CHAPTER 1

INTRODUCTION TO NURSING RESEARCH

Perspective of Nursing Research

Nursing research has a tremendous influence on current and future professional nursing
practice, thus, rendering it an essential component of the educational process. It is growing field in
which individuals within the profession contribute a variety of skills and experiences to the science of
nursing care. As such, nurses are clinically responsible in the nursing profession and to the larger health
care system which requires them of an extraordinary range of skills and talent. They are expected to
deliver the highest possible quality of care in a compassionate manner. To accomplish these, nurses
must critically think to obtain an extensive clinical and incorporate it into their clinical decision-making.
Nurses of today must become lifelong learners, capable of reflecting on, evaluating, and modifying their
clinical practice based on knowledge, hence, they are expected to become producers of new knowledge
through Nursing Research.

What is Nursing Research?

Research is a careful and detailed study into a specific problem, concern, or issues using the
scientific method. The ultimate goal of research is to develop, refine and expand a body of knowledge.
Nurses are increasingly engaged in disciplined studies that benefit the profession and its patients and
that contribute to improvements in the entire health care system. Nursing research is systematic
inquiry designed to develop knowledge about issues of importance to the nursing profession,
including nursing practice, education, administration, and informatics (Polit and Beck, 2004)
As stated by the American Nurses Association (1983), Nursing research develops
knowledge about health and the promotion of health over the full lifespan, care of persons with health
problems and disabilities, and nursing actions to enhance the ability of individuals to respond effectively
to actual or potential health problems. This chapter emphasizes that Clinical nursing research is a
research designed to generate knowledge to guide nursing practice and to improve the health and
quality of life of nurses’ clients.

Importance of Nursing Research

Nurses increasingly are expected to adopt an evidence-based practice (EBP),

which is broadly defined as the use of the best clinical evidence in making patient care
decisions. It is a vital component of health care field. Nursing research helps implement
new changes in the lifelong care of individual and used to develop treatment that provide
the most optimum level of care Focuses on developing and promoting high level of
standards in the following areas: High quality management of patient during long term
illnesses.; Reduce numbers of diseases in the community; Promotes healthy lifestyle and
prevents the onset of preventable diseases and illness; Increase the quality of life in
patients with degenerative diseases, as well as easing the transition for those who are
facing the end of life; and, Developing standards that help reduce the numbers of disease in
the community which encompasses a holistic approach and views the treatment of the
patients, family members and caregivers as a whole. With nursing research, new changes
will continue to be implemented and developed into therapies and treatments that will
ultimately bring faster healing and better quality of life to patients who need them most.
Reasons for Conducting Research in Nursing

Nursing Research is essential for nurses to better understand the varied dimension of
the profession. Hence, research in nursing is vital with the following reasons:

1. Gathers data or information on nursing situations or condition about which

little knowledge is available. Information is important in designing appropriate
nursing interventions and as basis for qualifying the extent of nursing care in the
solution of problems.
2. Provides scientific knowledge base from which nursing theories emerge and
develop. Consequently, research findings lead to the development of nursing
theories which serves as bases and guide to nursing practice and future researches.
3. Helps correct, clarify, and validate perceptions and expands these.
Knowledge is never absolute and must be continuously tested and
validated through research. The value of knowledge may either increase or
diminish through research depending on the extent of its use by a professional
discipline.
4. Provides theoretical and scientific basis of the nursing practice. Theories
derived from research findings help improve and justify nursing practice, firms up the
credibility of the nursing profession; defines the accountability of nursing practice,
and documents the legal and moral implications and cost effectiveness of the nursing
care.
5. Defines the parameters of nursing and identifies its boundaries. Research
clarifies the scope and limitations of nursing practice. Research focuses on expanding
knowledge and use of the nursing process in clinical situations. This consists of
assessment, planning nursing action or intervention, evaluation and documentation
of care.
6. Documents the social relevance and efficacy of nursing practice to people
and health care providers. Research enables nurses to verify the strengths and
weaknesses of certain modalities of care and their implications in the process of
meeting the needs and problems of people.
7. Describes the characteristics of the nursing situation about which little is
known. More issues and concerns about nursing care arise as nursing technology
advances. These limit the ability of nurses to respond intelligently to nursing
situations unless factual knowledge through research supports the basis of such
situations;
8. Predicts probable outcomes of nursing decisions in relation to client care.
Research makes it easy for nurses to forecast the effects or consequences of nursing
actions and helps anticipate shortfalls.
9. Provides knowledge for purposes of problem solving and decision making.
Knowledge that relate economic, social, political, cultural and technological
phenomena may have serious implications to health care and nursing practice as it is
used in deciding better ways of solving health problems. Research clarifies and
validates these knowledge for accurate decisions and actions; e.g., drug addiction,
teenage pregnancy and population explosion.
10. Develops and evaluates nursing theories and concepts and practices these
for clarify and validity of nursing actions. Research helps knowledge grow and
develop, determines its significance in order to modify or develop new ones, and or
revise these knowledge based on current research findings.
11. Prevents undesirable clients reactions. Research predicts outcome and potential
problems of clients, hence it requires the balancing of phenomena that will generate
positive result and control undesirable outcome.
12. Develops a considerable degree of confidence. Professional undertakings are
intended to achieve desired client behaviors. Adequate knowledge sustains self-
 confidence of a nurse that makes work easier and lighter, unburdened with
uncertainties and doubtful consequences of actions intended to restore client’s
health.

