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Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN



                                                                          Systematic study and assessment of nursing
                                                                           problems or phenomena; finding ways to improve
                                                                           nursing practice and patient care through creative
                                                                           studies;initiating and evaluating change; and taking
                                                                           action to make new knowledge useful in nursing.
                                                                           (Vreeland, 1963 )
                                                                          Includes the breadth and depth of the disciple of
                                                                           nursing and the rehabilitative, therapeutic and
                                                                           preventive aspects of nursing as well as the
                                                                           preparation of practitioners and personnel involved
                                                                           in the total nursing sphere.
                    NURSING RESEARCH                                      According to NCNR, nursing research is the testing
                                                                           of knowledge that can be used to guide nursing
                                                                           practice. It is concerned with examining questions
      Lecturer: Mark Fredderick R. Abejo RN, MAN                           and verifying interventions based on human
________________________________________________                           experiences.

                   NATURE OF RESEARCH
                                                                       The Goals of Nursing Research
                                                                        Efficiency and effectiveness in nursing care.
                                                                        Worthiness and value of the nursing
Research Definition
                                                                           profession.
     Derived from the old French word “CERCHIER”
                                                                        Indentify, implementing and evaluating
        meaning to seek or to search.
                                                                           effective health care modalities.
     The prefix “re” means again and signifies
                                                                        Potential for providing quality care of
        replication of the search, implying that the person
                                                                           clients.
        has to find out or to take another more careful look.
     Is a scientific study or investigation that is pursued
        to discover theories and concepts based on new facts     Sources of Knowledge in Nursing
        and information and its practical application.
     Systematic collection and analysis of data to                       Faith, Habits and Traditions
        illuminate, describe or explain new facts and                     Authority
        relationship and for the purposes of prediction or                Borrowing
        explanation.                                                      Clinical / Personal Experience
     An attempt to gain solutions to the problem. (Treece,               Trial and Error
        1986)                                                             Intuition
     Refers to a problem solving process that utilizes                   Role Modeling
        scientific and develop ideas and theories that give               Logical Reasoning
        meaningful answer to complex questions about                      Assembled Information
        human beings and the environment.                                 Disciplined Research
     The Committee on Research of the Philippine
        Nurses Association has come up with its own              Reason for Conducting Research in Nursing
        definition of research: Research is an honest,
        scientific investigation undertaken for the purpose      1.  Gather data or information on nursing situations or
        of discovering new facts or establishing new                 conditions about which little knowledge is available.
        relationship among facts already known which will        2. Provides scientific knowledge base from which nursing
        contribute to the present body of knowledge and              theories emerge and develop.
        can lead to an effective solution of existing            3. Helps correct, clarify and validate perceptions and
        problems.                                                    expands these.
                                                                 4. Provides theoretical and scientific basis for nursing
      Theory – systematic, abstract explanation of some              practice.
      aspect of reality.                                         5. Defines the parameters of nursing and identifies its
      Concepts – building blocks of theories                         boundaries.
      Data – pieces of information obtained in the course of     6. Documents the social relevance and efficacy of nursing
      investigation                                                  practice to people and health care providers.
      Phenomenon – an event, happening, incident and             7. Describes the characteristics of the nursing situation
      observable facts.                                              about which little knowledge is known.
                                                                 8. Predicts probable outcomes of nursing decisions in
                                                                     relations to client care.
Nursing Research Definition                                      9. Provides knowledge for purposes of problem solving and
     It is defined as a formal, systematic, rigorous and            decision making.
        intensive process used for solutions to nursing          10. Develops and evaluates nursing theories, concepts and
        problems or to discover and interpret new facts and          practices these for clarity and validity of nursing actions.
        trends in the clinical practice, nursing education and   11. Prevents undesirable client reactions.
        nursing administration. (Waltz and Bausell, 2001)        12. Develops a considerable degree of confidence.

Introduction to Nursing Research                                                                            Abejo
Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN



General and Specific Purposes of Research                                  Types of Research

General Purposes                                                           1. General Classification
    Research in general, answer questions to solve problems.
    Provide tools for observation in order to generate                         Basic / Pure Research
    knowledge as basis for predicting and controlling the                                 The researcher tries to find the truth about
    phenomenon. Thus, a nurse can apply this knowledge in                                 something.
    practice and prescribe accurately and professionally                                  It is done for the intellectual pleasure of
    without untoward client response or reactions to nursing                              learning to search for knowledge for its own
    interventions. (Polit and Beck, 2004 )                                                sake and eventually filter down the result into
                                                                                          real life situation.
Specific Purposes
Specifically, research aims to do the following tasks:                         Applied Research
 Description                                                                            Applied research seeks for practical application
 Exploration                                                                            of theoretical or abstract knowledge. The truth
 Explanation                                                                            is adapted to every situation.
 Prediction                                                                             It results from present problems or from
 Control                                                                                socially disorganized situations. It frequently
                                                                                         raises theoretical questions that must be
Research Purpose Related to Evidence- Based Practice                                     answered by basic/ pure research.

    Treatment, Therapy or Intervention                                             Purpose of Conducting Applied Research
    Diagnosis and Assessment                                                            To solve a problem
    Prognosis                                                                           To make a decision
    Prevention of harm                                                                  To develop a new program, product,
    Etiology or causation                                                                   methods and procedure
    Meaning and Process                                                                 To evaluate program and methods.

                                                                               Action Research
Paradigms for Nursing                                                                   The process involves the study of certain
                                                                                        problem and from that experience, decisions,
Paradigms – an overall belief system, a view of the world that                          actions and conclusion are drawn.
strives to make sense of the nature of reality and the basis of                         Findings are limited to settings    actually
knowledge.                                                                              studied.


