1. • BASIC RESEARCH CONCEPTS
• HISTORY OF NURSING RESEARCH
• TRENDS IN NURSING RESEARCH
• TYPES OF RESEARCH DESIGNS
Dr. Ram Sharan Mehta
Medical Surgical Nursing Department
College of Nursing
Dr. R S Mehta, MSND, BPKIHS 1

2. Basic Research Concepts
Dr. R S Mehta, MSND, BPKIHS 2

3. Research in Nursing:
1. Thermometer: Keep Dry and Clean
2. Cheatle Forcep: keep Dry Sterile Container
3. Soup Case near sink: source of Bacteria
4. Hand washing towel: source of infection
5. Room temperature water: for cold sponge
6. Instrument in cidex : Source of infection
7. OT/Bed: Contaminated: infection rate high
3
Dr. R S Mehta, MSND, BPKIHS

4. What is research?
 A systematic process of inquiry
 Goal directed
 Focused on uncovering new
knowledge to help understand
phenomena, answer questions, or
address problems

5. Research
• Research means “ to search again or
carefully examine” (Langford 2001).
• “A systematic study of problems in
patient care.”
- Diers
Dr. R S Mehta, MSND, BPKIHS 5

6. Abdellah
• “A systematic detailed attempt
to discover or confirm facts
that relate to a specific problem
to improve the practice and
profession of nursing.”

7. Polit and Hungler
• “A systematic search for
knowledge about issues of
importance to nursing.”

8. Henderson
• “A study of the problems in
practice relating to the effects
of nursing.”

9. What makes nursing research?
Nursing research is
“a scientific process that validates
and refines existing knowledge and
generates new knowledge, which
directly and indirectly influences
nursing practice”
(Burns & Grove, 2005)

10. Definition of Nursing Research…
___________________________
• An organized, systematic, data-based
critical scientific inquiry or investigation
into a specific problem, undertaken
with the objective of finding answers or
solutions to it.
Dr. R S Mehta, MSND, BPKIHS 10

11. GOALS OF NURSING
RESEARCH
_________________________________
1. Improve nursing care
2. Improve patient care outcomes
3. Improve quality of life
4. Define and expand the scope of nursing
practice
Dr. R S Mehta, MSND, BPKIHS 11

12. Utilization of Nursing Research
Findings
______________________________
1. To restore health.
2. To prevent illness.
3. To minimize the effects of acute &
chronic illness & disability.
Research: Synonyms of problem solving
Dr. R S Mehta, MSND, BPKIHS 12

13. Inductive Approach = Observation to Idea
Deductive Reasoning = General to Specific
Laws
Hypothesis
Deductive
Concepts Inductive
Approach
Approach
Facts
Empirical observations
Dr. R S Mehta, MSND, BPKIHS 13

14. Tips for research projects:
• Title : must be one breath
• Theoretical base to support empirical data
• Conceptual frame work clear
• Objective maximum three
• Objectives moves round the title
• Title must be like dani ( bamboo stick for
paddy removal using oxes)
• Methodology to achieve objectives
Dr. R S Mehta, MSND, BPKIHS 14

15. Tips for research projects…..
• Must read books
• Use multiple sources of data for validity
• Include advanced development in field
• Visit library, book shops regularly
• Find more original articles
• In literature : Killing many darlings
• Basis of conceptual frame work: Literature,
Theories, Experiences & Focus of research.
• Use triangulation method in research:
qualitative, quantitative and both.
Dr. R S Mehta, MSND, BPKIHS 15

16. History of Nursing Research
Dr. R S Mehta, MSND, BPKIHS 16

17. The Plight of New Graduates

18. Historical Development of nursing Research
Before 1850: No written documents.
After 1850:
• 1852: Nightingale wrote Cassandra.
• 1855 – N. Studied & calculated mortality rates of
British in Crimean war. (Mortality decrease by 43%)
• 1859 – N. Wrote notes on hospital.
• 1859 – N. Notes on nursing – published.
Dr. R S Mehta, MSND, BPKIHS 18

19. • 1860 – N. Founded: St. Thomas’s Hospital School
of Nursing in England.
• 1899 – ICN – Organized.
• 1900 – American Journal of Nursing publication
begins.
• 1912 – American nurses association established.
Dr. R S Mehta, MSND, BPKIHS 19

