NSG 415 Essential Content Notes

Week Two

What is Nursing Research?

"A scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences nursing practice."
Grove & Burns, (1995). "Understanding Nursing Research". Philadelphia: Saunders.

What is the Primary Goal of Nursing Research?

** To develop a specialized, scientifically based body of knowledge unique to nursing **

Other goals:

What Exactly is the Scientific Method?

The scientific method is an approach to solving problems.

Nursing research that uses the scientific method is one of the primary sources of generating nursing knowledge.

Scientific Method Characteristics:
  1. Control of variables and biases

  2. Use of empirical evidence to generate knowledge

  3. Produce generalizable results

As researchers, we use the Scientific Method to:

  1. Describe phenomena
  2. Explore relationships among phenomena
  3. Explain phenomena and increase understanding
  4. Predict the causes of relationships among phenomena
  5. Control phenomena

In nursing, use of the Scientific Method is limiting because:

In nursing, research also relies on other sources of knowledge:
Trial and Error
Personal Experience
Logical Reasoning

Nursing Research may be "Basic" or "Applied":

Basic: Undertaken to advance knowledge in a given area, helps the researcher understand relationships among phenomena

Applied: Undertaken to remedy a particular problem or modify a situation, helps the researcher to make decisions or evaluate techniques. (Clinical nursing problems)

What are the various nursing roles in the Research Process for graduates with the ADN, BSN, MSN or PhD?

ADN graduates: have awareness of the value of nursing research
BSN graduates: understand each step of the research process; interpret, evaluate, determine the credibility of research findings; integrate research into clinical practice; participate in studies
MSN graduates: are active members of the research team, they are clinical experts
PhD graduates: appraise, design and conduct research; they develop theoretical explanations of nursing phenomena; and they disseminate findings (presentations, publications)

Remember: Nursing research is important to ALL nurses!

What events have shaped our history in Nursing Research?

Historical Events in Nursing Research
1850 Nightingale, first Nurse Researcher
1923 Goldmark Report proposed reorganization of nursing education into the university setting
1948 Brown Report: technical ADN, professional BSN
1949 Ginzberg Report: four year nursing programs, technical nursing programs (ADN)
1952 Nursing Research published
1950's clinical research focus from fields of psychiatric & maternal-child health
1960's &
Nursing archives established; 1st Nursing Research Conference of ANA held, nursing research focused on clinical practice issues.
1970's increased master's and doctoral programs for nursing
1980's increased upper level nursing programs, especially doctoral; Increased interest in qualitative research
  • Refinement, development and utilization of research in clinical practice
  • NCNR established

  • Current research in nursing is focused on theory, practice, scientific inquiry, education and inter-disciplinary research.

    What can RNs do in research???

    "RNs are challenged to offer creative approaches to old and new health problems, designing new and innovative programs that make a difference in the health status of America. This can be done by integrating rapidly expanding knowledge about biological, behavioral and environmental influences on health into nursing practice. Nursing research provides a specialized scientific knowledge base that empowers the nursing profession to anticipate and meet these challenges and maintain our societal relevance"
    (LoBiondo-Wood & Haber, 1998, p.6)

    Week Three

    How is nursing theory linked to nursing research?

    To begin with, it is helpful to define "theory".
    A theory is a way to explain some segment of the empirical world, and can be used to describe, explain, predict or control that segment (Dubin, 1978). A theory is made up of a set of concepts that are defined and interrelated to present a view of phenomenon.
    Theories have been developed in nursing to explain phenomena that are of importance to clinical practice (Burns & Grove, 1999).

    Research is conducted to either develop or to test theory (Burns & Grove, 1993).

    According to Wood & Haber (1998), theoretical formulations supported by research findings may "become the foundations of theory-based practice in nursing" (p. 7).

    Nursing theories guide nursing research by generating hypotheses that can be supported or refuted. Nursing theories also may be generated from nursing research. Theory building approaches that begin with an existing theory and test hypotheses that are "deduced" from that theory are often called "deductive". Theory building approaches that generate hypotheses and explanatory data from observations, interviews and other data are often called "inductive".

    Research, then, is based on theory. The ideas that lead a researcher to develop a particular study have their roots in theory. As a researcher undertaking a study, you no doubt have a "theory" about what your study outcomes are expected to be, and why. This theory-based "framework" is expressed as the "study framework" or the "theoretical framework". By performing the study, the researcher can answer the question: "Was my theory correct?" So, a study tests the accuracy of theoretical ideas. When the study is completed, the researcher interprets the meaning of the findings in relation to the theoretical framework. Having an understanding of the theory upon which the study is based helps you to determine whether or not it is appropriate to apply the study findings to your clinical practice (Burns & Grove, 1999).

