Alexandria University

Faculty of
Nursing
Doctorate
Program
Nursing
Research
2016-2017

Research
Design

:Supervised by
Prof.Dr. Amani Ahmed Gamal El-dein

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:Prepared by
Mahmoud Mohamed Abd Elwahab
Outline
 Introduction

 Definition of research design

 Purpose of research design

 Characteristics of good research design

 Types of quantitative research design

 According to type of group comparisons dimension.

 According to time dimension

 According to amount of control dimension:

- Non-experimental research design

 Descriptive designs  Correlation designs

- Experimental research design

 True experimental designs

 Quasi experimental designs

 Pre experimental designs

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 Critique of a research design.

 References

 Introduction

The quality of any research project will be enhanced by a good

understanding of research design. Research design is the plan for
answering the research question or hypothesis. Different types of
questions or hypotheses demand different types of research designs, so it
is important to have a broad preparation and understanding of the
different types of research designs available.
Research designs are most often classified as either quantitative or
qualitative. Study designs are plans that tell a researcher how data are to
be collected, from whom data are to be collected, and how data will be
analyzed to answer specific research questions. The researcher chooses
the method based on the research question and the current level of
knowledge about the phenomena and the problem to be studied.

 Definition of research design

 It’s the overall plan for obtaining answer to the questions being
studied and for handling some of the difficulties encountered
during the research process.
 It is a map that tell the researcher how to solve problem or answer
question.

 Purpose of research design

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Research design provides a specific blueprint for conducting a study and
guides the researcher in planning and implementing the study to achieve
the intended goal.

The research design is the overall plan for obtaining answers to the
research questions, or testing the research hypotheses.

It tells the researcher what everything about the study:

 What to do  How to do it
 When to do it  Why doing it
 Where to do it  Who will do it

 Characteristics of good research design

 Should be appropriate with the research statement, research purposes
and research proposition.
 The population should be clearly defined.
 internal and external validity should be present:
 Internal validity: - the relationship between dependent and
independent variables.
 External validity: - degree of which the study results can be
generated.
 Controlling the environment which mean that extraneous variables
should be considered when designing a study.
 Freedom from bias. Variations are only due to random fluctuations
therefore differences can be attributed to independent variables at
work.
 Controlling measurement means the measures used in a study should
be reliable, consistently produce the same results.
 Controlling the intervention means that the intervention/ treatment is
administered to all subjects exactly the same way.

 Types of research designs

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 1-Qualitative research A systematic, subjective approach used to
describe life experiences and give them meaning.

2- Quantitative research A formal, objective, systematic process

used to describe and test relationships and examine cause-and-effect
interactions among variables.

 Quantitative research dimensions:

1- According to type of group comparisons dimension (between- the

subject and within – the subject)

2- According to Time dimension (Cross-sectional and longitudinal

designs)

3- According to amount of control dimension (Descriptive designs and

Correlational designs)

1) According to type of group comparison dimension

Most quantitative studies involve making comparison between

separate groups of people or within the same subjects.

1-Between - the subjects: (comparative)

 Subjects in groups being compared are different people.
 Involve making comparison of one variable or more between two
groups or more (comparative quantitative research).
For example
 Comparison of self-esteem between adolescents with insulin
dependent diabetes mellitus and healthy adolescents
 Smoking among Alexandria and Cairo student. (Comparative
descriptive R.D)

2- Within – the subjects:

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  Subjects in groups being compared are the same people at different
time or in different conditions.

For example:
 Quality of life among post natal in Alexandria.

2) According to Time dimension (Cross-sectional and

longitudinal designs)
Are conducted when the researcher want to examine the way variable
change over time. Studies are often categorized in term of how they deal
with time. There are two types of designs:

 Cross-sectional designs.
 Longitudinal designs.