20. In Nepal:
1991: NHRC established Autonomous body.
–Conducts Regular training on:
» Research methodology.
» Ethical guidelines.
» Data analysis. (SPSS)
» Epidemiological research.
» Others: regularly.
–Provide research grant
–Legal authority to control Research
Dr. R S Mehta, MSND, BPKIHS 20

21. – 1976 – PB BN. Started. (2033 BS) (IOM)
– 1995 – MN programme started.
– 1996 (2053 BS): -B. Sc. Nursing program
started at BPKIHS.
Research Compulsory: B.Sc. Nursing, BN,
M.N./MSN, PhD Nursing
Dr. R S Mehta, MSND, BPKIHS 21

22. Trends in nursing research
Dr. R S Mehta, MSND, BPKIHS 22

23. Trends in nursing research
• Nepal is virgin area for research.
• The national future trends mainly focus
in the following areas:
Nursing leadership and management,
primary health care, nursing education and
its utilization, new technology in health,
nursing curriculum and its implication,
reproductive health and communicable
disease
Dr. R S Mehta, MSND, BPKIHS 23

24. Prone Areas of Nursing Research:
Nursing Service:
- Cancer
- End life care/Geriatric nursing
- Feeding tubes
- HIV/AIDS
- Diabetes
- CVS disease
- CKD, CLD, HTN,Pain etc
Dr. R S Mehta, MSND, BPKIHS 24

25. Nursing Education:
• Assessment Methods: OSCE, OSPE,
OSLAR, MCQs, MRQs, RA, MEQs, TF,
MINI CEX (usually we use Essay type)
• Subject Placement
• Attitude of Students
• Problems of students
• Application of Theory in to practice
Dr. R S Mehta, MSND, BPKIHS 25

26. Areas of special research
1. Chronic illness experiences
2. Cultural and ethnic considerations
3. End-of-life/palliative care research
4. Health promotion and disease prevention
5. Implications of genetic advances
6. Quality of life and quality of care
7. Symptom management
8. Telehealth interventions and monitoring:
recently in Patan AHS Started.
Dr. R S Mehta, MSND, BPKIHS 26

27. TYPES OF RESEARCH
&
RESEARCH DESIGNS
Dr. R S Mehta, MSND, BPKIHS 27

28. Types of Study Design:
• There is no best type of study design
• The context, assumptions,
paradigms and perspectives decide
the type of research methodology
Dr. R S Mehta, MSND, BPKIHS 28

29. MRC MRC MRC
Note: CRD-complete random design, RBD-random block design, FD- factorial design 29

30. 4 Types of Research
• Basic research
• Applied research
• Action research
• Evaluation research
Dr. R S Mehta, MSND, BPKIHS 30

31. Basic Research
• Also known as fundamental research
(sometimes pure research) is research carried
out to increase understanding of fundamental
principles.
• Many times the end results have no direct or
immediate commercial benefits
• Basic research can be thought of as arising out of
curiosity.
• However, in the long term it is the basis for many
commercial products and applied research.
• Basic research is mainly carried out by
universities Dr. R S Mehta, MSND, BPKIHS 31

32. Applied Research
• Concern with addressing problem of the world
as they are perceived by participants,
organization or group of people
• Action oriented and aims to assess, describe,
document or inform people concerned about the
phenomenon under investigation
• Findings are intended to have immediate and
practical value
• In the field of education, policy, evaluation and
contract are all examples of applied research
Dr. R S Mehta, MSND, BPKIHS 32

33. Action Research
Action Research is simply a form of self-reflective
enquiry undertaken by participants in social
situations in order to improve the rationality and
justice of their own practices, their understanding
of these practices, and the situations in which these
practices are carried out.
Wilf Carr and Stephen Kemmis (1986)
Dr. R S Mehta, MSND, BPKIHS 33

34. Evaluation research
• Major concern is practical application
• Tends to be viewed as an isolated case study
though the methodologies may be transferable
• Rooted in values and politics
• Is immediately prescriptive based upon logic and
experience
• Reports are written for implementers, users and
other interested people
• The extent of dissemination is controlled by
sponsor
Dr. R S Mehta, MSND, BPKIHS 34

