N 199 (NURSING RESEARCH) PRELIM COVERAGE

Importance of Evidence-based practice

Nursing Research in Perspectives Research and EBP  Nurses’ leaders recognize the need to base specific nursing
Objectives:
decisions on evidence indicating that the decisions are
1. Define nursing research, its importance to evidence-based
clinically appropriate, cost-effective & result in positive
nursing and the roles of nurses in research
client outcomes.
2. Describe the history and future directions of nursing
o Eg: Kangaroo care, use of sterile water rather than
research in the Philippines
alcohol in umbilical cord
3. Identify sources of evidence for nursing research
Role of Nurses in Research
4. Identify several purposes of quantitative and qualitative
 Every nurse to engage in one or more activities along a
researches
continuum of research participation.
What is research?
 At one end continuum are uses (consumers) of nursing
Research from French word:
research, nurses who read research reports to keep up- to-
 “cerchier” meaning to seek or to search
date on findings that may affect their practice.
 prefix “re” means “again” and signifies replication of the
The Importance of Research to Evidence-Based Nursing cont.
search.
 Other end of the continuum are the producer of nursing
Research
research: nurses who actively design & undertake studies.
• × Systematic inquiry
• × Scientific method
• × Solve Problems and answer questions

 Research is an investigation into a particular topic or

social/business phenomena.
 the systematic investigation into and study of materials and
sources in order to establish facts and reach new
conclusions. (Oxford Languages)
 a detailed study of a subject, especially in order to discover
(new) information or reach a (new) understanding
(Cambridge Dictionary)
 careful study that is done to find and report new knowledge
about something (Merriam Webster Dictionary)

Research is an ORGANIZED and SYSTEMATIC way of FINDING

ANSWERS to QUESTIONS.
1. SYSTEMATIC because there is a definite set of scientific
procedures and principles which the researcher will NEED
to follow in order to get reliable and accurate results.
2. ORGANIZED because there is a structure or method for
doing research. The research process has a number of steps
to guide the researcher.
3. FINDING ANSWERS because every research seeks to answer
a question or a number of questions. Sometimes the answer
is no, but it is still an answer.
4. QUESTIONS are central to research. If there is no question,
then how do we begin the research. History of Nursing Research
- Research is focused on relevant, useful, and important questions.  In 1986: Establishment of the National Center for Nursing
Without a question, research has no focus, drive, or purpose. Research (NCNR) at the National Institutes of Health (NIH).
So, Why Do We Do Research?  The purpose of NCNR was to promote & financially support
✓ Create/develop something new research projects.
✓ Cause something particular to happen  In 1990s:, birth of more journals for nurses researchers &
✓ Make-sense-of what is happening specialty journals.
✓ Explain what is happening/verify  In 1993: National Institute of Nursing Research (NINR)
✓ Predict what will happen` established.
 International cooperation of EBP in nursing began to
What is Nursing Research? develop.
Research: Systemic enquiry Future Direction for Nursing Research
Ultimate goal: Gain knowledge that would be useful for people. 1. Continued focus on EBP.
Definition of Nursing Research: It is a systematic inquiry 2. Stronger evidence through confirmatory strategies.
designed to develop trustworthy evidence about issues of importance 3. Greater emphasis on systematic reviews.
to nurses and their clients. 4. Expanded local research in health care settings.
Clinical nursing research: research designed to guide nursing practice. 5. Expanded dissemination of research findings.
6. Increased focus on cultural issues & health disparities.
The Importance of Research to Evidence-Based Nursing
 Nursing has experienced profound changes in the past few Sources of Evidence for Nursing Practice
decades.  Decisions are based on knowledge by nurses.
 Nurses are increasingly expected to understand &  Nursing students are gaining skills from instructors,
undertake research, & their practice on evidence from textbooks, clinical placement.
research to adopt an EBP.  Knowledge transferred from one generation to another
Definition of evidence-based practice (EBP): based on clinical experience, trial and error, tradition and
 Is the use of the best evidence in making patient care expert opinion.
decisions, and such evidence typically comes from research
conducted by nurses & other health care professionals.

Components of evidence-based practice (EBP):

The Purpose of Nursing Research research community, and evolving societal, political, and health
 Is to answer questions. dynamics in the Philippines.
 Solve problems of relevance to nursing.
 To achieve varying levels of explanation. 3. The Philippine Plan for Gender-Responsive Development
 Research purposes linked to EBP. The Philippine Plan for Gender-Responsive Development (PPGD) rest
on a vision of development that is equitable, sustainable, free from
Research to Achieve Varying Levels of Explanation violence, respectful of human rights, participatory and empowering.
 One way to classify research purposes concerns the extent The PPGD puts greater emphasis on women as a disadvantage group.
to which studies are designed to provide explanations.
 Cause probing 4. Quality Mental Health Research in the Philippines
 Using descriptive framework Conceptualization Design and Methods
 Identification& description The purpose of this document is twofold: first, to serve as a working
 Exploration manual to guide mental health researchers in the submission of their
 Explanation proposals and other research organizations and second, to record the
 Prediction & control rich discourse on mental health concepts and research framework
generated from the write shop in writing research in mental health. It
is recognized that the production of this manual is an initial venture in
writing manuals on mental health research in the Philippines. It is to
develop quality mental health research in our country.

- The working manual contains the essential discussions exchanged

between the lecturers and participants during the writeshop and is
also supplemented with slide presentations used during the
writeshop which are made publicly accessible online, the PCHRD said.