    According to Wilson (1992), a theoretical framework for a study is an "essay that places the study in the context of existing related theory based on the literature that has been reviewed" (p. 81).

    At times, nursing uses theories developed in other disciplines, such as psychology, and apply them to nursing situations. Although we use these theories to guide our practice, in many instances, we have not tested them to determine whether or not the nursing actions proposed by the theory actually have the effects claimed Burns & Grove, 1999).

    Consider this example, taken from Burns & Grove "Understanding Nursing Research", 1999, p. 130:
    A theory of mother-infant bonding proposed that bonding between a mother and her newborn child occurred within hours or days of birth (Klaus & Kennell, 1976). The theory proposed that if physical contact between mother and child did not occur during this short time frame, bonding would not occur and the relationship between mother and child would be permanently impaired. Nurses leaped on this idea and focused intensely on ensuring that physical contact between mother and newborn occurred. However, research testing this theoretical notion demonstrated that it was not true (Walker, 1992). Mother and newborn, kept apart because of illness or other circumstances, were able to bond. A theory of attachment, based on long term studies of mothers and infants, emerged. These studies found that development of an attachment between mother and child was indeed critical but that the process occurred over a period of months rather than days. These findings, expressed as the theory of attachment, guide nurses in their care of mothers and their children.

    Wilson (1993), in describing the interdependence of nursing theory, research and practice, states: "Developing a body of knowledge about nursing and for nursing practice is critical if we are to move from a dsicipline based on tradition and authority to a discipline based on science. Placing nursing studies within the context of our evolving theoretical base is essential to that goal" (pp. 92-93).

    How are Computers used in Nursing Research?

    What is meant by Coding?

    It is the process of transforming qualitative data into numerical symbols that can be computerized
    (For example, 1 = male; 2 = female)

    What is Inductive Reasoning?

    It is a process by which general principles are inferred from specific observations. Inductive reasoning relies on the representativeness of the specific observations to arrive at valid conclusions.

    This line of reasoning moves from the particular to the general: Particular - moves to - General, or, stated another way,
    (Specific) - moves to - General

    What are some examples of Inductive Reasoning?

    A headache is an altered level of health that is stressful.

    A fractured bone is an altered level of health that is stressful.
    A terminal illness is an altered level of health that is stressful.

    Therefore, all altered levels of health are stressful.

    As you can see, this line of reasoning moves from the Specific - to the - General.

    What is Deductive Reasoning?

    It is a process by which specifics are inferred from general principles. Deductive reasoning relies on the accuracy of the general principles to arrive at valid conclusions.

    This line of reasoning moves from the general to the particular,
    General - moves to - Particular, or, stated another way,
    General - moves to - (Specific)

    What are some examples of Deductive Reasoning?

    Premises: All human beings experience loss.
    All adolescents are human beings.

    Conclusion: All adolescents experience loss.
    As you can see, this line of reasoning moves from the General - to the Specific.

    Remember that the conclusions generated from deductive reasoning are valid only if they are based on valid premises!

    Consider this example:

    Premises: All health professionals are caring.
    All nurses are health professionals.

    Conclusion: All nurses are caring. ****

    Note: * The premise that all health professionals are caring is not valid nor an accurate reflection of reality.

    Research is a means to test and confirm or refute a premise, so that valid premises can be used as a basis for reasoning in nursing practice.

    Inductive reasoning (particular to general) underlies qualitative research.

    What is Qualitative Research?

    Qualitative research is the investigation of human experiences in naturalistic settings, pursuing meanings that inform theory, practice and further research. (Generally, qualitative research is very lengthy and often explores cultural themes)

    If inductive reasoning is used most often in qualitative research, then is deductive reasoning used most often in quantitative research?

    Yes! Deductive reasoning is most often used in quantitative research.

    How is deductive reasoning used in quantitative research?

    Deductive reasoning uses two or more variables that form the basis for a concluding assertion of a relationship between the study variables (termed "relational statements"); quantitative research uses data represented as numbers.

    What are Conceptual and Operational Definitions?

    Conceptual Definition

    Conveys the general meaning of the concept; it reflects the theory used in the study of that concept.
    (see box 5-4, pg 142 of textbook)

    These definitions are GENERAL and give no indication of how the concepts will be MEASURED!!

