Developing Your Research Question I know what general area, but I’m not sure of my research question?

The Importance of Good Questions A good research question: Defines the investigation Sets boundaries Provides direction

Defining Your Topic If you are finding it a challenge to generate a research topic you can: Hone in on your passions Use your curiosity Look for inspiration from the creative arts Develop ‘right brain’ skills such as concept mapping

Concept Map of Potential Research Topics

NURSING RESEARCH Is a systematic inquiry designed to develop knowledge about issues of importance to the nursing profession, including nursing practice, education, administration, and informatics.

COMPARISON BETWEEN COHORT AND CASE-CONTROL STUDY Research design Conduction Measure of risk Temporal relationship between exposure and disease Cost of study Population size Best when Problems 安居木

Research Design

Design of cohort study START WITH: EXPOSED NOT EXPOSED AND THEN FOLLOW TO SEE IF DISEASE DEVELOPS DISEASE DOES NOT DEVELOP DISEASE DEVELOPS DISEASE DOES NOT DEVELP Design of cohort study

Design of a case-control study THEN DETERMINE EXPOSURE HISTORY Were not exposed Were not exposed Were exposed Were exposed HAVE THE DISEASE DO NOT HAVE THE DISEASE START WITH Design of a case-control study

In A COHORT STUDY IN A CASE-CONTROL STUDY GROUPS COMPARED EXPOSED PEOPLE NON-EXPOSED PEOPLE AND IN A CASE-CONTROL STUDY GROUPS COMPARED PEOPLE WITH THE DISEASE PEOPLE WITHOUT THE DISEASE AND ‘CASES ‘ ‘CONTROLS’

In A COHORT STUDY IN A CASE-CONTROL STUDY DETERMINE INCIDENCE RATES OF DISEASE IN: EXPOSED PEOPLE NON-EXPOSED PEOPLE AND IN A CASE-CONTROL STUDY DETERMINE THE PROPORTIONS EXPOSED IN: PEOPLE WITH THE DISEASE PEOPLE WITHOUT THE DISEASE AND CASES CONTROLS

Cohort study Case-control study Measure of risk Relative risk Odds ratio Temporal sequence Easy to establish Sometimes hard Multiple association Possible to study associations of an exposure with several disease Possible to study associations of a disease with several exposures or factors Time and cost required Long and expensive Relatively short and inexpensive Population size Relatively large Relatively small Potential bias Assessment of outcome Assessment of exposure Best when Exposure is rare, and disease is frequent among exposed Disease is rare, exposure is frequent among the diseased

Changes over time in criteria and methods Cohort study Case-control study Problems Selection of non-exposed comparison group often difficult; Changes over time in criteria and methods Selection of appropriate controls often difficult; Incomplete information on exposure

Not Exposed Exposed B C B B C B C C Develop Disease A Develop Disease Do not Develop Disease A B C Do not Develop Disease A B B C B C C

Not Exposed To A Not Exposed To A No Disease Disease C C C C B B B B Exposed to A Not Exposed To A Exposed to A Not Exposed To A No Disease Disease cases Controls

PURPOSE OF NURSING RESEARCH To test, refine and advance the knowledge on which improved education, clinical judgment, and cost-effective, safe, ethical nursing care rests.

DEVELOPMENT AND PROGRESSION OF NURSING RESEARCH

THE ORIGIN OF NURSING RESEARCH FLORENCE NIGHTINGALE – viewed as the person who first elevated nursing to the status of a PROFESSION, as presented in her first book NOTES ON NURSING (1859) Believed in the importance of “naming nursing” by the use of observed data to support the need for health-care reforms. Methodical Data gathering

A Look at Nursing Education 1923 – Committee for the Study of Nursing Education Studied educational preparation of nurse teachers, administrators, public health nurses and the clinical experiences of nursing students.

Gold Mark Report – identified many inadequacies in the educational backgrounds of the group studied and concluded that advanced educational preparation was essential.

