TRENDS AND ISSUES IN NURSING NUR487 Overview of research process Dr. Nazik Zakari Dr. Hanan A. Ezzat Dr. Olfat Salem Nursing Administration & Education Dept. 4/24/2017

Definition of Research The Root meaning of the word research is search again examine carefully Research is diligent systematic inquiry or investigation to validate and refine existing knowledge and generate new knowledge. Research is scientific process that validates old knowledge and generates new knowledge, that directly and indirectly influences clinical nursing practice. Diligent mean work hard Inquiry mean question to ask to get information 4/24/2017

Nursing research defined as Systemic inquiry designed to develop knowledge about issues of importance to nurses, including nursing practice, nursing education, and nursing Research-based practice: using research findings to inform the decisions, actions, and interaction of nurses with clients. 4/24/2017

Definition of Research continued Systematic, diligent inquiry is necessary for researcher to address the following question What needs to be known? What research methods as needed to validate, refine, and generate this knowledge? What meaning can be extracted from the studies in a discipline to build a sound knowledge Many disciplines conduct research. There is no difference, because the knowledge and skills required for research do not vary from one discipline to another.The research in nursing must address the questions relevant to nurses and must develop a unique body of knowledge for practice. Nursing involves providing holistic care to promote health in patients and families.Nursing studies focus on the understanding of human needs and the use of therapeutic interventions to promote health, prevent illness, and treat illness. 4/24/2017

Two Different Views about Nursing Research One view is that nursing research should focus on knowledge that is directly useful in clinical practice. Another view is that nursing research includes studies of nursing education, nursing administration, health services, and characteristics of nurses and nursing role as well as clinical practice. 4/24/2017

The Knowledge Generated Through Research Is Essential for --Description --Explanation --Prediction --Control Description: obtain complete and accurate information about phenomenon. involve identifying and understanding the nature of nursing phenomena and some time, the relationships among them for example study conducted to describe the informational needs of surgical patients. The study found that discharge instruction must include activity level, pain management, prevention of complications. Explanation: clarifies the relations among phenomena and identifies the reasons why certain events occur. Prediction:one can estimate the probability of specific outcome in a given situation.ex.,conduct a study to determine the effect of position and mattress type on skin pressure. Control: we can predict so we can control and manipulate.conduct a research with case and control 4/24/2017

The Knowledge Generated Through Research Is Essential for --Description obtain complete and accurate information about phenomenon. involve identifying and understanding the nature of nursing phenomena and some time, the relationships among them for example study conducted to describe the informational needs of surgical patients. The study found that discharge instruction must include activity level, pain management, prevention of complications. --Explanation clarifies the relations among phenomena and identifies the reasons why certain events occur. --Prediction one can estimate the probability of specific outcome in a given situation. ex., conduct a study to determine the effect of position and mattress type on skin pressure. --Control we can predict so we can control and manipulate conduct a research with case and control Description: obtain complete and accurate information about phenomenon. involve identifying and understanding the nature of nursing phenomena and some time, the relationships among them for example study conducted to describe the informational needs of surgical patients. The study found that discharge instruction must include activity level, pain management, prevention of complications. Explanation: clarifies the relations among phenomena and identifies the reasons why certain events occur. Prediction:one can estimate the probability of specific outcome in a given situation.ex.,conduct a study to determine the effect of position and mattress type on skin pressure. Control: we can predict so we can control and manipulate.conduct a research with case and control 4/24/2017

Research Methodology The only way to conduct research is to use scientific method. Scientific method include quantitative and qualitative research. identify knowledge is generated through an application of logical principles and reasoning ... 4/24/2017

Quantitative Research Is a formal, objective, systematic process in which numerical data are used to obtain information about the world. Is used to describe variables, examine relationships among variables, and determine cause and effect interactions between variables. 4/24/2017

Qualitative Research Is a systematic, interactive, subjective approach used to describe life experience and give them meaning. Is conducted to describe and promote understanding of human experiences such as pain,caring, and comfort. When conducting qualitative research, the researcher collects data consisting of words, pictures, observations of events.This type of research is very popular with the social sciences(anthropology, psychology, sociology) 4/24/2017

Concepts Relevant to Quantitative Research Basic research: Undertaken to advance knowledge in a given area understanding relationships among phenomena Applied research Undertaken to solve a particular problem or modify a situation to make decisions or evaluate techniques Basic research is what we usually picture as research that is conducted in a laboratory, involving test subjects. This type of research is carried out by biologists and chemists. Applied research is probably the research approach taken by public health practitioners in course of their work. Many researcher have chosen to conduct applied studies to produce finding that directly affected clinical practice. 4/24/2017

Steps of Research Process Research Problem Literature Review Conceptual & Theoretical Frameworks Variables & Hypotheses Research Design Population & Sample Data Collection Data Analysis Results & Findings Basic research is what we usually picture as research that is conducted in a laboratory, involving test subjects. This type of research is carried out by biologists and chemists. Applied research is probably the research approach taken by public health practitioners in course of their work. Many researcher have chosen to conduct applied studies to produce finding that directly affected clinical practice. 4/24/2017

