard Deviation (SD) UTILIZATION Interpreting individual score in relation to other scores in Last steps in Research distribution. Written, Journal 15-25 pages. Master of variability Publications, conventions, expositions, 3. Variance (V) | (SD2) seminars Graphs, bars Square of Standard Deviation Themes Steps: 1. Mean; 2. Compute standard deviation; 3. EBNP Research Square SD – Variance; 4. Total the squares; 5. Divide total squares Inferential Statistics – make conclusions to test hypothesis. Testing hypothesis – HO Steps: 1. check hypothesis – primary concern H1 2. check tailed test – 1 tailed (directional) | 2 tailed (non- directional) 3. level of significance – chance of rejecting true HO (p-value = 0.05) Alpha Value