Research Methods NURS 3030 2024 PDF

RESEARCH METHODS NURS 3030 J. AIKEN 2024 Overview of Nursing Research & EBP (2a) OBJECTIVES  At the end of the session, students will be able to:  Describe the benefits of Nursing Research and Evidence–Based Practice (EBP)  Discuss...

RESEARCH METHODS NURS 3030 J. AIKEN 2024 Overview of Nursing Research & EBP (2a) OBJECTIVES  At the end of the session, students will be able to:  Describe the 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?????? WHY?? ? What is Research? Answers Goal: To questions/ develop/ Systematic refine/ Inquiry Solve expand problems knowledge What is Nursing Research? Goal: Influence Systematic Develops Education, Inquiry Evidence Practice (EBP) and Administra tion Nursing Research :  “Systematic inquiry designed to develop evidence about issues of importance to the nursing profession, including nursing practice, education, administration.” (Polit & Beck, 2022)  “Scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences clinical nursing practice.” (Gray et al., 2017)  Research & Evidence - Based Practice  Evidence-based practice (EBP)—the use of the best clinical evidence in making patient care decisions  Nursing decisions need to be based on evidence.  Wearing PPE  Handwashing  Q2h turnings & re-positioning  Administering O2 to patients with COPD  Many recent clinical practice changes reflect the impact of research. Role of nurses in Research Consumer Producer of Research of Research Research expectation & competence BScN Read & critically appraise evidence. Use evidence in practice. Assist with Identifying problems/data collection MSc Critically appraise evidence for practice. Implement best evidence in practice. Develop research projects. Collaborate for research PhD Major role in conducting research [Primary Investigator]. Contributes to knowledge generation in nursing  Logic: valid reasoning to promote understanding Tradition – “we’ve always done it this way” Authority & Experts – persons with specialized Knowledg knowledge Eg. Dr Benjamin Spock’s view on positioning a baby on the stomach to sleep e Sources Trial & Error, clinical experience “If it works, we’ll use it” for Assembled information (e.g., quality improvement data, BPGs) Nursing Scientific research – the most objective source of EB nursing knowledge, databases eg. CINAHL, collaboration with other healthcare professionals Practice Logical reasoning Knowledge Sources cont’d: Logical Reasoning Logical reasoning Deductive – developing specific predictions from general principles All nursing students must do a research methods course. You are a nursing student therefore you are doing NURS 3030 Inductive - developing generalization from specific observation Headache, fracture & Ca are all altered states of health & stressful. Therefore, all altered states of health are stressful Overview of Nursing Research  Florence Nightingale – “Notes on Nursing” 1859.  Focus on environmental factors that promote physical and emotional well being  1900s – development of Journals of nursing. Focus mainly on Nursing Education  1970s – Focus on clinical research  International & Regional agencies support nursing research  WHO / PAHO  NIH / NINR (National Institute of Nursing Research)  CARPHA (Caribbean Public Health Agency) MOHW: Priorities Reduce/control the spread of  21st century – international research priorities: HIV/AIDS Maternal and Child Health, Eg,  Patient-centered care, reducing maternal mortality  Reducing health disparities, Implementing the Healthy  Reducing NCDs, reducing obesity etc Lifestyle Policy to reduce NCDs  Infection Control  Future Heightened focus on evidence-based practice Direction Use of multiple confirmatory strategies (e.g., replication and multisite studies) s for Greater stress on systematic reviews Nursing Expanded local research in health care settings Research More multidisciplinary collaboration Expanded dissemination of research findings Greater focus on cultural issues and health disparities Benefits of Nursing Research Promotes lifelong Supports the fact Improves clinical professional that nursing is a expertise and development of professional personal the discipline of discipline knowledge nursing Helps to implement. Documents the changes to Is the basis for cost-effectiveness provide Evidence Based of nursing care excellence in Practice nursing care Nursing Research: Basis for Evidence Based Practice (EBP) EBP contributes to Nurses also use research improved to shape health policy in Nurses conduct research, patient/families/communiti direct care, within an use research in practice, es and health care systems organization, and at the and teach about research outcomes , and decision local, regional and making international levels. Catalyst for changes in nursing practice (e.g. Enhances cost-effective Provides professional kangaroo care; use of positive outcomes for growth for nurses papaya for wound patients dressings) SUMMARY: Benefits of Nursing Research &EBP Improved Patient Outcomes Enhanced Quality of Care Increased Nurse Satisfaction Better Healthcare Policies  Kangaroo Care https://www.google.com/url?sa=i&url=https%3A%2F https://www.unicef.org/rwanda/stories/kangaroo-mother-care-helping- %2Fwww.healthynewbornnetwork.org premature-babies-survive-and-thrive-rwanda-0 Purpose of Research  Why would you do research???  “It was a class assignment”  “I was curious’  “My boss insists that I do it” General purpose is to answer questions (provide explanations) or solve nursing problems  Goals of Scientific Research Determine Describe Predict behaviour cause of Behaviour behaviour Explain behavior Purpose of Research cont’d  Specifically, research aims to do the following :  Identification  Description ( a social phenomenon)  Exploration (new topic)  Explanation (why an event occurred)  Prediction & Control  Studies may have multiple purposes (e.g. both to explore and to describe) but one purpose usually dominates  Purpose of Research cont’d  Identification: answers qualitative research questions only “ What is…?”  Description - describes phenomena of interest related to nursing  The researcher observes, describes and classifies  Qualitative – describes the nature, dimensions & meaning of phenomenon  Quantitative – focus on prevalence, size + measureable aspects of phenomenon Purpose of Research cont’d Explanation: Designed to get Exploration: Explores the answers to the “why” of specific dimensions of some phenomenon of natural phenomena (attempts to interest; how it manifests and other offer understanding of the underlying related factors. causes of phenomena) Especially useful when new area Generally linked to theories /topic is being investigated. Answers both qualitative and Answers both qualitative and quantitative research questions quantitative research questions Purpose of Research cont’d  Prediction and Control:  Predictions made to control phenomena based on findings from scientific investigations  answers quantitative research questions only Purpose of Research cont’d Purpose Type of questions: Types of questions: QUAN QUAL Purpose Type of questions: Types of questions: IDENTIFICATION What is the phenomenon? QUAN QUAL What is its name? IDENTIFICATION What is the phenomenon? DESCRIPTION How prevalent…? What are the characteristics? What is its name? How often does it occur? What is important about the phenomenon? EXPLORATION What factors are related? What is the full nature? What are the antecedents? What is really going on here? What is the process by which the phenomenon evolves? PREDICTION & If phenomenon X happens, CONTROL will Y follow? Can we prevent or control the phenomenon? EXPLANATION What is the underlying cause? Why does the phenomenon Does theory explain the exist? What does it mean? phenomenon? How did it happen? Scientific Process: Characteristics Control: Logical Order and involves imposing conditions on the research systematic: process to minimize biases and maximize the process follows a logical sequential validity. pre-specified plan of action from start Bias is an influence that produces a distortion to completion or error in study results. Validity refers to the soundness of the study’s evidence Scientific research process: Characteristics Empirical Generalization: evidence: based on objective reality and gathered directly or indirectly through the ability to transfer the findings from the specific to a more general setting the human senses. Imposes certain degree of objectivity on the research situation because ideas are exposed to testing in the real world  Scientific Research Process: Characteristics cont’d In other word, the research should display:  Purposiveness  Objectivity (have fixed answers)  Replicability (can be tested again and again)  Reliability (degree of consistency)  Validity / Rigor (measures what is intended to measure)  Limitation: Potential The Scientific Research Process: Limitations weakness of the study  The following limitations are possible: 1. Moral or ethical issues  the scientific research process cannot be used to answer moral or ethical issues e.g. regarding the practice of euthanasia (cannot answer questions that depends on moral values 2. Measurement problems  Accurate measures of psychological phenomena e.g. anxiety, pain, self-confidence have not been developed The Scientific Research Process: Limitations  3. Human complexity  Human beings are complex in personality, mental capacities, values etc. therefore it is difficult for the traditional scientific approach to adequately capture the complexity  This limitation has led researchers to embrace (or incorporate) the philosophic tradition known as phenomenology in their research process  4. General limitations  virtually, every research study contains some fault that may be specific to that study e.g. return rate of questionnaires administered Common Terms & Concepts  Research - Systematic inquiry using orderly, logical methods to answer questions /solve problems  Research utilization - the process of synthesizing, disseminating, and using research- generated knowledge to make an impact on or change in existing nursing practice. Much research is utilized indirectly as practitioners become aware or research findings, internalize them and then use the findings to inform their practice. Research findings may also be utilized directly to influence policy or practice change Common Terms & Concepts  Assumption  Something that you assume to be the case, even without proof  You are lazy if you are fat  An idea that is formed without evidence  There will be food at a party Common Terms & Concepts  Evidence based practice:  Practice that is guided by scientific practice. Must be culturally sensitive (acceptable)  The ultimate goal of nursing is to provide evidence-based care that provides quality outcomes for patients and their families, healthcare providers, and the healthcare system  EBP is the conscientious