35. RESEARCH DESIGNS
QUANTITATIVE QUALITATIVE
• Experimental study • Ethnography
• Quasi- • Case study
experimental study • Historical study
• Survey study
• Correlational study
Dr. R S Mehta, MSND, BPKIHS 35

36. Experimental Design
• Test whether an educational practice or
idea makes a difference for individuals
Dr. R S Mehta, MSND, BPKIHS 36

37. Randomized Controlled Trials
• Similar groups of individuals from same source
population are allocated at random to receive or
not to receive an intervention, then observed for
occurrence of outcome(s).
DESIGN
Experimental Outcome
Subjects
Group
with
condition of
Interest Control Outcome
Dr. R S Mehta, MSND, BPKIHS 37

38. A Factorial RCT for Two Studies for the Price of One
38

39. CASE-CONTROL STUDIES
SOME KEY POINTS
• Frequently used study design
• Participants selected on the basis of whether or
not they are DISEASED (remember in a cohort
study participants are selected based on
exposure status)
• Those who are diseased are called CASES.
• Those who are not diseased are called
CONTROLS.
Dr. R S Mehta, MSND, BPKIHS 39

40. Cross-Sectional Study
Disease
Exposure yes no total
yes a b a+b
no c d c+d
Dr. R S Mehta, MSND, BPKIHS 40

41. Cohort Studies
Group by common characteristics
Start with a group of subjects who lack a positive
history of the outcome of interest yet are at risk
for it (cohort).
Think of going from cause to effect.
The exposure of interest is determined for each
member of the cohort and the group is followed
to document incidence in the exposed and non-
exposed members.
Dr. R S Mehta, MSND, BPKIHS 41

42. When is a cohort study
warranted?
• When good evidence suggests
an association of a disease with
a certain exposure or exposures
e.g. Smoking & Lung Cancer.
Dr. R S Mehta, MSND, BPKIHS 42

43. True, Qusi, & Pre-
Experimental Study
Randomization, Control and Manipulation
• True exp.: All 3: R C M
• Quasi exp.: M + R or C
• Pre exp.: M, no R & no C
Dr. R S Mehta, MSND, BPKIHS 43

44. Correlational Study
• Focus more on examining the association or
relation of one or more variables within a
single group of individuals
• Researcher measures the degree of
association or relation between two or more
variables using the statistical procedure of
correlational analysis
• Degree of association indicates whether the
two variables are related or whether one can
predict another
Dr. R S Mehta, MSND, BPKIHS 44

45. Survey Designs
• Describe trends in a large population of
individuals
• Administer a survey or questionnaire to a
small group of people (sample) to identify
trends in attitudes, opinions, behaviors or
characteristics of a larger group of people
(population)
Dr. R S Mehta, MSND, BPKIHS 45

46. Descriptive Research Design:
• Describe facts
• Discover new facts
• Not invent new theory and methods
• Largest effort given on data
collection
• It answers questions: satisfy
curiosity
• Solve problems

47. Qualitative Research
Dr. R S Mehta, MSND, BPKIHS 47

48. Choice of Colours
• 1. What colour would you like the most?
Dr. R S Mehta, MSND, BPKIHS 48

49. 2.What do you associate this colour with?
Good luck
love
Confidence
Truthfulness
Lively
Danger
…
Dr. R S Mehta, MSND, BPKIHS 49

50. 3. What is the source of this knowledge?
– Own Idea
– Own Belief
– Own observation
– Own experiences
– Cultural and Traditional
– Books & articles
– etc
Dr. R S Mehta, MSND, BPKIHS 50

51. • Not every thing can be quantified.
• Some valuable ideas, opinions,
perceptions, experiences, behaviours,
qualities can be described only in
words
• These subjective things are shared
between people, but the meanings may
be distorted in the process of
communication and recording.
Dr. R S Mehta, MSND, BPKIHS 51

52. • Although subjective, these
aspects often add richness and
depth
• The art of the doctor and the
experience of being human are
aspects that need a qualitative
approach to
investigate/research properly.
Dr. R S Mehta, MSND, BPKIHS 52