5. DOST 6Ps and 2Is Project Output Guide

The 6Ps and 2Is serves as the quantitative metric for assessing
potential outputs. This includes:
(1) Publication, (2) Patent, (3) Products, (4) People Services, (5)
Research Purposed Linked to EBP Policies, and (6) Partnership;
 Another system for classifying studies has emerged in 2Is includes (1) Social Impact and (2) Economic Impact.
efforts to communicate EBP-related purposes.
 The various purposes can best be addressed with
quantitative research except (meaning / process) which
requires qualitative research.

RESEARCH AGENDA

1. Sustainable Development Goals

In 2015, member states of the United Nations adapted the 2030’s
Agenda for Sustainable Development. The agenda provides a shared
plan for peace, prosperity, people and the planet. The agenda has
seventeen (17) core goals which are imperative and urgent call for
action by all developed and developing countries. The 17 Sustainable
Development Goals (Figure 1) recognize the essentiality of ending
poverty and any other forms of deprivations through strategies that The Department of Science and Technology – Philippine Council for
improve health and education, lessen inequality and stimulate Health Research and Development (DOST-PCHRD) introduced its three
economic progress – all while preserving our oceans and forest and new R&D programs under its research grant services during the 2nd
addressing the impacts of climate change. day of the DOST-PCHRD 40th Anniversary Main Conference on 18
March 2022.
- As a prominent member of the United Nations, the Philippines
adopted the principles of the sustainable development goals on its One of the flagship services offered by the DOST-PCHRD is its research
social, economic and environmental programs. In terms of its research grant services that provides funding and assistance to Filipino
and development undertakings, the SDGs serve as the core for its researchers in the conduct of health research. To ensure that the
planning, prioritization, and decision making. Council invests in projects that solve pressing, real-world problems; it
outlines research priority areas with specific topics for each round of
call for proposals.

“For forty years, hundreds of health research programs and projects

worth billions of investments and funding have been managed by the
dynamic team of program heads and project managers, who
constantly adapt to the signs of the time through solid management
and monitoring of these crucial health researches,” said Mr. Paul
Ernest de Leon, Chief Science Research Specialist of the Research and
Development Management Division (RDMD) of the DOST-PCHRD.

Responding to the current national health concerns, the Council,

through the RDMD, introduced three new priority health research
areas namely:
✓ Re-emerging and Emerging Diseases
2. National Unified Health Research Agenda (NUHRA) 2023-2028 ✓ Digital and Frontier Technologies for Health, and
The National Unified Health Research Agenda (NUHRA) is the prime ✓ Nutrition and Food Safety
instrument of the PNHRS to direct activities and funding for health
research. It serves as a platform to garner local, national, and global With the threat of re-emerging and emerging diseases to public
backing for health research priorities. The NUHRA aims to address the health, the Re-emerging and Emerging Diseases (RED) program is an
health needs of the population aligned with the nations health sector expansion of the DOST-PCHRD’s Dengue and Other Arboviruses
goals. The periodic review and formulation of the NUHRA every six program. It supports R&D that generates local and novel technology
years is a response to the evolving nature of health issues, public platforms, therapeutics, preventive measures, surveillance, and
policies, scientific progress and societal changes. control and management protocols for various diseases. The program
is intended to equip the country’s health systems with research-based
- The NUHRA 2023-2028 is the fourth iteration of the Philippine health solutions and innovations for better disease management and
research agenda by the PNHRS. The NUHRA 2023-2028 is a response prevention.
to intricate health systems and challenges, fueled by a growing
On the other hand, the Digital and Frontier Technologies for Health Site: The specific location for the research—it could be an entire
program builds from the Council’s Information and Communication community (e.g., an Asian neighborhood in Muscat) or an institution
Technology (ICT) for Health program. To respond to eHealth needs (e.g., a clinic in Salalah).
emphasized by the implementation of universal health care (UHC), the Multisite
updated research program now focuses on R&D utilizing artificial
intelligence and other elements of the 4th industrial revolution, ➢ Concepts, Constructs, and Theories
connectivity platforms and new fields of digitalization. Phenomena (qualitative studies) or concepts: Abstract terms. Eg; pain,
fatigue, and resilience
Lastly, the Nutrition and Food Safety Program aims to address various Construct: An abstraction, often deliberately invented (or
malnutrition and food safety issues using science and technology. This constructed). For example, self-care in Orem's model of health
research priority area hopes to cover studies on the nutrition of all age maintenance is a construct.
groups (pediatric, adolescent, adult, and geriatric), malnutrition and Theory: an explanation of some aspect of reality. Concepts are knitted
its relation to infectious diseases, use of innovative technologies such together into a coherent system.
as omics for individual diets, fad diets, nutrition for the disabled as
well as for athletes or people active in sports, safety of foods sold in - In a quantitative study, researchers often start with a theory and,
the local markets, and tools that can be used to identify and prevent using deductive reasoning, test them.
diseases related to food safety. - In qualitative studies, theory often is the product of the research.

The PNHRS launched the National Unified Health Research Agenda ➢ Variables
(NUHRA) in September 2006 to serve as the country’s template for Variables- concepts: Something that varies. Eg; Weight, anxiety, and
health research and development efforts specifying the areas and fatigue.
topics that needed to be addressed in a 5-year scope. - Eg; In lung cancer research, lung cancer is a variable because not
everybody has this disease. Smoking is also a variable because not
NUHRA is a product of a series of regional and national consultations everyone smokes.
with stakeholders and consolidation of research priorities of the four - Variables are the central building blocks of quantitative studies
core agencies of the PNHRS. It is regularly updated during the mid- - Sometimes researchers create a variable.
period of the five-year agenda to account for recent developments, Eg; If a researcher tests the effectiveness of patient-controlled
new directions, and thrusts. The updating takes into consideration the analgesia compared to intramuscular analgesia in relieving pain after
Millennium Development Goals, Medium-term Philippine surgery.
Development Plan, and various national health plans anchored on - Categories (e.g., male, female, or blood type A, B, AB, or O).
every presidential term.