POSITIVIST PARADIGM ASSUMPTION POSITIVIST PARADIGM Ontologic (what is the nature of reality?) Reality exists; there is a real world driven by real natural courses Epistemologic (How is the inquirer related to those being researched?) The inquirer is independent from those being researched; findings are not influenced by the researcher Axiologic (What is the role of Values in the inquiry?) Values and biases are to be held in check; objectivity is sought Methodologic (How is knowledge obtained?) Deductive process, emphasis on discrete, specific concepts; fixed design, tight controls over context, emphasis on measured, quantitative information; statistical analysis; seeks generalization

NATURALISTIC PARADIGM ASSUMPTION NATURALISTIC PARADIGM Ontologic (what is the nature of reality?) Reality is multiple and subjective, mentally constructed by individuals Epistemologic (How is the inquirer related to those being researched?) The inquirer interacts with those being researched; findings are creation of the interactive process Axiologic (What is the role of Values in the inquiry?) Subjectivity and values are inevitable and desirable Methodologic (How is knowledge obtained?) Inductive process; emphasis on entirely of some phenomenon, holistic; emerging interpretations grounded in participants’ experiences; flexible design; context-bound; emphasis on narrative information Qualitative analysis

QUANTITATIVE RESEARCH Uses deductive reasoning Systematic Uses control Uses measurements Researchers gather empirical evidence (objective in nature) Information gathered is usually (but not always) quantitative/numerical Uses statistical analysis Cannot be used to answer moral or ethical questions

NATURALISTIC METHODS AND QUALITATIVE RESEARCH NATURALISTIC METHOD – attempt to deal with the issue of human complexity by exploring it directly. Investigations place a heavy emphasis on understanding the human experience as it is lived.

QUALITATIVE RESEARCH Uses inductive reasoning Used for theory development Approach is flexible Always takes place in the field Concurrent collection and analysis of data Gathers rich and in-depth information (subjective in nature) Report is written in narrative form Involves small group of people or subjects Cannot be used to answer moral or ethical questions

People who are being studied Quantitative – subjects, study participants, respondents Qualitative – informants, key informants, study participants Sample – composed of the people being studied Person who undertakes the research Quantitative – researcher, investigator, scientist Qualitative – researcher, investigator

Research Settings – specific places where data collection occurs Quantitative – laboratory setting, (sometimes) field settings Example: Pierce and Clancy (2001) studied the effects of hypoxia on diaphragm activity in anesthetized rats. Qualitative – naturalistic setting/field Example: Carlisle (2000) studied the search for meaning in the care giving experience among informal carers of people living with HIV and AIDS. The researcher gathered in-depth information from carers in their homes and in HIV/AIDS org.

THEORIES AND CONCEPTUAL FRAMEWORKS Theory – systematic, abstract explanation of some aspect of reality Example: Nightingale’s Environmental Nursing Theory Conceptual Frameworks/Models – interrelated concepts or abstractions assembled together in a rational scheme by virtue of their relevance to a common theme. Example: Betty Neuman's Health Care Systems Model

RESEARCH DATA Pieces of information obtained in the course of investigation

Minding Practicalities Research directions are not always at the full discretion of the researcher. Practicalities include: Appropriateness of the topic Your ability to get supervisory support Funding opportunities and commitments

From Interesting Topics to Researchable Questions An ‘angle’ for your research can come from insights stemming from: personal experience theory observations contemporary issues engagement with the literature

Narrowing and Clarifying Narrowing, clarifying, and even redefining your questions is essential to the research process. Forming the right ‘questions’ should be seen as an iterative process that is informed by reading and doing at all stages.

Cycles of Research Question Development

The Concept Map Revisited Attraction to opposite sex School ridicule Peers Media Parents Diet ads You’re so pretty!! Desire to be popular Do parents teach their daughters that worth is dependent on external beauty? Compliments Thin TV Stars Magazine Models Poor Self Image in Young Girls Size of ‘stars’ is newsworthy Weight obsessed mother You look so nice in that! Do young girls have an unrealistic perception of normal?

