Chapter 1

Foundations of Nursing Research
Seventh Edition
Chapter 1
Development of Nursing
Research
Copyright © 2018, 2013, 2008 Pearson Education, Inc. All Rights Reserved
Learning Objectives
1.1 Identify the importance of research to nursing.

1.2 Describe four goals for conducting nursing research.
1.3 Compare qualitative and quantitative research.
1.4 Describe the various roles of nurses in research.
1.5 Summarize the development of nursing research and
future priorities.
Learning Objective 1.1
Identify the importance of research to nursing
Importance of Research to Nursing (1 of 2)
• Many people are unaware nurses conduct research.

• Nurses must seek opportunities to discuss research and
make results available to the general public.
• Research and evidence-based knowledge from nursing
and sciences were identified as basis for practice.
• Nurses must take the lead to communicate results and
encourage use of research findings in practice settings.
Importance of Research to Nursing (2 of 2)
• Research knowledge will help you become an excellent

nurse.
• If an intervention is not based on research evidence,
there is no way to determine that the intervention is the
optimum one.
Definitions of Nursing Research (1 of 2)
• The systematic, objective process of analyzing

phenomena of importance to nursing
• Nursing research includes all studies concerning:
– Nursing practice.
– Nursing education.
– Nursing administration.
– Nurses themselves.
Definitions of Nursing Research (2 of 2)
• Clinical nursing research

– Nursing research that involves clients
– Studies that have the potential to affect the care of
clients
▪ Studies with patients or with so-called normal
participants
– Scientific method is only one source of nursing
knowledge.
▪ Generally considered to be the most reliable
Sources of Nursing Knowledge
• Tradition
– The handing down of knowledge from one generation
to another
• Experts, authorities
– Past: nurses looked to physicians
– Today: nurses have a unique body of nursing
knowledge
• Trial and error
– Means of discovering knowledge
– Reasons for success or failure not determined
Scientific Research (1 of 4)
• handing down of knowledge from one generation to

another
• Similarities with problem-solving approach

– Identify problem areas
– Establish plans of action
– Collect data and information
– Evaluate data results
• Varied Purposes
– Problem-solving approach
▪ Specific in scope
▪ Seeks a solution to a problem in specific setting
▪ Uses knowledge for people in specific setting
– Broader in scope
– Obtains data for generalization
– Applies knowledge to other people and settings
Purposes of Nursing Research (1 of 3)
• Basic
– Concerned with generating new knowledge
• Applied
– Concerned with using knowledge to solve immediate
problems
• Basic research
– Generates new knowledge
– Knowledge for knowledge’s sake
– Develops, tests, and refines theories
– Often uses laboratory animals as subjects
– Immediate application of results is rare
• Applied research
– Uses new knowledge to near future
– Majority of nursing research
Applied Research
• Difficulty distinguishing two purposes

– Findings of basic research are sometimes applied
quickly.
– Applied research findings actually lead to basic
studies.
– Difference related more to funding than purpose.
Funding of Nursing Research (1 of 2)
• Federal government provides the most money for

research in this country
– National Institute for Nursing Research
▪ $140.9 million in 2015
Funding of Nursing Research (2 of 2)
• Other sources
– Private foundations
– Corporations
– Professional organizations
▪ Sigma Theta Tau International
– American Nurses Foundation
Describe four goals for conducting nursing research
Goals for Conducting Nursing Research
• Promote evidence-based nursing practice

• Ensure credibility of the nursing profession
• Provide accountability for nursing practice
• Document cost effectiveness of nursing care
Promote Evidence-Based Nursing Practice
(1 of 2)
• Major reason is to foster optimum care for clients.

• Evidence-based nursing practice (EBNP)
– Clinical decisions based on:
▪ Best research evidence.
▪ Nurses’ clinical expertise.
▪ Health care preferences of clients.
– Aim is to provide best possible care based on the best
available research.
Promote Evidence-Based Nursing Practice
(2 of 2)
• Nursing profession exists to provide a service to society.

