Research: An Introduction Ma.

Irma Bustamante, RN, PhD Sources of knowledge

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Tradition: accepted as given on the basis of inherited customs Authority: comes from people with expertise Experience Trial and error Intuition Sources of knowledge Logical reasoning: combines, intellectual faculties and formal system of thought Disciplined research: the most sophisticated method of acquiring knowledge. Definitions Research is a systematic, controlled, empirical and critical investigation of hypothetical propositions about the presumed relations among natural phenomena. Kerlinger, 1973 Definitions Systematic – follows certain steps Controlled – every step of the investigation is planned Empirical – evidence is on hand, there is confidence in the results Definitions

Predict - Through prediction, one can estimate the probability of a specific outcome in a given situation. However, predicting an outcome does not necessarily enable one to modify or control the outcome. Control - If one can predict the outcome of a situation, the next step is to control or manipulate the situation to produce the desired outcome. Nurses do research because…

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Nursing is a profession

Nursing should contribute to the generation of new knowledge Through research, nurses could evaluate and document their contributions to their clients’ health and wellbeing and to the health care delivery system Cruz-Earnshaw, 2007 Nurses do research because…

RA 9173 Section 28 (e )states that: It shall be the duty of the nurse to: (e) Undertake nursing and health human resource development training and research which shall include, but not limited to the development of advance nursing practice; Classifications of Research

Research in its broadest sense is an attempt to gain solutions to problems. More precisely, it is the collection of data in a rigorously controlled situation for the purpose of prediction or explanation. Treece and Treece, 1974 Definitions

According to level of investigation 1. Exploratory 2. Descriptive 3. Experimental

Classifications of Research

According to approach 1. Experimental 2. Non-experimental

Nursing research is research for nursing. It includes the breadth and depth of the discipline of nursing: the rehabilitative, therapeutic, and preventive aspects of nursing, as well as the preparation of practitioners and personnel

Classifications of Research

According to measurement & data analysis 1. Quantitative 2. Qualitative

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Definitions

involved in the total nursing sphere.

Classifications of Research

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According to time frame 1. Longitudinal 2. Cross sectional Classifications of Research According to motive or objective 1. Basic research 2. Applied research

Nursing research is defined as a scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences nursing practice. Burns and Grove, 2005 Purposes of Research 1. Describe 2. Explain 3. Predict 4. Control

Classifications of Research

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According to time line 1. Retrospective 2. Prospective Classifications of Research According to research environment 1. Field 2. Laboratory

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Describe - involves identifying and understanding the nature of phenomena and sometimes the relationship among them. Explain - It clarifies the relationships among phenomena and identifies the reasons why certain events occur. It could be the basis for conducting research for prediction and control

Quantitative Research

Quantitative research is the investigation of phenomena that lend themselves to precise measurement and quantification, often involving a rigorous and controlled design.

Quantitative Research Methods

Descriptive – provides an accurate portrayal or account of characteristics of a particular individual, situation or group. Quantitative Research Methods

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Critical theory – an approach to viewing the world that involves a critique of society, with the goal of envisioning new possibilities and effecting social change Qualitative Research Methods Feminist research – seeks to understand, typically through qualitative approaches, how gender and a gendered social order shape women’s lives and their consciousness. Mixed Methods Research

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Correlational – involves the systematic investigation of relationships/association between two or more variables Quantitative Research Methods Comparative – used to describe the differences in variables in two or more groups in a natural setting Quantitative Research Methods Quasi-experimental – causal relationships between two selected variables are examined through manipulation of the independent variable but without control or randomization. Quantitative Research Methods

TRIANGULATION – the use of multiple methods to collect and interpret data about a phenomenon, so as to converge on an accurate representation of reality Steps in the Research Process

Experimental – it is an objective, systematic, controlled investigation for the purpose of predicting and controlling phenomena. Characteristics include manipulation, control, and randomization. Quantitative Research Methods

Ex post facto – the independent variable is not manipulated, either because it is inherently unmanipulable or because it occurred in the past Qualitative Research

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Identification of problem Review of related literature Construction of a framework Formulate the hypothesis Select the research design Select the sample Collect the data Analyze and interpret the data Write the research report Communicate the research report

Qualitative research is the investigation of phenomena typically in an in-depth and holistic fashion, through the collection of rich narrative materials using a flexible research design. Qualitative Research Methods

Major Steps: Quantitative Study Phase I: The Conceptual Phase Step 1: Formulating and delimiting the problem Step 2: Reviewing the related research literature Step 3: Undertaking clinical fieldwork Step 4: Defining the framework and conceptual definitions Step 5: Formulating the hypothesis

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Phenomenological – describes an experience as they are lived by people Qualitative Research Methods Grounded theory – discovers what problems exist in a social scene and the process persons use to handle them Qualitative Research Methods

Ethnographic – it is associated with anthropology and focuses on the culture of a group of people, with an effort to understand the world view of those under study. Qualitative Research Methods