    MAJOR ASSUMPTIONS OF THE POSITIVIST AND                                2.   According to Level of Investigation
           NATURALISTIC PARADIGMS
                                                                               Exploratory Research
                                                                                        Allows one to study the variables pertinent to a
                         Positivist                  Naturalistic                       specific situation.
                         Paradigm                     Paradigm
Nature of          Reality exist                Reality is multiple and        Descriptive Research
reality                                         subjective                               The exploration and description of phenomena
Relationship       Inquirer is independent      Inquirer interacts with                  in real life situation.
bet.               from     those    being      those being research
Researcher         researched
                                                                                         Provides an accurate account of characteristics
and those                                                                                of particular individuals, situations or groups.
being
researched
The role of        Values and biases are        Subjectivity and value     3.   According to Time Element
values      in     to be held in check          are inevitable
inquiry                                                                        Historical Research
Best method        Deductive processes          Inductive processes                      Describes what was?
for obtaining      Emphasis on discrete,        Emphasize on whole
evidence           specific concept             Focus on the subjective
                   Focus on objectives          Flexible                       Descriptive Research
                   Verification of              Insider knowledge as                     Describes what is?
                   researchers predictions      internal
                   Fixed designed               Narrative information      4.   According to Duration
                   Outsider knowledge as        Seek in depth
                   external                     understanding                  Longitudinal Study
                   Measured                     Focus on the product and
                   Seek generalization          process
                                                                                        Follows the subjects for a long period of time
                   Focus on the product                                                 in order to observe change.


Introduction to Nursing Research                                                                                      Abejo
Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN



    Cross – sectional Study
              Takes information one at a time and may
              require subjects to recall past events or feelings.
              It may contribute to a loss of accuracy and              Qualitative Research
              support bias. It is more often done than the                  A systematic, interactive, subjective approach used
              longitudinal studies                                          to describe life experiences and give them meaning.
                                                                            A type of research conducted to describe and
5.   According to Research Design                                           promote understanding of human experiences.
                                                                            Evolved from the behavioral and social sciences as a
    Correlational Research                                                 method of understanding unique, dynamic, holistic
              Involves the systematic investigation of                      nature of human beings.
              relationship between or among variables.
              This design is used to quantify the strength of               Approaches in Qualitative Research
              the relationships in the real world.
              This design is used to quantify the strength of                   Phenomenological Research
              the relationship between variables or in testing                   -   Used to answer questions of meaning
              a hypothesis about a specific relationship.                        -   Begin with accumulation of evidence
                                                                                     when little topic is known or when
    Experimental                                                                    studying new topic it involves gathering of
             An objective, systematic, highly controlled                             fresh perspective.
             investigation for the purpose of predicting and                     -   The goal of phenomenological inquiry is
             controlling phenomena in nursing practice.                              to understand fully lived experience and
             The researcher actively introduces some form                            perceptions.
             of treatment and has greater control over                           -   Aspects of Lived Experience involves:
             extraneous variables.                                                   a. Lived Space (spatiality)
                                                                                     b. Live Body (corporeality)
    Non Experimental                                                                c. Lived Time (temporality)
             The researcher collects data without                                    d. Live Human Relation (relationality)
             introducing any treatment or making any
             changes.                                                           Grounded Theory Research
             Non experimental research usually includes                          -   Method designed to inductively develop a
             studies where the researcher’s primary interest                         theory based observations of selected
             is understanding some human behavior in                                 people.
             naturalistic contexts.                                              -   The primary purpose of grounded theory
                                                                                     research is to develop a theory. The
    Quasi – Experimental                                                            concepts and theories discovered through
              Is like experimental research because it actively                      this research approach are derived directly
                                                                                     from the data.
              introduces some form of treatment or
                                                                                 -   The following are the major premises of
              manipulation of an independent variable.
                                                                                     grounded theory:
              Unlike experimental research, however, it does
                                                                                          Humans act toward objects on the
              not utilize randomization or control group.
                                                                                           basis of the meaning those objects
                                                                                           have for them.
                                                                                          Social meaning arise from social
                                                                                           interaction
                                                                                          People use interpretive processes to
Nursing Research Methodologies
                                                                                           handle and change meanings in
                                                                                           dealing with their situations.
                                                                                 -   Fundamental characteristic of grounded
                                                                                     theory research is that data collection, data
    Quantitative Research
                                                                                     analysis and sampling of participants
        A formal, objective, systematic process in which
                                                                                     occur at the same time.
        numerical data are used to obtain information about
                                                                                 -   In depth interview and observation are the
        the world.
                                                                                     most common data source.
        This method is used to describe variables, examine
        relationships among variables and determine cause                       Ethnographic Research
        and effect interactions between variables.                               -   A tool for studying cultures
                                                                                 -   It has been associated with studies of
            Rigor in Quantitative
                                                                                     primitive, foreign or remote cultures
            Rigor is the striving for excellence in research
                                                                                     which allows the researcher to acquire
            and it requires discipline, adherence to detail
                                                                                     new perspectives beyond his/her own
            and strict accuracy.
                                                                                     ethnocentric perspective.
            Control in Quantitative
            Involves the imposing of rules by the
            researcher to decrease the possibility of error.
Introduction to Nursing Research                                                                             Abejo
Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN



                Narrative Research
                 -   Focus on story as the object of inquiry, to              COMPARISON OF QUANTITATIVE AND
                     determine how individuals make sense of                      QUALITATIVE RESEARCH
                     events in their lives.
                 -   The data can be collected as a story or                                Quantitative              Qualitative
                     filed notes.
                 -   It may be used for comparison among               General          Seek to confirm          Seek to explore
                     groups, to learn about a social                   Framework        hypotheses about         phenomena
                     phenomenon or historical period or to                              phenomenon
                     explore a personality
                                                                                        Instrument use more      Instrument use more
                Case Study                                                             rigid style of           flexible, repetitious
                 -   Involves an in-depth description of                                eliciting and            style of eliciting and
                     essential dimension and processes of the                           categorizing             categorizing
                     phenomenon being studied.                                          response to question     responses to
                 -   Are means of providing in depth, evidence                                                   questions
                     base discussion of clinical topics along                           Use highly
                     with practical information                                         structured methods       Use semi structured
                                                                                        such as                  methods such as in
                                                                                        questionnaires,          depth interviews,
                                                                                        survey and               focus groups and
  COMPARISON ON PHASES OF COMPARISON OF                                                 structured               participant
  QUANTITATIVE AND QUALITATIVE RESEARCH                                                 observation              observation


                         Quantitative               Qualitative        Analytical       To quantify              To describe variation
Conceptual           Formulating problem        Topic identification   Objectives       variation
Phase                Review related lit.        Situation appraisal                                              To describe and
                     Defining framework         Develop                                 To predict causal        explain relationship
                     Formulating                hypotheses                              relationship
                     hypotheses                 Framework                                                        To describe
                                                development                             To describe              individual
                                                Objective                               characteristics of a     experiences
                                                formulation                             population
Design /             Selecting research         Research plan                                                    To describe group
Planning             design                     formulation                                                      norms
Phase                Develop protocol for                              Question         Close - ended            Open – ended
                     intervention                                      Format
                     Design sampling                                   Data Format      Numerical                Textual
                     plan                                              Flexibility in   Study design is          Some aspects of the
                     Develop methods to                                Design           stable from              study are flexible.
                     safeguard rights                                                   beginning to end
Empirical            Collecting data            Data gathering and
                     Preparing data             collection                              Participant              Participant responses
                     analysis                                                           responses do not         affect how and which
Analytical           Analyze the data           Data analysis and                       influence or             questions researchers
Phase                Interpreting the           interpretation                          determine how and        ask next
                     results                    Conclusion                              which questions
Dissemination        Communicating              Communicating                           researchers ask next     Study design is
Phase                findings                   and utilizing the                                                repetitious, that is,
                     Utilizing findings in      findings                                Study design is          data collection and
                     practice                                                           subject to statistical   research question are
                                                                                        assumptions and          adjusted according to
                                                                                        conditions.              what is learned.




Introduction to Nursing Research                                                                                  Abejo
Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN



CONTRAST OF QUANTITATIVE AND QUALITATIVE                                  Links           Relationships          Patterns
         RESEARCH APPROACHES                                              between         (causal,functional)
                                                                          concepts
   Element               Quantitative                Qualitative          Logical         Deductive              Inductive reasoning
View of reality       Reality is                Reality is constructed    reasoning       reasoning
                      objective and can         by the individual         processes
                      be seen and                                         Quality of      Reliability,           Trustworthiness
                      measured                                            evidence        validity,
View of time          Reality is                Reality is                                generalization
                      relatively constant       continuously              Parts/phases    Statement of the       Aim of the study
                                                constructed               of research     problems
Context               Reality can be            Reality is embedded       output          Results                Findings
                      separated from            in its context                            Literature review      Reconnaissance
                      context                                                             Sampling               Selection
Researcher            Objective,                Personally involved                       Study framework        Study simulacrum
Approach              detached                                                            Main problem           Central question
Population            Samples that              Individual cases,                         Specific problem       Issues
Studied               represent overall         represented as                            Interview guide        Aide memoir
                      populations, as           informants.                               Data analysis          Mode of analysis
                      subjects                                                            Method                 Design
Measures              Human behavior            Study the meaning
                      or other                  that individuals create
                      observable
                      phenomena                                              Outcome Research
Observations          Analyze reality as        Make holistic                     This method examines the results of care and
                      definable variables       observations of the               measures the change in health status of clients.
                                                total context                     The following are areas that require investigation
Design                Preconceived and          Emergent and fluid,               through outcome research:
                      highly controlled         adaptable to                       Clinical client response to medical and nursing
                                                informant’s views                      interventions.
Analysis              Descriptive and           Analytic induction to              Functional maintenance or improvement of
                      inferential               determine meaning                      physical functioning
                      statistics                                                   Financial outcomes achieved with most
Generalization        Use inference to          Transfer knowledge                     efficient use of resources.
                      generalize from a         from case analysis to              Perceptual client’s satisfaction with outcomes,
                      sample to a               similar cases                          care received and providers.
                      defined population
Reports               Objective,                Interpretative reports       Intervention Research
                      impersonal reports        that reflect the                   Involves the investigation of the effectiveness of a
                      in which                  researcher’s                       nursing intervention in achieving the desired
                      researcher’s              reconstruction of the              outcome or outcomes in natural setting.
                      opinions are              meaning of the data                Intervention research should be theory driven, which
                      undetectable                                                 means that the theory determines the nature of the
                                                                                   intervention, the health professionals to deliver the
                                                                                   intervention, the setting where the intervention is to
                                                                                   be provided, the type of client to receive the
   JARGONS QUANTITATIVE AND QUALITATIVE                                            intervention and the selection and measurement of
           RESEARCH APPROACHES                                                     outcome variables.