53. Definitions
• Quantitative Research - investigation in which
the researcher attempts to understand some
larger reality by isolating and measuring
components of that reality without regard to their
contextual setting.
• Qualitative Research - investigation in which the
researcher attempts to understand some larger
reality by examining it in a holistic way or by
examining components of that reality within their
contextual setting.
Dr. R S Mehta, MSND, BPKIHS 53

54. Qualitative Research
– Human understanding and
interpretation define reality
– Complex reality can be understood and not
as simply a sum of its parts
– Goal of research is to examine complex
phenomena to define the reality within
– To be meaningful, inquiry must be holistic
and contextual

55. Characteristics of Qualitative
Research
• Purpose is understanding
• Oriented toward discovery
• Uses subjective data
• Extracts meaning from data
• Interprets results in context
• Focus is holistic

56. Disadvantages of Qualitative
Research
• Subjectivity leads to procedural problems
• Replicability is very difficult
• Researcher bias is built in and unavoidable
• In-depth, comprehensive approach to
data gathering limits scope
• Labor intensive, expensive
• Not understood well by “classical”
researchers

57. Organizational Structures
(Types)
Historical Analysis
Ethnography
Phenomenology
Life History,
Chronology,
Historiography
Case Study
Dr. R S Mehta, MSND, BPKIHS 57

58. Advantages of Qualitative Research
In-depth Examination of Phenomena
(Phenomenological Study/Research)
Uses subjective information
Not limited to rigidly definable variables
Examine complex questions that can be
impossible with quantitative methods
Deal with value-laden questions
Explore new areas of research
Build new theories Dr. R S Mehta, MSND, BPKIHS 58

59. Disadvantages of Qualitative
Research
Subjectivity leads to procedural problems
Replicability is very difficult
Researcher bias is built in and unavoidable
In-depth, comprehensive approach to
data gathering limits scope
Labor intensive, expensive
Not understood well by
“classical” researchers
Dr. R S Mehta, MSND, BPKIHS 59

60. Meta Analysis
• Statistically combines results of existing
research to estimate overall size of
relation between variables
• Helps in
• Developing theory
• Identifying research needs,
• Establishing validity
• Can replace large-scale research studies
• Better than literature reviews
60
Dr. R S Mehta, MSND, BPKIHS

61. Note: CRD-complete random design, RBD-random block design, FD- factorial design 61

62. Relative strength of various study designs
(based on level of evidence for a cause &
effect relationship)
Strength Design
Strong Clinical trial
Cohort study
Case control study
Cross sectional
Case series
Weak Case report
Dr. R S Mehta, MSND, BPKIHS 62

63. Websites, Search Engine, and
address of Journals
• www.pubmed.com
• www.google.com
• www.yahoo.com
• www.msn.com
• www.rn.com
• www.who.int (WHO website)
• www.randamization.com
• www.tnaionline.org (TNAI Journal)
• www.hellis.org (NHRC library site)
• www.kumj.com.np
• www.nhrc.org.np
• www.uicc.org (cancer website)
• www.unaids.org (HIV/AIDS website)
• www.ncasc.org.np (HIV/AIDS website)
• www.healthinternetwork.org (HINARI: needs password)
• www.blackwell-synergy.com (need passwords)
• www.doaj.org (free online journal) Dr. R S Mehta, MSND, BPKIHS 63

64. Some Popular Resource Sites for Nurses
• www.delicious.com
• www.connotea.org You can
• www.scribd.ocm
create your
• www.authorstream
• www.zotero.org own account
• www.scratch.mit.edu and use it.
• www.myebook.com
• www.forvo.com
• www.biomedcentral.com
• www.library.nams.org.np (all study conducted in Nepal)
• www.refworks.com
• www.sourceforge.net
• www.citationmachine.net

65. Web 2.0 includes:
• Social networking
• Blogs
• Wikis
• Video sharing sites
• Hosted services
• Web application
• Etc.
Dr. R S Mehta, MSND, BPKIHS 65

66. “The beautiful thing about
learning is that nobody can
take it away from you.”
--BB King
Thank-You 66
Dr. R S Mehta, MSND, BPKIHS