Phase II: The Design and Planning Phase Step 6: Selecting a research design Step 7: Developing protocols for intervention Step 8: Identifying the population to be studied Step 9: Designing the sampling plan Step 10: Specifying methods to measure variables Step 11: Developing methods to protect human/animal rights Step 12: Finalizing and reviewing the research plan Phase III: The Empirical Phase Step 13: Collecting the data Step 14: Preparing data for analysis Phase IV: The Analytic Phase Step 15: Analyzing the data Step 16: Interpreting the results

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Historical – a narrative description or analysis of events that occurred in the remote or recent past. Qualitative Research Methods Philosophical inquiry – involves using intellectual analysis to clarify meanings, makes values manifest, identify ethics, and study the nature of knowledge Qualitative Research Methods

Phase V: The Dissemination Phase Step 17: Communicating the findings Step 18: Utilizing research evidence in practice Activities: Qualitative Study Conceptualizing and planning a qualitative study

Case study – involves a thorough, in-depth analysis of an individual, a group, or an institution or other social units. Qualitative Research Methods

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sites

Identifying a research problem Doing a literature review Selecting and gaining entrée into research

Designing qualitative studies

Addressing ethical issues Activities: Qualitative Study Conducting a qualitative study The title

4. It helps the other researchers refer to the work.

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Obtaining and analyzing qualitative data

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Titles should be clear and specific.

Disseminating qualitative findings Writing qualitative research

Thank you for your attention The Problem Ma. Irma Bustamante, RN, PhD What is a research problem?

It should include variables, relationships, target population, and setting. Ideally, it should have a maximum of 20 substantive words, with function words not included in in the counting. The title

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A problem is a condition requiring a solution.

In research, a problem statement is an expression of a dilemma or a disturbing situation that needs investigation. Sources of research problems

Example The Effects of Home Visits of Public Health Nurses on the Dietary Compliance of Adult Diabetic Patients in Two Barangays in Quezon City The Variable

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Personal experiences and observations Readings

Conversations with peers, experts, clients Attendance in conferences, lectures Everyday occurrences Social and political issues affecting health Characteristics of a researchable problem

Variable – an attribute of a person or object that varies, that is, takes on different values. It is anything that is liable to change or likely to vary. Independent variable – cause Dependent variable – effect Extraneous variables – not studied but affects results The Variable

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Interest Usefulness

Intervening – comes between the dependent and independent variables. Ex. - stress, anxiety, motivation Organismic – those that can not be changed through manipulation. Ex. – age, sex, race Confounding or interfering – interfere with the study design and the data gathering process by influencing the subjects or the dependent variable. Ex. – social support The Variable

Novelty Feasibility of time and resources Ethical Availability of data Ability of the researcher Situations manifesting a problem

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Absence of information Incomplete information

Conflicting information A fact exists and you intend your study to explain it. There is a gap in knowledge The research question

Antecedent – occurs earlier than the independent variable and bears a relationship both to it and to the dependent variable. Ex.- poor health, superstitious beliefs RANDOMIZATION is the best control over unknown variables. Significance of the study

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The problem is specifically stated in the form of a research question. The research question should be clear, concise, and stated in measurable terms specifically in quantitative research. The research question

Example What is the level of creativity among senior student nurses of a center of excellence college in Manila in terms of originality and flexibility?

The title

Issues relevant in considering the significance of the study: 1. Implications for nursing practice – Is it able to produce evidence for nursing practice? 2. Extension of knowledge base – Is it able to produce new knowledge which is useful? Significance of the study 3. Promotion of theory development – Is it able to test or develop a new theory? 4. Correspondence to research priorities – Is it in line with research priorities of the country, profession, or funding institutions? Scope and Limitations

Functions of a title 1. It draws in summary form, the content of the entire investigation. 2. It serves as a frame of reference for the whole thesis. 3. It enables the researcher to claim the title as his own.

Scope defines where and when the study was conducted and who the participants (subjects) were. The scope sets the delimitations and establishes the boundaries of the study. Limitations – are the weaknesses and shortcomings

of the study as acknowledged by the researcher. Definition of terms

Operational definition – description of how variables or concepts will be measured or manipulated in the study Conceptual definition – provides a variable with connotative meaning. It tells what the concept means. Assumptions

Basic Rights It includes the right to decide at any point to terminate their participation, to refuse to give information, or to ask for clarification about the purpose of the study or specific study procedures PRINCIPLE: Respect for human dignity Basic Rights Vulnerable subjects or persons with diminished autonomy are those who are less advantaged because of legal or mental incompetence, terminal illness, or confinement to an institution. Basic Rights The right to full disclosure and the right to self determination are the two major elements on which informed consent is based Basic Rights Informed consent means that the subjects have adequate information regarding the research; are capable of comprehending the information; and have the power of free choice, enabling them to voluntarily consent to participate or decline participation in the research study. Basic Rights Informed consent involves the disclosure of the following information: subject status, study purpose, type of information to be obtained, nature of the commitment, sponsorship, subject selection, procedures, potential risks, costs, and benefits, confidentiality pledge, voluntary consent, right to withdraw, alternatives, and contact information. Basic Rights

An assumption is any fact presumed to be true but not actually verified. It pertains to events or situations that seem so true that they are taken for granted. Unlike the hypothesis it does not need testing or confirmation. Ethics in Research Ma. Irma C. Bustamante, RN, PhD Basic Rights