  Concepts             Quantitative                  Qualitative          Components of Scientific Research
Person              Study participant           Study participant             Order and system
contributing                                                                  Control
information         Respondents                 Informant, Key                Empiricism
                                                informant                     Generalization
Person              Researcher,                 Researcher,
undertaking         investigator                investigator
the study                                                                 Characteristics of Research
That which is       Concepts                    Phenomena
being studied       Variables                   Concepts                     It involves the gathering of new data from new sources or
                                                Variables                     first-hand information.
                                                                             It is directed towards the solution of a problem
Information         Data (numeric               Data (narrative              It is characterized by carefully designed procedures
gathered            value)                      descriptions)                 applying rigorous analysis
Introduction to Nursing Research                                                                                    Abejo
Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN



    It emphasizes the development of generalizations,
                                                                        Qualities of a Good
     principles hypotheses and theories that may be helpful in
                                                                        Researcher
     predicting future occurrences.
    It requires expertise
                                                                        R - Research Oriented
    It demands accurate observation and description of what
                                                                        E - Efficient
     is being studied.
                                                                        S - Scientific
    It strives to be logical, applying every possible test to
                                                                        E - Effective
     validate the procedures being employed.
                                                                        A - Active
    It is characterized by patient and unhurried activities.
                                                                        R - Resourceful
    It requires innovative approaches and determination to
                                                                        C - Creative
     succeed.
                                                                        H - Honest
    It is carefully and accurately recorded and reported.
                                                                        E - Economical
                                                                        R - Religous
Limitations of Research

    Result of faulty planning and implementation of the          The Consumer-Producer Continuum in Nursing Research
     project.
    The individual researcher
    The scope of knowledge or information available about             Consumer of                           Producer of
     the topic and the problem under study also must be                 Research                               Research
     considered.
    Sources of data
    The tools of measurement may be inadequate or entirely           The consumers of research are nurses at one end of the
     lacking.                                                          continuum whose involvement in research is indirect.
                                                                       These nurses:
Reasons for Lack of Clinical Research
                                                                           Identify clinical problems in nursing practice
1.   Nurses tend to feel that they are “too busy to care for               Use library and information technology resources.
     patients”.                                                            Read research reports to develop new skills and
2.   Unless the nurse has had academic training in theoretical             search for relevant findings that affect practice.
     conceptualizations, research may not seem important.                  Participates in journal clubs
3.   Unless the importance of research is felt and recognized,             Use research to solve clinical problems
     nurses may not be able to identify researchable problems.             Use research in clinical decisions
4.   Many nurse do not have the academic training needed to
                                                                           Collaborate in developing an idea for a research
     feel confident in doing clinical research.
                                                                           project.
5.   The ethics or research tends to researchers. Fear of
                                                                           Reviews a research proposal for feasibility and offer
     harming a patient is also a hindrance to some researchers.
                                                                           suggestion to improve the plan.
6.   Unless administrators are research-oriented, the nursing
                                                                           Assist in data collection
     staff feels the futility of support for nursing research,
     hence, there is no motivation to pursue this.                         Participate in research study or survey
7.   Research takes time, time costs money which must be                   Lead a journal club or ground discussion.
     budgeted.                                                             Participate in unit or service based research councils.

                                                                      The producers of research at the other end of the
Characteristics of the Good Nurse Researcher                           continuum are the nurses who actively participate in:

          Honest and Credible                                             Designing and implementing studies
          Intellectual Curiosity                                          Conducting studies
          Accurate in his/her data                                        Disseminating research findings
          Organized and Systematic                                        Appraising the clinical relevance of research
          Prudence                                                        findings.
          Logic                                                           Provides leadership for integrating findings in
          Self- Awareness                                                 clinical practice.
          Healthy Criticism
          Intellectual Honestly                                  Nursing Research       Guidelines    for    the     Investigative
          Good Relationship with his/her respondents             Function of Nurses

                                                                  1.   Associate Degree in Nursing
                                                                           Demonstrates awareness of the value or relevance of
                                                                           research in nursing
                                                                           Assists in identifying problem areas in nursing
                                                                           practice.
                                                                           Assists in collection of data within an established
                                                                           structured format.
Introduction to Nursing Research                                                                              Abejo
Lecture Notes on Nursing Research
Prepared By: Mark Fredderick R Abejo R.N, MAN




2.   Baccalaureate Degree in Nursing
         Reads, interprets and evaluates research for              Ethics in research requires honesty and accuracy of
         applicability to nursing practice.                        data. The researcher must guarantee factual and
         Identifies nursing problems that need to be               evidenced based data. There should be no
         investigated and participates in the implementation       “plagiarism” such as presenting the ideas or words of
         of scientific studies.                                    another as one’s own, nor distort or fabricate data for
         Uses nursing practice as a means of gathering data        purposes of completing the research on time.
         and refining and extending practice.                      The Philippine Copyright Law (R.A No. 8293 )
         Applies established findings of nursing and other         protects the intellectual property rights of authors and
         health related research to nursing practice.              artist .
         Shares research findings with colleagues.


3.   Master’s Degree in Nursing
        Analyzes and reformulates nursing practice
        problems so that scientific knowledge and scientific
        methods can be used to find solutions.
        Provides expertise in clinical problems by providing
        knowledge about the way clinical services are
        delivered which enhances quality and clinical
        relevance of nursing.
        Facilitates investigation of problems in clinical
        settings by contributing to a climate of supportive
        investigative activities, collaborating with others in
        investigations and enhancing nurse’s access to
        clients and data.
        Investigates for the purpose of monitoring the
        quality of nursing practice in a clinical setting.
        Assists others in applying scientific knowledge in
        nursing practice.

