Nursing Research

Caridad C. Lintao, RN., MAN

Nursing Research 1 Course Code : NRes 1 Course Code : NRes I Course Credit: 3 units (CMO# 30) 2 units lecture & 1 unit RLE (CMO#14) Course Description : This is an introductory course intended

concepts, principles in research starting from an overview of the major phases of the research process. The course will include discussion from formulation to dissemination of research findings, focus on the formulation of a research

This course will require the students to present a research proposal in a colloquium to apply knowledge and demonstrate skills and attitude in the conceptual, design and planning phases of the research process.

Course Outline: A. Introduction to Nursing research B. Overview of the Research Process in Quantitative and Qualitative Studies. C. Ethical Aspects of Nursing Research D. Steps of Writing a Good Research Proposal

Nursing Research - 2
Course Code : NRes II Course Credit: 3 units (CMO# 30) 2 units RLE (CMO#14) Course Description : This course is a continuation of Nursing Research 1 which includes collection of data, analysis, interpretation, summary and

Advising is done throughout the practicum sessions. The course will provide the student an opportunity to undergo the final research defense process to appreciate data gathering, analyze and interpret study results disseminate the findings and make recommendations based on the results of their respective studies.

Course Objectives: At the end of the course and given actual situation, a group of student will be able to : 1. Undertaken a final research defense process ( from data gathering, analysis and interpretation of study results, dissemination of the research findings and making appropriate recommendations based on the results of their respective

Course Objectives 2. Submit a written group research study. 3. Critique a research study based on stated guidelines. 4. Observe ethical concepts/ principles and standards in research.

Course Outline : I. REVIEW OF THE FIRST 2 PHASES OF THE RESEARCH PROCESS A. Conceptual Phase B. Designing and Planning Phase

II. CONTINUATION OF THE PHASES OF THE RESEARCH PROCESS: A. Empirical Phase 1. Measurement and the Assessment of Quantitative Data a. Definition of measurement b. Levels of measurement c. Advantages of measurement

Course Outline : A. Empirical Phase 2. Reliability a. Three important aspects of reliability ( stability, internal consistency and equivalence)

Course Outline : A. Empirical Phase 3. Validity a. Three important aspects of validity (content validity, criterion- related validity and construct). b. Sensitivity and specificity

Course Outline : A. Empirical Phase - Developing fine tuning research instruments. - Identifying methods of determining quality of research instruments. Quantitative reliability, validity Qualitative trustworthiness - Methods of gathering

Course Outline : B. The Analytical Phase 1. Analyzing the quantitative and qualitative data a. Descriptive data analysis b. Inferential data analysis c. Classification of statistics d. Criteria for selecting statistical tool

Course Outline : B. The Analytical Phase - Content analysis - Utilization of computer in analysis of data

Course Outline : C. The Dissemination Phase

a. Communicating the research findings b. Using research in evidence based nursing practice D. Writing the final research report E. Critiquing of research reports - Guidelines for use in critiquing reports. - Presentation of research findings

LECTURE PROPER

Research - is the collection of data in rigorously controlled situation for the purpose of prediction or explanation. - It is a more formal, systemic and intensive process of carrying on a scientific method of analysis, carried out for the discovery and development of an organized body

Research - Is formal, systematic, rigorous and intensive process used for solution to nursing process. - Is based on new facts, information and practical application. - In a form of unbiased data - Refers to a problem solving process.

Research - Is concerned with nurses themselves, their attitude and behavior in dealing with patients and their environment, their personal and professional relationship with the members of the health team and the intrinsic and extrinsic factors affecting nursing practice

Nursing Research is a breath and depth of the discipline of nursing as well as the preparation of practitioners and personnel involved in the total nursing sphere, ( preventive, therapeutic and rehabilitative).

Qualities of Good Nurse Researchers 1. Honest and credible 2. Accurate in his/ her data 3. Organized and systemic 4. Logical 5. Self awareness 6. Imagination and curious 7. Persistent with barriers 8. Good relationship with other researcher and with his/ her respondents.

Purposes of Research 1. To discover new facts about known phenomena. 2. To find answers to problems which are only partially solved by existing methods and information. 3. To improve existing techniques and develop new instruments or products.