The right to protection from harm and discomfort. PRINCIPLE: Beneficence – imposes a duty on researchers to minimize harm and to maximize benefits. A related principle is nonmaleficence (avoid, prevent or minimize harm)

Right to full disclosure – means that the researcher has fully described the nature of the study, the subject’s right to refuse participation, the researcher’s responsibilities, and the likely risks and benefits that would be incurred. PRINCIPLE: Respect for human dignity Basic Rights Debriefing is communication with subjects, generally after their participation has been completed regarding various aspects of the study. Basic Rights Covert data collection or concealment is the collection of data without the subject’s knowledge. Deception can involve either withholding information about the study or providing subjects with false information. Basic Rights Placebo is a medically harmless, ineffective substance that is usually used in testing a new drug when it is given to a control group. It is done to rule out any possible biases of subjects and investigators. Basic Rights There are two variations in the use of placebo

Informed consent for children is called assent. The study must be explained within the child’s level of comprehension. Most assent are accompanied by parental consent. Basic Rights

Right to fair treatment means that the subjects receive equitable treatment before, during, and after their participation in the study. PRINCIPLE: Justice Basic Rights

Right to privacy means that researchers need to ensure that their research is not more intrusive than it needs to be and that the subject’s privacy is maintained throughout the study PRINCIPLE: Justice Basic Rights Anonymity occurs when even the researcher can not link a subject with the information for that subject. The subjects remain unknown. Basic Rights A promise of confidentiality to the subjects is a guarantee that any information that the subjects provide will not be publicly reported or made accessible to parties other than those involved in the research. The IRB IRB stands for Institutional Review Board. This is a formal committee in most universities and hospitals where researches are conducted. They review proposals for its adherence to ethical standards. Basis for Ethical Standards

Single blind test design: it is one in which the evaluations of the results of a treatment are kept from the subjects who have received it. Basic Rights 2. Double blind test design: it is one in which the investigators and the subjects involved in the study are kept ignorant about the process – that is, they are not suppose to know who are receiving the treatment and who are not Basic Rights Right to self determination means that the prospective subjects have the right to voluntarily decide whether or not to participate in a study, without the risk of imposing any penalties or prejudicial treatment.

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Nuremberg Code Déclaration of Helsinki Literature Review Ma. Irma Bustamante, RN, PhD What is a literature review?

CIOMS (Council for International Organizations of Medical Research) Belmont Report Professional Code of Ethics for Nurses Nuremberg Code This ethical code of conduct contains rules that were developed to guide investigators in conducting research ethically w/c are: 1. voluntary consent 2. withdrawal of subjects from studies 3. protection of subjects from physical and mental suffering, injury, disability, death 4. balance of benefits and risk Declaration of Helsinki

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It is a collection of materials on a topic.

It discusses published information in a particular subject area sometimes within a certain time period. What is a literature review?

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It can be a simple summary of sources but has an organizational pattern and combines both summary and synthesis. Summary

Differentiated therapeutic from nontherapeutic research Therapeutic research gives the patient the opportunity to receive an experimental treatment that might have beneficial results Nontherapeutic research is conducted to generate knowledge for a discipline. Results of the study might benefit future patients but will probably not benefit those acting as research subjects. CIOMS

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A summary is a recap of the important information found in the literature. Synthesis A synthesis is a re-organization, or a reshuffling of information to: 1. Give a new interpretation of old materials 2. Combine new with old interpretations 3. Trace the intellectual progression of the field including major debates. Purpose

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The CIOMS Guidelines, formally known as International Ethical Guidelines for Biomedical Research Involving Human Subjects, is a set of ethical principles regarding human experimentation. Created in 1993 by the Council for International Organizations of Medical Sciences (CIOMS) and updated in 2002, these 21 guidelines (15 in the original report) address issues including informed consent, standards for external review, recruitment of participants, and more. The Guidelines are general instructions and principles of ethical biomedical research Belmont Report

It is conducted to generate a picture of what is known about a particular situation and the knowledge gaps that exist in it. Functions

On July 12, 1974, the National Research Act (Pub. L. 93-348) was signed into law, there-by creating the National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research. One of the charges to the Commission was to identify the basic ethical principles that should underlie the conduct of biomedical and behavioral research involving human subjects and to develop guidelines which should be followed to assure that such research is conducted in accordance with those principles. Belmont Report considerations

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Source for research ideas Orientation to what is already known

Provides the conceptual or theoretical framework of the planned research Provides information on research approaches and techniques. Kinds of literature Research literature: refers to published reports of actual research studies done previously Conceptual literature consists of articles or books written by authorities giving their opinions, experiences, theories, or ideas. Sources for literature review

(i) the boundaries between biomedical and behavioral research and the accepted and routine practice of medicine, (ii) the role of assessment of riskbenefit criteria in the determination of the appropriateness of research involving human subjects, (iii) appropriate guidelines for the selection of human subjects for participation in such research and (iv) the nature and definition of informed consent in various research settings. Code of Ethics for Nurses

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A primary source: is the description of an investigation written by the person who conducted it A secondary source: is a description of a study or studies prepared by someone other than the original researcher Where can literature be found?