4.   Doctorate Degree in Nursing or Related Discipline

           Provides leadership for the integration of scientific
           knowledge with others types of knowledge for the
           advancement of practice.
           Conducts investigations to evaluate the contributions
           of nursing activities to the well-being of clients.
           Develops methods to monitor the quality of nursing
           practice in a clinical setting and to evaluate
           contributions of nursing activities to the well-being
           of clients.

Role of Nurses in Research

    As Principal Investigators                                     _________________________________________
    As Member of a Research Team
    As Evaluator of Research Findings                              References:
    As Consumers of Research Findings
                                                                    1.   Venzon. 2004. Introduction to Nursing Research: Quest for Quality
    As Client Advocate in a Research Study                              Nursing, 1st ed. Philippines: C&E Publishing Inc.
    As Subject of Research                                         2.   Barrientos-Tan. 2006. A Research Guide in Nursing Education, 3rd
                                                                         ed. Philippines: Visual Print Enterprises.
                                                                    3.   Reyes & Layug. 2009. Comprehensive Reviewer for the Nurse
Ethics in Research                                                       Licensure Exam, Philippines: East West Educational Specialists,
                                                                         C&E Publishing Inc.
    Informed Consent                                               4.   Brink & Wood. 2001. Basic Steps in Planning Nursing Research,
    Beneficence and Non-maleficence                                     5th ed. Philippines: Jones and Bartlett Publisher Inc.
                                                                    5.   Burns & Grove. 2007. Understanding Nursing Research : Building
     -    Freedom from any Physical and Psychological Harm               an Evidence-Based Practice, 4th ed. China; Elsevier, Health
     -    Freedom from Exploitation                                      Sciences.
    Respect for Human Dignity                                      6.   LoBiondo-Wood & Haber. 2006. Nursing Research: Methods and
     -    The right to self determination                                Critical Appraisal for Evidence-Based Practice, 6th ed. USA: Mosby
                                                                         Inc.
     -    The right to full disclosure                              7.   Polit & Beck. 2008. Nursing Research: Generating and Assessing
     -    Anonymity and Confidentiality                                  Evidence for Nursing Practice, 8th ed. Philadelphia: Lippincott
    Justice and Fairness                                                Williams & Wilkins.

Introduction to Nursing Research                                                                                  Abejo

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Nursing research introduction