History of Nursing Research

 Florence nightingale supported theoretical propositions through research, as statistical data and
prepared graphs were used to depict the impact of nursing care on the health of British soldiers.
 Afterwards, for almost century reports of nursing were rare
 Research and theory developed separately in nursing.
 Between 1928 and 1959 only 2 out of 152 studies reported a theoretical basis for the research
design.
 In 1970’s growing number of nurse theorist were seeking researchers to test their models in
research and clinical application.
 Grand nursing theories are still not widely used. In 1990’s borrowed theories were used more.
 Now the focus of research and theory have moved more towards middle range theories

Sources of Evidences for Nursing Practice

Nursing knowledge is drawn from a multifaceted base and includes evidences that come
from sciences – research and evaluation, experiences and personally derived understanding.
Clinical nursing practice relies on a collection of information sources that vary in dependability
and validity. Hence, the following are sources of evidences.
a. Tradition is the transmission of customs or beliefs from generation to generation, or the
fact of being passed on in this way. It facilitates communication by providing a common
foundation of acceptable truth. However, it also poses some problems because many traditions
have never been evaluated for their validity.
b. Authority. People with specialized expertise- in every filed. Making decisions about
matters by trusting the judgment of people who are authoritative on an issue by virtue
of specialized training experience.
c. Clinical Experience, Trial and Error and Intuition. Clinical experience represents a
familiar and functional source of knowledge, though it has limitation as type of evidence
such as restricted individual experiences. Related to clinical experience is a method of
trial and error, alternatives are tried successively until solution to a problem is found
(e.g. if a patient dislike the taste of potassium chloride solution, nurses disguise the
taste of the medication in various ways until one method meet the approval of
patients), Trial and error offers a practical means of securing knowledge but it is fallible,
it is haphazard and the knowledge obtain is often unrecorded, hence inaccessible is
subsequent clinical situation. Intuition is types of knowledge that cannot be explain on
the basis of reasoning or prior instructions. Although , intuition and hunches
undoubtedly play a role in nursing practice- as they do in the conduct of research- it is
difficult to develop policies and practices for nurses on the basis of intuition
d. Assembled Information.
Benchmarking (international, national and local) provides information on such issues as
the rates of using various procedures ( e.g rates of CS) or rates of infection (rates of
nosocomial pneumonia) and can serve as guide in evaluating practices. Cost Data –
information on the costs associated with certain procedures, policies or practices – are
sometimes used as a factor in clinical decision-making. Quality improvement and risk
 data – such as medication error reports and evidences on the incidence and prevalence
of skin breakdown, can be used to assess practices and determine the needs for practice
change.
e. Disciplined Research. Research conducted within a discipline format is the most
sophisticated method of acquiring evidence that humans have develops.
Paradigms for Nursing Research
Paradigm is a word view, a general perspective on the complexities of the real world.
Two Alternative Paradigms
1. The Positivist Paradigm- Known as “Positivism”

Assumptions and beliefs of the Positivist Paradigm:

 realist ontology - assumes that there are real world objects apart from the human
knower.  In other words, there is an objective reality.
 representational epistemology - assumes people can know this reality and use symbols
to accurately describe and explain this objective reality.
By positing a reality separate from our knowledge of it (separation of subject and object),
the positivist paradigm provides an objective reality against which researchers can compare
their claims and ascertain truth.

 Prediction and control - assumes that there are general patterns of cause and effect that
can be used as a basis for predicting and controlling natural phenomenon.  The goal is to
discover these patterns.
 Empirical verification - assumes that we can rely on our perceptions of the world to
provide us with accurate data.
 Research has been assumed to be value-free; if strict methodological protocol is
followed, research will be free of subjective bias and objectivity will be achieved.