The Code of Ethics for Nurses, revised in 2000, is a guide for action based on social values and needs. The Code has served as the standard for nurses worldwide since it was first adopted in 1953. The new version, revised for the first time in 27 years, responds to the realities of nursing and health care in a changing society.

Journal articles

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Books Conference proceedings Government and corporate reports Newspapers

The use of a framework

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Worldviews are mental lenses or cognitive and perceptual maps that we continually use to find our way through the social landscape surrounding us. They are extremely encompassing in content and pervasive in adherence. They are composed of beliefs, belief systems and social values associated with them. Terminologies A concept is a term that abstractly describes and names an object, a phenomenon, or an idea, thus providing it with a separate identity or meaning. Constructs are concepts at very high level of abstraction and have general meaning Variables are more concrete and are narrow in their definition. Terminologies Construct Emotional Responses Concept Variable Terminologies Anxiety Palmar Sweating Concrete Abstract

Where can literature be found? Theses and dissertations Internet – electronic journals CD – ROM Magazines

Reading the literatures Read the easier articles first Scan the article – Read the abstract first. Read for depth Allow enough time Do not put writing off until you have finished reading

Keep bibliographic information. Writing the literature review The review is not just a list describing one published study after another but rather requires that the author critically analyze the available literature on the topic. The review should be organized into sections that present themes or identified trends. Revise…revise…revise

A conceptual map is a strategy for expressing a framework. It diagrams the interrelationships of the concepts and statements. A conceptual map

Hypothesis Ma. Irma Bustamante, RN, PhD Framework Ma. Irma Bustamante, RN, PhD Definitions Definitions

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A framework is the abstract, logical structure of meaning that guides the development of the study and enables the researcher to link the findings to nursing's body of knowledge. It is the conceptual underpinnings of a study.

The hypothesis is a tentative, declarative statement about the relationship between two or more variables. It is a tentative explanation for certain behaviors, phenomena or events which have occurred or will occur. It is an educated guess which needs to be tested. Characteristics It should be reasonable.

Definitions Theoretical framework is based on theories. Conceptual framework is rooted on specific concepts or conceptual model Both provides the structure for examining a problem and serves as a guide to examine relationships between variables. The use of a framework In quantitative research, the framework is a testable theory that may emerge from a conceptual model or may be developed inductively from published research or clinical observations In qualitative research, the initial framework is a philosophy or a worldview. A theory consistent with the philosophy is developed as the outcome of the study.

It should state in definite terms, the relationship between variables. It should be testable. Sources Observations of phenomena Real life experiences

May be generated from relationships expressed in theories. Literature review Results of previous researches

Types

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Null hypothesis (Ho) is a statement of a no relationship, no difference, no effect or no interaction. It is tested with statistics. Example There is no relationship between nursing admission test results and board examination ratings among the graduates of nursing schools in Manila. Types

Research Designs Ma. Irma C. Bustamante, RN, PhD Definitions

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Research design is the plan, structure, and strategy of an investigation. Research method is the totality of how the study is carried out. It includes the design, sample, setting, instruments, interventions, procedures, and data analysis. Interrelationship: Design, Problem, Literature Review, Framework, and Hypothesis Quantitative Designs

Alternative or research hypothesis (H1) is the expectation based on theory. This could either be: Directional – specifies the direction of the relationship. Non-directional – only specifies that there is a relationship. Types Examples Directional The higher the nursing admission test results, the higher is the board examination ratings. Non-directional There is a relationship between nursing admission test results and board examination ratings among the graduates of nursing schools in Manila.

A descriptive design is used to identify a phenomenon of interest, identify variables within the phenomenon, event or group in real life situations for the purpose of discovering new meaning, describing what exists, determining the frequency with which something occurs, and categorizing information. Quantitative Descriptive


Types

Survey designs are employed to measure the existing phenomenon without inquiring into why it exists. The main intention is to use the data for problem solving rather than for hypothesis testing. Quantitative Descriptive

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Simple hypothesis has one independent and one dependent variable. Example There is no relationship between nursing admission test results and board examination ratings among the graduates of nursing schools in Manila. Types

Correlational designs help one determine the extent to which different variables are related to each other in the population of interest. The critical distinguishing characteristic is the effort to estimate a relationship as distinguished from simple description. Quantitative Descriptive

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Complex hypothesis has two or more independent and dependent variables Example There is no relationship between nursing admission test results and grade point average to board examination ratings and CGFNS results among the graduates of nursing schools in Manila. Wording the hypothesis

Comparative designs examine and describe differences in variables in two or more groups that occur naturally in the setting. Descriptive and inferential statistical analyses are used to examine differences between or among groups. Quantitative Descriptive

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Hypothesis should specify the independent and dependent variables and the relationship between them. Hypothesis should be worded in the present tense

Hypothesis should be stated declaratively. Remember Hypotheses are never proved through hypothesis testing rather they are accepted or supported or rejected. Findings are always tentative. If results are replicated in numerous investigations, greater confidence can be placed in the conclusions. Hypotheses come to be supported with mounting evidences.

