1. Understanding the Research Process
Cynthia A. Logan, PhD, RN

2. Research is… Systematic process of Purpose Collecting Analyzing
Interpreting
Purpose
Understand a phenomenon of interest
Communicate findings to the nursing community

3. Typical Characteristics of Research
Originates with a question or problem
Requires clear articulation of a goal
Requires a specific plan for proceeding
May divide initial problem into subproblems
Guided by problem, question, or hypothesis
Accepts certain assumptions
Requires data collection and interpretation
Cyclical or helical
Several steps to research process—do not always follow same sequence
Systematic, rigorous, planned.

4. Research is not……. Reading for personal learning
Transporting facts from one place to another
Rummaging for information
Information gathering

5. Why Research?????? Practical Application
Reading
Consider the source
Expert review
Sufficient details
Logical organization
Utilizing
Agree/disagree with findings
Implementation in clinical setting
Conducting
Significance
Researchability
Feasibility
Reading – Utilizing
Evaluation of the applicability of research requires some knowledge of the process. One way of looking at research is to check out the journal the research report appears in.
Ask yourself:
What does the journal require of its authors? Can usually be found in the journal or on the website.
Are the manuscripts submitted reviewed by others or does one person control publication?
Are sufficient details about the process included in the article? Enough to allow you to make a judgment about the value of the findings?
Does the journal have the respect of the profession?
Do you think that the article is logically organized, written so that you can understand the findings, even if you don’t really understand the choice of statistical techniques, etc.
Does it make sense to you? Don’t underestimate your knowledge.
Conducting Research
Time and money are often in short supply where research is concerned, even when it is an expectation. Some questions should be discussed in the early stages in order to use wisely everyone’s investment of time and money.
Is the problem important? Will the findings be of interest to many or to few?
How costly will it be? Are people available to conduct the study who are interested, motivated, and qualified? Will other employees be affected and how? Will all who are affected given the opportunity to have input on some level or to opt out?

6. What to Research? Finding a researchable problem
General Categories: People, Things, Records, Thoughts, Dynamics, and Energy
Observations & Experience
“GRIPES”
Identifying needs & problems
Your own interests
Nursing literature
Ideas from others
Why????
What???
How??
Curiosity is a natural accompaniment to finding a researchable problem.
Questioning mind asks Why? What happened here? What caused that?
Sources of research problems usually fall into one of these categories, regardless of discipline:
People – (lots of application to nursing)
individuals, groups, families, students, workers, management, disadvantaged, wealthy, poor, etc.
Things –
biological and vegetable life, e.g. rocks, space, pharmacological problems, machines, food, and clothing, etc.
Thoughts –
opinions, reactions, concepts, theories, viewpoints, perceptions, observations, issues, language, semanticss, etc.
Dynamics & energy –
Metabolism, bionics, quantum mechanics, nuclear energy, black holes, and extragalactic radiation.
Griping, though it has lots of negatives, has an upside too and can help us to identify needs and difficulties that may result in a researchable problem. Does a problem recur, can you discern a pattern in a situation? The answer may reveal more to you about the problem. Explore….Take some time to read
articles in your field. Bring interesting articles to your unit to share. What do you do with down time? Don’t have any? Go to the gift shop? Gripe or gossip?
Think about --
What irks you, frustrates you, affects patient care in unintended ways, or affects your job performance? We all have opinions about patient care and job performance, but we are not always provoked to act on the problem. Research is one way of acting on a problem and giving ourselves another dimension to make work life more meaningful.
Requires critical examination of what we do and why we do it? Including the decisions that we make.
What are your decisions based on?
Tradition
Evidence of effectiveness
Custom
Is the basis on which you make decisions in need of challenge?

7. Problem Statement: A Matter of Words
Briefly describes the dilemma or situation in need of investigation
Describes the scope of the problem
Identifies the nature of the problem , its context, and significance
States what the researcher intends to do
Focus of the study written in 4 sentences or less, usually
Delimitation – states what the researcher does not intend to do.
Definitions of terms – the reader cannot evaluate the research or determine whether the researcher has carried out what was proposed in the problem statement, unless the researcher clearly defines the terms important to the study.

8. Literature Review Identifies:
What is known and what is not known
Gaps and inconsistencies in body of knowledge
New interventions to test
Available instruments with established reliability and validity
Theoretical or conceptual frameworks
Types of research designs already used
Problems you may encounter
Not only helps to identify problems, but also can help you explore the area to find out what has been done and what suggestions for future research exist.
If a problem has been fully researched, there may be no point in developing another study unless you have a fresh perspective.
Primary vs. secondary sources
Locating literature—print resources, internet resources, online search of electronic databases, references lists attached to research reports
Limiting your search, so that you don’t get thousands of articles
Seeing the same references or authors again and again may give you a clue to something important that you may want to include in your review.