    Operational Definition

    Delineates the procedures or operations required to measure the concept. Supplies the information needed to collect data on the problem being studied.
    (see examples in box on pg 143 of textbook)

    Term (example)Conceptual DefinitionOperational Definition
    TENS"TENS is thought to activate the large diameter, myelinated A-beta fibers which have a low threshold for electrical stimulation. The increased activity in these fibers would serve to decrease the transmission of painful stimuli through the small diameter A-delta and C fibers" (Melzack & Wall, 1984, p. 159"Piece of equipment with a portable GRASS SD9 stimulator (Grass Instrument Co., Quincy, MA) and two pre-jelled sterile surface electrodes 3 cm in diameter (Myo-Trode II, No. 410)" (p. 160).
    Benefits"...Benefits are beliefs about the positive aspects that arouse motives to carry out health care activities" (Murdaugh & Hinshaw, 1986, p.19)."Benefit Scales (BES) are used to measure a person's perceived benefits in undertaking preventive behaviors that reduce risk factors in coronary artery disease." (p. 20).
    Health Care Activities"Health care activities are types of behavior, and behavior is defined as any response to meaningful stimuli that can be measured directly or indirectly." (p. 20)."In the present study, health care activities included participation in a regular exercise program or being a nonsmoker (p. 20)... Health Care Activity Scale is used to elicit smoking and exercise behaviors." (p. 21).

    Remember, all variables or concepts in a study require conceptual and operational definitions. A conceptual definition provides the theoretical meaning of a concept or variable and is derived from a theorist's definition of the concept or is developed through concept analysis. The conceptual definition provides a basis for formulating an operational definition.

    An operational definition is derived from a set of procedures or progressive acts that a researcher performs to receive sensory impressions that indicate the existence or degree of existence of a variable. Operational definitions need to be independent of time and setting, so that variables can be investigated at different times and in different settings using the same definition.

    In experimental and quasi-experimental (quantitative) studies, operational definitions are specific and precisely developed.

    In qualitative studies, the definitions of concepts are fairly abstract and broad, so the scope of the investigation is not limited. (Burns & Grove, 1993).

    Weeks Four and Five

    The Research Problem.

    What is a research problem?
    A situation in need of a solution, improvement, or alteration; or a discrepancy between the way things are and the way they ought to be (Burns & Grove, 1995).

    As we have already noted, Nursing Research may be:
    ** Quantitative Research
    - or -
    ** Qualitative Research

    Quantitative Research may be:
    Descriptive Research
    Correlational Research
    Quasi-Experimental Research
    Experimental Research

    What about qualitative research?
    Qualitative Research uses nonnumerical data, generally collected through interviews, observations, and document analysis

    What steps are followed in Quantitative Nursing Research?

    What are Propositions?

    "Statements that link concepts and lay a foundation for the development of methods that test relationships" (Wood & Haber, 1998).

    "...in developing a theoretical framework for nursing, knowledge may be acquired from other disciplines or directly from nursing. In either case, that knowledge is used to answer specific nursing questions" (Wood & Haber, 1998)>

    What is meant by Serendipity?

    The accidental discovery of something useful or valuable. Serendipitous findings are important to the development of new insights in nursing theory.

    Furthermore, a Serendipitous finding:

    What is Critical Thinking?

    "...the rational examination of ideas, references, assumptions, principles, arguments, conclusions, issues..." (Bandman & Bandman, 1988).
    Critical thinking involves "thinking about your thinking" - to become clearer, more accurate, more defensible

    What components are included in a research proposal/report?

    The Hypothesis:

    Specifies how to answer the question(s) posed by the research problem.
    The hypothesis is:

    Where do I begin?

    Step One:

    The Problem Statement:

    The Final Problem Statement:
    states the relationship between 2 or more variables; it clearly identifies the relationship between the independent variable (IV) and the dependent variable (DV).

    However, as you read research, you may find that the problem statement may not be explicitly stated.

    Often, you (the reader) must infer the problem statement from the study title, abstract, introduction or purpose!

    What about the purpose statement?

    The purpose statement often provides the most information about the intent of the problem statement and the hypotheses.

    Major points to remember when developing a research proposal:

    The research problem is a "situation in need of a solution, improvement or alteration or a discrepancy in the way things are or the way they ought to be" (Burns & Grove, 1993, p. 57).

    What about Research Hypotheses?

    (Note: 1 = hypothesis; 2 or more = hypotheses)

    Research Hypotheses flow from the problem statement, literature review and theoretical framework

    The hypothesis is more concise than the problem statement; it provides direction for conducting the study

    The hypothesis is a statement about the relationship between 2 or more variables; it provides direction for gathering and interpreting data.

    Hypotheses are written before data collection; they are never altered after data analysis; otherwise, the study is invalid!

    The researcher formulates as many hypotheses as needed to address all aspects of the research problem.

    Wow! This is interesting! Tell me more about hypotheses!
    In order to test the hypothesis, the researcher must be able to define all of the variables theoretically and operationally.

    The hypothesis predicts relationships among two or more variables and identifies the population to be studied.

    The hypothesis directs the research study, unifies theory and reality and helps extend nursing's knowledge base.

    Hypotheses are never proven; they are accepted or rejected, or supported or not supported.

    Hypotheses can be classified as simple, complex, directional, non directional, research or null

    Each hypothesis is a subset of the research problem.