NUHRA 2023-2028

The culmination of 17 regional consultation workshops that identified

170 health research priorities which were consolidated into themes
and sub-themes, namely:
1. Disease management
2. Halal in health
3. Health security, emergency, and disaster risk management
4. Health technology and innovation
5. Health of vulnerable populations
6. Health promotion
7. Health systems strengthening towards UHC
8. Maternal, newborn, and child health
9. Mental health
10. Nutrition and food security
11. Sexual and reproductive health

THE BUILDING BLOCKS OF RESEARCH

Objectives:
1. Define the key concepts in quantitative and qualitative
research
2. Identify the major classes of quantitative and qualitative
research
3. Compare the steps and activities in qualitative and
quantitative research ➢ Conceptual and Operational Definitions
 Conceptual definition: Abstract or theoretical meaning of a
KEY CONCEPTS IN QUANTITATIVE AND QUALITATIVE RESEARCH concept.
 Eg; Concept of caring. Has five categories of conceptual
The Faces and Places of Research definitions:
 Study (or an investigation): when researchers answer a  as a human trait
question through disciplined research—regardless of  a moral imperative
whether it is qualitative or quantitative  an affect
 2 sets of people  an interpersonal relationship
o Researcher: those who conduct the research  therapeutic intervention
o Participant: those who provide the information
- Researchers undertaking studies of caring need to clarify which
conceptual definition they have adopted.
- Operational definition: Indicates what the researchers specifically
must do to measure the concept and collect needed information.
 Eg; Weight: operationally defined as the amount that a
person weighs in pounds, to the nearest full pound. The
weight will be measured using a digital scale with subjects
fully undressed after 10 hours of fasting.
 Eg; Anxiety: Defined in terms of both physiologic and
psychological functioning.
- physiologic aspects of anxiety: a measure of as pulse rate.
- psychological state: scores on a paper-and pencil test such as the
➢ Setting
State Anxiety Scale.
Settings: Types of places where information is gathered, for example,
hospitals, homes, or other community settings.
 Phenomenology:
 Developed by Husserl and Heidegger
 Concerned with the lived experiences of humans.
 Focus: What life experiences of people are like and what
they mean.
 The phenomenological researcher asks the questions: What
is
 the essence of this phenomenon as experienced by these
people?
 e.g - exploring the lived experiences of women undergoing
breast biopsy

➢ Nursing as a Caring Science – Phenomenon of interest

 A phenomenon is the term, description, or label given to
describe an idea or responses about an event, a situation, a
process, a group of events, or a group of situations (Meleis,
Data (singular, datum): Pieces of information gathered in a study. 2011).
 Quantitative data—numeric form.  Nursing theories focus on the phenomena of nursing and nursing
 Qualitative data- narrative descriptions care.

Relationship: Connection between two or more phenomena; e.g.; Ethnography:

relationship between cigarette smoking and lung cancer.  provides a framework for studying the patterns, lifeways,
- In quantitative studies, and experiences of a defined cultural group in a holistic
 Relationship between independent variables and outcomes fashion.
 Cause and effect expressed in quantitative terms, such as  the study of people in their own environment through the
more than, less than, and so on. use of methods such as participant observation and face-to-
- Height: Taller people will weigh more than shorter people. face interviewing
- Caloric intake: People with higher caloric intake will be heavier than  Ethnographers engage in extensive fieldwork, participating
those with lower caloric intake. to the extent possible in the life of the culture under study.
- Exercise: The lower the amount of exercise, the greater will be the  Focus: To learn from members of a cultural group, to
person’s weight. understand their world view, and to describe their customs
and norms.
Each statement expresses a predicted relationship between weight  E.g - Observing medical personnel in a high-volume hospital.
(the outcome) and a measurable

Notice: Qualitative research is not concerned with quantifying

Relationships

MAJOR CLASSES OF QUANTITATIVE AND QUALITATIVE RESEARCH

❖ Phase 1: The Conceptual Phase

 Activities with a strong conceptual element.
 Skills as creativity, deductive reasoning, and a grounding in
existing research evidence on the topic of interest is
essential

Step 1: Formulating and delimiting the problem

Identifying an interesting, significant research problem and
formulating good research questions.
➢ Qualitative Research: Types Consider the following:
Grounded theory:
 Seeks to describe and understand the key social
psychological processes that occur in a social setting and
generate explanations of phenomena that are grounded in
reality. It is a research method concerned with the
generation of ‘theory’, which is ‘grounded’ in data that has
been systematically collected and analyzed.
 Developed in the 1960s by two sociologists, Glaser and
Strauss (‘Awareness of dying’)
 Focus: a developing social experience—the social and
psychological phases that characterize a particular event or
episode. Step 2: Reviewing the Related Literature
 Major component: discovery of a core variable that is Strive to understand what is already known about a topic by
central in that social scene. E.g., job satisfaction of undertaking a thorough literature review before any data are
employees collected.
Step 3: undertaking clinical fieldwork
 Spending time in relevant clinical settings (in the field)
 Discussing the topic with clinicians
 Observing current practices.
 Provides insights into clinicians’ and clients’ perspectives.

Step 4: defining the framework and developing conceptual

definitions
To provide have broader significance and utility to the findings.
- Researchers should have a conceptual rationale and a clear vision of
the concepts under study.

➢ Conceptual Framework: Roadmap of a Study

Purpose of conceptual framework

A conceptual framework is like a roadmap for your study, helping you
visualise yourresearch project and put it into action. It defines the
relevant variables for your study and maps out how they might relate
to each other.