– Should be based on accurate knowledge
• Research determined to be the most reliable means of
obtaining knowledge.
Ensure Credibility of Nursing Profession
• Nursing considered a vocation rather than a profession

• Establishing own body of knowledge distinct from other
disciplines
• Research helps determine what makes nursing
profession unique.
• Ranked highest on honesty and ethical standards
Provide Accountability for Nursing
Practice
• Increased independence brings a need for more

accountability
• Nurses must have a sound rationale for their actions.
• Nurses have responsibility of keeping knowledge base
current.
Document the Cost Effectiveness of
Nursing Care (1 of 2)
• It has been difficult for nurses to consider the cost-

effectiveness of nursing care.
• Goal to help people achieve or maintain health,
regardless of cost.
• Reality has forced nurses to think in monetary terms.
Document the Cost Effectiveness of
Nursing Care (2 of 2)
• Nursing services can consume a large percentage of a

hospital’s budget.
– Nursing care services are being closely examined.
• To determine that nursing care is effective, research is
needed.
• Nurses need to appreciate how economic market forces
impact nursing.
Compare qualitative and quantitative research
Quantitative and Qualitative Research (1 of 2)
• Nurse researchers conduct both quantitative and qualitative
studies.
• Quantitative research
– Objectivity
– Tight controls
– Generalization of findings
– Typically designed to collect numerical data
• Qualitative research
– Concerned with the subjective meaning of experiences to
individuals
– Natural setting with a small number of research participants
Quantitative and Qualitative Research (2 of 2)
• In the past, nurse researchers have primarily conducted

quantitative research.
• Number of nurse researchers who conduct qualitative
research has increased.
• This book focuses more on quantitative research than on
qualitative research.
Describe the various roles of nurses in research
Nurses and Research (1 of 4)
• Nurses at the baccalaureate level should be able to:

– Understand and apply research findings from nursing
in their clinical practice.
– Work with others to identify potential research
problems.
– Collaborate on research teams.
• Masters-prepared nurses should be able to:

– Evaluate research findings and develop and
implement evidence-based practice guidelines.
– Identify practice and systems problems that require
research.
– Collaborate with scientists to initiate research.
• Graduates of practice-focused doctoral programs should:

– Be prepared for highest level of nursing practice
expertise.
– Use advanced leadership knowledge and skills to
evaluate and translate research into practice.
– Be prepared to collaborate with scientists on new
health policy research opportunities.
• Graduates of research-focused doctoral programs

should:
– Be prepared to conduct independent research.
– Expect to plan and implement an independent
program of research.
– Begin to involve others in their research interest area.
Roles of Nurses in Research (1 of 8)
• Nurses can assume many roles with research projects

1. Principal investigator
2. Member of research team
3. Identifier of researchable problems
4. Evaluator of research findings
5. User of research findings
6. Patient/client advocate during studies
7. Subject/participant in studies
• Principal investigator
– Special research preparation is necessary.
– Beginning nurse researcher
▪ Small-scale surveys
– Independent researcher
▪ Preparation beyond baccalaureate, or even
master’s, is necessary.
• Member of research team

– Data collectors
– Administer experimental interventions
– Interest and enthusiasm to conduct their own
investigations may grow.
• Identifier of researchable problems

– All levels of nursing preparation share this
responsibility.
– Ideal situation for bedside nurses
• Evaluator of research findings

– Nurses have the obligation to:
▪ Become familiar with research findings.
▪ Determine the usefulness of these findings.
– Beginning researchers should critique research
articles.
• User of research findings
– Research findings have no value if they are not put into
use.
– Nurses must be judicious in their use of research findings.
– Research utilization
▪ Focuses on implementation of findings from specific
research studies.
– Evidence-based nursing practice (EBNP)
▪ Broader
▪ Involves searching for the best evidence to use in
nursing practice
• Patient/client advocate during studies

– All nurses have responsibility to act as advocates
when patients/clients are involved in research.
▪ Ethical aspects of research must be upheld.
– Answer questions
– Explain studies to participants
– Nurses should serve as resources for information
about clinical trials.
• Subject/participant in studies
– Nurses act in both roles.
– Nurses’ Health Study I and II
▪ Harvard Medical School (begun 1976)
▪ Health risks that pose special threats to women
History of Nursing Research (1 of 13)
• Early nursing education