    A hypothesis can be generated for each unit of the research problem.

    The hypothesis converts the question posed by the research problem into a declarative statement.

    The hypothesis must be testable: the variables must lend themselves to observation, measurement and analysis (Wood & Haber, pp 76-77)

    What is a Directional Hypothesis?

    A directional hypothesis specifies the expected direction of the relationship between the independent and dependent variables (see Table 3-8, p. 79 of textbook).

    What about a Non directional Hypothesis?

    A non directional hypothesis indicates existence of a relationship between variables, but does not specify the anticipated direction of the relationship.

    Both forms of hypotheses statements are acceptable!

    What about the Research (or scientific) Hypothesis?

    The research hypothesis indicates what the outcome of the study is expected to be; directional or non directional. If statistically significant findings are obtained, then the hypothesis is supported. (see example, p. 81 of text)

    What is the Null Hypothesis?
    The null hypothesis states that there is NO relationship between the Independent variable and the Dependent variable.

    If you ACCEPT the Null hypothesis, then you have found NO statistically significant difference in your variables. (Example of Null hypothesis, p. 81, text) If you REJECT the Null hypothesis, then you HAVE found a statistically significant difference in the relationship between the study variables.
    Rejection of the Null hypothesis = acceptance of the research hypothesis. (You are saying that there IS a difference between the study variables!)

    So, tell me more about Variables. What exactly is a variable?

    A variable is any factor that varies.

    A variable is a concept examined in a research study (examples: gender, age, heart rate, pain perception, skin integrity).

    All variables must be concretely defined before they can be studied and measured.

    What is the Dependent Variable (DV)?
    In research studies, the DV is symbolized as "Y".

    The dependent variable is the study variable under investigation; it is the one that the researcher examines as a RESULT of conducting the study.

    It may be the "effect" or "outcome" of experiment.

    With Dependent Variables, the variability presumably DEPENDS on the cause or conditions manipulated by the researcher in the study.

    Usually, the Dependent Variables are the ones that the researcher is intending to understand, explain or predict.

    Dependent Variables are what the researcher measures about the subjects AFTER they have experienced or been exposed to the independent variable.

    Dependent variables may also be referred to as the consequence variables.


    The dependent variable is NOT manipulated! Instead, it is observed and measured (see p. 67, textbook).

    What is the Independent Variable (IV)?
    In research studies, the IV is symbolized by "X".

    The Independent Variable is the variable which has the presumed effect on the dependent variable (Y).

    The Independent Variable IS manipulated by the researcher in experimental designs.

    IVs are the causes or conditions the investigator manipulates or identifies to determine the effects or outcomes. Their values are established independently ahead of time by the investigator.

    Independent variables precede measurement of the Dependent Variables.

    "In non experimental research, the IV is NOT manipulated and is assumed to have occurred naturally before or during the study" (Wood & Haber, 1998 p. 67).

    For example, in a non experimental research design, the investigator is studying the variable "anxiety" in preoperative patients. The patients' anxiety level is the independent variable - it occurs naturally - and the investigator is observing and measuring it only, the investigator is not manipulating it.

    Tell me more about the nature of Variables!

    With variables, the researcher is asking:

    What is an Extraneous (Mediating) Variable?
    An extraneous variable interferes with the operations of the phenomena being studied (For example: age, gender, mental status, etc.).

    An extraneous variable can affect the dependent variable and interfere with the results (see text p. 159).

    What are Characteristics of Variables?
    Variables identify the concepts to be studied.

    Variables are measurable.

    Variables are usually narrow and specific in focus.

    What is a Confounding Variable?
    A confounding is an extraneous variable that has not been recognized or controlled.

    When planning a study, it is important to define relevant variables


    also consider other variables that might have effects on the DV other than, or in addition to, the IV.

    Otherwise, these "other variables" can confuse interpretation of a study's results, because they confound the effects of the IV.

    An Extraneous variable that is not controlled is a confounding variable.

    What is Meant by "Control"?

    Control is measures that the researcher uses to hold the study conditions uniform and avoid bias of the dependent variable or outcome. (Wood & Haber, p. 157,159).

    The researcher always attempts to maximize the degree of control.

    Rules used to achieve control are referred to as "design".

    Through control, the researcher can reduce the influence or confounding effect of extraneous variables on the research variables.

    Experimental studies are designed to have much control.

    How does one achieve control?

    What are mechanisms for control in quantitative research?

    Note: With Descriptive research, there is no control!

    Let's revisit important information covered in the past two weeks concerning independent and dependent variables.
    Evaluate your understanding of Independent/Dependent Variables! For the following examples, determine which it is: IV or DV?
    1. "Parents spend more time teaching their children about water safety after completing a water safety course".
      • Completing a water safety course is the ____?
      • Time spent teaching is the ____?

