discovering nursing research lecture 1 what is the value of nursing research encoura 2921000

Discovering Nursing Research Lecture 1 What is the value of nursing research -Encourages provision of best care

-Relevant to change in care, get better

-Will have to apply research according to hospital policy

ACCN: The goal is that the graduate is able to review research and use research findings from nursing and other disciplines that can be applied to their clinical practice

Value of Nursing Research 1. Establishing Professionalism

-emerging profession

-developing body of knowledge

2. Accountability

-Economics

-Evidence

-keeping current, read journals attend conferences

-Participation in research

*As number of old people increase, it makes more sense for us to study them

3. Social Relevance

-documentation of effectiveness

-contribution to improvement

4. Standards of Care

-application

-knowledge of research helps in making informed decisions Magnet Recognition Program -American nurses credentialing center

-recognition of health care organizations that provide high quality nursing care

-elevates the standards of nursing profession

-integration of nursing research and evidenced based practice is expected

*Education is important for employees First Nurse Researcher Florence Nightingale

-Revolutionary philosophy type writing

-Notes on Nursing 1859

-Known for data collection and analyses during Crimean War

-Focused on healthy environments, light, ventilation, public water, nutrition

-these extended to army and public health too

-First real evidenced based practice (using her own evidence to adjust practices) Nursing Research in 1850s-1950s 1.Quantitative: Focused on nursing education

-identifying inadequacy of nursing education

2. Goldmark and Brown Reports begin publishing

3. Journal: American Journal of Nursing began publish in 1930s

4. Journal: Nursing Research: prestigious journal 1952

5. 1950s focus on the characteristics of nurse

6. Establishment of nursing research centers (ANI, Research institute) Nursing Research 1960s-1970s 1960s:

-theory based

-conceptual frameworks, nursing process

-research taught grad schools, conferences

1970s:

-Journals: Advances in Nursing science, research in nursing & health, western journal of nursing research

-standards of practice

-nursing diagnoses

-qualitative research

-continues to evolve 1980s -Utilization of research to practice

-National center for nursing research (later becomes national institute of nursing research)->gov funded

-Journals: Applied Nursing Research, Scholarly Inquiry for Nursing Practice, Nursing Science Quarterly

*Gov recognizes importance of nursing research 1990s-2015 -NINR budget=approx $140 million for 2015

-Clinical Nursing Research, Qualitative Health Research, Biological Research for Nursing, Worldviews on Evidenced-based nursing

-Increased focus on outcomes research (How what we are doing is affecting outcomes for patients)

-Agency for health care policy and research (AHCPR), now Agency for healthcare research and quality (AHRQ)

-The Cochrane Collaboration: reviews to help support healthcare in general, not just nursing findings from different sources Nursing Research in the Future -Increased focus on evidenced based practice

-Replication of studies, multi-site studies (can’t generalize research until it can be replicated)

-Continued focus on outcomes research(want positive)

-Multidisciplinary collaboration

-New focus: chronic illness, end of life care, quality of life, symptom management

-Continued funding expected

-Shortage of nursing researchers

-NINRs scientific goals and objectives

-continued focus on evidence based practice (continue to develop and change) Sources of Knowledge for Nursing Common nursing practices are based on knowledge from: 1. Tradition

-ex. ice water for women in labor

2. Authority

-nurse educators, professors

3. Experience/Trial and Error

4. Borrowing

-multidisciplinary

5. Role Modeling

-expert of older nurse learn from

6. Logical Reasoning/Critical thinking

-Inductive vs deductive

-Inductive: specific to general

-deductive: general to specific

*can lead to poor outcomes at times

7. Nursing Research

-most reliable

-best source

-most sophisticated

-combines features from all other sources

*also, more published protocols, give nurses more free will on time management, pt relationship etc What is nursing research? Research=to search again

-validates and refines existing scientific/empirical knowledge (can confirm with data)

-question and replicate

-generates new scientific/empirical knowledge Quantitative Research (Scientific approach) -Based on positivist paradigm: reality exists, wanting to be discovered

-objectivity sought

-deductive process

-seeks generalization to individuals

-orderly and systematic (logic, planned action)

-tight control (for bias)

-empirical evidence

-formal instruments/questionnaires(estabilished tools/sclaes)

-usually quantitative(numeric)