9. Clinical Fieldwork Talk informally with others in your field
Collect expert opinions
Think about the situation
who affects the situation
who is affected by the situation
Begin to plan your next steps
Expands your knowledge of the factors involved and may give you ideas about the significance to nursing.
Who’s an expert?

10. Defining the Framework
Theory: “an abstract generalization that offers a systematic explanation abut how phenomena are interrelated.” Polit & Beck
Set of propositions that explain a relationship among concepts
Conceptual Models, Conceptual Frameworks, Conceptual Schemes (terms often used interchangeably): views about the nursing process and the nature of nurse-client relationships
Less formal but also deal with abstractions
Concepts that are relevant to a common theme
Research findings become a part of the body of knowledge that is nursing. Having an appropriate theoretical or conceptual framework assists with this process by linking new research to existing knowledge

11. Hypothesis: It’s Worth a Guess
Speculation about the answer to a question
Essential to experimental research
A position from which the researcher can explore
Serves as a “reality check” for the findings that the data reveal
Findings support the hypothesis? Accept!
Or not? Reject!
Not necessarily proof.
If not supported, no fault in this outcome. Setting out to “prove” a hypothesis may bias your research.
Null hypothesis
Research Question – identifies the concepts under investigation and asks how the concepts might be related.
Example:
RQ -- Is preeclamptic toxemia in pregnant women associated with stress factors present during pregnancy?
Hypothesis – Pregnant women with a higher incidence of stressful events during pregnancy will be more likely than women with a lower incidence of stress to experience preeclamptic toxemia.

12. Research Designs General strategy for solving a research problem
Guides the planning needed for implementing a study
Resources
Procedures
Data
Experimental vs. Nonexperimental
Research designs vary according to:
Degree of structure --
Quantitative research designs tend to be more structured than qualitative designs and are very specific re: interventions, comparisons made, methods to control extraneous variables, data collection, types of participants, etc. All specified in advance of the start of data collection.
Qualitative designs are more fluid/flexible and some modifications may be made along the way.
Type of group comparisons
Time frame
Control over IV
Measurement of IV & DV

13. Research Methodology & Intervention Protocols
Specific to the discipline
Addresses practical issues precisely and realistically:
Type of data
Data availability
Data collection
Data interpretation
Intervention protocol
“You cannot study chromosomes with a questionnaire and you cannot study attitudes with a chemical analysis.”
How will you get to where you want to go? The details should be planned in advance not haphazardly along the way. Sometimes something comes up unexpectedly that must be dealt with, but planning is essential.
Feasibility
Time & cost
Intervention protocol

14. Population & Sample
Population – those who conform to a certain set of characteristics which will be studied.
Those to whom findings can be generalized.
Sample – participants in the study, a subset of the population.
Representative of the population
Generalizability—to whom will your finding apply
Example—a nurse researcher may want to study labor and delivery nurses, so the population may be defined as all L & D nurses in the U. S.
Probably will not have the time or the money to conduct a study including the entire population, so you select a sample of nurses from this population, which could include
your L & D friends, a convenience sample
2. your L & D friends and their L & D friends, snowball or network sample, also a convenience sample
3. Selection according to some existing characteristic, such as the percentage of males (20%) and females (80%) in nursing, quota sample
Urban/rural, older/younger, etc
4. Hand picking nurses who are judged by the researcher to be typical of a certain population of nurses, purposive sampling
Frequently used by qualitative researchers
Used when testing and evaluating new instruments often
All of the above—non-probability sampling
Problem with non-probability sampling is that they are rarely representative of the population. They are used chiefly because of convenience and low cost.
Probability sampling involves the random selection of elements from a population
If I listed every L & D nurse here (sampling frame) and selected 10% by drawing out of a hat, then I have a better chance of getting an unbiased sample, representative of the population, but not a guarantee.
There are other methods of obtaining a sample, also based on random selection but more complicated.

15. Research Variables
Definition: “an attribute or a person or object that varies, that is, takes on different values…” Polit & Beck
Weight, temperature, anxiety level, income…
Hypothesis is a predicted relationship between two or more variables.
Independent variable
Dependent variable
In cause-effect studies IV is the presumed cause and the presumed effect is the dependent variable
Smoking causes lung cancer
“Nursing intervention” causes more rapid recovery.
Not always written so clearly– more often talking about associations or relationships, not cause/effect which is the most difficult to find.
= DV Italics=IV
The incidence of decubitus ulcers is related to the frequency of turning patients.
Nurses administer the same amount of narcotic analgesics to male and female patients.