use of current best evidence of making clinical decisions about patient care  EBP evolves from the integration of the best research evidence with clinical expertise and patient needs and values Common Terms continued Description Systematic Review Rigorous synthesis of research findings, using systematic sampling and data collection and a formal protocol Meta-analysis Technique for quantitatively integrating the results of multiple studies addressing the same or highly similar research question Randomized Control Trial (RCT) Full experimental test of an intervention involving random assignment to treatment groups Common Terms & Concepts cont’d  Hypothesis: predicts the relationship between 2 or more variables. It presents the researcher’s expectation about the outcomes of the study  Written as a statement  Simple (one dependent variable) or complex (≥ 2 dependent variables)  Directional (leading towards a particular relationship between variables) or non-directional (just states that there is a relationship but does not state how)  Research (alternative) or null  Must be worded in a way that it can be either rejected or accepted; i.e.  You either have evidence to support it or you do not Common terms & concepts cont’d  Hypotheses should flow logically from a discussion of the literature  Hypothesis should flow logically from the gaps in theory and research you have reviewed OR  Construct a hypothesis to replicate a study  Clear wording helps minimize personal bias  Null hypothesis - H0 Alternative Hypothesis  Researcher tries to disprove, reject  Is what the researcher really thinks or nullify is the cause of a phenomenon  “Rejecting or “accepting”  Statement of expected relationship between variables  Also known as statistical hypothesis  Also known as research, substantive, declarative or scientific hypothesis Common Terms & Concepts Theory – systematic, abstract explanation of some aspect of reality Concepts – building blocks of theories Data – pieces of information obtained in the course of investigation Phenomenon – an event, happening, incident and observable facts Types of evidence & Evidence hierarchies  Systematic reviews are the best evidence  Level I: Evidence from a systematic review of all relevant randomized controlled trials (RCT's), or evidence-based clinical practice guidelines based on systematic reviews of RCT's Level II: Evidence obtained from at least one well- designed Randomized Controlled Trial (RCT) Level III: Evidence obtained from well-designed controlled trials without randomization, quasi-experimental Level IV: Evidence from well-designed case-control and cohort studies Level V: Evidence from systematic reviews of descriptive and qualitative studies Level VI: Evidence from a single descriptive or qualitative study Level VII: Evidence from the opinion of authorities and/or reports of expert committees  Examples of EB Interventions IInterventions (Evidence Problems Identified Interventions (EBP) (Evidence Practice) Coronary heart disease Diet and lifestyle changes Gastroenteritis Oral rehydration therapy Communicable disease Immunization Dental health Salt fluoridation Motor vehicle safety Seatbelt legislation Lung cancer Tobacco control Common terms: Quantitative research  Investigation of phenomena that lends itself to precise measurement and quantification ( dealing with numbers)  Research design is rigorous and controlled  Collects evidence that can be transformed into numerical data which can be statistically manipulated to confirm /or reject the research hypothesis  Also used to explain causal relationships between variables  Quantitative research is descriptive and provides hard data on the numbers of people exhibiting certain behaviours, attitudes, etc. It provides information in breadth and allows researcher to sample large numbers of the population. Common terms : Qualitative research  The investigation of phenomena typically in an in-depth and holistic fashion through the collection of rich narrative material  Research design is flexible; allows researcher to explore perceptions, attitudes and motivations and to understand how they are formed  Subjective approach – researcher is actively involved in the research process  Verbatim quotes are used in reports to illustrate points and this brings the subject to life for the reader. However, it relies heavily on the skills of the moderator, is inevitably subjective and samples are small.  Techniques include group discussions/workshop sessions, paired interviews, and individual in-depth interviews Common terms:  Pilot study – small scale / trial run done in preparation for a larger study; usually done to assess feasibility  Validity - refers to the degree to which an instrument measures what it is intended to measure  Reliability – The degree to which measurement is free from error – is accurate and consistent References  Polit, D., & Beck, C. (2022). Essentials of nursing research: Appraising evidence for nursing practice (10th ed.). Wolters Kluwer.  Gray, J., Grove, S.K., & Sutherland, S. (2017). Burns & Groves: The practice of Nursing Research: Appraisal, synthesis and generation of evidence(8th ed.). Elsevier.  Gerrish, K., & Lacey, A. (2010). The research process in nursing (6th ed.). Wiley-Blackwell  http://www.businessdictionary.com/definition/scientific-research.html  www.brad.ac.uk/.../Introduction-to-Research-and-Research-Methods.pdf  http://www.newagepublishers.com/samplechapter/000896.pdf