The Hypothesis Dilemma Hypotheses are designed to express relationships between variables. If this is the nature of your question, a hypothesis can add to your research If your question is more descriptive or explorative, generating a hypothesis may not be appropriate

The Hypothesis Dilemma A hypothesis may not be appropriate if: You do not have a hunch or educated guess about a particular situation You do not have a set of defined variables. Your question centres on phenomenological description (see Chapter 9) Your question centres on an ethnographic study of a cultural group (see Chapter 9)  Your aim is to engage in, and research, the process of collaborative change (see Chapter 10)

Good Question Checklist Is the question right for me? Will the question hold my interest? Can I manage any potential biases/subjectivities I may have?

Good Question Checklist  Is the question right for the field? Will the findings be considered significant? Will it make a contribution?

Good Question Checklist Is the question well articulated? Are the terms well-defined? Are there any unchecked assumptions?  

O'Leary, Z. (2004) The Essential Guide to Doing Research. London: Sage O'Leary, Z. (2004) The Essential Guide to Doing Research. London: Sage. Chapter Three

Good Question Checklist Is the question doable? Can information be collected in an attempt to answer the question? Do I have the skills and expertise necessary to access this information? If not, can the skills be developed? Will I be able to get it all done within my time constraints? Are costs likely to exceed my budget? Are there any potential ethics problems?  

O'Leary, Z. (2004) The Essential Guide to Doing Research. London: Sage O'Leary, Z. (2004) The Essential Guide to Doing Research. London: Sage. Chapter Three

O'Leary, Z. (2004) The Essential Guide to Doing Research. London: Sage O'Leary, Z. (2004) The Essential Guide to Doing Research. London: Sage. Chapter Three

O'Leary, Z. (2004) The Essential Guide to Doing Research. London: Sage O'Leary, Z. (2004) The Essential Guide to Doing Research. London: Sage. Chapter Three

Evidence Based Resources Models Here is how the tool applies to some of the Ovid databases. We have Cochrane at the top and Medline/CINAHL at the bottom. Claude Moore Health Sciences Library, 2003

The cognitive continuum. This diagram is an analysis of something called the cognitive continuum, in this instance based on research among nurses in the UK. It shows 6 steps of information used in decision making, from using intuition on the left, to the most highly analytic and structured information: the scientific experiment, on the right. In this study they followed nurses around and kept track of their decision making processes. What determines whether a nurse uses intuitive decision-making (or NOT evidence based practice) or a more rational decision making (EBP) depends on where the decision task lies on this chart. So, the more structured the decision is, such as through forming a PICO question, by learning how to search in a structured way, the more likely the nurse will use rational decision making. Short time frames for decision turn around encourage intuitive decision making, so learning how to search databases efficiently reduces that time and makes nurses more likely to use EBP. Other factors that increase the likelihood that a nurse will use EBP: whether the information has been broken down into components The need to demonstrate decision making reasoning to others, such as developing a policy or budget rationale to administrators. Thompson, C. et al. Evid Based Nurs 2004;7:68-72 Copyright ©2004 BMJ Publishing Group Ltd.

Evaluating Evidence

Are plans that tell a researcher STUDY DESIGNS Are plans that tell a researcher how data are to be collected, from whom data are to be collected, how data will be analyzed to answer specific research questions.

Research studies are classified into two basic methods: Quantitative research is a formal, objective, systematic process in which numeric data are used. Qualitative research is a systematic approach used to describe and promote understanding of human experiences such as pain

EBP (Medicine) United States: Agency for Health Care Policy and Research (AHCPR) Department of Health & Human Services http://www.ahcpr.gov/ Developed many clinical guidelines to direct the EBM movement.

Good Question Checklist Does the question get the tick of approval from those in the know? Does my supervisor think I am on the right track? Do ‘experts’ in the field think my question is relevant/ important/ doable?