Purposes of Research 4. To discover previously unrecognized substances or elements. 5. To discover pathways of action of known substances and elements. 6. To classify or arrange in order related and valid generalizations into systematized science.

Types of Research 1. General Classification a. Basic / Pure Research the researcher tries to find the truth about something. It is done for the intellectual pleasure of learning to search for knowledge for it is own sake and eventually filter down the results into real life situation.

Types of Research 1. General Classification b. Applied Research seek for practical application of theoretical or abstract knowledge. The truth is adapted to everyday situation. It results from present problem or from socially disorganized situations. It frequently raises theoretical questions that must be answered by basic/ pure research.

Types of Research 2. According to the Levels of Investigation a. Exploratory research allows one to study the variables pertinent to a specific situation. b. Descriptive research studies the relationship of the variables. 3. According to Time Element a. Historical research describes the past b. Descriptive research describes the

4. According to Duration a. Longitudinal Study follow the subject for a long period of time in order to observe changes. b. Cross sectional Study takes information one at a time and may require subjects to recall past events or feelings. It may contribute to a loss of accuracy and support bias.

5. According to Research Design a. Experimental the researcher actively introduces some form of treatment and has great control over extraneous variables. b. Non Experimental - the researcher collect data without introducing any treatment or making any changes.

c. Quasi- experimental it actively introduce some forms of treatment or manipulation but it does not utilize randomization or control group.

Variables - are qualities, properties, or characteristics of people, things, events or situations under study that vary from one person to another. -are factors that affect research outcome.

Kinds of Variables 1. Explanatory Variables 2. Extraneous Variables 3. Abstract or Continuous Variables 4. Dichotomous Variables 5. Active Variables 6. Attribute Variables

Kinds of Variables 1. Explanatory Variables it indicates direction of influences to what the researcher would like to discover. Types of Explanatory Variables a. Independent Variables considered to be the cause. b. Dependent Variables considered to be the effect.

Types of Explanatory Variables c. Intervening Variables / Correlated or Mediator Variables comes between dependent and independent variables. It cannot be controlled nor measured and research tools.
Ex. Infant age of gestation, birth weight, method of delivery.

Independent

Intervening Experience: attitude of the nurse Age, sex, education Skills of the nurse

Dependent Extent of recovery Extent of patients satisfaction Extent of pain relief needed by the nurse

Nursing Intervention Primary nursing care  Post operative teaching

Types of Explanatory Variables d. Antecedent Variables / Moderator Variables occurs earlier than the independent variables and bears a relationship both to the Independent variables and the dependent variables. e. Confounding or Interfering Variables interferes with the study design and

Types of Variables

2. Extraneous Variable an uncontrolled variable that greatly influences the result of the study. Two types of Extraneous Variables; a. Organismic Variables cannot be change through manipulation( age, sex, civil status). b. Environmental Variables these are economic, anthropological, sociological, and physical factors.

Types of Variables 3. Abstract or Continuous Variables these are quantitative measures and statistically tested. Ex. BP 120/80 to 180/110. 4. Dichotomous Variables these are factors with only two values, used in comparative studies Ex. Smokers Non smokers

Types of Variables 5. Active Variables these are factors commonly used in experimental studies. 6. Attribute Variables These are pre- existing characteristics of the subjects that can be observes and measures. Ex. Age, height, and weight

The Research undertakes the investigation systematically in an ordered sequences of steps as follows 1. Identifying the problem 2. Determine the purpose of study 3. Review of related literature 4. Theoretical/ conceptual framework 5. Study assumptions

The Research undertakes the investigation systematically in an ordered sequences of steps as follows 7. Formulating null hypothesis 8. Defining study variables 9. Choice research design 10. Identifying the target population 11. Choosing the study samples 12. Conducting the field test

Steps in Designing a Research Plan 1. Identify and define research focus. 2. Review related literature and undertaken initial documentary studies. 3. Clarify goals, objective and expectations of the study in consultation with others. 4. Choose main topic and

Steps in Designing a Research Plan 5. Prepare a list of sub topics and key questions 6. Identify methodology to be used (qualitative or quantitative). 7. Identify source of information for each sub-topic. 8. Select tools to collect and analyze information ( target population, sampling).