Cross-sectional designs
- It involves the collection of data at one point in time: the phenomena
under study are captured during one period of data collection.
- Cross-sectional studies are appropriate for describing a phenomena or
for describing relationships among phenomena (at a fixed point in
time).
 For example, studying grief reactions at various periods after death
of a spouse.
Group whose spouse had died 1 week ago 50
Group whose spouse had died 6 months ago 50
Group whose spouse had died 1 year ago 50
 Another example, Anxiety level during four academic years
1st 50
2nd 50
rd
3 50
th
4 50
 Another example, Anxiety level during pregnancy
1st trimester 50
nd
2 trimester 50
3rd trimester 50

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 Advantage of cross-sectional designs:
 Easy to manage.
 Practical less time consuming.
 Relatively economical.
Disadvantages
 Not the same persons, each person has unique personality
characters.
Longitudinal design:
A study in which data are collected at more than one point in time over
an extended period.
There are several types of longitudinal designs:-
 Panel studies
 Trend studies
 Cohort or follow-up studies.

 Panel studies involve the repeated measurement among the same

subject at specified time intervals (one group more than one time).

 For example: Study changes in professionalism as nursing student's

progress through a 4-year baccalaureate program
1st 2014 / 2nd 2015 / 3rd 2016 / 4th 2017

 Trend studies:
 Researcher select different sample from the same population at
specified time intervals.
 It is longitudinal in nature of phenomena over time.
 Data collected each short period from different group with
description of phenomena without relationship.

 For example: study of quality of psychiatric patients' record through

five years in El-Maamoura hospital.
 Another example: Study about smoking in the Egypt over 5 years
period, using data from 2000, 2002,2003, 2004 and 2005 . They found
high rate of smoking had fallen between 2002and 2004.

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 Cohort studies (prospective) or follow-up are undertaken to
determine subsequent status of the subjects with a specified condition
or those who received a specified intervention. This type study the
nature of phenomena in the future.

 For example: premature infants may be followed up to assess their

later perceptual and motor development (prospective studies).
 Another example: smoking during pregnancy and low birth weight.
(Select smoking and non-smoking pregnant and follow up.)
 Another example: the relationship between fetal sonography and
newborn’s birth weight and apgar score.

Advantages of longitudinal research design:

 Allows the researcher to measure the pattern of change.
 Obtain factual information, requiring collection on a regular or
continuing basis, thus enhancing its accuracy.
Disadvantages
 Expensive, time consuming, and subject to the risk of attrition (loss
of participants over time).

3) According to amount of control dimension

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Non experimental research design

These designs do not involve manipulation of independent variable,

control and randomization. There is no control over independent variable.
Here, a phenomenon or study variable is observed, measured and
described as it exists.

Reasons for undertaking non experimental research

 Vast numbers of human characteristics are inherently not
subjects to experimental manipulation (e.g., blood type, personality,
health beliefs) the effects of these characteristics on other phenomena
cannot be studied experimentally.
 There are many variables that could be technically manipulated but
could not be manipulated ethically. If manipulating the independent
variable could cause physical or mental harm to the subjects.
 There are many research situations where it is simply not practical
to conduct a true experiment. Constraints might involve insufficient time,
inconvenience to sample or staff, lack of administrative approval.
 There are many research questions for which an experimental
design is not appropriate, prevalence, intensity or full nature of
phenomena.
 When the purpose of the study is not proving causality, but rather
to describe phenomena and explore, explain the relationship between
variable.

Types of non-experimental design

Descriptive designs Correlational designs

- Simple descriptive design(pure) - Correlational descriptive design

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 - Comparative descriptive design - Retrospective design (ex post facto)
- Univariate descriptive design - Prospective design(cohort study)
- Path analysis design

Descriptive designs (exploratory) :

The researcher observes, describes, and documents various aspects of a
phenomenon. There is no manipulation of variables or search for cause and
effect related to the phenomenon. Descriptive designs just describe what
actually exists, determine the frequency with which it occurs, and categorizes
the information.

1.Typical descriptive study design (simple pure descriptive):-

The most commonly used design of descriptive studies. It involves describing
and documenting the phenomena as it currently exist to provide a complete
description as possible.
 Example: - Study of pain sensation experienced during removal of tubes
in acute postoperative patients.

2. Comparative descriptive design

It is designed to do a comparison between two variables or one between
two or more groups. Information is obtained from each group, using
statistical analysis to identify the difference that exists between the
groups.
 Example: - Comparative study was done to determine differences in
teaching strategies between two groups of student.
 Physical and physiological stressors among male and female care
giver at home care.

3.Univariate descriptive design

It describes more than one variable but alone without relation as
incidence, prevalence. There are multiple variable in the study, but the
primary purpose is to describe the status of each on and not to relate them
to one another.

