1. Exploring Nursing Research in Canada Class One September 16, 2009 Judith Shaw, Ph.D.,R.N.

2. What is research? n to search again n diligent and systematic inquiry n to discovery

3. Define Nursing Research

4. n a scientific process that validates and refined existing knowledge, and n generates new knowledge that directly and indirectly influences nursing practice

5. Nursing Research Provides the scientific basis for the practice of the profession. (American Association of College of Nursing)

6. Definition of Nursing Research Requires an understanding of what knowledge is relevant for nursing-

7. Definition of Nursing Research Specifically- what knowledge is needed to improve nursing practice (Burns & Grove, 2007)

8. Metaparadigm n A global statement that identifies the subject matter of each discipline or field of study. (Fawcett, 2005)

9. Metaparadigm of Nursing n Human beings n The environment n Health n Nursing

10. Nursing Research A formal, systematic, and rigorous process of inquiry used to generate and test theories about the health-related experiences of human beings within their environments and about the actions and processes that nurses use in practice (Fawcett & Garity, 2009)

11. Comparison Nursing Process & Nursing Research 1. Assessment & Interpretation of Data 2. Diagnosis of problem 1. Selection of a social context 2. Formulation of research question; explication of researcher’s beliefs

12. Comparison Nursing Process & Nursing Research 3. Development and implementation of plan of care 3. Develop and implement methodology plan Cyclical process of data collection, analysis, and concept formation and modification

13. Comparison Nursing Process & Nursing Research 4. Evaluation of plan of care 4. Interpretation of findings May involve review of literature at this stage Validation of findings with participants

14. Comparison Nursing Process & Nursing Research 5. Revision of plan based on evaluation 5. Communication of the findings. Implications and recommendations

15. OR

16. Nursing Process  Nursing Research (Fawcett, 2005) 1. Assessment 2. Planning 3. Implementation 4. Evaluation 5. Documentation 1. Statement of the problem 2. Research Methods 3. Conduct of the Research 4. Interpretation of results 5. Research Report

17. The Importance of Research in Nursing Description (what is)

18. The Importance of Research in Nursing Explanation (relationship; nursing interventions with client outcomes)

19. The Importance of Research in Nursing Prediction (probability of a certain outcome in a specific situation)

20. The Importance of Research in Nursing Control (to produce the desired outcome)

21. Kinds of Nursing Knowledge n Traditions n Authority n Borrowing n Trial and Error n Personal Experience n Role-Modeling n Intuition n Reasoning n Research

22. Epistemology n -the study of the nature of knowledge How we know what we know

23. Ways of Knowing n Aesthetics n Ethical Knowing n Personal Knowing n Empirical Knowing (Carper, 1978) n *Socio-Political (*White, 1995) n **Unknowing in Knowledge (**Heath,1998; Munhall, 1993)

24. Aesthetics n The nature of beauty or art …art of nursing

25. Ethical Knowing n The obligation, moral component –what should be done –what is good, right and desired

26. Personal Knowledge n Interpersonal interactions and relationships between the nurse and a client –therapeutic use of self –authentic personal relationship

27. Empirical Knowledge n Knowledge of the experienced or empirical world

28. Socio-Political n Situates nursing practice in the world of society, community life, culture, economics, and politics n Who’s voice is heard? n Whose voice is silenced.

29. Unknowing in Knowledge n All knowledge is tentative and dynamic. n Openness, qualitative receptivity to what may be learned. n Not all important questions have been asked. n Many answers to both scientific and philosophical questions remain elusive.

30. How does nursing thought flow from both concrete to abstract thinking?

31. The World of Nursing Research PhilosophyAbstract Knowledge ScienceAbstractTheory Thought Processes Reality Testing (Research) Empirical World (Nursing Practice) Concrete

32. Research Nursing Knowledge More reliable vs. Other Kinds of Nursing Knowledge

33. Philosophy in Nursing Research n Framework for identifying central concept n Assumptions for theory development n Relates nursing to practice world n Information on how to learn about the world

34. Philosophical Position Qualitative Research Approaches

35. Assumptions - interpretive worldview - multiple realities - many sources of information - knowing how social experience constructs reality is important

36. Philosophy philosophicalresearch notionsquestion of scientific truth

37. Philosophy Research Methods Question of Inquiry in Nursing

38. Qualitative Research Six Characteristics

39. 1. Multiple Realities The individual: - active participates in social action - comes to know and understand phenomena in very different ways