Steps in Designing a Research Plan 9. Design the research tools to be used. 10. Outline field work task ( permission, assignment task). 11. Collect field data or implement the methodology. 12. Edit data in the field for clarification. 13. Prepare tabulation and analysis

Steps in Designing a Research Plan 14. Process the data gathered ( tabulation, graphical representation, statistical analysis). 15. Complete the data analysis. 16. Distill major findings and recommendations based on stated objectives. 17. Disseminate results through publication and/or seminar.

Criteria for Choice of Research 1. Significance of the problem focus on an existing or prevailing problems. 2. Problem research ability problem must be manageable in nature and scope. 3. Feasibility of the problem time, availability of subjects, administrative control group support, fiscal resources (fund),

Criteria for Choice of Research 4. Experiences of the researcher 5. Ethical consideration 6. Potentials of researcher genuine interest and curiosity

Ethical Principles and Guidelines for Nurse Researcher (Polit and Beck, 2004) 1. Informed consent 2. Beneficence and non- maleficence to do good and to do no harm. 3. Respect human dignity. 4. Justice and fairness

PRACTICE NO PLAGIARISM R.A. 8293 protects the intellectual property rights of authors with respect to his/her personal relationship with the work and utilization of this by other.

Characteristics of Researchable Problems 1. Originality 2. Significance 3. Manageability 4. Measurability 5. Resource availability

Criteria for Choosing a Problem A. External availability of the subject, institutional or administrative support, ethical consideration, facilities and equipment. B. Internal motivation, experience, time management, cost and return, hazard, penalties.

TABLE OF CONTENTS Title page Thesis abstract Approval sheet Certificate of originality Certificate of editor Acknowledgement Dedication Table of contents

TABLE OF CONTENTS List of tables List of figures Chapter one the problem and setting Introduction Background of the study Theoretical Framework Research paradigm Statement of the problem

TABLE OF CONTENTS
Hypotheses Scope and delimitation Significance of the study Definition of terms Chapter two review of related literature Related readings Related studies Foreign Local

TABLE OF CONTENTS
Chapter three methodology Research methodology Population and sampling Research instrument Data gathering procedure Statistical treatment data Chapter four presentation, analysis and interpretation of data Presentation

TABLE OF CONTENTS
Tables Figures Interpretation of data Chapter five Summary, findings, conclusion, and recommendation Summary Findings Conclusion Recommendation

Bibliography Books Published and unpublished studies Online resources Appendices Letter of request Questionnaire Background information of editor and statistician Time table of activities Curriculum vitae

Essential Steps of a Research Design 1. Title of the Study/ Title Page - it must be clearly stated and consist not more than 15 words.
Ex. Work Values of Nurses and their Clinical Performance in Selected Government Hospitals in Cavite Province. Ex. Thermoregulation of Newborn Infant Utilizing Oil Bath in Selected Tertiary

2. Abstract is a comprehensive summary of the study about 120 words. 3. Introduction it serves as a springboard for the statement of the problem . It should stimulate the interest of the reader . It includes the following: (a) Context of the

4. Background includes the analysis of existing situation and the problems that call for the conduct of the particular research. 5. Statement of the Problem it indicates the population and the major variables of

The statement of the problem consist of :

a.) main or major problem Direct attention to the main issues. b.) specific or sub problem support the major problem

Research problem may stated in various ways such as:

a. ) Interrogative Form Major questions is followed by specific questions. b. ) Declarative Form give specificity to

6. Hypothesis is a statement of the researchers expectations concerning relationship between the variables being studied. - It serves as a skeletal structure of the data analysis and research findings. Types of Hypothesis 1. Null indicates expectation of no difference. 2. Operational indicates expectation of difference using a tool.

Essential Steps of a Research Design 7. Objective Formulation stated both as a general and specific concerns. a. General Objectives states that overarching purposes of the research either in the form of statement or in the form of questions. b. Specific Objectives present the detail aspects of general

Good Research Objective have the following characteristics 1. Specific 2. Measurable 3. Attainable 4. Realistic 5. Time Bound

Essential Steps of a Research Design 8. Significance of the Study it emphasize the significant contributions of the proposed research study to it target population. - For improvement, contribution, guide, added knowledge, personal and societal development.

