NURSING RESEARCH

DEFINITION
 Research 
 Is systemic inquiry that uses disciplined methods to answer questions or solve problems 
 Systemic inquiry
Scientific method
Solve Problems and answer questions
 Nursing Research
 Is systematic inquiry designed to develop trustworthy evidence about issues of importance to the:
 Nursing Profession:
 Nursing practice
 Education
 Administration
 Informatics

PURPOSES OF NURSING RESEARCH

Accountability for Nursing Practice
Credibility to Nursing, Cost effectiveness 
Evidence-Based Nursing Practice
Documentation of Nursing Care  

TYPES OF RESEARCH ACCORDING TO PURPOSE

BASIC APPLIED
General knowledge Find solution to existing problem
Formulate/ refine a theory Focus on intervention to achieve desired goal
General principles of human behavior How principles can be used to solved problems in such
nursing practice
Ex. In-depth study to be better understanding Ex. Study to determine effectiveness of a nursing
normal grieving process intervention to ease grieving 
  
 Basic Research
 Is undertaken to extend the base of knowledge in a discipline, or to formulate or refine a theory.
Example: The Sun to the Earth and beyond: Panel Reports (2003)

 Applied Research 
 Focuses on finding solutions to existing problems and thus tends to be of greater immediate utility
for evidence-based practice.
 Is designed to indicate how these principles can be used to solve problems in nursing practices.

Example: The use of breastfeeding for pain relief during neonatal immunization injections.
TYPES OF RESEARCH ACCORDING TO DESIGN
 Quantitative Research
 Use mechanism designed to control the study
 Information gathered in such a study is numeric information that results in some type of formal
measurement and that is analysed with statistical procedure.
 Quantitative data- information in numeric form
 Qualitative research 
 Materials are narrative and subjective 
 Takes place in the field, often over an extended period of time
 Tends to emphasize the dynamic, holistic, and individual aspects of human experience
  Qualitative data- narrative description
VARIABLES
 Variables- a characteristic or quality that takes on different values.
 Dependent Variable
 The behaviour, characteristic or outcome the research is interested in understanding, explaining
or affecting. It is the presumed effect. 
 Independent Variable 
 The presumed cause of antecedent to or influence on the dependent variable.
 Example: the relationship between the number of prenatal classes attended by pregnant women and
the degree of anxiety concerning labor and delivery.
 Independent variable: number of prenatal classes
 Dependent variable: degree of anxiety

QUANTITATIVE QUALITATIVE
Positive traditions Naturalistic inquiry 
Scientific method Human experience
Numerical data  Narrative description data
Objective  Subjective
Systematic Controlled Flexible/ evolving
Empiricism (use of Analytical insight
senses)
General/ Broad  Specific/ direct
Cause and effect Meaning/ Discovery 
Deductive reasoning  Inductive reasoning
Theory testing Theory development
Laboratory settings Field setting

QUANTITATIVE RESEARCH 
Experimental Research
 Researches actively introduce an intervention or treatment
 Example: the effect of pressure-relieving devices on prevention of heel pressure ulcers.

 True experimental design

 Manipulation
 An intervention or treatment is introduced to some subject
 Treatment group
 The group who receives interventions
 Control 
 The experimenter introduces control over the experimental situation
 Control group
 Group without treatment
 Refers to a group of subjects whose performance on a dependent variable is used to
evaluate the performance of the treatment group on the same dependent variable.
 Randomization 
 The experimenter assigns subjects to a control or experimental condition on a random basis.
 Random means that every subject has an equal chance of being assigned to any group.

 Example: An experimental study was conducted to determine the effects of classical music in
improving the grades of elementary school students. The students were selected through random
sampling. One group was exposed to classical music during review sessions. The other group was
placed into another room without the intervention. After the review session, a post test was given to
the students.
M- The classical music
 R- The students were randomly selected
C- The presence of a control group (without intervention)

 Quasi- Experimental design 

 Involves an intervention, however, quasi-experimental designs lack randomization, the signature of
a true experiment.
Non-Experimental Research
 They collect data without introducing treatments or making changes.

1. Correctional Research 
 Designs that examine relationships between variables
 A correlation is an interrelationship or association between two variables, that is, a tendency for
variation in one variable to be related to variation in another.
 E.g. The relationship of nursing supervisors perceived sense of humor with staff nurses’ job
satisfaction.
2. Comparative Research
 Identify, analyze and explain similarities and differences across societies.
 E.g. Preparing educators towards educational technology: comparative study of students and
educators perception in learning programming languages.
3. Survey Research
 Is designed to obtain information about the prevalence, distribution, and interrelations of variables
within a population.
 Telephone interviews
 Questionnaires 

 E.g. For a political or ethical survey about which anybody can have a valid opinion, you want to try
and represent a well balanced cross section of society.