    2. "Oxygen inhalation by nasal cannula of up to 6 LPM does not affect oral temperature taken with an electronic thermometer".
      • Oxygen inhalation by nasal cannula is the ____?
      • Oral temp is the ____?

    What is Meant by "Rigor"?

    Rigor is "the striving for excellence in research... involves discipline, scrupulous adherence to detail and strict accuracy" (Burns & Grove, 1993, p. 39).

    Rigorous = strives for more precise measurement tools, a more representative sample, tighter control

    A research proposal always includes a Review of the Literature.
    What exactly is meant by a review of the literature?

    A review of the literature is: "A broad, comprehensive, in-depth, systematic and critical review of scholarly publications, unpublished scholarly print materials, A-V materials, personal communications" (Wood & Haber, 1998, p. 127)
    Tips on conducting the literature review:

    What is a "synthesis of the literature"?

    Synthesis of the literature is combining ideas/concepts in the literature to form a conclusion.

    What is meant by Internal Validity?

    With internal validity, the researcher is asking:

    What is meant by "threats" to internal validity?

    (see textbook, p. 164)

    Threat: a factor other than the IV which affected the study results.


    What is Meant by External Validity?

    External validity is the extent to which the findings can be generalized beyond the sample used in the study.

    External validity depends on whether the relationship between the IV and the DV can be applied to other populations or situations.

    What are Threats to External Validity?

    What is Meant by "Reliability"?

    Reliability is "the extent to which the instrument yields the same results on repeated measures".

    Reliability is concerned with consistency, accuracy, precision, stability, equivalence and homogeneity (Wood & Haber, p. 337).

    Reliability asks: "How consistently does the instrument measure the concept of interest?"

    Example: Use of a thermometer to measure temperature. Under different environmental conditions and with different techniques, one should always obtain the same results, if the instrument is reliable.

    How can one determine Reliability for Instruments?

    1. Test-retest: stability over time - give a test to subjects; wait for a period of time and then give the same test to the same subjects; compare scores - this demonstrates stability of the instrument. (Wood & Haber, p. 340)

    2. Split-half: measures internal consistency (homogeneity) - is a way to do test/retest without administering the instrument twice. Split the instrument items in half and do a correlation between the two halves. (Wood & Haber, p. 341)

    3. Interrater reliability: For instruments that measure observed behavior; interrater reliability measures the reliability of the observer (Wood & Haber, p. 344).

    Remember, validity and reliability have to do with the instrument and NOT the study itself!

    What is Meant by Content Validity?

    With content validity, the researcher asks:
    "Does the instrument (which is being administered) cover the content? Were major concepts left out?" One way to help assure content validity is to ask a panel of "judges", who are expert reviewers on your topic (Wood & Haber, p. 331).

    What about Criterion-Related Validity?

    There are two types of criterion-related validity:
    1. Predictive: Assesses how well a score on an instrument can predict future performance.

    2. Concurrent: Indicates an individual's current standing on a criterion measure related to the concept of interest.
      Example: Ask subjects to respond to an instrument on leadership - also ask them to respond to an instrument on management - to see if a high score on one indicates a high score on the other.

    What is Construct Validity?

    Construct validity estimates how well an instrument measures a theoretical construct. Construct validity may be assessed but it is not definitively established.

    The process of developing construct validity for an instrument often requires years of scientific work (Burns & Grove, 1993, 268).

    What is Meant by Sampling?

    Sampling means selecting representative units of a population for study.

    The larger group of subjects from which a sample is drawn. The group to whom the results will be generalized. The population is the total number of subjects.

    A subgroup of the larger population under study. One uses the sample to make inferences and estimates about the larger, unmeasured population.

    Target population:
    the entire set of cases about which the researcher would like to generalize.

    Selecting a portion of the designated population to represent the entire population (Wood & Haber, p. 250).

    What are the Two Major Sample Types?

    1. Non probability: Subjects are chosen by non random methods. With this method, one cannot estimate the probability that each unit has the same chance of being included in the study. It is convenient and used most often!

    2. Probability: A sampling method that is very rigorous; it allows the researcher to estimate the probability that each unit has an equal chance of being included in the study.

    Non probability Sampling

    1. Convenience: One uses the most readily available persons in a study. Very easy to obtain. (W & H, p.253) This method of sampling carries the greatest risk of bias.

    2. Quota: One uses knowledge about the population of interest to select the sample. Not random. Proportional segments of the population are included in the sample.

    3. Purposive: One uses knowledge of the population to hand-pick the units to be included in the sample. One selects subjects who are considered to be "typical" of the population. (Wood & Haber, p. 254).

    Probability Sampling

    Probability sampling involves random selection of units from the population. Allows for a representative sample.