– Florence Nightingale (FN)
▪ Derived foundation for modern nursing education
from military tradition
▪ Tradition and authority
▪ British influence
• Paradigm shift in nursing education

– Research developed with education levels of nurse
preparation.
– University school started in 1909.
– Leaders were more concerned with establishing
nursing schools than with university programs.
• The start of research studies

– Nurses weren’t prepared
– The Goldmark Report (1923)
– Other disciplines conducted early studies
▪ Sociology
▪ Psychology
▪ Education
▪ Did not necessarily expand nursing’s body of
knowledge
• Changes in research studies

– 1927-Interest starts in nursing procedures.
▪ Marvin, American Journal of Nursing
– 1950s-Interest rises in nursing care studies
– 1970s-Practice-related research expanded
• Continuum of studies
– 1850s
▪ Florence Nightingale
– Called for research focused on nursing practice
– 1900 to 1920
▪ Lavinia Dock
– Reported a school nurse experiment
▪ Adelaide Nutting
– Conducted a survey on the educational status
of nursing
▪ First university school established
– University of Minnesota
– 1920s
▪ Goldmark Report
– Funded by the Rockefeller Foundation
– Instrumental in establishment of early collegiate
nursing schools
▪ First doctoral program
– Teachers college
▪ First doctoral degree for a nurse
– Edith S. Bryan, Johns Hopkins
▪ Study on activities of nurses
– Ethel Johns and Blanche Pfefferkorn
– 1931 to 1950
▪ Thermometer-disinfecting techniques investigated.
▪ Sigma Theta Tau funds research.
– National Honor Society for Nursing
▪ Brown Report
– Nursing for the Future
▪ Division of Nursing Resources organized.
– 1950s
▪ Nursing Research journal published.
▪ Institute of Research and Service in Nursing
Education founded.
▪ American Nurses Foundation established.
▪ Nursing practice established at Walter Reed Army
Institute of Research.
– 1960s
▪ Nursing Research Grants and Fellowship
Programs begun.
▪ Lydia Hall publishes study of chronically ill.
– 1970s
▪ National Commission for the Study of Nursing and
Nursing Education published An Abstract for
Action.
▪ ANA established a Department of Nursing Research.
▪ Commission on Nursing Research recommends
research preparation in included in education
programs.
▪ First issues of Research in Nursing and Health and
Western Journal of Nursing Research published.
– 1980s
▪ ANA Commission on Research identifies priorities
▪ Conduct and Utilization of Research in Nursing (C
URN)
▪ Center for Nursing Research was established.
▪ National Center for Nursing Research (NCNR) was
established
▪ CORP#1
▪ First issues of Applied Nursing Research and
Nursing Science Quarterly published.
– 1990s
▪ First issue of Clinical Nursing Research published.
▪ National Institute of Nursing Research (NINR) was
established.
▪ First issues of Qualitative Nursing Research and
Biological Research for Nursing published.
National Institute for Nursing Research (1 of
2)
• Replaced the National Center for Nursing Research (NC

NR)
• Established in 1993
• Part of NIH
– One of 27 institutes
• Boosted nursing research respectability
• Increased funding
National Institute for Nursing Research (2 of
2)
• Goals
– Clinical and basic research
– Research training
– Promote health, prevent disease and disability
– Managing symptoms
– Improving palliative and end-of-life care
The Cochrane Collaboration and the
Cochrane Nursing Care Field (1 of 4)
• Established in 1993
• International nonprofit organization
• Well-informed health care decisions
• Organization of the Collaboration

– More than 25,000 contributors
– More than 120 countries
• Reviews are accessible online through Cochrane Library
portal
– Considered to be the most comprehensive, reliable,
and relevant sources
• The Cochrane Nursing Care Field (CNCF)

– Established in 2009
– Objectives
▪ Identify priority topics
▪ Search for studies related to nursing care
▪ Promote the field’s perspectives
▪ Raise awareness of CC among practitioners of
nursing
▪ Disseminate summaries of nursing-care relevant
Cochrane Reviews
– Nursing research resources