40. 2. Multiple Ways of Understanding Finding a method or approach to appropriately answer the question

41. 3. Participant’s Point of View To present the participant’s view of reality - understand the context of what is researched

42. 4. Context Alter as little as possible

43. 5. Researcher- Part of the Study Researcher as instrument -subjective bias

44. 6. Reporting Participant’s perspective -rich, literary style -participant’s quotes, commentaries, and stories

45. Development of Nursing Science Three perspectives 1. Positivist 2. Interpretive 3. Critical [Social Theory]

46. Positivist Perspective Strict rules of logic, truth, axioms, and predictions

47. Interpretive Perspective Reality is based on personal perceptions What we know has meaning only within a given context

48. Critical Perspective Human behavior consist of different groups attempting to enhance their interests at the expense of less powerful groups

49. Three Levels of Quantitative Research * Constructaxiom*Construct [relationship between constructs] *Conceptproposition*Concept [relationship between concepts] Indicators hypotheses Indicators *different authors reverse these; Gillis and Jackson (2002) reverse the order

50. Qualitative Research Naming - discovering meanings in contexts - process and meaning are described

51. Qualitative Research Cyclical Process Researcher moves back and forth between the data collection and analysis stages -to identify and describe the participant’s perspective

52. QUESTIONS ASKED HOW/WHAT

53. Triangulation Use of multiple methods to generate and collect data about one phenomenon

54. Triangulation Within-Methods Between-Methods

55. Within-Methods Triangulation Example -different types of qualitative data collections strategies

56. Between-Methods Triangulation Example - both qualitative/quantitative data collection procedures

57. Unit of Analysis The element or set of elements selected to study -individual -aggregrate [group, community]

58. LINK OF PRACTICE, THEORY, AND RESEARCH Practice Theory Research

59. NURSING RESEARCH PRIORITIES To Improve: Nursing as a Profession Nursing Practice Patient Outcomes

60. Quantitative & Qualitative Research Characteristics Quantitative Research –Hard Science –Focus: Concise & Narrow –Reductionistic –Objective –Reasoning: Logistic, Deductive –Basis of Knowing: Cause & Effect, Relationships Qualitative Research - Soft Science - Focus: Complex & Broad - Holistic - Subjective - Reasoning: Dialectic, Inductive - Basis of Knowing: Meaning, Discovery

61. Quantitative Qualitative Research Research –Tests Theory –Control –Instruments –Basic Element of Analysis: Numbers –Statistical Analysis –Generalization –Develop Theory –Shared Interpretation –Communication & Observation –Basic Element of Analysis: Words –Individual Interpretation –Uniqueness

62. RESEARCH-MINDEDNESS

63. Research-based Practice

64. Deterrents to Conducting Research

65. n limited number of nurses prepared to conduct research n nurse researchers may not be involved with or knowledgeable about nursing practice n difficulty in asking the research question

66. Deterrents to Conducting Research lack of congruency between research purposes and research methods insufficient time access to patients

67. Deterrents to Disseminating & Applying Research n Understanding by practicing nursing n Faculty not involved in research n Lack of scientific rationale/nursing textbooks n Inadequate preparation

68. Promotion of Research & Research-Based Practice n Increase number of B Sc..N, Master’s & doctoral prepared nurses n Emphasize students learn to critique research for quality data n Develop a climate that rewards research

69. Promotion of Research & Research-Based Practice n Strengthen collaboration of practice/research/education n Research-based protocols n Research interest groups n Increase opportunities for publishing

70. FINANCING NURSING RESEARCH IN CANADA

71. Federal Support for Research 3 categories: research grants, research fellowships, & auxiliary grants (indirect $) –1971-McGill, first Center for Nursing research –gradual increase in funding –increase in doctoral programs/increase in research

72. FUNDING n Canadian Institutes of Health Research (CIHR) Medical Research Council, National Health Research & Development Program n Charitable organizations n Canadian Nurses Fund n Canadian Health Services Research Foundation (CHSRF) n Social Science & Humanities Research Council of Canada (SSHRC) n Nova Scotia Health Research Foundation

73. PRAXIS WITHIN NURSING theory, practice and research informing the others to produce powerful new forms of knowledge