    Random Selection: Each unit of the population has an EQUAL chance of being included in the sample.

    Types of Probability Sampling

    1. Simple random sampling: Allows the researcher to select units randomly from a sampling frame (a list of all units of the population). Involves use of a table of random numbers (see text p. 257). Very time consuming and inefficient (Wood & Haber, p. 258).

    2. Stratified Random Sampling: Requires the population to be divided into subgroups which are homogeneous. The goal is to achieve representativeness, uses a random selection process for obtaining sample subjects (Wood & Haber, p. 258)

    3. Cluster Sampling: Successive random sampling of units ("clusters") that progress from large to small and meet sample criteria. One begins with large clusters, or sampling units, then progresses to smaller units. This method is faster and less expensive than other types of probability sampling, but it is associated with more error and is difficult to analyze. (See example in text, p. 260).

    4. Systematic Sampling: Select every "kth" case drawn from the population (i.e., every 10th member listed...) One must use a starting point that is selected randomly; otherwise, it is not a probability sample. Need to narrowly define the population

    5. Snowball Sampling: Takes advantage of social networks and the idea that individuals with similar characteristics often group together. Used to locate samples difficult or impossible to locate in other ways. (Example: crack cocaine users)

    Regarding Sample Size:

    Remember, a Population may consist of people, objects or events

    Eligibility criteria (to be included in the study) are descriptors of the population which provide the basis for selection (for example, five year breast cancer survivors).

    What Constitutes an Experimental Research Design?

    Three criteria are essential:
    Randomization: random assignment to a group

    Control: Imposing of "rules" to decrease the possibility of error and to increase the probability that the study's findings are an accurate reflection of reality (Burns & Grove, 1993, p. 765).

    Manipulation: "doing something" to at least some of the subjects (i.e., medication, therapy, teaching, etc.). (Wood & Haber, p. 178).

    Experimental Designs are used for testing cause-and-effect relationships.

    Quasi experimental Designs are used when full experimental control is not possible.

    With a quasi experimental design, a "treatment" occurs but some characteristic of a true experiment is missing, often randomization, or perhaps, the presence of a control group.

    What About Non experimental Research Designs?

    Non experimental design may be:

    for example, a survey in which one collects information on existing variables.

    Used to examine a "relationship" between variables.

    Ex Post Facto:
    "from after the fact" - used for explaining causality without manipulating the IV or using randomization (Wood & Haber, p. 200).

    Cross-Sectional Study:
    Examines data at one point in time, with the same subjects (Wood & Haber, p. 202).

    Longitudinal Studies:
    One collects data from the same group at different points in time.

    Retrospective Studies:
    Same as ex post facto. The DV has already been affected by the IV. (Wood & Haber, p. 204).

    Prospective Studies:
    Begin in the present and end in the future. This design is used to explore presumed causes to move forward in time to the presumed effect (W & H, p. 204).

    What is a "Pilot Study"?

    A Pilot Study is a "practice run", a small scale study.

    What else? Experiments may be classified according to setting. Field and Laboratory Experiments use different environments: laboratory experiments take place in artificial settings; field experiments take place in a "real" setting; in nursing, most experiments are "field" experiments (Wood & Haber, p. 181).

    What About Qualitative Research Methods?

    Historically, qualitative research was a: Method for "understanding the past through collection, organization and critical appraisal of facts" (Wood & Haber, p. 231).

    Much qualitative research is "Ethnographic": It focuses on "scientific descriptions of cultural groups" (W & H, p. 229).

    Ethnonursing research is described by Leininger from her theory of transcultural nursing.

    A Cohort is a group of people who have something in common; who have been followed over time (Example: identify a cohort of 45 year old twins; follow them over the years to study their aging patterns).

    What is Meant by the "Halo Effect"?

    The Halo Effect occurs when the researcher has some knowledge/opinion about the subject that biases the data collection.
    Ex: An RN manager is assigned an honors graduate from what the manager considers to be a prestigious university; subsequently, the manager's evaluation of the honors graduate is biased.

    What is a "Blind" Study?

    It is used in an experimental design; the subjects do not know whether or not they are receiving the "treatment".

    What about a "Double Blind" Study?

    It is used in an experimental design; neither the subjects nor the researchers know who is receiving the "treatment".

    What Kinds of Data Collection Methods Are Available?

    Many types exist. They include:
    Physiological tools

    Observational tools



    What is meant by a "scale"?