Conceptual frameworks have different uses in different types of

studies.

In quantitative studies, a conceptual framework might be used to

determine survey questions or data points, or to generate a
hypothesis for explanations and predictions. In qualitative studies, a
conceptual framework might be used to provide a working hypothesis
or a set of research questions, or to identify or explore categories in
descriptive research.
❖ Phase 2: The Design and Planning Phase
Here, researchers make decisions about the methods and procedures
to be used to address the research question.

Step 6: Selecting a Research Design

 Overall plan/ architectural backbone of the study
 To obtain answers to the research questions and to handle
challenges that can undermine the study evidence.
 Tend to be highly structured and controlled, with the goal of
minimizing bias.
 Also indicates other aspects—how often data will be
collected, what types of comparisons will be made, and
where the study will take place.

Step 7: Developing Protocols for the Intervention

 An intervention protocol for the study must be developed,
specifying exactly what the intervention will entail (e.g.,
who would administer it, how frequently and over how long
a period the treatment would last, and so on) and what the
alternative condition would be.
 In non-experimental research, this step is not necessary.

Step 8: Identifying the Population

 Know what characteristics the study participants should
Step 5: Formulating Hypotheses possess
 Hypotheses: deductively derived, hypotheses are  clarify the group to whom study results can be
predictions of the relationships researchers expect to generalized—that is, they must identify the population to be
observe in the study data. studied.
 Technically speaking, the word “hypothesis” is a Greek word  A population is all the individuals or objects with common,
that means “an assumption subject to verification” defining characteristics (the “P” component in PICO
 Quantitative studies are designed to test hypotheses questions).
through statistical analysis.
Step 9: Designing the Sampling Plan
➢ Formulating Hypotheses  Sample: A subset of the population.
A hypothesis is a tentative statement about the relationship between  Using samples is more practical than collecting data from an
two or more variables. It is a specific, testable prediction about what entire population
you expect to happen in a study.  sampling plan specifies how the sample will be selected and
how many subjects there will be
 H0 - Students who eat breakfast will perform better on a
math exam than students who do not eat breakfast.” Step 10: Specifying methods to measure variables
 Ha -Students who eat breakfast will perform better on a  Methods to measure the research variables accurately.
math exam than students who do not eat breakfast.  The primary methods are
o Self-reports (e.g., Interviews and questionnaires)
➢ Null and alternative hypotheses o Observations (e.g., Watching and recording
people’s behavior)
 H0 = The null hypothesis is always stated in the negative. o Biophysiologic measurements.
This is because you have to be able to prove something is
indeed true. Step 11: Developing methods to safeguard human/animal rights
 Ha = An alternative hypothesis is one in which a difference  Most nursing research involves human subjects/some
(or an effect) between two or more variables is anticipated involve animals.
by the researchers; that is, the observed pattern of the data  Procedures need to be developed to ensure that the study
is not due to a chance occurrence. adheres to ethical principles.

Step 12: Reviewing and finalizing the research plan

 “Tests” to ensure that procedures will work smoothly.
  Researcher may evaluate the readability of written  Begin with a broad topic, often focusing on an aspect about
materials which little is known.
 Researchers have their research plan critiqued by reviewers 2. Doing a Literature Review
to obtain clinical or methodologic feedback before  Some believe that researchers should not consult the
implementing it. literature before collecting data as this might influence the
 For financial support, submit a proposal to a funding source conceptualization of the phenomenon under study.
 Reviewers usually suggest improvements. 3. Selecting and Gaining Entrée Into Research Sites
 Gaining entrée involves negotiations with gatekeepers who
❖ Phase 3: The Empirical Phase have the authority to permit entry into their world.
 Involves collecting the research data. 4. Developing an Overall Approach
 Most time-consuming part of the study.  Emergent design—a design that emerges during the course
 May require months of work. of data collection.
 Qualitative studies rarely have rigidly structured design.
Step 13: Collecting the Data 5. Addressing Ethical Issues
 Proceeds according to a pre-established plan.  Must also develop plans for addressing ethical- because of
 Procedures for training data collection staff, collecting data the more intimate nature of the relationship that develops
(e.g., Where and when the data will be gathered); and for between researchers and participants.
recording information.
Phase 2: Conducting a Qualitative Study
Step 14: Preparing the Data for Analysis  Sampling, data collection, data analysis, and interpretation
 Coding: translating verbal data into numeric form take place iteratively.
 (e.g., Coding gender information as “1” for females and “2”  Qualitative researchers begin by talking with or observing
for males). people with firsthand experience with the phenomenon
 Transferring the data from written documents onto under study.
computer files for analysis.  The discussions and observations are loosely structured,
allowing participants to express a full range of beliefs,
❖ Phase 4: The Analytic Phase feelings, and behaviors.
 Analysis and interpretation of data gathered in the empirical  Analysis and interpretation are ongoing.
phase.  Themes and categories : Involves inductive reasoning. The
actual process of data analysis involves clustering together
Step 15: Analyzing the Data related types of narrative information into a coherent
 To answer research questions and test hypotheses. scheme; to build a rich description or theory of the
 Analyzed through statistical analyses, which include some phenomenon.
simple procedures as well as more complex, sophisticated  Concept development and verification: As
methods. conceptualizations develop, the researcher seeks
participants who can confirm and enrich theoretical
Step 16: Interpreting the Results understandings, who can potentially challenge them and
 Making sense of study results and examining their lead to further insights.
implications.  Sampling: Sampling decisions are guided by the data; data
 Based on prior evidence, theory, and clinical experience, saturation occurs when themes and categories in the data
and adequacy of the methods used in the study. become repetitive and redundant, such that no new
information can be obtained by further data collection.
❖ Phase 5: The Dissemination Phase  Tools: Qualitative researchers are the main data collection
instrument and must take steps to demonstrate the
Step 17: Communicating the Findings trustworthiness of the data. The findings must accurately
 Preparation of a research report that can be shared reflect the experiences and viewpoints of participants,
Step 18: Putting the Evidence into Practice rather than researchers 'perceptions.
 Plan for its use in practice settings.  One confirmatory activity, for example, involves going back
 Contribute by developing recommendations on how the to participants, sharing preliminary interpretations with
evidence could be used in practice them, and asking them to evaluate whether the
 Ensuring that adequate information has been provided for researcher’s thematic analysis is consistent with their
a meta-analysis experiences.
 Pursuing opportunities to disseminate the findings to  Dissemination of Findings: Qualitative nursing researchers
practicing nurses. strive to share their findings at conferences and in journal
articles; to shape nurses’ perceptions of a problem or
situation, their conceptualizations of potential solutions,
and their understanding of patients’ concerns and
experiences.