  • 1. Lecture Notes on Nursing Research Prepared By: Mark Fredderick R Abejo R.N, MAN  Systematic study and assessment of nursing problems or phenomena; finding ways to improve nursing practice and patient care through creative studies;initiating and evaluating change; and taking action to make new knowledge useful in nursing. (Vreeland, 1963 )  Includes the breadth and depth of the disciple of nursing and the rehabilitative, therapeutic and preventive aspects of nursing as well as the preparation of practitioners and personnel involved in the total nursing sphere. NURSING RESEARCH  According to NCNR, nursing research is the testing of knowledge that can be used to guide nursing practice. It is concerned with examining questions Lecturer: Mark Fredderick R. Abejo RN, MAN and verifying interventions based on human ________________________________________________ experiences. NATURE OF RESEARCH The Goals of Nursing Research  Efficiency and effectiveness in nursing care.  Worthiness and value of the nursing Research Definition profession.  Derived from the old French word “CERCHIER”  Indentify, implementing and evaluating meaning to seek or to search. effective health care modalities.  The prefix “re” means again and signifies  Potential for providing quality care of replication of the search, implying that the person clients. has to find out or to take another more careful look.  Is a scientific study or investigation that is pursued to discover theories and concepts based on new facts Sources of Knowledge in Nursing and information and its practical application.  Systematic collection and analysis of data to  Faith, Habits and Traditions illuminate, describe or explain new facts and  Authority relationship and for the purposes of prediction or  Borrowing explanation.  Clinical / Personal Experience  An attempt to gain solutions to the problem. (Treece,  Trial and Error 1986)  Intuition  Refers to a problem solving process that utilizes  Role Modeling scientific and develop ideas and theories that give  Logical Reasoning meaningful answer to complex questions about  Assembled Information human beings and the environment.  Disciplined Research  The Committee on Research of the Philippine Nurses Association has come up with its own Reason for Conducting Research in Nursing definition of research: Research is an honest, scientific investigation undertaken for the purpose 1. Gather data or information on nursing situations or of discovering new facts or establishing new conditions about which little knowledge is available. relationship among facts already known which will 2. Provides scientific knowledge base from which nursing contribute to the present body of knowledge and theories emerge and develop. can lead to an effective solution of existing 3. Helps correct, clarify and validate perceptions and problems. expands these. 4. Provides theoretical and scientific basis for nursing Theory – systematic, abstract explanation of some practice. aspect of reality. 5. Defines the parameters of nursing and identifies its Concepts – building blocks of theories boundaries. Data – pieces of information obtained in the course of 6. Documents the social relevance and efficacy of nursing investigation practice to people and health care providers. Phenomenon – an event, happening, incident and 7. Describes the characteristics of the nursing situation observable facts. about which little knowledge is known. 8. Predicts probable outcomes of nursing decisions in relations to client care. Nursing Research Definition 9. Provides knowledge for purposes of problem solving and  It is defined as a formal, systematic, rigorous and decision making. intensive process used for solutions to nursing 10. Develops and evaluates nursing theories, concepts and problems or to discover and interpret new facts and practices these for clarity and validity of nursing actions. trends in the clinical practice, nursing education and 11. Prevents undesirable client reactions. nursing administration. (Waltz and Bausell, 2001) 12. Develops a considerable degree of confidence. Introduction to Nursing Research Abejo
  • 2. Lecture Notes on Nursing Research Prepared By: Mark Fredderick R Abejo R.N, MAN General and Specific Purposes of Research Types of Research General Purposes 1. General Classification Research in general, answer questions to solve problems. Provide tools for observation in order to generate  Basic / Pure Research knowledge as basis for predicting and controlling the The researcher tries to find the truth about phenomenon. Thus, a nurse can apply this knowledge in something. practice and prescribe accurately and professionally It is done for the intellectual pleasure of without untoward client response or reactions to nursing learning to search for knowledge for its own interventions. (Polit and Beck, 2004 ) sake and eventually filter down the result into real life situation. Specific Purposes Specifically, research aims to do the following tasks:  Applied Research  Description Applied research seeks for practical application  Exploration of theoretical or abstract knowledge. The truth  Explanation is adapted to every situation.  Prediction It results from present problems or from  Control socially disorganized situations. It frequently raises theoretical questions that must be Research Purpose Related to Evidence- Based Practice answered by basic/ pure research.  Treatment, Therapy or Intervention Purpose of Conducting Applied Research  Diagnosis and Assessment  To solve a problem  Prognosis  To make a decision  Prevention of harm  To develop a new program, product,  Etiology or causation methods and procedure  Meaning and Process  To evaluate program and methods.  Action Research Paradigms for Nursing The process involves the study of certain problem and from that experience, decisions, Paradigms – an overall belief system, a view of the world that actions and conclusion are drawn. strives to make sense of the nature of reality and the basis of Findings are limited to settings actually knowledge. studied. MAJOR ASSUMPTIONS OF THE POSITIVIST AND 2. According to Level of Investigation NATURALISTIC PARADIGMS  Exploratory Research Allows one to study the variables pertinent to a Positivist Naturalistic specific situation. Paradigm Paradigm Nature of Reality exist Reality is multiple and  Descriptive Research reality subjective The exploration and description of phenomena Relationship Inquirer is independent Inquirer interacts with in real life situation. bet. from those being those being research Researcher researched Provides an accurate account of characteristics and those of particular individuals, situations or groups. being researched The role of Values and biases are Subjectivity and value 3. According to Time Element values in to be held in check are inevitable inquiry  Historical Research Best method Deductive processes Inductive processes Describes what was? for obtaining Emphasis on discrete, Emphasize on whole evidence specific concept Focus on the subjective Focus on objectives Flexible  Descriptive Research Verification of Insider knowledge as Describes what is? researchers predictions internal Fixed designed Narrative information 4. According to Duration Outsider knowledge as Seek in depth external understanding  Longitudinal Study Measured Focus on the product and Seek generalization process Follows the subjects for a long period of time Focus on the product in order to observe change. Introduction to Nursing Research Abejo