    With a Scale, a rating or "score" is assigned to each item to get an overall score. (Wood & Haber, p. 317)
    Likert Scale
    A Likert Scale uses a close-ended, "fixed response" format, such as: "strongly agree"; "agree"; "disagree"; "strongly disagree"

    Types of Scales
    (W & H, pp 352-354)
    Classifies objects/events into categories
    Example: 1 = Male; 2 = Female
    Uses rank order
    Example: Low - Medium - High
    No information is provided regarding the distance between low-medium-high

    Ordinal Scale (Likert)

    Example: 5 = extremely depressed; 4 = very depressed; 3 = moderately depressed; 2 = slightly depressed; 1 = not depressed
    Responses 5>4>3>2>>1 but there is no guarantee that the intervals between the numbers are equidistant.

    Equal intervals between the numbers
    Example: BP reading: 150/90 > 140/90
    An interval scale has no absolute zero point; instead, zero is arbitrary.
    Example: Fahrenheit thermometer uses a zero point of "0"; Celsius thermometer uses a zero point of "32"

    Ratio Scale:
    Has rank order
    Has equal intervals
    Has an absolute zero point

    A ratio scale is the highest level of measurement scale for statistical analysis

    A ratio scale is used with physical/biological measures, not with psychosocial qualities

    Tips for designing questionnaires

    How is a Frequency Distribution created?

    By arranging numerical values from lowest to highest, and then counting how many times each value appears in the data (see table p. 356).

    Central Tendency:
    Central = middle value
    Tendency = general trend of the numbers
    1. Mode: Most frequent score
    2. Median: Middle score
    3. Mean: Arithmetic mean
    (see textbook pp 358-360)

    What is a Normal Distribution?

    Review the Normal Curve (p. 360 of textbook)

    non symmetry of the curve; if the longer "tail" is to the right, it is positively skewed; if the longer "tail" is to the left, it is negatively skewed (p. 361, 362 of textbook)

    related to the peakness or flatness of a distribution (see figure, p. 362 of textbook)

    Cross Tabulation
    Allows for visual comparison of data
    (example: sad by seasons)

    What is Meant by Type I and Type II Errors?

    Type I: Committed if you reject the null hypothesis when it is actually TRUE.
    (see figure 15-2, p. 374 of textbook)
    Type II: Committed if you accept the null hypothesis when it is actually FALSE.
    (see figure 15-2, p. 374 of textbook)

    In practice, a Type I error is more serious because if you say that differences do exist (and they do not), the potential is there for patient care to be adversely affected. (see example in textbook found on page 374).

    What is Meant by Level of Significance? (alpha level)

    Examples of Statistical Tests:

    t Test:
    Used to determine if the means between the two groups are different; it uses interval or ratio level data (textbook, p. 378)

    Used to determine if the frequency in each category is different from what would be expected to occur; it uses nominal level data (see example in text, p. 379)

    Pearson Correlation Coefficient
    (Pearson r, or Pearson product moment correlation coefficient):
    Test for Correlation (relationship) (see textbook, p. 380). Correlation coefficients range in value from -1.0 to +1.0. A zero coefficient = NO relationship between the variables. "The magnitude of the relationship between the variables is indicated by how close the correlation comes to the absolute value of 1." (W & H, p. 381)
    • -0.76 is as strong a correlation as +0.76.

    • 0.52 is "stronger" than 0.34. A positive (direct) relationship indicates that as the values of one variable become larger or smaller, so do the values of the other variable. A negative (inverse) relationship indicates that as the values of one variable tend to become large, the values of the other variable tend to become small.

    • Values are displayed on a "scatter plot"

    We've covered a lot of ground! To prepare for the research article critique, let's review a few items:

    What is a research critique?

    According to Leininger (1968), a research critique is a "critical estimate of a piece of research which has been carefully and systematically studied by a critic who has used specific criteria to appraise...the general features..." The challenge is to determine what the researcher has tried to do and to evaluate the strategies selected, in light of the overall constraints of the study. The purpose of the critique is to help research investigators refine and improve their programs of inquiry, and to help research consumers decide how to use findings from a study, based on the judicious appraisal of its strengths and limitations (Wilson,1993, p. 269).

    What Steps are Involved in Critiquing the Report? Carefully consider each section of the report - problem statement, literature review, hypotheses/questions, methodology and design, legal/ethical considerations, data analysis, conclusions, implications, recommendations (see W&H, pp. 409-12)

    When conducting the research critique:

    What about communication/dissemination of the research?

    Communicating research findings represents the final step in the research process. It involves the development of a research report which is disseminated through presentations and publications to audiences of nurses, health care professionals and health care consumers (Burns & Grove, 1993).

    It is important that any study proposal include a plan for dissemination of findings - and money and time should be allotted for this purpose.

    Conclusions should address implications for nursing: practice, education, and research

    Findings must be communicated in order to have an impact on nursing practice

    Communicate findings through a research report: written, oral, poster (be sure it is legible!)

    A well-organized report needs to include the logical development of ideas and lead to a scholarly conclusion (Burns & Grove, 1993).

    Always provide major conclusions and findings - and recommendations for further research.