▪ Cochrane Review Summaries
▪ Nursing care-related podcasts
▪ Online and face-to-face involvement
Summarize the development of nursing research and

future priorities
Research Priorities into the Future
• ANA Commission on Nursing Research identified

priorities (1980).
– Research concerned with health promotion and
preventive health practices for all age groups
– Healthcare needs of high-risk groups
– Life satisfaction of individuals and families
– Development of cost-effective healthcare systems.
National Association of Orthopaedic
Nurses
• Identified a list of priorities

• Used a Delphi technique to survey experts
• Highest ratings were given to:
– Preventing confusion in elderly patients following a
hip fracture
– Determining most effective safety measures to use
with patients with acute confusional states
– Differentiating pain responses according to diagnoses,
ages, and pain management interventions
Mental Health Nursing (1 of 2)
• Six broad categories were identified (1999).

– Support
– Holism
– Mental health nursing practice
– Quality care outcomes
– Mental health etiology
– Mental health delivery systems
Mental Health Nursing (2 of 2)
• WHO-supported action plan has four objectives:

– Provision of comprehensive, integrated, and
responsive mental healthcare services in community-
based settings
– Strengthening of information systems, evidence, and
research related to mental health
Oncology Nursing Society
• Top 20 research priorities were identified (2013),

including:
– Symptom management
– Screening and early detection activities
– Development of effective interventions for those at
risk of cancer
– Prevention of central line infections
– Prevention of medicine errors
Institute of Emergency Nursing Research
• Research priorities
– Investigations that address the generation,
dissemination, and translation of research related to
the organization’s strategic framework related to:
▪ Crowding
▪ Boarding
▪ Psychiatric emergency patient care
▪ Workplace violence
Association of Community Health Nurse
Educators
• Priorities published in 2010

– Population-focused outcomes
– Workforce issues
• Called for “multisite studies, clinical trials, community-
based participatory research, development and/or
analysis of existing large data sets”
Research in Nursing Education
• National League for Nursing (NLN) task group worked for

7 years to compile research
– Concluded more research needed on effective
teaching
– There is a need to build a science of nursing
education.
Future Strategies for Improved Healthcare
Quality
• Need for a collective vision

– Needs to focus on the “so what” outcomes
– Nursing profession is central to the interdisciplinary
changes necessary to achieve the goals of effective,
safe, and efficient care.
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Foundations of Nursing Research

1.1 Identify the importance of research to nursing.

Identify the importance of research to nursing

• Many people are unaware nurses conduct research.

• Research knowledge will help you become an excellent

• The systematic, objective process of analyzing

• Clinical nursing research

• handing down of knowledge from one generation to

• Similarities with problem-solving approach

• Difficulty distinguishing two purposes

• Federal government provides the most money for

Describe four goals for conducting nursing research

• Promote evidence-based nursing practice

• Major reason is to foster optimum care for clients.

• Nursing profession exists to provide a service to society.

• Nursing considered a vocation rather than a profession

• Increased independence brings a need for more

• It has been difficult for nurses to consider the cost-

• Nursing services can consume a large percentage of a

Compare qualitative and quantitative research

• In the past, nurse researchers have primarily conducted

Describe the various roles of nurses in research

• Nurses at the baccalaureate level should be able to:

• Masters-prepared nurses should be able to:

• Graduates of practice-focused doctoral programs should:

• Graduates of research-focused doctoral programs

• Nurses can assume many roles with research projects

• Member of research team

• Identifier of researchable problems

• Evaluator of research findings

• Patient/client advocate during studies

• Early nursing education

• Paradigm shift in nursing education

• The start of research studies

• Changes in research studies

• Replaced the National Center for Nursing Research (NC

• Organization of the Collaboration

• The Cochrane Nursing Care Field (CNCF)

– Nursing research resources

Summarize the development of nursing research and

• ANA Commission on Nursing Research identified

• Identified a list of priorities

• Six broad categories were identified (1999).

• WHO-supported action plan has four objectives:

• Top 20 research priorities were identified (2013),

• Priorities published in 2010

• National League for Nursing (NLN) task group worked for

• Need for a collective vision

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