  • 3. Lecture Notes on Nursing Research Prepared By: Mark Fredderick R Abejo R.N, MAN  Cross – sectional Study Takes information one at a time and may require subjects to recall past events or feelings. It may contribute to a loss of accuracy and  Qualitative Research support bias. It is more often done than the A systematic, interactive, subjective approach used longitudinal studies to describe life experiences and give them meaning. A type of research conducted to describe and 5. According to Research Design promote understanding of human experiences. Evolved from the behavioral and social sciences as a  Correlational Research method of understanding unique, dynamic, holistic Involves the systematic investigation of nature of human beings. relationship between or among variables. This design is used to quantify the strength of Approaches in Qualitative Research the relationships in the real world. This design is used to quantify the strength of  Phenomenological Research the relationship between variables or in testing - Used to answer questions of meaning a hypothesis about a specific relationship. - Begin with accumulation of evidence when little topic is known or when  Experimental studying new topic it involves gathering of An objective, systematic, highly controlled fresh perspective. investigation for the purpose of predicting and - The goal of phenomenological inquiry is controlling phenomena in nursing practice. to understand fully lived experience and The researcher actively introduces some form perceptions. of treatment and has greater control over - Aspects of Lived Experience involves: extraneous variables. a. Lived Space (spatiality) b. Live Body (corporeality)  Non Experimental c. Lived Time (temporality) The researcher collects data without d. Live Human Relation (relationality) introducing any treatment or making any changes.  Grounded Theory Research Non experimental research usually includes - Method designed to inductively develop a studies where the researcher’s primary interest theory based observations of selected is understanding some human behavior in people. naturalistic contexts. - The primary purpose of grounded theory research is to develop a theory. The  Quasi – Experimental concepts and theories discovered through Is like experimental research because it actively this research approach are derived directly from the data. introduces some form of treatment or - The following are the major premises of manipulation of an independent variable. grounded theory: Unlike experimental research, however, it does  Humans act toward objects on the not utilize randomization or control group. basis of the meaning those objects have for them.  Social meaning arise from social interaction  People use interpretive processes to Nursing Research Methodologies handle and change meanings in dealing with their situations. - Fundamental characteristic of grounded theory research is that data collection, data  Quantitative Research analysis and sampling of participants A formal, objective, systematic process in which occur at the same time. numerical data are used to obtain information about - In depth interview and observation are the the world. most common data source. This method is used to describe variables, examine relationships among variables and determine cause  Ethnographic Research and effect interactions between variables. - A tool for studying cultures - It has been associated with studies of Rigor in Quantitative primitive, foreign or remote cultures Rigor is the striving for excellence in research which allows the researcher to acquire and it requires discipline, adherence to detail new perspectives beyond his/her own and strict accuracy. ethnocentric perspective. Control in Quantitative Involves the imposing of rules by the researcher to decrease the possibility of error. Introduction to Nursing Research Abejo
  • 4. Lecture Notes on Nursing Research Prepared By: Mark Fredderick R Abejo R.N, MAN  Narrative Research - Focus on story as the object of inquiry, to COMPARISON OF QUANTITATIVE AND determine how individuals make sense of QUALITATIVE RESEARCH events in their lives. - The data can be collected as a story or Quantitative Qualitative filed notes. - It may be used for comparison among General Seek to confirm Seek to explore groups, to learn about a social Framework hypotheses about phenomena phenomenon or historical period or to phenomenon explore a personality Instrument use more Instrument use more  Case Study rigid style of flexible, repetitious - Involves an in-depth description of eliciting and style of eliciting and essential dimension and processes of the categorizing categorizing phenomenon being studied. response to question responses to - Are means of providing in depth, evidence questions base discussion of clinical topics along Use highly with practical information structured methods Use semi structured such as methods such as in questionnaires, depth interviews, survey and focus groups and COMPARISON ON PHASES OF COMPARISON OF structured participant QUANTITATIVE AND QUALITATIVE RESEARCH observation observation Quantitative Qualitative Analytical To quantify To describe variation Conceptual Formulating problem Topic identification Objectives variation Phase Review related lit. Situation appraisal To describe and Defining framework Develop To predict causal explain relationship Formulating hypotheses relationship hypotheses Framework To describe development To describe individual Objective characteristics of a experiences formulation population Design / Selecting research Research plan To describe group Planning design formulation norms Phase Develop protocol for Question Close - ended Open – ended intervention Format Design sampling Data Format Numerical Textual plan Flexibility in Study design is Some aspects of the Develop methods to Design stable from study are flexible. safeguard rights beginning to end Empirical Collecting data Data gathering and Preparing data collection Participant Participant responses analysis responses do not affect how and which Analytical Analyze the data Data analysis and influence or questions researchers Phase Interpreting the interpretation determine how and ask next results Conclusion which questions Dissemination Communicating Communicating researchers ask next Study design is Phase findings and utilizing the repetitious, that is, Utilizing findings in findings Study design is data collection and practice subject to statistical research question are assumptions and adjusted according to conditions. what is learned. Introduction to Nursing Research Abejo
  • 5. Lecture Notes on Nursing Research Prepared By: Mark Fredderick R Abejo R.N, MAN CONTRAST OF QUANTITATIVE AND QUALITATIVE Links Relationships Patterns RESEARCH APPROACHES between (causal,functional) concepts Element Quantitative Qualitative Logical Deductive Inductive reasoning View of reality Reality is Reality is constructed reasoning reasoning objective and can by the individual processes be seen and Quality of Reliability, Trustworthiness measured evidence validity, View of time Reality is Reality is generalization relatively constant continuously Parts/phases Statement of the Aim of the study constructed of research problems Context Reality can be Reality is embedded output Results Findings separated from in its context Literature review Reconnaissance context Sampling Selection Researcher Objective, Personally involved Study framework Study simulacrum Approach detached Main problem Central question Population Samples that Individual cases, Specific problem Issues Studied represent overall represented as Interview guide Aide memoir populations, as informants. Data analysis Mode of analysis subjects Method Design Measures Human behavior Study the meaning or other that individuals create observable phenomena  Outcome Research Observations Analyze reality as Make holistic This method examines the results of care and definable variables observations of the measures the change in health status of clients. total context The following are areas that require investigation Design Preconceived and Emergent and fluid, through outcome research: highly controlled adaptable to  Clinical client response to medical and nursing informant’s views interventions. Analysis Descriptive and Analytic induction to  Functional maintenance or improvement of inferential determine meaning physical functioning statistics  Financial outcomes achieved with most Generalization Use inference to Transfer knowledge efficient use of resources. generalize from a from case analysis to  Perceptual client’s satisfaction with outcomes, sample to a similar cases care received and providers. defined population Reports Objective, Interpretative reports  Intervention Research impersonal reports that reflect the Involves the investigation of the effectiveness of a in which researcher’s nursing intervention in achieving the desired researcher’s reconstruction of the outcome or outcomes in natural setting. opinions are meaning of the data Intervention research should be theory driven, which undetectable means that the theory determines the nature of the intervention, the health professionals to deliver the intervention, the setting where the intervention is to be provided, the type of client to receive the JARGONS QUANTITATIVE AND QUALITATIVE intervention and the selection and measurement of RESEARCH APPROACHES outcome variables. Concepts Quantitative Qualitative Components of Scientific Research Person Study participant Study participant  Order and system contributing  Control information Respondents Informant, Key  Empiricism informant  Generalization Person Researcher, Researcher, undertaking investigator investigator the study Characteristics of Research That which is Concepts Phenomena being studied Variables Concepts  It involves the gathering of new data from new sources or Variables first-hand information.  It is directed towards the solution of a problem Information Data (numeric Data (narrative  It is characterized by carefully designed procedures gathered value) descriptions) applying rigorous analysis Introduction to Nursing Research Abejo