    Illustrations provide a picture of the results and often include diagrams and graphs which are discussed in the narrative of the report.

    For journals, send query letters to editors to assess their interest in your topic (it is important to choose journals that are peer reviewed).

    Keep your query letter limited to one page

    Submit the manuscript to only ONE journal at a time.

    Include: research problem; brief discussion; significant findings; author contact information

    When writing the article, consider your journal audience:

    What exactly is meant by "peer reviewed", or "refereed"?

    A refereed journal (or committee, as in the case of a scientific meeting/convention) uses a panel of external and internal reviewers/editors (peers) who review submitted manuscripts for possible publication. These external reviewers are nurse scholars who are experts in their field. Most often, the reviewers do not know the identity of the author(s), and thus are able to remain objective. The credibility of the reported research is enhanced through peer review.
    (see p. 106 of textbook)

    What about "primary" and "secondary" sources?

    When conducting the literature review, it is important to note the use of primary sources. A primary source is written by the individual(s) who developed the theory or conducted the research (Wood & Haber, p. 106). A secondary source is written by someone other than the individual who developed the theory or conducted the research. The secondary source frequently represents a critique of a theorist's or researcher's work or an analysis of the work discussed (Wood & Haber, p. 106). Secondary sources are generally used when the primary source is unavailable (uncommon today) or to stimulate thoughtful consideration of others' viewpoints.

    Legal/Ethical Issues in Research

    Beginnings: post W.W.II, Nazi "medical research" led to the AMA code of ethics for research "that would be asked as a standard for judging the medical atrocities committed by physicians on concentration camp prisoners" (Wood & Haber, p. 276).

    The Nuremberg Code (1949) was the first international effort to create formal ethical standards

    Declaration of Helsinki

    International standard adopted in 1964 by World Medical Assembly; revised in 1975

    The National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research was created in 1974. It was charged with identification of the basic principles that should underlie the conduct of biomedical and behavioral research involving human subjects.

    Three Basic Ethical Principles for research were identified: (see W & H, pp. 277, 280; course document)
    Ethics Terminology
    a theory in which rules/principles are right in themselves (irregardless of consequences)

    one ought not inflict harm/evil

    the doctrine that acts are right/wrong regardless of consequences

    an attitude that another needs to be protected from consequences of own actions

    fair treatment; equal right of basic liberties for all

    See additional Ethics terms for further information.

    ANA "Human Rights Guidelines for Nursing in Clinical and Other Research"- nursing's code of ethics for research (see p. 283 of textbook)
    Protection of Human Rights (ANA, 1985): Five rights outlined are:

    Professional Codes of Ethics:
    Informed Consent

    Informed consent is the legal principle that "governs a patient's ability to accept or reject medical interventions designed to diagnose or treat an illness" (Wood & Haber, p. 285)

    Informed consent "determines and regulates participation in research" (Wood & Haber, p. 285).

    A researcher may NOT involve a human being as a research subject before obtaining the (legal) informed consent from the subject or a legally authorized representative (W & H, p. 285).

    Subjects must be given time to decide to participate.

    Subjects must never be coerced; they may withdraw from the study at any time without any penalty.

    No data may be collected on subjects who refuse to participate.

    Language of the consent form must be understandable (no > 8th grade reading level, no technical language).

    Obtaining informed consent:

    What is the purpose of the Institutional Review Board (IRB)?

    To review research proposals and assess whether or not ethical standards are met in relation to the protection of the rights of human subjects (see textbook, p. 293).

    National Research Act (1974): mandates that all agencies (universities, hospitals, etc.) MUST submit with funding requests that they have an IRB (AKA "human subjects committee") which reviews research projects and protects the rights of human subjects (see textbook, p. 293).

    IRB Requirements

    IRB Roles

    Determines if the study has minimal level of risk to the subject; protects subjects from undue risk and loss of personal rights and dignity

    Provides guidelines to researchers to enhance approval

    IRB may approve, require modifications or disapprove a study

    IRB approval MUST be received before beginning research

    IRB may suspend or terminate approval if research is not conducted in accordance with the IRB requirements

    IRB may conduct an expedited review:

    usually shortens the length of the review process if project involves minimal risk - but - the IRB makes the FINAL determination and research cannot begin until that time! (categories for expedited review - see textbook, pp. 293-294)

    What Constitutes Scientific Fraud/Misconduct?

    Highlights of the U.S. Copyright Act (1976)

    "Fair use" copying allows one to make copies without author permission. Four criteria determine "fair use":

    Obtaining permission - write to the publisher

    Copyright duration - depends upon original copyright date [?more detail]

    U.S. Gov. documents - are in the public domain and are not protected by the Copyright Law

    ????(See additional information located in the Course document)????

    last updated: 24 July 2001