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  For example: women’s experience during menopause.
The study describe the frequency of various symptoms, the average
age at menopause, the percentage of women seeking formal health
care and the percentage of women using medication to alleviate the
symptoms. Here, each variable is described independently without
correlating to any other variable.

 Another example: Smoking among students of nursing faculty.

Types of univariate descriptive study from the field of epidemiology

Prevalence studies: are done to determine the prevalence rate of some
conditions a (e.g., disease or condition such as smoking) at particular
point in time. The researcher takes snapshot of the population at risk
to determine the extent to which condition of interest is present.

 Incidence studies: are used to measure the frequency of developing

new cases. The researcher must first establish who is at risk of
becoming a new case.

 Correlational designs
These designs are conducted to:
 Study relationships among two variables.
 Examine the strength of relationship between variables by
determining how changes in one variable are associated with
changes in another variable.
 Design to explore causal relationships sometimes is described as
retrospective or prospective. ( Correlation does not prove
causation)

Types of correlational designs

1. Descriptive correlational design
The relationship between two variables or more at the same time.
 For example: For example: the relationship between burnout and
social support in family caregivers. the independent variable would be

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 burnout they experienced and the dependent variable would be the
social support.
 Another example: The relationship between cognitive impairments
and the quality of life of patients with schizophrenia, the independent
variable would be cognitive impairments and the dependent variable
would be the quality of life.

2. Retrospective design (ex post facto)

The literal translation from Latin term ex post facto is (from after the
fact) this means that the study has been conducted after the variations in
independent variable have occurred. The researcher starts with an effect
and looks back to determine what in past is associated with this effect to
determine the presumed cause.

 For example, in a retrospective lung cancer research, the researcher

begins with sample of those have lung cancer and a sample of those
who do not. The researcher then looks for difference between groups
in antecedent behavior or conditions such as smoking.
Advantages
1. Utilize existing data and therefore may be faster and less
expensive.
2. Case control provides an evidence for relationships among
variables.
Disadvantage
 Subjects may have recall bias in which they are more aware of
their personal histories and over reporting events or may have
difficulty in recalling an event.(not accurate)

3. Prospective Non-experimental Designs

The researcher selects a population and follows it over time to determine
outcomes. It starts with a presumed cause and then goes forward in time
to the presumed effect.

 For example, we might want to test the hypothesis that the incidence
of rubella during pregnancy (the independent variable) is related to

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 infant abnormalities (the dependent variable). To test this hypothesis
prospectively:
1. We would begin with a sample of pregnant women, including some
who contracted rubella during their pregnancy and others who did
not.
2. The subsequent occurrence of congenital anomalies would be
assessed for all subjects
3. We would examine whether women with rubella were more likely
than other women to bear malformed infants.

Advantages
1. Can provide convincing evidence of the nature of the relationship
between variable.
2. Its result provides essential preliminary research to generate
hypotheses that can be tested.
3. It is easier to determine sequencing of events over time, which
makes it usual in determining temporal antecedents.
Disadvantages:
1. Time consuming and expensive
2. Still cannot be used to infer causality.

4.Path Analytic Studies

It is complicated research design that uses statistical analysis to test
hypothesized causal relationships.

 The hypothesis to be tested is often theory or model that has been

developed. The model can be tested to determine if it is supported by
data.
 The structural model here that is developed can be used to determine the
impact that one variable has on other variable and allows the researcher
to determine both main effect and interaction effect.
o Main effects are the effects of one variable on other variable.
o Interaction effects are effects of the interaction of two or more
variables on other variables.

Advantages
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 1. Test theories and conceptual framework.
2. Provide strong evidence for causality than types of ex post facto
research.

Disadvantages
1) Weaker than experimental and quasi experimental.
2) Still cannot be used to infer causality.

 Example
The researcher used path analysis to test a model to predict self-care in
adult waiting renal transplantation. His analysis tested hypothesized
causal pathways between personality traits, health status, self-care
abilities and self-care behavior.

Experimental research design

These are considered to be classical form of research and experiment has
the potential to provide most evidence for the strength of association
between variable. Experiments are concerned with testing hypothesis and
establishing causality.

The researcher manipulates independent variables (e.g., type of

treatment, teaching method, communication strategy) and measures
dependent variables (anxiety level, marital satisfaction) in order to
establish cause-and-effect relationships between them.