Pilot Study Done before a major study begins Minimizes the possibility of having significant difficulties occurring during the major study Reasons for conducting pilot study To determine whether the study is feasible ( are subject available, does the researcher have the time and money to do the study To identify problem with the design To determine whether the sample is representative of the population or whether the sampling techniques is effective.To examine the reliability and validity of the research instruments. . 4/24/2017

Importance of research in nursing Emphasizing on the development and utilization of nursing knowledge, which is essential for continued improvement in patient care. Nurses need to document the effectiveness of their practices not only to the profession, but also to the clients, administrators, and other professionals. Nurses’ need for understanding the varied dimensions of their profession, (theoretical, ethical, practical dimensions, etc). 4/24/2017

Research enables nurses to Describe the following: The characteristics of a particular nursing situation about which little is known. Explain phenomena that must be considered in planning nursing care. Predict the probable outcomes of certain nursing decisions. Control the occurrence of undesired outcomes. Initiate activities to promote desired client behavior. 4/24/2017

Roles of nurses in nursing research Indirect participation: This is a minimum nurse involvement in a research responsibility. It is done when a nurse read a research report to keep up-to-date on relevant findings that may affect their practice. This level is called “research utilization”. Research Utilization: “Is the use of the research findings in a practice setting”. Direct participation: in which nurses are nursing research producers. They are actively participating in designing and implementing research studies. 4/24/2017

Roles of nurses in nursing research Cont. Attending research presentations at professional conferences. Evaluating completed research for its possible use in practice. Discussing the implications and relevance of research findings with clients. Giving clients information and advice about participation in studies. Assisting in the collection of research information (e.g., distributing questionnaires to clients). Reviewing a proposed research plan for its applicability in clinical settings. Assisting with the development of an idea for a clinical research project. 4/24/2017

Characteristics of a scientific research Should include a problem that need a solution or a question that need an answer. Should achieve a general objective rather than a personal objective. It should follow the scientific approach that characterized by order and control. It should add new information through: New facts that was not known before. Validates results of previous research. Tests theories. Explains findings of a previous research. Find out new relationships among present phenomena 4/24/2017

Characteristics of a scientific research Cont. Research results should be liable to: Testing ________ When another researcher choose the same problem and follows the same steps, he/she probably gets the same results. Generalization _______ That is the results could be generalized from the study sample to the study population. 4/24/2017

Source of Knowledge for Nursing Research Tradition: Within nursing profession, certain beliefs are accepted (for example, one of the tasks traditionally performed by nurses is the change-of-shift report for each and every patient, whether or not the patient’s condition has changed, without proving its productivity and/or effectiveness under certain circumstances). But traditions may undermine effective problem solving. Authorities: An authority is a person with specialized expertise and recognition for that expertise. Dependency on nursing authorities (such as nursing faculty) is inevitable. Authorities as a source of information have limitations as: May depend on their personal experiences. Their knowledge often goes unchallenged. 4/24/2017

Source of Knowledge for Nursing Research Cont. Personal experience: We all solve problems based on observations and experiences. Personal experiences are based on recognition, generalization, and predictions based on observations. Personal experience has limitations as: Each person’s experience may be too restricted to be useful. Personal experiences are often biased. 4/24/2017

Source of Knowledge for Nursing Research Cton. Trial and error: The trial and error approach to nursing knowledge usually involves multiple attempts to solve a particular problem until a satisfactory solution is found. 4/24/2017

Ethical Context of Nursing Research Beneficence “DO NO HARM” protection of participants from physical or psychological harm. researcher should weigh risk/ benefit ratio of participation to individuals and must also weigh the risk to the participant against the benefits to society. Respect for Human Dignity The right to self determination, full disclosure means that the researcher has fully described to the participant the nature of the study and participants rights 4/24/2017

Ethical Context of Nursing Research Cont. Justice Right to fair treatment Both in the selection of the participant and during the course of the study. Right to privacy Formal confidential procedures. informed consent participants with fully information about the study to them take a reasoned decision about participation in the study. 4/24/2017

Mental processing of ideas to solve problems. Logical reasoning… What is reasoning ?? Reasoning Mental processing of ideas to solve problems. 4/24/2017

Intellectual Mechanisms Two intellectual mechanisms are used in reasoning inductive Deductive 4/24/2017

Inductive Reasoning: Process of developing conclusions and generalizations from specific observations. It moves from the specific to the general. Specific situations are observed and then combined into a larger, more general statement that can be tested through research. 4/24/2017

Example… The obstetrics nurse described observed hundreds of individual clients in labor over many years. From these observations, the nurse was able to propose a general theory about women who are in labor that could then be tested through formal research. 4/24/2017

Deductive Reasoning: process of developing specific predictions from general principles. Nurse reaches a conclusion by moving from the general to the specific. It is the approach used to test predictions and validate existing relationships. 4/24/2017

Example… An obstetrics nurse has noticed over many years of practice that women who have no support person with them while giving birth require more supportive nursing care than those accompanied by a mother, a partner, or friend. When this nurse then admits a young woman in labor who arrives at the hospital alone, the nurse anticipates that additional care measures will be appropriate for this client 4/24/2017