Time dimensional designs were developed within the discipline of epidemiology where the occurrence and distribution of disease among populations are studied. These designs examine sequences and patterns of change, growth or change over time. The dimension of time becomes an important factor. Quantitative Descriptive

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Longitudinal designs examine changes in the same subjects over an extended period. Cross sectional designs are used to examine groups of subjects in various stages of development simultaneously with the intent to describe changes in the phenomenon across stages.

Quantitative Descriptive

3 Primary longitudinal designs 1. Trend studies: the general population is studied at different points over a long period of time. Participants are not the same at each period but they are representative of the population at that time. Quantitative Descriptive 2. Cohort studies: focus on the same specific population each time data are collected, samples may be composed of different subjects but with similar characteristics. 3. Panel studies: use the same respondents for each progressive time period that the data are collected. Characteristics of a True Experiment

Experimental group Control group Designs: Pre-experimental

X

O1 O2

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One-Group Pretest Posttest Design Notation: O1 X O2

Where: O1 – Pretest X - Treatment/Intervention O2 - Posttest

Designs: Pre-experimental

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Static Group Comparison

Manipulation: the researcher manipulates i.e. provides intervention or treatment in the experimental group. The independent variable is manipulated to assess its effect on the dependent variable. Characteristics of a True Experiment

Control: imposing of rules by the researcher to decrease the possibility of error and increase the probability that the study’s findings are an accurate reflection of reality. Characteristics of a True Experiment

Notation: X O1 -----------------O2 Where: X – Treatment/Intervention O1 – Experimental posttest O2 – Control posttest ---- - Non-random selection Quantitative Experimental

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True experimental designs possess the characteristics of a true experiment. True Experimental Designs Pretest Posttest Control Group Design or Classical Experimental Design Notation: RS O1 X O2 ____________________ RC O3 O4 True Experimental Designs

Ways of control: 1. Homogenecity: the researcher limits the subjects to only one level of extraneous variable to reduce the impact on study findings Characteristics of a True Experiment 2. Blocking: including the extraneous variable as part of the design 3. Matching: it is used when a subject in the experimental group is randomly selected and then a subject similar in relation to important extraneous variables is randomly selected for the control group. Characteristics of a True Experiment

Randomization: each individual in the population should have a greater than zero opportunity to be selected for the sample. Random assignment is the assignment of subjects to treatment conditions in a manner determined by chance. Quantitative Experimental

Where: R – Random assignment O1 – Experimental pretest O2 - Experimental posttest O3 – Control pretest O4 – Control posttest X - Treatment/Intervention S – Study group C – Control group

True Experimental Designs

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Solomon Four Group Design Notation: RS O1 RC O3 RS RC X X O2 O4 O5 O6

Pre-experimental design is a research design that does not include mechanisms to compensate for the absence of either randomization or a control group. Done as a preliminary study. Designs: Pre-experimental

Quantitative Experimental

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One shot case study Notation X O

Where: X – Treatment/intervention O - Posttest

Quasi-experimental designs are studies involving an intervention in which subjects are not randomly assigned to treatment conditions but the researcher exercises controls to enhance the study’s internal validity. Quasi-experimental Designs

Designs: Pre-experimental

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Time series experiment O1 O2 O3 O4 X O5 O6 O7 O8 Non-equivalent control group design

Posttest only design with comparison group Notation

O1 X O2 --------------------O3 O4 Threats to Experimental Validity

Internal validity: refers to the condition that the observed differences on the dependent variable are a direct result of the manipulation of the independent variable, not some other variable Threats to Experimental Validity

Threats to internal validity History effect: an event that is not related to the planned study but occurs during the time of the study and could influence the responses of subjects to the treatment Threats to Experimental Validity Selection threat is more likely to occur in studies in which randomization is not possible Maturation is defined as growing older, wiser, stronger, hungrier, more tired, or more experienced during the study. Unplanned and unrecognized changes can influence the findings of the study. Threats to Experimental Validity Mortality is due to subjects who drop out of a study before completion

External validity refers to the condition wherein the results are generalizable or applicable to groups and environments outside of the experimental setting Epidemiological Designs

Two broad classifications 1. Observational studies – examine associations between risk factors and outcomes 2. Intervention studies – explore the association between interventions and outcomes Epidemiological Designs

basic research because all extraneous factors other than those of interest can be controlled or accounted for (e.g., age, gender, genetics, nutrition, environment, comorbidity, strain of infectious agent) Epidemiological Designs Observational studies 1. Cohort (Incidence, Longitudinal Study) - A prospective, analytical, observational study, based on data, usually primary, from a follow-up period of a group in which some have had, have or will have the exposure of interest, to determine the association between that exposure and an outcome. Epidemiological Designs 2. Case-Control Study - A retrospective, analytical, observational study often based on secondary data in which the proportion of cases with a potential risk factor are compared to the proportion of controls (individuals without the disease) with the same risk factor. The common association measure for a case-control study is the odds ratio. Epidemiological Designs 3. Ecologic (Aggregate) Study - An observational analytical study based on aggregated secondary data. Aggregate data on risk factors and disease prevalence from different population groups is compared to identify associations. Epidemiological Designs 4. Cross-Sectional (Prevalence Study) Study - A descriptive study of the relationship between diseases and other factors at one point in time (usually) in a defined population Epidemiological Designs 5. Case Series - A descriptive, observational study of a series of cases, typically describing the manifestations, clinical course, and prognosis of a condition. Epidemiological Designs 6. Case Report - Anecdotal evidence. A description of a single case, typically describing the manifestations, clinical course, and prognosis of that case. Qualitative Designs