ACTIVITIES IN A QUALITATIVE STUDY

 Qualitative researchers are continually examining and
interpreting data and making decisions about how to
proceed based on what has already been discovered.
 Hence, progression is not linear.

Steps in qualitative research;

1. Conceptualizing and Planning a Qualitative Study
2. Conducting a Qualitative Study

Phase 1: Conceptualizing and Planning

1. Identifying the Research Problem
 Communicating Research Problems and Questions
 A problem statement is presented early in a research article
and begins with the first sentence after the abstract.

Problem Statements
 A good problem statement is a well-structured declaration
of what it is that is problematic, what it is that “needs
fixing,” or what it is that is poorly understood.

Problem Statements: Components

1. Problem Identification – What is wrong with the current
situation?
2. Background - What is the nature of the problem, or the
context of the situation, that readers need to understand?
3. Scope of the Problem - How big a problem is it, and how
many people are affected?
4. Consequences of the Problem - What is the cost of not fixing
the problem?
5. Knowledge Gaps – What information about the problem is
lacking?
6. Proposed Solution – How will the new study contribute to
THE PROBLEM STATEMENTS AND HYPOTHESIS the solution of the problem?
Objectives
1. Describe basic terminologies and sources of research Example Problem Statements
problem. Topic: Video Games
2. Describe problem statements in terms of its goals and When/Time? – Last 10 years (2001-2011)
components. Where/Place? – USA
Research Problem What/Event? – Violence
 Refers to an enigmatic or troubling condition. The purpose Who/Person? – Children
of research is to “solve” the problem – or to contribute to  Research Question: Are children who play video games
its solution – by gathering relevant data. more likely to be violent?

Problem Statement Topic: Divorce

 Articulates the problem and an argument that explains the When/Time? – Recent research (2005-2011)
need for a study. Where/Place? – USA
What/Event? – Social Development
Statement of Purpose Who/Person? – Children
 Refers to the researcher’s summary of the overall goal.  Research Question: How does divorce influence children's
Sometimes the words aim or objective are used in lieu of social development?
purpose, but these alternatives sometimes encompass
broader goals (e.g., developing recommendations for Topic: Academic Success
changes to nursing practice based on the study evidence). When/Time? – Recent research (2005-present)
Where/Place? – High schools and undergraduate institutions
Research Questions What/Event? – Standardized Testing
 They are the specific queries researchers want to answer, Who/Person? – College Freshmen Students
which guide the type of data to be collected in study.  Research Question: How good of a predictor is standardized
testing for college academic success?
Hypotheses
 Statement of specific predictions made by the researcher, Problem statements for a qualitative study express the nature of the
about answer to research questions pose that are then problem, its context, its scope, and information needed to address it.
tested.
Examples of Qualitative Research Problems
Research Problems and Paradigms  What are the experiences of people working night shifts in
health care?
 How would overweight people describe their meal times
while dieting?
 How do social media tools affect a student’s grades in his
academic years?
 What reasons contribute directly to the rising rate nurse
understaffing?