Significance of the Study Beneficiaries of Research Studies Nursing profession, Nursing Service, Nursing Education, Nursing Students Nursing Practitioners, Hospital Administrators, Public end user of health Care or Community.

9. Definition of Terms - three types:

a. Conceptual Definition a term understood by the people. It is used hypothetical criteria to identify rather than what is observable. b. Operational Definition researchers own definition of terms as used in the study. It is observable characteristics and measurable being define within the context of the study. c. Lexical or Authorative Definition taken from authorities.

Example; Variables (A professional) Conceptual (an individual who practice a particular profession) Operational (any individual with four years of college education)

Types of Operational Definition 1. Denotative defined in terms Ex. Father a male parent 2. Connotative defined according to implications. Ex. Father strong, provider, head of the family.

10. Scope and Delimitation in terms of issues ( past & present), areas of concern, respondents, time frame, type of data ( quantitative, qualitative, or combined). Delimitation a parameter of the study by accepting what should be included and rejecting what should be excluded.

Essential Steps of a Research Design 11. Conceptual Framework Development / Theoretical Framework - How are the general and specific objectives translated into indicators? Indicators these are statements of traits that describe variables.

Essential Steps of a Research Design 12. Justification for the Research it is the statement for the foreseen contribution of the proposed research to : a) knowledge; b) policy making; c) programs. It state how the research can improve the current situation.

13. Review of Literature - what are the relevant issues and gaps that need to be filled or explained. - An account of what has been published on a topic by accredited researchers. Purpose : It aims to convey to the

Essential Steps of a Research Design 14. Determination of Sampling the sampling scheme may be ; a. Purposive with no consideration for representative. b. Probabilistic each unit/ element has an equal probability.

Types of Sampling 1. Simple Random Sampling this is done through the use of table of random numbers. Ex. roulette wheel, 2. Stratified Sampling where population is divided into strata having common characteristics and a random sample is chosen from each stratum.

Types of Sampling

3. Cluster Sampling where the population is divided into geographical clusters and certain clusters are picked at random. 4. Systematic Sampling where the sample is chosen systematically from each population with a random start from A to Z chose A, C, E 5. Multistage Sampling where the population is divided into tiers and

Types of Sampling

6. Quota or Purposive Sampling the researcher selecting some special group tat represent the total population. 7. Sequential Sampling the researcher examining the subject and stop when the results already adequately satisfied. 8. Incidental Sampling utilize readily available subject.

Essential Steps of a Research Design 15. Research Design is an overall plan on how to test the hypotheses or obtain answer s to the problem being studied. Quantitative - analysis focus on survey. Qualitative - analysis focus on group discussion, interview, case study.

Qualitative Research is a carefully

planned discussion whose objective is to learn about the perceptions, feelings, attitudes, and ideas of the group/ individuals participating in the discussion with respect to a defined area of interest. It is also concerned with subjective meaning of experience to an

Types of Qualitative 1. Phenomenological Studies

examining the lived experience of individual through description and analysis such as stress and anxiety.

Involve the following step: (1) Bracketing

belief and opinion, (2) Intuiting attributed experience, (3) Analyzing dissecting significant meanings of event,(4)Describing

Types of Qualitative 2. Ethnographic Studies refers to the collection and analysis of data on the lifestyle and daily activities of ethnics. -description and interpretation of cultural and social behavior of people in a group. 3. Grounded Theory Studies refers

Types of Qualitative

4. Historical Studies refers to the past

event to shed light on the present behavior , trend or practices.

5. Field Studies a natural investigation

done in the community.

6. Biographies explore the life of an

individual. It includes personal history, growth & development pattern, significant accomplish,

Quantitative it is concerned with the objective meaning of experience to an individual both non- experimental or experimental that need numerical data which can be subjected to statistical analysis. It can control phenomena and

The Characteristics of Good Research Design and Methodology 1. Appropriateness to research problem. 2. Lack of bias 3. Precision which achieved through control of extraneous variables. 4. Ability of a research design to detect relationship among variables.