*can’t answer all of nursings questions

-ethical and moral

-complex phenom

-not enough info Deductive Reasoning -Moves from general to specific

ex:

-all human beings experience loss

-all adolescents are human beings

It can be deduced that all adolescents experience loss Qualitative Research -Based on naturalistic/phenomenologic paradigm: reality is subjective and constructed by individuals (what affects one person may not affect another)

-subjectivity inevitable and desirable

-Inductive process

-seeks patterns

-emphasis on complex human experience

-flexible

-gathers narrative evidence (interviews taped or recorded)

-non quantitative

*still can’t answer all of nursing’s questions

-answers a much more specific question

-smaller sample=less generalizable, not numerical so you can’t make assumptions

-may interpret things differently than what the person meant (bias) Inductive Reasoning -Moves from specific to general

Example:

-a headache is an altered level of health that is stressful

-a terminal illness is an altered level of health that is stressful

-It can be induced that all altered levels of health are stressful Purposes of Quantitative and Qualitative Nursing Research 1. identification: especially of phenomenon (starts qual then quant)

2. description: observation and description of what were researching (quant=how often, qual=whats causing, why important)

3. Exploration: study, use both

4. Explanation of Phenomena: use both, often linked to theories: quant=deductive theory

5. Prediction and control

-typically quant, but also used in qual

qual=developing theories
quant=pick existing theory to work under

Majority of research is quantitative

The Research Process The Language of Research -Must be mastered to grasp more complex aspects of research

-Language differs between quantitative and qualitative The Study Vocab 1. Study=Research project or investigation

2. Person(s) doing the study=researcher, investigator,scientist

3. Leader=principle investigator or project director

4. 2 or more leaders=co-investigators

5. Subject=participant(more positive term)

6. Concept(quantitative)=an abstract idea based on observation (more observable and measurable)

7. Construct (quantitative)=an abstract idea that is invented

-ex. credibility, more abstract

*must have a conceptual definition

8. Phenomenon (qualitative)=an abstract idea

-ex: experience of caregiving Variables -Quantitative term

-A concept or construct that varies (takes on different values) from one person to another

-In contrast to a constant

Ex. age, bp, gener, pain levels

Constant=not changing

Ex. having dementia

-Types of Variables:

1. Continuous

-can take on an infinite range of values on a continuum

ex. 98.768373, such as temp or weight

2. Discrete

-has a finite number of values between two points

-Example: having 2 children

3. Categorical

-small range of values that do not represent a quantity

-example: gender, marital status, blood type (not numerical)

4. Dichotomous

-has 2 values or categories

-Ex. Yes or no answers. Cancer or no, preg or no

5. Independent

-presumed cause, influence, or antecedent

-thing you’re changing

6. Dependent variable

-presumed effect or outcome

-variability depends on variability of IV

-a variable that is independent in one study may be dependent in another

-not always causal More Vocab 1. Operational Definition

-definition of a variable in terms of the procedures by which it is to be measured

-multiple methods of measurement available for most variables (questionnaires, fittest, forms etc)

-The PI chooses the method that best matches the conceptual definition

2. Data

-data=plural (always say data were…)

-Quantitative: actual values of the variables for a research project

-Qualitative: usually narrative or transcribed descriptions

3. Examination of Relationships

-most often researchers examine relationships among variables or phenomenon (more than, less than)

-Quantitative:

*often the relationship between IV and DV

*may be a cause and effect relationship

*may be a functional relationship (is one thing r/t another)

-looking at the relationship between phenoms or variables and looking at the strength of relationships

-Qualitative:

*seeking patterns to identify the meaning and dimensions of relationships between phenomenon

(examine relationship overall

4. Control

Quantitative:

-holding constant all possible influences on the dependent variables

-Goal=the true relationship between the IV and DV can be understood

-Must identify extraneous variables that can influence the DV while at the same time be related to the IV

*extraneous variables=variables outside study that can disrupt study or results Phases/Steps of Quantitative Research Phase 1: Conceptual Phase

1. Thinking stage

-Purpose statement: what the researcher proposes to examine

-Problem statement: why is it important and needs to be examined

2. Literature Review

-to build on existing theory and research

-usually based on scholarly or research nursing journals within the last 5 years

3. Undertaking Clinical Fieldwork

-spending time in clinical setting

-discussing topic with other practicing nurses

-observing nursing practice

-this helps us think about other variables and help understand how to obtain data

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