THE RESEARCH QUESTION

Objectives:
1. Describe statement of purpose, research questions and
hypothesis questions in terms of its goals, components and
Sources of Research Problems
how they are written
 Researchers’ Interests
2. Describe the function and characteristics of research
o Clinical Experience
hypotheses
o Nursing Literature
3. Distinguish different types of hypotheses
o Social Issues
o Theories
Statements of Purpose
o Ideas from External Source
 The purpose statement establishes the general direction of
Development and Refinement of Research Problems
the inquiry and captures, usually in one or two sentences,
the study's substance.
 It is usually easy to identify a purpose statement because
the word purpose is explicitly stated: “The purpose of this
study was...”—although sometimes the words aim, goal, or
objective are used instead, as in “The aim of this study was
to....”
o Eg; The purpose of this study was to investigate
the effectiveness of chilled and unchilled baby oil
therapy for treating uremic pruritus in
hemodialysis patients (Lin et al., 2012).
  In a quantitative study, a statement of purpose identifies the ➢ “Participants who have been deprived of sleep for 24 hours
key study variables and their possible interrelationships, as will have more cold symptoms in the following week after
well as the population of interest (i.e., all the PICO exposure to a virus than participants who have not been
elements). sleep deprived”; the hypothesis compares the two
groups/conditions and states which one will ....have
Statements of Purpose: Qualitative more/less, be quicker/slower, etc.
 The statements of purpose in qualitative studies often ➢ Non-directional hypothesis: A non-directional (or two
“encode” the tradition of inquiry not only through the tailed hypothesis) simply states that there will be a
researcher’s choice of verbs but also through the use of difference between the two groups/conditions but does not
certain terms or “buzz words” associated with those say which will be greater/smaller, quicker/slower etc. Using
traditions, as follows: our example above we would say...
 Grounded theory: Processes; social structures; social ➢ “There will be a difference between the number of cold
interactions symptoms experienced in the following week after exposure
 Phenomenological studies: Experience; lived to a virus for those participants who have been sleep
experience; meaning; essence deprived for 24 hours compared with those who have not
 Ethnographic studies: Culture; roles; lifeways; cultural been sleep deprived for 24 hours.”
behavior
Research vs. Null
Research Questions  Research hypotheses are statements of expected
 Research questions are, in some cases, direct rewordings relationships between variables. All the hypotheses
of statements of purpose, phrased interrogatively rather presented thus far are research hypotheses that indicate
than declaratively. actual expectations. Statistical inference operates on a logic
 Examples: that may be confusing. This logic requires that hypotheses
o The purpose of this study is to assess the be expressed as an expected absence of a relationship.
relationship between the dependency level of  Null hypotheses state that there is no relationship between
renal transplant recipients and their rate of the independent and dependent variables.
recovery. o Eg; Older patients are just as likely as younger
o What is the relationship between the dependency patients to fall. The null hypothesis is the formal
level of renal transplant recipients and their rate statement of this assumption of innocence.
of recovery?  Research articles typically state research rather than null
 In quantitative studies research questions identify the hypotheses.
population (P) under study, the key study variables (I, C,
and O components),and relationships among the variables. Hypothesis Testing and Proof
 Research questions in qualitative studies include the  Hypotheses are formally tested through statistical analysis.
phenomenon and the group of interest.  Researchers use statistics to test whether their hypotheses
have a high probability of being correct (i.e., has a
Research Hypotheses probability <.05).
 A hypothesis is a prediction, involving a predicted  Statistical analysis does not provide proof, it only supports
relationship between two or more variables. inferences that a hypothesis is probably correct (or not).
 Qualitative researchers do not have formal hypotheses,  Hypotheses are never proved (or disproved); rather, they
because qualitative researchers want the inquiry to be are accepted or supported (or rejected).
guided by participants’ viewpoints rather than by their own  The accuracy of the measures and the effects of
hunches. uncontrolled variables prevent researchers from concluding
that hypotheses are proved.
Function of Hypotheses in Qualitative Research
 The soundness of a theory is evaluated through hypothesis Critiquing Research Problems, Research Questions, and Hypotheses
testing.  Research problem: Is the problem has significance for
 Pediatric patients who are given a reward (e.g., Permission nursing. Is the research problem is compatible with the
to watch television) for cooperating during nursing chosen research paradigm and its associated methods.
procedures tend to be more cooperative than no rewarded o Is the statement of purpose or research questions
peers. been properly worded and lend themselves to
 The development of predictions forces researchers to think empirical inquiry.
logically and to exercise critical judgment.  Hypothesis: If a research article describing a quantitative
 The failure of data to support a prediction forces study does not state hypotheses, consider whether their
researchers to analyze theory or previous research critically, absence is justified. Are the hypotheses sensible and
to review study limitations, and to explore alternative consistent with existing evidence or relevant theory.
explanations for the findings.
MODELS, THEORIES AND FRAMEWORKS
Characteristics of Testable Hypotheses Objectives:
 Research hypotheses state the expected relationship 1. Differentiate models, theories and frameworks from each
between the independent variable (the presumed cause or other by describing the major characteristics of each
influence) and the dependent variable (the presumed 2. Identify several conceptual models used in nursing
outcome or effect) within a population. researches – (Roy’s and Roger’s)

Wording of Hypotheses What’s a theory?