Essential Steps of a Research Design

16. Research Instrumentation it must be valid and reliable to avoid inaccurate data and results. These are administered to the subject or respondents by means of pre- test or dry runs.

Data Collection - Data Phase of

Research Process involve : target population must be defined, method of selecting population,

Types of Research Instruments 1. Questionnaire paper and pencil 2. Scanning questionnaire face to face interview 3. Interview guide one on one dialogue with the subject 4. Anecdotal records, other documentary materials and mechanical instrument laboratory results, computer assisted, BP apparatus.

Methods of Interviewing 1. Personal interview 2. Telephone survey 3. Mail survey 4. Computer direct interview 5. E- mail survey 6. Internet survey

Types of Close ended questions 1. Dichotomous Item allow the respondents to choose between two response alternative such as yes or no. 2. Multichotomous Item allow respondents to answer questions with a range of response as in a multiple choice test.

Types of Close ended questions 3. Fixed Alternative or Multiple Choices Items allow respondents to response alternative. 4. Projective Questions a technique used word fill in the blank sentences. 5. Cafeteria Questions respondents are asked to respond according to their own viewpoint.

Types of Close ended questions 6. Rank order questions respondents are asked to rank answer from most to least important. 7. Checklist matrix questions. Questions are written horizontally while respondent s answers are written vertically

The following are types of error 1. Telescoping resulting from the tendency of people to remember events as occurring more recently than the actually did. 2. Recall occur when people forget that an event occurred

Ways stating research questions

1. State questions affirmative rather than in a negative. 2. Questions should be neutrally worded to avoid biased response. 3. Ambiguous questions must be avoided. 4. Avoid double negative questions which are difficult for respondents to answer.

Presenting Data in a Table or Graph Types of Data 1. Categorical data 2. Rank data 3. Metric data

Qualitative Descriptive Analytical Phase 1. Nominal Scale- categorized according to frequency of occurrence ( male/ female ) 2. Ordinal Scale - ordering observations according to magnitude or intensity.

Types of Ordinal Scale 1. Likert Scale used to assess the

attitude of respondents towards the variables being investigated. Ex. Agree or disagree. 2. Graphic rating scale respond in a bipolar continuum such as from highest to lowest or most to least. 3. Guttman Scale used to assess the attitude of respondents, using a continuum accumulation statement. Ex.

Types of Ordinal Scale

4. Semantic differential Scale - used to measure the emotional evaluative component of the respondents attitude. Ex. Bad/ good, passive/ active 5. Interval level of measurement categorized the actual number of scale. Ex. 1 - 38C, 2 - 37. 6C 6. Ratio level of measurement the distance between rank is specified up to zero point level.

Statistics is a branch of mathematics used to summarized, organize, present, analyze and interpret numerical data. Kinds of Statistics 1. Descriptive Statistics 2. Inferential Statistics

Kinds of Statistics Descriptive Statistics refers to the statistics intended to organize and summarized numerical data from the population.
Uses: a. Measures and condenses data frequency distribution graphical representation. b. Measures of central tendency used to describe mode, median, and mean

Measures of Center, Location and Variability 1. MODE the score which appears most frequently. 2. MEDIAN is the middle score after the score have been arranged in either increasing or decreasing order

Kinds of Statistics Inferential Statistics concerned with population and use of sample data to predict future occurences. Uses: a. To estimate population parameters b. Testing null hypothesis Degree of freedom (df) the

Statistical tools for treatment data 1. Percentage (p) is computed to determine the proportion of a part to a whole such as a given number of respondents in relation to the entire population. Formula p= f x 100 n Percentage/ frequency of response/ n= total number of respondent

Statistical tools for treatment data 2. Ranking to determine the order of decrease or increase magnitude of variables. 3. Weight mean refers to the over all average of responses of the study respondents. Ex. 5 4.51 5 / 2 1.51 - 2 4 3.51 4 / 1 0.51- 1

Statistical tools for treatment data 4. Measures of central tendency mode, median, mean 5. Standard deviation determines the homogeneity or sameness or degree, heterogeneity or dispersal variables. 6. T- test used to compare the responses of the two respondents group in the study.

