Chapter 1 Introduction to Nursing Research in an Evidence-Based Practice Environment

1. Chapter 1 Introduction to Nursing Research in an Evidence-Based Practice Environment

2. What Is Research? • Research • Systematic inquiry using disciplined methods to solve problems or answer questions • Nursing research • Systematic inquiry to develop knowledge about issues of importance to the nursing profession

3. Roles of Nurses in Research • Continuum of participation, from producers of research to skilled consumers of research findings who use research evidence in their practice • Evidence-based practice (EBP)—the use of the best clinical evidence in making patient care decisions • Both consumers and producers play a key role in EBP

4. For students to develop skills as consumers of research. To help students recognize the value of research to the practice of nursing. Goals of this course:

5. History of Nursing Research • Pioneered by Florence Nightingale, 1850s • First journal on research (Nursing Research) emerged, 1950s • Clinical research increasingly important, 1980s • National Center for Nursing Research established at NIH, 1986 • National Institutes of Nursing Research (NINR) established, 1993 • NINR budget exceeds $100 million, 2000s

6. Future Directions for Nursing Research • Heightened focus on evidence-based practice • Use of multiple confirmatory strategies (e.g., replicationand multisite studies • Greater stress on systematic reviews • Expanded local research in health care settings (e.g., as part of Magnet process) • More multidisciplinary collaboration • Expanded dissemination of research findings • Greater focus on cultural issues and health disparities

7. Question Is the following statement True or False? • Clinical research became increasingly important in the 1960s.

8. Sources of Evidence for Nursing Practice • Tradition • Authority • Clinical experience; trial and error; intuition • Logical reasoning (inductive & deductive) • Assembled information (e.g., quality improvement data) • Disciplined research

9. Paradigms for Nursing Research • Paradigm: a world view; a general perspective on the complexities of the real world, with certain assumptions about reality • Key paradigms for nursing research: • Positivist paradigm • Naturalistic paradigm

10. What is Truth?

11. What Is the Nature of Reality? • Positivist assumption • Reality exists. • There is a real world driven by natural causes. • Naturalist assumption • Reality is multiple and subjective, constructed by individuals.

12. How Is the Inquirer Related to Those Being Studied? • Positivist assumption: The inquirer is independent from those being studied. • Naturalist assumption: The inquirer interacts with those being studied; findings reflect the interaction.

13. Question Is the following statement True or False? • Application of the positivist paradigm involves viewing reality as being driven by natural causes.

14. What Is the Role of Values in the Inquiry? • Positivist assumption: Values are held in check; objectivity is sought • Naturalist assumption: Subjectivity and values are inevitable, desirable

15. How Is Knowledge Obtained? • Research methods: the techniques used to structure a study and to gather, analyze, and interpret information • Quantitative research—most often allied with the positivist tradition • Qualitative research—most often allied with the naturalist tradition

16. Key Differences in Research Methods PositivistNaturalist Fixed design Flexible design Discrete, specific concepts Holistic Deductive processes Inductive processes Control over context Context-bound Verification of hunches Emerging interpretations Quantitative information Qualitative information Seeks generalizations Seeks patterns

17. Question Which of the following characterizes naturalistic research methods? • Fixed design • Deductive processes • Qualitative information • Seeking of generalizations

18. Spirituality was defined as the belief system of the patients. The participants described their belief system as the “essence” of “who you are” as a person. Their belief system was their set of “core beliefs” and their “guiding force.” It determines “how you live your life” and “how you act.” Gail said: “I believe that we have free will, and I think that the way we exercise that free will is guided by our spirituality, so the decisions we make are guided by this compass that I call…spirituality.” These beliefs had been “seriously” considered and are “cherished” by the participants. Participants’ beliefs consisted of five dimensions (sub-themes) about which the beliefs centered: a) connections to God/others/nature, b) spiritual feelings, c) beliefs about an afterlife, d) finding meaning in events, ande) beliefs about a higher being. Example: What is the Meaning of Spirituality for the Ill Individual with No Religious Affiliation

19. Researchers have used tools to measure health literacy of individuals and have found that individuals with low health literacy skills: Have less knowledge about chronic illness More frequent hospitalizations Participate less in health prevention Example

20. Purposes of Nursing Research • One way to categorize purposes: a description–explanation continuum •  A basic distinction, especially relevant to quantitative studies, is whether the study is cause-probing, i.e., seeks to illuminate the underlying causes of phenomena. 

21. Specific Purposes of Nursing Research QuantitativeQualitative • Identification X •  Description X X •  Exploration X X •  Prediction and Control X • Explanation X X

23. Specific Purposes of Nursing Research—EBP Framework • Treatment, Therapy, Intervention •  Diagnosis, Assessment •  Prognosis •  Harm and Etiology • Meaning, Process

24. Question Is the following statement True or False? • Quantitative research attempts to identify a phenomenon.

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