16. Participants’ Rights Ethical dilemmas result of: Ethics Principles
Not aware of participation
Dealing with sensitive information
Revelation of information
Denial of benefits
Ethics Principles
Codes of Ethics
Ethical Guidelines
Dilemmas –
Participants must be made aware that they are in a study.
Studies dealing with sensitive information or interventions that may be uncomfortable, physically or emotionally.
Denial of benefits of treatment.
Revelation of information by participants about immoral or illegal behavior.
Principles –
Beneficence –
not just freedom from harm but must do good. What can be built into a study to minimize or reduce the potential risks. If there are any potential benefits to participants, should be spelled out.
Freedom from exploitation – need to assure that information collected will not be used against them, e.g. informing health insurance carrier, affecting grade in course or standing in university.
Risk/benefit ratio
Respect –
Self-determination – right to ask questions, to terminate participation, no coercion to participate, use of money as incentive, etc.
Right to disclosure – essential for informed consent
Justice –
Right to fair treatment –
Selection unbiased, honoring all agreements made, access to assistance if risk present, debriefing, courtesy
Right to privacy –
Informed Consent –
Comprehension – readability
Consent and assent (affirmative agreement to participate)
Vulnerable groups – children, terminally ill, “captive audiences,” disabled
Anonymity & Confidentiality – difference
When anonymity impossible, steps must be taken to ensure confidentiality. Usually, these steps are spelled out in the information that goes to IRB, the participants, and described in the research report.
Codes –
Nuremberg Code – international standard developed after WWII atrocities.
Declaration of Helsinki, adopted in 1964 by World Medical Association and revised 2000.
Unethical actions have led to greater visibility and increased oversight of human rights.
Tuskegee Syphilis Study—treatment withheld
Radiation experiments on prisoners and others in 1940’s
ANA Code of Ethics—Provision 7 states:
“The nurse participates in the advancement of the profession through contributions to practice, education, administration, and knowledge development.”
Interpretative statement re: research -- excerpts
“…Ongoing scholarly activities are essential to fulfilling a profession’s obligations to society. All nurses working alone or in collaboration with others can participate in the advancement of the profession through the development, evaluation, dissemination, and application of knowledge in practice… an organizational climate and infrastructure conducive to scholarly inquiry must be valued and implemented for this to occur.”
In addition ANA put out a document in 1995 titled Ethical Guidelines in the Conduct, Dissemeination, and Implementation of Nursing Research which gives additional direction re: research in nursing.
Belmont Report—serves as the basis for regulations affecting research sponsored by the federal government. Articulated 3 primary ethical principles on which standards of ethical conduct in research are based: beneficence, respect for human dignity, and justice.
Institutional Review Boards (IRB)—formal committee for reviewing proposals with set protocols before they are implemented. May go by other names but all have responsibility for unbiased review of proposals to protect the rights of human participants.

17. Pretesting/Pilot Study
Allows researcher to try out protocols, instruments, participant response, etc.
Allows researcher to make adjustment before investing major time and energy
Pretest vs. Pilot Study
Instrument pretesting
Small scale trial run—pilot study
Proposal review

18. Data Collection Answers the following questions:
What data are necessary?
What are their characteristics?
Where is the data located?
How will data be secured?
How will data be interpreted?

19. Data Analysis Varies according to the type of design Preparing data
Determining if usable
Assigning identification codes, if not already done
Statistical analysis
Quantitative vs. qualitative
Experimental vs. Nonexperimental
Identification codes
Coding data—translating verbal into numeric

20. Interpreting Results Process of making sense of the data
Were hypotheses supported?
Yes!
If not, why not?
Critical evaluation needed
Critical evaluation needed of all decisions made

21. Communicating Findings
Dissemination of study results contributes evidence to nursing practice through:
Research reports
Presentations
Articles

22. Utilizing Research Findings
Researcher should:
include recommendations for using the findings in nursing
Pursue opportunities to disseminate findings to practicing nurses
Practicing nurses have the final word!

23. Example: Topic vs. Problem Statement
“Side effects of chemotherapy”
Polit & Beck
“N & V are common SE’s among pts on chemotx, and interventions to date have been only moderately successful in  these effects. New interventions that can  or prevent these side effects need to be identified.”
Sets up the problem and focuses the reader on the need for this research.
Immediately tells the reader what is important and what direction this study will take.

24. Example: Research Question
“What is the relative effectiveness of patient-controlled antiemetic therapy versus nurse-controlled antiemetic therapy with regard to (a) medication consumption and
(b) Control of nausea and vomiting in patients on chemotx?”
Polit & Beck
More specific
Requires definition of terms
Antiemetic therapy
Patient-controlled antiemetic therapy
Nurse-controlled antiemetic therapy
Medication consumption
Control of N & V

25. Example: Hypotheses
“Subjects receiving antiemetic therapy by a patient-controlled pump will report less nausea than subjects receiving the therapy by nurse administration.
Subjects receiving antiemetic therapy by a patient-controlled pump will vomit less than subjects receiving the therapy by nurse administration.”
Polit & Beck
Definition of terms—is retching nausea or vomiting?

26. The End