Experimental research design may be:

I. True-experimental It is classified into:

1- Pretest posttest control group design 2-Post-test only control group design
3- Solomon four group design 4- Factorial design
Crossover design 6- Clinical trial -5
II. Quasi-experimental It is classified into:
1-Nonequivalent control group design 2- Time-series design
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 III. Pre-Experimental Research Design

1- One shot case study 2- One group pretest post test design

1) True experimental design

True experimental designs examine the cause and effect relationships

between independent (predictor) and dependent (outcome) variables
under highly controlled conditions. The controlled experiment is
considered by many to be an ideal-the gold slandered for yielding reliable
evidence about causes and effect, to understand relationship between
variables. For example: Does certain drug result in cure of a
disease?

The strength of true experiments lies in the fact that experimenter can
achieve greater confidence in the genuineness of causal relationships
because they are observed under control condition.

Characteristics of true experimental designs:

Is characterized by the following properties:

1- Manipulation

The introduction of that something (i.e. treatment or

intervention) constitutes the independent variable. The
experimenter manipulates the independent variable by
administering a treatment to some subjects and withholding it
from others or by administering some other treatment.) The
experimenter thus consciously varies the independent variable
and observes the effect on the dependent variable.

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For example Effect of tactile stimulation on postoperative pain
among neonates after abdominal surgery. We hypothesized that"
tactile stimulation is effective as pain relief measure for neonates after
abdominal surgery ". The independent variable is tactile stimulation
which could be manipulated by cuddling with certain technique and with
holding it from others. We would then compare the patient's pain level
(dependent variable) in two groups to see difference in average pain level.

2-Control
The term control refers to group of subjects whose performance on
dependent variable is used to evaluate the performance of experimental
group or treatment group on the same dependent variable.

For example Effect of evidence- based guidelines of breast feeding on

growth parameters of low birth weight neonates in neonatal intensive care
unite

Nurse researcher might implement new evidence- based guidelines of

breast feeding with a group of low birth weight neonates and use the
routine feeding methods with another group (control group). Growth
parameters of both groups of low birth weight neonates is the dependent
variable that was observed. Control group usually indicate group in an
experimental study that does not receive treatment. In nursing research
the withholding of a treatment may be unethical. To overcome this
problem the control group should receive the normal or routine
interventions.

3-Randomization
Involve placing subjects in groups at random. Every subject has an equal
chance of being assigned to any group.

Types of true experimental designs

A. Pretest-Posttest Control Group Design.

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In the pretest-posttest control group design, or classic experiment,
subjects are randomly assigned (R) to either a control or experimental
group. Both groups are pretested (O). The experimental group is exposed
to a treatment (X) or different treatments (X1, X2), and then both groups
are posttested (O).

For example if we test the effectiveness of diabetic teaching film on

diabetic client's knowledge. The groups are pretested on their knowledge
of diabetes. Then experimental group watch the diabetic teaching film
while control group asked to read printed material about diabetic
teaching. Finally both groups are posttested on their knowledge and
difference between the posttest score of two groups is compared.

B. Posttest Only Control Group Design.

In posttest only control group design, subjects are randomly assigned

(R) to either a control or an experimental group. The groups are not
pretested. One group is exposed to a treatment (X) or series of
different treatments (X1, X2), and then both groups are posttested (O).

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  The posttest only design should be used when it is not possible to
administer a pretest or when it would not make sense to
administer a pretest.
 For example Effect of designed breast feeding education
program on breast feeding practice among mothers` of premature
infants.

C. Solomon four group design

 Solomon four-group design involves two experimental groups and
two control groups.
 One experimental group and one control group are administered
the pretest and the other groups are not, thereby allowing the
effects of the pretest measure and intervention to be segregated.
Posttest is given to all four groups.
 This design is considered to be the most prestigious experimental
design because it minimizes threats to internal and external
validity.
 It does not only control for the threats to internal validity but also
controls for reactive effects of the pretest.
 Where any difference between the experimental and control
group can be more confidently associated with intervention
(independent variable).
 Used when assess knowledge, believe, perception, attitude.
 Example:- the effect of educational guidelines on student
knowledge

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 D. Factorial design

Here the researcher wants to study the effect of one or more

independent variables on dependent variable. Factorial design is
particularly useful when there are multiple independent variable, which
are called factors to be tested.