 Directional vs. Non-directional A theory may be defined as a system of ideas that is presumed to
 Research vs. Null explain a given phenomenon. For now, think of a theory as a major,
very well-articulated idea about something important. Theories are
Directional vs. Non-directional used to describe, predict, and control phenomena. (Kozier, 2016, pp.
 Directional hypothesis: specifies not only the existence but 37)
the expected direction of the relationship between
variables. In the six versions of the hypothesis, versions 1, 3, Examples:
5, and 6 are directional because they explicitly predict that • Freud and Jung’s theories of the unconscious (Psychology)
older patients are more likely to fall than younger ones. • Sullivan and Piaget’s theories of development (Psychology)
 Non- directional hypothesis does not stipulate the direction • Darwin’s theory of evolution (Biology)
of the relationship (versions 2 and 4). • Isaac Newton’ s law of gravitation (Physics)
 The hypotheses are worded in the present tense. • Albert Einstein’s theory of relativity (Physics)
 Researchers make a prediction about a relationship that
exists in the population—not just about a relationship for a In science, a fact is an observation that's been confirmed so many
particular sample of study participants. times that scientists can, for all intents and purposes, accept it as
"true."
➢ A directional (or one tailed hypothesis) states which way
you think the results are going to go, for example in an A hypothesis is a tentative explanation about an observation that can
experimental study we might say... be tested. It's just a starting point for further investigation.
A law is a detailed description of how some aspect of the natural world • These models are tested using statistical methods.
behaves, usually involving math.
 Schematic models
A theory is an explanation of some aspect of the natural world that's • Also called conceptual maps
well-substantiated by facts, tested hypotheses, and laws • Visually represent relationships among phenomena
• Used in both qualitative and quantitative research.
Why theory in nursing? • Concepts and linkages between them are depicted
Most undergraduate students are introduced to the major theories in graphically through boxes, arrows, or other symbols.
their disciplines. • Schematic models are appealing as visual summaries
of complex ideas.
In the 19th century, Florence Nightingale (Environmental Theory): • Eg; Pender's Health Promotion Model (HPM), explains
often considered the first nurse theorist, described nursing 150 years and predicts the health-promotion component of
ago as establishing an environment that allows persons to recover lifestyle.
from illness (Nightingale, 1860/1969). She linked health with five
environmental factors: (1) pure or fresh air, (2) pure water, (3) efficient WHAT ARE FRAMEWORKS?
drainage, (4) cleanliness, and (5) light, especially direct sunlight. • A framework is the conceptual underpinning of a study
Deficiencies in these five factors produced lack of health or illness. • Not every study is based on a theory or conceptual model,
but every study has framework. (Analogy: A house may be
In many cases, nursing theory guides knowledge development and built without a cement, but all houses have frameworks)
directs education, research, and practice although each influences the
• A study’s framework is often implicit (not formally
others.
acknowledged or described), and researchers who clarify
conceptual definitions of key variables provide important
THEORY
information about the study’s framework.
 Classical theory - An abstract generalization that explains how
phenomena are interrelated. Theories consist of concepts and a
 Theoretical framework: Framework of a study based on a theory.
set of propositions that form a logically interrelated system,
 Conceptual framework: Framework of a study that has its roots
providing mechanism for deducing hypotheses from the original
in a specified conceptual model.
propositions.
 Reinforcement theory - States that behavior that is reinforced
• Quantitative researchers generally do not identify their
(i.e., rewarded) tends to be repeated and learned. The
frameworks.
proposition is that one concept (reinforcement) affects the other
• In qualitative research, the framework is part of the research
(learning).
tradition in which the study is embedded. They inherently reflect
 Descriptive theory: Thoroughly describes a phenomenon.
certain theoretical formulations.
• Are inductive
o Ethnography: Begin within a theory of culture.
• Observation-based abstractions
o Grounded theory: Researchers incorporate sociological
• Describe/classify characteristics of individuals, groups, principles into their framework.
or situations by summarizing their commonalities.
• Recently, concept analysis has become an important enterprise
• Important in qualitative studies. among students and nurse scholars.
• Theories guide researchers’ understanding not only of the
“what” of natural phenomena but also of the “why” of their THE NATURE OF THEORIES AND CONCEPTUAL MODELS
occurrence.
• Theories, conceptual frameworks, and models are not
• Theories can also help to stimulate research by providing both
discovered; they are created.
direction and impetus.
• Theory building depends on observable evidence, and also on a
 Grand theories (or macrotheories)
theorist’s ingenuity in pulling evidence together and making
• Explain large segments of human experience.
sense of it.
• According to Smith & Parker (2015), grand theories
• Theory construction is a creative enterprise that can be done by
define a broad perspective for nursing practice and
anyone who is insightful, understands existing evidence, and can
approach nursing practice from a philosophical point,
knit evidence together into a lucid pattern.
hence, are not testable, and also, they can be applied
• A theory cannot be proved—through research, theories evolve
in a range of topics.
and are sometimes discarded.
• In nursing, they offer explanations for the whole of
• This may happen if new evidence undermines a previously
nursing and address the nature and mission of nursing
accepted theory or a new theory might integrate new
practice, as distinct from the discipline of medicine.
observations with an existing theory to yield a more
• E.g. Parse’s Theory of Human Becoming (Parse, 1999)
parsimonious explanation of a phenomenon.
• Theories of relevance to researchers are often less
• Theory and research have a reciprocal relationship.
abstract than grand theories.
o Theories are built inductively from observations, and
 Middle-range theories
research is an excellent source for those observations.
• Explain such phenomena as stress, comfort, and health o The theory, in turn, must be tested by subjecting
promotion. deductions from it (hypotheses) to systematic inquiry.
• Compared to grand theories, they are more specific Thus, research plays a role in theory building and
and more amenable to empirical testing. testing.
o Theory guides and generates ideas for research;
WHAT ARE MODELS? o Research assesses the worth of the theory and
In research, model also known as conceptual models, is a pictorial or provides a foundation for new theories.
graphic representation of key concepts. it shows, (with the help of
arrows and other diagrams), the relationship between various types Conceptual models and theories used in nursing research
of variables e.g. independent, dependent, moderating, mediating
variables etc.
 Conceptual model
• Deals with abstractions (concepts) that are assembled
because of their relevance to a common theme.
• Provide a conceptual perspective regarding
interrelated phenomena
• More loosely structured than theories and do not link
concepts in a logically derived deductive system.
• Broadly presents an understanding of the A conceptual framework is a group of related ideas, statements, or
phenomenon of interest concepts. Freud’s structure of the mind (id, ego, superego) could be
• Reflects the assumptions and philosophical views of considered a conceptual framework. The term conceptual model is
the model’s designer. often used interchangeably with conceptual framework, and
• Like theories, can serve as springboards for generating sometimes with grand theories, those that articulate a broad range of
hypotheses. the significant relationships among the concepts of a discipline
 Statistical models (Peterson & Bredow, 2013 as cited from Kozier, 2016).
• Equations that mathematically express relationships
among a set of variables.
Conceptual Models of Nursing ▪ Nurse researchers may turn to these conceptual frameworks for
No scientific theory is purely objective, because each is developed in inspiration in formulating research questions and hypotheses.
cultures and expressed in language. Theories offer ways of looking at ▪ These models serve as the guiding direction to future research, and
or conceptualizing the central interests of a discipline. application of theory to practice.

