HNI/HNC 440 Research in Nursing

1. HNI/HNC 440Research in Nursing Marie Ann Marino, EdD, RN, PNP Clinical Associate Professor

2. Course Overview • Course Outline • Texts and Readings • Course Requirements • Late Submissions • Attendance • Group Formation

3. The Role of Research in Nursing

4. How Do Nurses Know What They Know? • Tradition • Authority • Clinical experience and intuition • Logical reasoning • Disciplined research

5. What is Nursing Research? • A systematic inquiry designed to develop knowledge about issues important to the nursing profession

6. Nursing Research: An Historical Perspective

7. Nineteenth Century – After 1850 Beginning of nursing as a formal discipline Concepts are congruent with current priorities of nursing research Believed systematic collection and exploration of data were necessary for nursing Her research led to a variety of health reforms during the Crimean War

8. Twentieth Century – Before 1950 Focus was mainly on nursing education Leaders: Lavinia Dock, Anne Goodrich, Adelaide Nutting, Isabel Hampton Robb and Lillian Wald Gathered documentation to establish nursing as a profession and reform nursing education Clinically-oriented research centered mainly on morbidity and mortality rates 1920: First nursing research course

9. Twentieth Century – After 1950 Groundwork is laid for nursing’s current level of research skill Expansion of nursing programs; graduate programs including research courses Research priority: Practice-oriented research 1986: National Center for Nursing Formed (later became NINR) Expansion of master’s and doctoral programs

10. Future Directions Continued expansion of nursing knowledge Numerous opportunities to study important research questions Focus is on promoting health and ameliorating the side effects of illness and the consequences of treatment Goal is to provide the foundation for evidence-based practice Expansion of doctoral programs

11. NINR: Research Themes • Changing lifestyle behavior for better health (starting healthy behaviors) • Managing the effects of chronic illness to improve quality of life • Identifying effective strategies to reduce health disparities • Harnessing advanced technologies to serve human needs • Enhancing end-of-life experience for patients and families

12. Purposes of Nursing Research • Basic research • Applied research

13. Methods for Nursing Research • Scientific Method and Quantitative Research • Naturalistic Method and Qualitative Research

14. Importance of Nursing Research • Evidence-Based Nursing Practice • Credibility of the Nursing Profession • Accountability for Nursing Practice • Documentation of Cost-Effectiveness of Nursing Care

15. Research Utility • General consensus that the research role of the baccalaureate graduate calls for the skill of critical appraisal • The nurse must be a knowledgeable consumer of research • Also, to be able to critique research and use existing standards to determine the readiness and merit of that research for use in clinical practice

16. Consuming Nursing Research: Be Informed • Use critical thinking • Understand the steps in the research process

17. Evidence-Based Practice • Integrates individual clinical expertise and the best evidence to guide (mutual) decision making and patient preference. • Sackett, 2000

18. Steps to Develop Evidence-Based Interventions • First step: Be able to critically read the literature • Research articles • Clinical articles • Clinical guidelines

19. Research Article vs. Clinical Article Research Article • Follows the steps of the research process • Not a “how to,” but answers a question with all the components of research clearly presented

20. Assess Strength of Evidence • Level I Meta-analysis or systematic review of RCTs/experimental studies • Level II RCTs or experimental studies • Level III Quasi-experimental studies • Level IV Nonexperimental studies • Level V Case reports, program evaluation, qualitative research • Level VI Opinion of respected authorities

21. Assessing Strength • Quality: Extent to which a study’s design, implementation, and analysis minimizes bias • Quantity: Number of studies that have evaluated the research question, including sample size across studies • Consistency: Degree to which studies have similar and different designs yet the same research question and similar findings

22. The Research Process: The Sum of It’s Parts

23. Abstract • Short comprehensive synopsis or summary of a study • Located at the beginning of a study • Quickly focuses the reader on the main points of the study • 50 to 250 words • Should accurately represent the study’s methods and results

24. Variable • A characteristic or quality that takes on different values, i.e., that varies from one person to the next • Blood type • Weight • Length of stay in hospital

25. Types of Variables • Continuous (age, height) • Discrete (number of children) • Categorical (blood type) • Dichotomous (gender) • Attribute variable vs. Active variable

26. Types of Variables (cont’d) • Independent variable—the presumed cause (of a dependent variable) • Dependent variable—the presumed effect (of an independent variable) Example: Smoking (IV)  Lung cancer (DV)

27. Definitions of Concepts and Variables • Conceptual definition • the abstract or theoretical meaning of a concept being studied • Operational definition • the operations (measurements) a researcher must perform to collect the desired information

28. Identification of a Research Purpose/Question Researchproblem An unexplained, perplexing, or troubling condition Problem statement A statement describing the research problem and indicating the need for a study

29. Research Question/Hypotheses Research questions The specific questions the researcher wants to answer in addressing the research problem Hypotheses The researcher’s predictions about relationships among variables

30. Research Design and Data • Quantitative Studies—Researchers identify variables of interest, develop operational definitions, then collect relevant data from subjects. The actual values of the study variables constitute data for the project • Qualitative Studies—Researcher primarily collects narrative data

31. Example of Quantitative Data

32. Example of Qualitative Data

33. Major Methodologic Challenge Designing studies that are: • Reliable and valid (quantitative studies) • Trustworthy (qualitative studies)

34. Criteria for Evaluating Quantitative Research Reliability The accuracy & consistency of obtained information Validity The soundness of the evidence—whether findings are convincing, well-grounded

35. Dimensions of Trustworthiness in Qualitative Studies • Credibility • Confirmability • Dependability

36. Results • Analysis • Discussion • Recommendations/Implications • Communication

37. Generalizability and Transferability Generalizability (Quantitative research): The extent to which study findings are valid for other groups not in the study Transferability (Qualitative research): The extent to which qualitative findings can be transferred to other settings

38. Questions??