 Typical factorial design incorporates a 2 by 2 factorial or 2 by 3

factorial designs. The first number refer to the independent variable
and second number to the level of treatment or length of treatment .

Factorial Designs: Minimum of two independent variables (called

factors) with at least two levels of each independent variable.
For example: Using a 2 by2 factorial design to study the effect of tactile
and auditory stimulation on neonate’s development.
Type of Simulation
Time
Auditory (A1) Tactile (A2)
B1 (15 min) A1B1 A2B1
B2 (30 min) A1B2 A2B2
B3 (45 min) A1B3 A2B3

Factorial design permits the analysis of both main effects and interaction
effect.
Main effect is the effect of one variable alone that is the effect of
individual or group therapy.
Interaction effect combination of variables and helps to determine if a
combination of group and individual therapy is more effective than either
treatment alone.

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 Example, using a 2-2 factorial design to study treatments to reduce
diarrhea among critically ill tube-fed patients receiving antibiotics.
One factor was fiber-containing versus fiber-free tube feeding. The
second was administration of pectin versus a placebo. The researcher
found a trend toward fewer diarrheas in the fiber/pectin group.

E. Crossover design or Repeated measures design

In the cross-over, or counterbalanced, switchover, or rotation design,
subjects are given two treatments, one being the experimental treatment
(XE), the other a control or reference treatment (XC). The subjects are
randomly assigned to one of two groups. One group receives the
experimental treatment first and the other group receives the experimental
group second. After a period of time, sufficient to allow for any treatment
effect to wash out (W), the treatments are crossed over. Multiple cross-
over designs involve several treatments. It ensures the highest possible
equivalence among subject exposed to different conditions.

For example

To study the effect of two alternatives back rest positions (flat /horizontal
versus 30 degree elevation on intracranial and cerebral perfusion
pressures in brain injured adult the elevated position resulted in
significant and clinically important improvement.

F-Clinical trial design (Randomized clinical trial)

The subjects are assigned randomly to experimental and control

groups or treatments, the design is known as a randomized controlled
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 trial. Random assignment minimizes the chance that either group is not
typical of the population. If the subjects are blind (or masked) to the
identity of the treatment, the design is a single-blind controlled trial. The
control or reference treatment in such a study is called a placebo: the
researcher use for inactive pills or treatments that are given to patients in
the guise of effective treatments. Blinding of subjects eliminates the
placebo effect, whereby people react differently to a treatment if they
think it is in some way special.

In a double-blind study, the experimenter also does not know

which treatment the subjects receive until all measurements are taken.
Blinding of the experimenter is important to stop him or her treating
subjects in one group differently from those in another. In the best studies
even the data are analyzed blind, to prevent conscious or unconscious
fudging or prejudiced interpretation.

For example: The effect of heparin versus normal saline for maintaining
potency in intravenous lock during pregnancy women were randomly
assigned to the two treatment groups. The hospital pharmacy prepared
batches of the two treatment solutions and only pharmacy staff (not
patient nor any nurse) had access to the list of group assignment.

2) Quasi-Experimental Research Design

  The
word "quasi" means as if or almost, so a quasi-experiment means
almost a true experiment.

It is similar to experimental research because there is manipulation of

independent variable. It differs from experimental research because either
there is no control group or random assignment is used to assign
subjects.

Types Quasi experimental designs

Nonequivalent Control Group Designs
The most frequently used quasi-experimental design is the nonequivalent
control group pretest—posttest design, which involves an experimental

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 treatment and two groups of subjects observed before and after its
implementation. (No randomization but present control and study
group).
O1 X O2 experimental
O1 O2 comparison
X= Treatment or intervention
O = Observation or measurement

Time Series Designs

The researcher here observes or measures the subjects periodically. One
group contains manipulation but not contain randomization. The
experimental treatment is administered between two of observation.

Researcher might asses the pain level of patient with low back pain. After
3 weeks of pain assessment (O1, O2, O3) subjects could be taught a special
exercise to alleviate pain. During next 3 weeks pain level again be
measured (O4, O5, O6). The result would help the researcher to determine
if low back pain persists, if exercise is effective.

