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)?