  • 6. Lecture Notes on Nursing Research Prepared By: Mark Fredderick R Abejo R.N, MAN  It emphasizes the development of generalizations, Qualities of a Good principles hypotheses and theories that may be helpful in Researcher predicting future occurrences.  It requires expertise R - Research Oriented  It demands accurate observation and description of what E - Efficient is being studied. S - Scientific  It strives to be logical, applying every possible test to E - Effective validate the procedures being employed. A - Active  It is characterized by patient and unhurried activities. R - Resourceful  It requires innovative approaches and determination to C - Creative succeed. H - Honest  It is carefully and accurately recorded and reported. E - Economical R - Religous Limitations of Research  Result of faulty planning and implementation of the The Consumer-Producer Continuum in Nursing Research project.  The individual researcher  The scope of knowledge or information available about Consumer of Producer of the topic and the problem under study also must be Research Research considered.  Sources of data  The tools of measurement may be inadequate or entirely  The consumers of research are nurses at one end of the lacking. continuum whose involvement in research is indirect. These nurses: Reasons for Lack of Clinical Research Identify clinical problems in nursing practice 1. Nurses tend to feel that they are “too busy to care for Use library and information technology resources. patients”. Read research reports to develop new skills and 2. Unless the nurse has had academic training in theoretical search for relevant findings that affect practice. conceptualizations, research may not seem important. Participates in journal clubs 3. Unless the importance of research is felt and recognized, Use research to solve clinical problems nurses may not be able to identify researchable problems. Use research in clinical decisions 4. Many nurse do not have the academic training needed to Collaborate in developing an idea for a research feel confident in doing clinical research. project. 5. The ethics or research tends to researchers. Fear of Reviews a research proposal for feasibility and offer harming a patient is also a hindrance to some researchers. suggestion to improve the plan. 6. Unless administrators are research-oriented, the nursing Assist in data collection staff feels the futility of support for nursing research, hence, there is no motivation to pursue this. Participate in research study or survey 7. Research takes time, time costs money which must be Lead a journal club or ground discussion. budgeted. Participate in unit or service based research councils.  The producers of research at the other end of the Characteristics of the Good Nurse Researcher continuum are the nurses who actively participate in:  Honest and Credible Designing and implementing studies  Intellectual Curiosity Conducting studies  Accurate in his/her data Disseminating research findings  Organized and Systematic Appraising the clinical relevance of research  Prudence findings.  Logic Provides leadership for integrating findings in  Self- Awareness clinical practice.  Healthy Criticism  Intellectual Honestly Nursing Research Guidelines for the Investigative  Good Relationship with his/her respondents Function of Nurses 1. Associate Degree in Nursing Demonstrates awareness of the value or relevance of research in nursing Assists in identifying problem areas in nursing practice. Assists in collection of data within an established structured format. Introduction to Nursing Research Abejo
  • 7. Lecture Notes on Nursing Research Prepared By: Mark Fredderick R Abejo R.N, MAN 2. Baccalaureate Degree in Nursing Reads, interprets and evaluates research for Ethics in research requires honesty and accuracy of applicability to nursing practice. data. The researcher must guarantee factual and Identifies nursing problems that need to be evidenced based data. There should be no investigated and participates in the implementation “plagiarism” such as presenting the ideas or words of of scientific studies. another as one’s own, nor distort or fabricate data for Uses nursing practice as a means of gathering data purposes of completing the research on time. and refining and extending practice. The Philippine Copyright Law (R.A No. 8293 ) Applies established findings of nursing and other protects the intellectual property rights of authors and health related research to nursing practice. artist . Shares research findings with colleagues. 3. Master’s Degree in Nursing Analyzes and reformulates nursing practice problems so that scientific knowledge and scientific methods can be used to find solutions. Provides expertise in clinical problems by providing knowledge about the way clinical services are delivered which enhances quality and clinical relevance of nursing. Facilitates investigation of problems in clinical settings by contributing to a climate of supportive investigative activities, collaborating with others in investigations and enhancing nurse’s access to clients and data. Investigates for the purpose of monitoring the quality of nursing practice in a clinical setting. Assists others in applying scientific knowledge in nursing practice. 4. Doctorate Degree in Nursing or Related Discipline Provides leadership for the integration of scientific knowledge with others types of knowledge for the advancement of practice. Conducts investigations to evaluate the contributions of nursing activities to the well-being of clients. Develops methods to monitor the quality of nursing practice in a clinical setting and to evaluate contributions of nursing activities to the well-being of clients. Role of Nurses in Research  As Principal Investigators _________________________________________  As Member of a Research Team  As Evaluator of Research Findings References:  As Consumers of Research Findings 1. Venzon. 2004. Introduction to Nursing Research: Quest for Quality  As Client Advocate in a Research Study Nursing, 1st ed. Philippines: C&E Publishing Inc.  As Subject of Research 2. Barrientos-Tan. 2006. A Research Guide in Nursing Education, 3rd ed. Philippines: Visual Print Enterprises. 3. Reyes & Layug. 2009. Comprehensive Reviewer for the Nurse Ethics in Research Licensure Exam, Philippines: East West Educational Specialists, C&E Publishing Inc.  Informed Consent 4. Brink & Wood. 2001. Basic Steps in Planning Nursing Research,  Beneficence and Non-maleficence 5th ed. Philippines: Jones and Bartlett Publisher Inc. 5. Burns & Grove. 2007. Understanding Nursing Research : Building - Freedom from any Physical and Psychological Harm an Evidence-Based Practice, 4th ed. China; Elsevier, Health - Freedom from Exploitation Sciences.  Respect for Human Dignity 6. LoBiondo-Wood & Haber. 2006. Nursing Research: Methods and - The right to self determination Critical Appraisal for Evidence-Based Practice, 6th ed. USA: Mosby Inc. - The right to full disclosure 7. Polit & Beck. 2008. Nursing Research: Generating and Assessing - Anonymity and Confidentiality Evidence for Nursing Practice, 8th ed. Philadelphia: Lippincott  Justice and Fairness Williams & Wilkins. Introduction to Nursing Research Abejo