nursing research: 63-377 dr. wally j. bartfay

Nursing Research: 63-377Dr. Wally J. Bartfay

“Imagination is more important than knowledge.”(Albert Einstein, 1879-1955)

Research Questions

Are specific statements about the query the researcher wants to answer

E.g.1: “What is the effect of a 3 year television community-based heart health program on the CVD mortality rate in Ontario?”

E.g.2: “What is the effect of passive ROM on the prevention of DVT’s during the first 24 hours following stroke?”

Research Questions: Quantitative

They often identify key variables (e.g., BP, cholesterol, knowledge), the proposed relationships between (e.g., less, more, higher, lower, etc) them & the target population (e.g., stroke survivors, children with IDDM) {more solid}

E.g., What is the effect of a 10 week walking program on subjects BP, cholesterol profiles and serum ferritin levels in post-menopausal women aged 50 to 60 years?

Research Questions: Qualitative

May evolve & change over course of study (fairly broad at onset, narrows overtime) {more fluid B/C researcher is often the instrument & subjectivity is essential for understanding human experiences}

E.g., time 1: What is the lived experience of women who have undergone a C-section?

E.g., time 2: What are the specific negative connotations & images r/t to birth process identified by women who have undergone a C-section?

Summary Flow Chart: Formulating A Research Question

Observation,Clinical practice &

Literature

Identify research topics of interest& Research problems

Non-researchable problems

(e.g., ethical concerns, lack of subjects)

Researchable problems

Formulate Research Questions

(Refinement)

Research Hypotheses

Specifies the variables to be manipulated or measured Identifies the target population to be examined They “predict” the outcomes May be based on a theory (e.g., behavioral modification) May be simple (one independent & dependent variable) or

complex (multiple variables/ outcomes) May be directional (e.g., higher, lower) or non-directional

(variables related but no direction how) May be associative versus causal

Research Hypothesis: A real example

At least 50% of nursing students enrolled in 63-377 will be able to recall 7+/-2 items on a memory challenge test

Research Hypothesis: A real example

Mirror, ray, cat, periscope, system, nucleus Sand, elephant, pen-knife, gigantic, camera Jupiter, organic, ice-cream, cow, bladder Photosynthesis, root, teeth, taxi, snake, x-ray

Research Hypothesis: A real example

At least 50% of nursing students enrolled in 63-377 will be able to recall 7+/-2 items on a memory challenge test

Class results? Accept or reject hypothesis

Purposes of Hypotheses

(1) To provide a bridge between theory & reality, in this sense, unifying the 2 domains

(2) To be tools for advancement of knowledge b/c they enable the researcher to objectively enter new areas of discovery

(3) To provide direction for research endeavors by identifying the anticipated outcome

Assumptions r/t Hypotheses

Nature of the relationships, either causal or associative, is implied

They are testable, which means variables have to be observable & measurable

Sound hypotheses are consistent with existing body of knowledge, theory & research findings (white horse scenario)

Developing Research Hypotheses

Should be a statement about the relationship between 2 or more variables that suggest an answer to the research ?

Should convert the question posed by research problem into a declarative statement that predicts an expected outcome

Should flow from research problem, lit. review & theoretical framework

Developing Research Hypotheses

Theoretical Frameworks

Literature ReviewProblem Statements

Hypotheses

Interrelationships of problem statement, lit. review, theoretical framework & hypotheses

Review exercise: Examples of hypotheses formulated

(1) There will be a positive relationship between recalled psychological distress & the onset of G.I. symptoms in clients with irritable bowel syndrome

(2) There will be a positive relationship between recalled psychological distress and exacerbation of G.I. symptoms in clients with irritable bowel syndrome

Critiquing Criteria for Hypotheses

Does it r/t research problem? Is it concisely stated in a declarative form? Are independent & dependent variables clearly

identified? Are variables measurable? Is it testable? Is theoretical rationale explicit? Is it stated objectively, without value-laden words?

Review of Literature

Research

Practice

Theory

EducationReview of Literature

Proposed relationships between research, education, practice & literature

Review of Literature: Major Goal

To develop a sound and strong knowledge base to carry-out research and other scholarly educational and clinical practice activities

Critical elements in literature review: Grant proposal development

When the problem/ concept was identified When was it 1st investigated How was it previously investigated (specific

designs employed, target populations) By whom was it investigated (individual,

multi-site, WHO etc) Gaps & inconsistencies identified (provides

directions for future research)

Review of Literature: Objectives

(1) Determines what is known & not known about a problem, subject or concept

(2) Determines gaps, consistencies and inconsistencies

(3) Helps to uncover unanswered ?’s (4) Helps to identify conceptual frameworks used to

examine problems (5) May uncover new practice interventions and/or

provides rationale for current and proposed interventions, protocols & policies

Review of Literature: Objectives

(6) Helps generate useful research ?’s & hypotheses of interest to nursing

(7) Helps determine appropriate research design, methodology, & analysis based on earlier reports

(8) Determines need for replication of study or refinement (e.g., other target populations)

(9) Synthesizes strengths & weaknesses of earlier reports in a concise manner

(10) Provides rationale & clinical significance for new research endeavors (research proposals)

Steps For Reviewing The Literature:

(1) Determine concept/ issue/ topic/ problem of interest

(2) Identify key words, variables, terms (3) Conduct print (esp. recent reviews) & computer

searches of abstracts (e.g., PUBMED, MEDLINE, CINAHL, ERIC)

(4) Print-out key abstracts & organize sources for retrieval (e.g., organize by journal name, year etc)

(5) Retrieve relevant articles (esp. current reviews as a starting point)

Steps For Reviewing The Literature:

(6) Proof articles & weed-out all irrelevant articles (7) Copy all relevant, classical & ground-breaking

articles (hint: who’s quoting who?) (8) Review articles systematically (abstract,

background, research ?s, hypotheses, methods, results, discussion)

(9) Summarize & systematically critique each source (10) Synthesize critical summaries (e.g.,

chronologically, according to type etc)

Databases: Print & Internet based

CINAHL (1st published in 1956- note: historical research) Index Medicus {IM} (oldest health related index, 1st published in

1879) Psychological Abstracts (covers 1927 to present) International Nursing Index {INI} (started in 1966) Nursing Studies Index (developed by Virginia Henderson, from

1900 to 1959) Hospital & Health Administration Index {HHAI} (1945) Current Index to Journals in Education {CIJE} (1969, now

known as ERIC) Many others, including MEDLINE (since 1966), PUBMED,

HealthStar, Psychological Abstracts, Sociological Abstracts, Nursing Abstracts, Dissertation Abstracts, etc

Critiquing Criteria for Review of Literature:

(1) What are gaps or inconsistencies? (2) How does the review reflect critical thinking? (3) Are all relevant concepts & variables included in

the review? (4) Do summaries reflect essential components of

the study (e.g., ?s, study design, results, instruments, validity, reliability issues, etc)? {See page 107 of Polit & Tatano Beck, (2004)}

(5) Does critique include strengths, weaknesses, limitations with design, conflicts, gaps, etc?

Critiquing Criteria for Review of Literature:

(6) Are both conceptual & data-based lit. included? (7) Are primary & current sources used mostly

(unless Hx. Research)? (8) Is there a written synthesis of the reports? (9) Does organization flow logically (e.g.,

chronologically, based on design etc)? (10) Does lit. review fit purpose(s) of the current

proposed study (relevant or not)?