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Qualitative designs uses systematic, interactive approach which is used to describe life experiences and give them meaning. Qualitative Phenomenology Phenomenological design is used to describe experiences as they are lived Bracketing is the suspension of the researcher’s preconceptions, prejudices and beliefs so that they do not interfere with or influences their description of the respondent’s experience. Qualitative Grounded Theory

Observational studies 1. Analytical – determinants and risk of disease 2. Descriptive – patterns and frequency of disease Epidemiological Designs Intervention or experimental studies - provides the strongest clinical evidence. 1.) Randomized Controlled Clinical Trial (RCT) - A prospective, analytical, experimental study using primary data generated in the clinical environment. Individuals similar at the beginning are randomly allocated to two or more treatment groups and the outcomes the groups are compared after sufficient follow-up time. Properly executed, the RCT is the strongest evidence of the clinical efficacy of preventive and therapeutic procedures in the clinical setting. Epidemiological Designs 2. Randomized Cross-Over Clinical Trial - A prospective, analytical, experimental study using primary data generated in the clinical environment. Individuals with a chronic condition are randomly allocated to one of two treatment groups, and, after a sufficient treatment period and often a washout period, are switched to the other treatment for the same period. Epidemiological Designs 3. Randomized Controlled Laboratory Study - A prospective, analytical, experimental study using primary data generated in the laboratory environment. Laboratory studies are very powerful tools for doing

Grounded theory provides a way to transcend experience – to move it from a description of what is happening to understanding the process by which it happens. Qualitative Ethnographic

Ethnographic design provides a mechanism for studying our own culture and that of others. Qualitative Historical

Historical design is the systematic collection and critical evaluation of data relating to past occurrences. External criticism: authenticity and genuiness of data Internal criticism: worthiness or truthfulness of data

Qualitative Philosophical Inquiry

Philosophical inquiry considers an idea or an issue from all perspectives by extensively exploring the literature, examining conceptual meaning, raising questions, providing answers, and suggesting the implications of those answers. Qualitative Critical Social Theory

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Sampling frame is a list of all cases, objects, or groups of cases in the populations. Generalizing means that the findings can be applied to the population. Representativeness means that the sample must be like the population in as many ways as possible. Categories of Sampling Plans

Critical social theory dares to question the unquestioned and uncovers injustice and inequity in the society. Qualitative Feminist Research

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Feminist research is based on the premise that gender is a central construct in a society that privileges men and marginalizes women. It seeks to equalize power relations by using a broad range of methodologies. Case Study

Probability sampling: a process in which each element of the population has an equal chance of being chosen for the sample. There is randomization. Non-probability sampling: elements are selected by non-random methods Sample Size RULE: The larger the sample, the more representative of the population.

Involves an extensive exploration of a single unit of study, such as a person, family, group, community, or institution, or a very small number of subjects who are examined intensively. It may have both quantitative and qualitative elements. Used for rare, interesting, or representative cases Triangulation

Minimum acceptable sample size 1. Descriptive: 10 – 20% of the population 2. Correlational: 30 subjects 3. Ex post facto: 15 subjects 4. Experimental: 15 – 30 subjects per group Gay and Diehl,1992

Sample Size

It is the combined use of two or more theories, methods, data sources, investigators, or analysis methods in the study of the same phenomenon. Remember The KEY in choosing the research design The best research design is the one that is most appropriate for the problem and the purpose of the study.

Slovin’s Formula n = N 1 + Ne2 Where: n = sample size N = population e = desired margin of error ( 0.05 or 0.01 ) Probability Techniques

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Simple random: sampling by chance either by lottery or by the use of table of random numbers Probability Techniques Stratified random: involves taking certain areas of the population, dividing the areas into sections, and then taking a random sample from each section. Probability Techniques

Sample Ma. Irma C. Bustamante, RN, PhD Definitions

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Sampling involves selecting a group of people, events, behaviors, or other elements with which to conduct a study. Sampling plan defines the process of making the selection. Sample defines the selected group of people or elements. Population or target population is the entire set of individuals or elements who meet the sampling criteria. Definitions

Systematic sampling: every nth name from a roster of names can be taken as sample. K = N/n Where: K = sampling interval N = population n = sample size Probability Techniques

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Cluster sampling: sampling in groups

Probability Techniques Multi-stage sampling: used for extremely large populations. It proceeds through a set of stages from larger to smaller sampling units. Non-probability Techniques

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Sampling criteria list the characteristics essential for membership in the target population. Accessible population is the portion of the target population to which the researcher has reasonable access. Elements are the entities that make up the sample or the population Definitions