3) Pre experimental design

Its name is applied by Campbell and Stanley (19963) to
experimental deigns that are considered very weak and in which the
researcher has little control over the research.

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 Pre-experimental research is needed because there are many
independent variables that we cannot manipulate, either ethically, or
practically.
 Example: Randomly sample and randomly assign 500 infants to
experimental and comparison groups.
 The experimental group must smoke cigarettes; the comparison
group does not.

 Pre-experimental research lacks the manipulation of an independent

variable by the researcher.
 The researcher investigates conditions that naturally occur or that
have already occurred.
 The researcher studies how variables are related.
 These designs cannot be used as the basis for cause and effect
relationships.

Types of pre experimental design:-

 One-shot case study design

 One-group pretest-posttest design
 Static-group comparison

One-shot case study design

A single group is studied at a single point in time after some treatment

that is presumed to have caused change. The carefully studied single
instance is compared to general expectations of what the case would have
looked like had the treatment not occurred and to other events casually
observed. No control or comparison group is employed.

One-group pretest-posttest design

A single case is observed at two time points, one before the treatment and
one after the treatment. Changes in the outcome of interest are presumed
to be the result of the intervention or treatment. No control or comparison
group is employed.

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Static-group comparison

A group that has experienced some treatment is compared with one that
has not. Observed differences between the two groups are assumed to be
a result of the treatment.

 Types of pre experimental design

 Difference between True experimental, Quasi experimental, and

Pre-experimental designs

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  Critique of research design:-
A research critique is an analysis of a research undertaking that
focuses on its strengths and limitations. Critiquing is a systematic process for
evaluating research studies and the results reported.

How to critique research design??

In critiquing the research design, a number of questions need to be asked.
However, these questions are seeking more than a simple 'yes' or 'no'
answer. The questions are posed to stimulate the reviewer to consider the
implications of what the researcher has done.
1. Is the research design clearly addressed? Identify the specific design
of the study. Is the design employed appropriate?
2. Does the research question imply a question about the causal
relationship between the independent and dependent variables?
3. What would be strongest design for the research question? How does
this compare to the design actually used? Was the most rigorous
possible design used, given the purpose of the research?
4. Does the researcher use the various concepts of control that are
consistent with the type of design chosen?

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5. What elements are controlled? What elements could have been
controlled to improve the design?
6. What was the feasibility of controlling particular elements of the
study? What was the effect of not controlling these elements on the
validity of the study findings?
7. Were appropriate comparisons made to enhance interpretability of
findings?
8. What elements of the design were manipulated and how were they
manipulated?
9. Does the design used seem to flow from the proposed research
problem, theoretical framework, literature review and the hypothesis?
10.What are the threats to internal and external validity?
11.What are the controls for the threats of internal and external validity?
12.Does the study include a treatment or intervention? If so is the
treatment is clearly defined conceptually and operationally? Clearly
described and consistently implemented?
13.Does the study report, who implemented the treatment? If more than
one person were they trained to ensure consistency in the delivery of
the treatment? Was any control or comparison group intervention
described?
14.If experimental (or quasi) study, what specific experimental (or quasi)
design was used? Were randomization procedures adequately
explained?
15.If the study was non experimental, was the study inherently non
experimental? What was the design used?
16.If the study has more than one group, how were the subjects assigned
to groups?
17.What types of comparisons are specified in the design (before-after,
between groups)?
18.Was the study longitudinal? Was the timing of the collection of data
appropriate? Was he number of data collection points reasonable?
19.Is the design logically linked to the sampling method and statistical
analyses?
20.Does the design provide a mean to examine all of the objectives,
questions or hypothesis and the study purpose?

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 References
1. Macnee C. Mccabe S. Understanding nursing research using research
in evidence based practice.2nd ed. Philadelphia: lippincotte com, 2008.

2. Experimental research design Available at:

www.napce.org/documents/research-design.../13_experiment_4th.pdf

3. Pre- and True Experimental Research Designs Available at:

www.trop.troy.edu/drsmall/Class
%20Stuff/.../Final.../Salkind_Chapter_11.pdf.

4. Polit D, Beck C. Essential of Nursing Research: Methods, Appraisal,

and Utilization. 6th edPhiladelphia: Lippincott Williams & Wilkins.
2006;177-208

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