Roy’s Adaptation Model

• In this model, humans are viewed as bio-psychosocial adaptive
systems who cope with environmental change through the process of
adaptation.
• Within the human system, there are four subsystems:
physiologic/physical, self- concept/group identity, role function, and
interdependence.
• These subsystems constitute adaptive modes that provide
mechanisms for coping with environmental stimuli and change.
• Health is viewed as both a state and process of being and becoming
integrated and whole that reflects the mutuality of persons and
environment.
• The goal of nursing, according to this model, is to promote client
adaptation; nursing also regulates stimuli affecting adaptation.
• Nursing interventions usually take the form of increasing,
decreasing, modifying, removing, or maintaining internal and external
stimuli that affect adaptation.
• Roy’s Adaptation Model has been the basis for several middle-range
theories and dozens of studies.

Conceptual Models of Nursing

Example:
▪ Rogers’ Theory of Unitary Human Beings (Martha Rogers ,1994)
▪ Rogers’ theory defined Nursing as “an art and science that is
humanistic and humanitarian. It is directed toward the unitary human
and is concerned with the nature and direction of human
development. The goal of nurses is to participate in the process of
change.”
▪ Emphasized the centrality of the individual as a unified whole, and
her model views nursing as a process in which clients are aided in
achieving maximum well-being within their potential.

RESEARCH ARTICLES- CONTENT AND TIPS

TYPES OF RESEARCH REPORTS

Journal articles:
 Descriptions of studies published in professional journals. Brief
(15 to 20 double spaced pages). Researchers must condense a lot
of information about the study into a short report.
 Manuscripts are reviewed by two or more peer reviewers (other
The theory views nursing as both a science and an art as it provides a researchers) who make recommendations about whether to
way to view the unitary human being, who is integral with the accept or reject the manuscript, or to suggest revisions.
universe. The unitary human being and his or her environment are  Reviews are usually “blind”—reviewers are not told researchers’
one. Nursing focuses on people and the manifestations that emerge names, and authors are not told reviewers names. As a result of
from the mutual human-environmental field process. Rogers views peer review, consumers have some assurance that journal
the person as an irreducible whole, the whole being greater than the articles have been critiqued by other nurse researchers.
sum of its parts.
Oral report:
 Done at conferences.
 Follow a format similar to that used in journal articles.
 The presenter is allotted 10 to 20 minutes to describe key
features of the study.
Posters:
 Visual displays summarizing the studies; conference
attendees walk around the room looking at these displays.
 Conferences also offer an opportunity for dialogue between
attendees.

3. RESULTS SECTION

▪Presents the findings that were obtained by analyzing the study data-
summary of key findings, accompanied by detailed tables.
▪Basic descriptive information- a description of the participants (e.g.,
average age, percent male and female).
▪The names of statistical tests used: Statistical tests to test hypotheses
and assess the probability that the results are accurate.
▪The value of the calculated statistic. Computers are used to calculate
a numeric value for the particular statistical test used. The value
allows researchers to reach conclusions about their hypotheses.

THE RESULTS SECTION

 The significance: If a researcher reports that the results are
statistically significant, it means the findings are probably true
and replicable with a new sample. Research reports also indicate
the level of significance, which is an index of how probable it is
that the findings are reliable.
 For example, if a report indicates that a finding was significant at
the .05 level, this means that only 5 times out of 100 (5/100 =
 .05) would the obtained result be spurious (not being what it TIPS ON READING RESEARCH ARTICLES
purports to be; false or fake.) In other words, 95 times out of 100,
similar results would be obtained with a new sample. Readers 1. Grow accustomed to the style of research articles- Read them
can thus have a high degree of confidence—but not total frequently, even though you may not yet understand all the technical
assurance—that the results are accurate. points.
 In qualitative reports, researchers often organize findings 2. Read from a report that has been photocopied (or downloaded and
according to the major themes, processes, or categories that printed) so that you can highlight or underline portions and write
were identified in the data. questions or notes in the margins.
 The results section of qualitative reports sometimes has several 3. Read journal articles slowly. It may be useful to skim the article first
 subsections, the headings of which correspond to the to get the major points and then read the article more carefully a
researcher’s labels for the themes. second time.
 Excerpts from the raw data (the actual words of participants) are 4. On the second reading, train yourself to become an active reader.
presented to support and provide a rich description of the Reading actively means that you constantly monitor yourself to verify
thematic analysis. that you understand what you are reading. If you have difficulty, you
 The results section of qualitative studies may also present the can ask someone for help.
researcher’s emerging theory about the phenomenon under 5. Keep this textbook with you as a reference when you read articles
study. so that you can look up unfamiliar terms in the glossary or the index.
6. Try not to get bogged down in (or scared away by) statistical
information. Try to grasp the gist of the story without letting symbols
and numbers frustrate you.
7. Until you become accustomed to the style and jargon of research
articles, you may want to “translate” them.

4. THE DISCUSSION SECTION

Researcher presents conclusions about the meaning and implications

of the findings
• An interpretation of the results
• Clinical and research implications
• Study limitations
Researchers are in the best position to point out deficiencies in their
studies. A discussion section that presents the researcher’s grasp of
study limitations demonstrates to readers that the authors were
aware of the limitations and probably took them into account in
interpreting the findings.

WHY ARE RESEARCH ARTICLES SO HARD TO READ?

1. Compactness. Journal space is limited, so authors compress a lot
of information into a short space. Interesting, personalized
aspects cannot be reported.
2. Jargon. The authors may use research terms that may seem
unfamiliar.
3. Objectivity. Lack of subjectivity makes the report sound
impersonal. They are written in the passive voice, which tends to
make the articles less inviting and lively.
4. Statistical information. In quantitative reports, numbers and
statistical symbols may intimidate readers who do not have
statistical training.