Statistical tools for treatment data 7. One way analysis of variance or ANOVA this is a statistical procedure for testing mean difference among 3 or more groups by comparing variable between groups to variability with in group. 8. Multiple regression analysis is use to correlate more than two variables. 9. Complete randomized block design

ANALYSIS AND INTERPRETATION OF DATA Should be systematic and expressed in the past tense. Analysis should be supported by the statistics. Hypothesis should be tested is either accepted or rejected followed by interpretation based on the depth analysis. - Finding of the study - Presentation of the study

Presentation of the study 1. Textual form consist of numerical description that represent data. 2. Tabular form used in organizing and presenting data in a systematic way. 3. Figures are usual presentations of process data includes graph, diagram, line drawing, and photographs.

Tabular data 1. Row horizontal entries 2. Column vertical entries 3. Cells boxes where rows and column intersects

ANALYSIS AND INTERPRETATION OF DATA 1. Finding of the study 2. Presentation of the study 3. Interpretation of findings it allows the researcher to discuss findings in the light of the theoretical framework, interviews results and within the context of the literature review.

ANALYSIS AND INTERPRETATION OF DATA 4. Interpretation of results of the test on the null hypothesis support the action through explanation on the implication of the study. 5. Conclusion is a logical outgrowth of the summary focus on the answer to the major problem.

ANALYSIS AND INTERPRETATION OF DATA 6. Recommendation the researcher suggest solution to the problem to prevent occurrence of these effect or impact. Recommendation are addressed to the sectors concerned or beneficiaries of the research study such as Nursing Director, Nursing Instructor, Nursing Students and

Facilitating Therapeutic Communication

1. 2. 3. 4. 5. 6. 7. 8. Comfortable environment Privacy Confidentiality Optimal facing Providing personal space Listening attentively Conveying warmth and acceptance Offering oneself

Phase 1 - Conceptualization Steps - identify the problem, review the literature, develop theoretical framework, formulate variables Phase 5 - Use the study Steps - recommend further research, states implication of nursing, disseminates results Phase 4 - Analyze the study Steps describe the sample, answer the research question, interpret the results.

Phases of Research Process

Phase 2 - Design the study Steps - select research design, identify sample, evaluate quality of instruments Phase 3 - Conduct the study Steps - Get approval to use human subject, recruit subject, collect data

THE PHASES OF RESEARCH PROCESS A. Conceptual Phase

Step 1 formulate and delimit the research problem - curiosity about the specific problem - identify the reason for doing the research Step 2 review of related literature - focus the search on the previous studies or articles done on the same problem

THE PHASES OF RESEARCH PROCESS A. Conceptual Phase Step 4 formulate the hypothesis B. Design and Planning Phase Step 5 select a research design and methodology Step 6 identify the population to be studied Step 7 specify methods to collect

THE PHASES OF RESEARCH PROCESS

C. Empirical Phase Step 8 actual data collection D. Analysis Phase Step 9 analyze the data - interpret the response of the subject to measurement tool. - apply statistical treatment to the responses depending on the relationship between the variables.

THE PHASES OF RESEARCH PROCESS

Step 10 Interpret the data Step 11 Write the research report Step 12- Disseminate research findings

Research process Nursing Process Identify the areas of interest Problem identification - Review of related literature

- Formulate the theoretical framework - identify study variables and hypotheses Design the study protocol -Select research design and identify sample population - Select data collection method - Select Instrumentation: Questionnaire - formulate proposed analysis Obtain necessary approvals -Pilot study may be done initially -Continually assess the study methodology Analyze the result of the study - Interpret demographics of study population - Analyze each questions - Interpret the results including conclusions, limitations. Formulate recommendations for further research - Determine implication to nursing and disseminate the findings.

Study design

Conducting the study Data analysis Use of finding

Bibliography
Example : Fox, D.J. 1976. Fundamentals of Research in Nursing New York Appleton Century Croft. Tan, Crestita. 2006. A Research Guide in Nursing Education third edition: Visual Print Enterprises. Osteria, T.S. Nursing Research Manila: Yunchengco Center, De La Salle University. Poll, D. F. 1995. Nursing Research Principles and Methods, Philedelhia: J.B. Lippincott Company. Treece , E.W. 1982. Elements of Research in Nursing St. Louis: The C.V. Mocby Company.

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