Purposive or judgmental: subjects are hand picked to be included in the sample, based upon the researcher’s knowledge of the population. Non-probability Techniques

Quota sampling: researchers identify strata of the population and then determine how many participants are needed from each stratum to meet a quota. Non-probability Techniques

Structured: the interviewer has a list of prepared questions in the form of an interview schedule Unstructured interview: more like a conversation. The interviewer uses an interview guide

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Accidental, convenience, incidental: utilizes readily available subjects Non-probability Techniques Snowball or network: subjects act as informants who identify others for inclusion in the sample who in turn leads to more samples Steps in Sampling General outline of procedures 1. Identify the target population 2. Identify the accessible population 3. Decide the sample size and how the sample will be taken. 4. Recruit subjects according to the designated plan. 5. Obtain the subject’s cooperation. N.B. The steps may vary from one sampling design to another Qualitative sampling

Interview Tools Observation • Observation: involves looking at the phenomenon • Used to study human behavior • Hawthorne effect: is the effect on the dependent variable caused by the subject’s awareness that they are participants in a study Types of Observation • Structured observation is one in which aspects of the phenomenon to be observed are decided in advance • Unstructured observation is a nonselective description of the phenomenon to be observed Types of Observation • Participant observation is done when the researcher is involved in the setting with the subject • Non-participant observation is when the researcher is merely viewing the situation Records • Records are prepared and preexisting data • Selective deposit and selective survival are the two major sources of bias. • Records available for use may not constitute the entire set of all possible data. Physiologic Measurement • Physiologic measurements are techniques used to measure physiologic variables either directly or indirectly. This is also called biophysiologic measures • Used in clinical nursing studies • The choice of the physiologic measure is dependent upon its ability to yield good information. Physiologic Measurement Criteria for effective question • Clarity of language • Specificity of content and time period • Singleness of purpose • Freedom from assumption • Freedom from suggestion • Linguistic completeness • Grammatical consistency Types of questions • Closed ended: respondents answer a number of alternative responses 1. Dichotomous: two response alternative 2. Multichotomous: multiple responses • Open ended: respondents are given enough flexibility to answer questions or specify answers other than those found in the questionnaire Characteristics of tools • Validity refers to the ability of a data gathering instrument to measure what it is supposed to measure and to obtain data relevant to what is being measured.

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Sample size is not predetermined in qualitative research Saturation: is the point in data gathering where no new data emerge therefore sampling is stopped. There is data repetition. Data Collection Ma. Irma C. Bustamante, RN, PhD Goal and Purpose • Goal – to collect data that are meaningful for the purpose of the study • Meaningful data depend on the quality of the instrument employed in the process • No amount of sophisticated statistics can salvage a poor set of data gathered through defective instruments. Questionnaire • Questionnaire: a paper and pencil instrument completed by the study subjects • Formats 1. Checklist 2. Multiple Choice 3. Rating Scales: list an ordered series of categories of a variable assumed to be based on an underlying continuum. A numerical value is assigned to each category. Questionnaire Formats • Checklist • Multiple Choice • Rating Scale and Ranking Type Interview • Interview involves verbal communication between the researcher and the subject

Interview structure is the amount of direction and restriction imposed by the interview situation

Interview Types

Reliability refers to the ability to obtain consistent results when reused.

2 = Dissatisfied 3 = A little satisfied

5 = Very Satisfied

Data Analysis and Interpretation Ma. Irma C. Bustamante, RN, PhD Data Analysis

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Data analysis is the systematic organization and synthesis of research data and, in most quantitative studies, the testing of the hypotheses using those data. Quantitative Analysis The manipulation of numerical data through statistical procedures for the purpose of describing phenomenon or assessing the magnitude and reliability of relationships among them. Quantitative Analysis

QUAN - Shape of distribution • Frequency distribution Frequency Table _________________________________ Score Frequency (f) Percentage 1 2 12.50% 2 4 25.00% 3 6 37.50% 4 3 18.75% 5 1 6.25% n = 16 100%

QUAN - Shape of distribution

Frequency polygon

QUAN - Shape of distribution

Purposes of statistics Summarize Organize Evaluate Numeric Interpret Information Communicate

A distribution is said to be symmetrical in shape if when folded over, the two halves of a frequency polygon would be superimposed. Shape: Symmetrical Distributions Shape: Symmetrical Distributions Shape: Asymmetrical Distributions Positively Skewed: Tail points to the right Shape: Asymmetrical Distributions

Quantitative Analysis

Factors to consider in choosing the appropriate statistical test 1. Purpose of the study 2. Research questions 3. Number and measure of variables 4. Sampling technique and sample size 5.Availability of statistical software 6. Ability of the researcher Quantitative Analysis

Example – Positively skewed distribution Personal income – most people have low to moderate income with very few at the tail end. The mean is larger than the median because there are so many low scores. Shape: Asymmetrical Distributions Negatively skewed: Tail points to the left Shape: Asymmetrical Distributions

Branches of statistics 1. Descriptive statistics used to describe and synthesize data obtained from empirical observations and measurements. 2. Inferential statistics: it is concerned with making decisions about a large body of data in the population of interest by using a sample of that universe. Quantitative Analysis

Example – Negatively skewed distribution Age at death – most people die when they are old, few die when they are young. The bulk of the people are at the upper end of the distribution. The median is larger than the mean because there are so many high scores. Shape: Kurtosis

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Kurtosis explains the degree of peakedness of the curve, which is related to the spread of variance of scores. Extreme kurtosis can affect the validity of statistical analysis because the scores have little variation Shape: Kurtosis QUAN – Central Tendency

A set of data can be summarized in terms of 3 characteristics 1. Shape of distribution 2. Central tendency 3. Variability QUAN - Shape of distribution

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Mode – that numerical value in a distribution that occurs most frequently Median – that point in a distribution above which and below which 50% of the subjects fall Mean – the point on the score scale that is equal to the sum of scores divided by the number of scores. It is also known as average. QUAN – Variability

Frequency distribution is a systematic arrangement of numerical values from the lowest to the highest, together with a count of the number of times each value was obtained. A frequency distribution can be obtained graphically by means of a frequency polygon QUAN - Shape of distribution Scores in a pilot survey on patient satisfaction 1 4 3 4 3 3 2 2 5 1 3 2 2 3 4 3 1 = Very dissatisfied 4 = Satisfied

Standard deviation (SD) captures the degree to which the scores deviate from one another. The SD tells us how much on the average the scores deviate from the mean. It also tells us the homogenecity or heterogenecity of the group.


score.

Range is the highest score minus the lowest

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State the rationale.

QUAN – Measurement levels

Include key previous researches to strengthen the reason for the investigation. Include the significance, scope and limitations, & definition of terms. Writing the literature review Include conflicting viewpoints of various authors. State how each literature relates to the topic under investigation. Put together references saying the same thing.

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Nominal – lowest level; name categories; assignment of numbers to simply classify characteristics into categories Ordinal – attributes are ordered or ranked according to some criterion Interval 0≠0 The distance between any 2 numbers on the

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Ratio – Highest scale are 0=0 of known and equal size Qualitative Analysis Qualitative analysis is the organization and interpretation of non-numerical data for the purpose of discovering important underlying dimensions and patterns of relationships Qualitative Analysis Data analysis components Qualitative Analysis

Learn to choose ONLY relevant literature. Writing the methodology Include the research design and the justification of why it was chosen. Present the population and the sampling design, setting, and sample size. Describe the tool used together with the validity and reliability testing. Discuss how the data was analyzed. Writing the results & discussion Present results in a logical order with the research question as guide. Use tables, figures, and other devises to maximize the lucidity of the presentation. Text should be followed by tables. Consistency in style should be followed in writing the discussion. RESULTS are data bound: DISCUSSION is data based

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Categories are underlying regularities, concepts, and clusters of concepts. Themes develop within categories of data. They emerge from the data. A theme is an abstract entity that brings meaning and identity to experiences and its variant manifestations. It captures and unifies the nature or basis of the experience into a meaningful whole. Qualitative Analysis Process

Comprehending – making sense of the data and learning “what is going on” and preparing a thorough description of the phenomenon. Qualitative Analysis Process

Synthesizing – involves sifting of the data and putting pieces together. Researchers get a sense of what is typical with regard to the phenomenon and what variation is like. Qualitative Analysis Process

Writing the summary

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Theorizing – involves a systematic sorting of the data. Researchers develop alternative explanations of the phenomenon and then hold these explanations up to determine their fit with the data. Qualitative Analysis Process

The summary puts together the highlights of the important findings of the investigation. Look back at the questions and tie them up with the main findings. Do not write everything in the findings in the summary. Writing the conclusions REMEMBER: the conclusion is an abstraction drawn from the summary of findings and is tied from the question investigated. Writing recommendations Recommendations should have a logical link with the data and the conclusions. Recommendations are geared towards: education, practice, future research, population or institution if applicable. Characteristics of scientific writing

Recontextualizing – involves the further development of the theory such that its applicability to other settings or groups is explored.

Writing the Research Report Ma. Irma C. Bustamante, RN, PhD Purpose in writing the report

To communicate in writing: the problem investigated, the methods used, the findings generated, the interpretation of results, the integration with the theory, what conclusions have been drawn at the end, and how the findings relate to past research. Writing the introduction and problem

Go directly into what the problem is investigating.

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Simplicity Conciseness Straight forwardness Consistency in the use of terms

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Continuity through transitional sentences Accuracy Parsimony

Communicating Research Ma. Irma C. Bustamante, RN, PhD Communicating research

Communicating research findings, the final step in the research process, involves developing a research report and disseminating it through presentations and publications to audiences of nurses, health care professionals, policy makers, and health consumers. Advantages

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Researchers are able to advance the knowledge of a discipline. Researchers receive personal recognition and professional advancement It promotes critique and replication It helps identify additional problems

Promotes the use of research findings in practice Avenues for communicating research Publication in journals including on-line journals Oral presentation in conferences Poster presentation in conferences Publication in conference proceedings Publication in other sources e.g. books, newspapers, magazines

REMEMBER Genius is the ability to reduce the complicated to the simple. C. W. Cheran

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