4. Methodological Research 
 Studies are investigation of the ways of obtaining and organizing data and conducting rigorous
research.
QUALITATIVE RESEARCH
1. Grounded Theory 
 Researchers strive to generate comprehensive explanations of phenomena that are grounded in
reality
 A research method that will:
 Develop a theory 
 Offer an explanation
 Focus on the main concern of the population
 Show how the concern is resolved or processed 
2. Phenomenological Research 
 Is concerned with the lived experience of humans
 Is an approach to thinking about what life experiences of people are like
 Example: In-depth interviews to explore the experiences of women who had undergone vaginal
closure surgery to correct severe vaginal prolapse
3.  Ethnographical Research
 Is the primary research tradition within anthropology and provides a framework for studying the
patterns, lifeways and experiences of a cultural group in a holistic fashion. 
 Example: Ramon and Mei Joy conducted ethnographic fieldwork in two rural Ecuadorian
communities and studied the burdens of women’s roles, the women’s perceived health needs, and
health care resources.
 4. Historical Research
 The systematic collection and critical evaluation and interpretation of historical evidence (data
relating to past occurrence) 
5. Case Studies 
 Are in depth investigations of a single entity or a small number of entitles
 Example: Ralf and Carlo conducted an in-depth case study of a patient who had had a stroke 2
years ago and is experiencing eating difficulties.

MAJOR STEPS IN A QUANTITATIVE STUDY

Phase 1: Conceptual Phase

1. Formulating and Delimiting the Problem 
 Identify an interesting, significant research problem and research question
 Research problem
 Is the situation that causes the researcher to feel apprehensive, confused and ill at ease
 Is the demarcation of a problem area within a certain context involving the who or what, the
where, the when and the why of the problem situation.
 Problem statement
 Articulates the problem to be addressed and indicates the need for a study through the
development of an argument.
 Research questions
 Are the specific queries researcher wants to answer addressing the research problem
2. Reviewing the Related Literature
 Provides a foundation on which to base new evidence and usually is conducted well before any
data are collected.
 Primary source 
 Descriptions of studies written by the researchers who conducted them.
 Mostly recommended.
 Secondary source- description of studies prepared by someone other than the original
researcher.
3. Defining the Framework and Developing Conceptual Definition
 Framework is the overall conceptual underpinnings of a study.
 Conceptual framework
 Deals with abstractions that are assembled by virtue of their relevance to a common theme.
 It is a study that has roots in a specified conceptual model.
 Theoretical framework
 It is a study based on a theory.
 Conceptual definition
 Presents the abstract or theoretical meaning of the concepts being studied.
 E.g. Weight is a measurement of gravitational force acting on an object.
 Operational definition
 Specifies the operation that researchers must perform to collect and measure the required
information.
 E.g. Weight is a result of measurement of an object on a Newtown spring scale.
4. Formulating Hypothesis 
 Hypothesis 
 Is a statement of the researcher’s expectations about relationships between study variables.
 Research hypothesis
 Statements of expected relationships between variables.
 Non-Directional 
 E.g. There is a difference in the test scores of students of clinical instructors with 5 years
bedside experience and students of clinical instructors with only 1 year of bedside
experience.
 Directional 
E.g. There is a positive relationship between fast food consumption and weight gain.
 Null hypothesis 
 State that there is no relationship between the independent and dependent variables.
 E.g. There is no significant relationship between anxiety and duration of fertility.

Phase 2: The Design and Planning Phase

1. Selecting a Research Design
 Cross-sectional design
 Involves the collection of data once: the phenomena under study are captured during one
period of data collection. 
 Longitudinal design 
 A study in which data are collected are more than one point in time over an extended period.
 E.g. Premature infants-evaluating development during childhood.

 Retrospective design 
 Involves collecting data on an outcome occurring in the present, and then linking it
retrospectively to antecedents or determinants occurring in the past.
 Prospective design
 Information is first collected about a presumed cause or antecedent, and then subsequently the
effect or outcome is measured
 E.g. Framingham Heart Study; Nurses study. Those who develop certain diseases are
compared to those who don’t.
2. Identifying the Population
 People who provide information to the researchers or investigators are:
 Subjects
 Study participants
 Respondents
 Informant (Qualitative Study)
 Population
 All the individuals or objects with common, defining characteristics
 Accessible/Source Population
 Is the aggregate of cases that conform to designated criteria and that are accessible as
subjects for a study
 Target Population
 Is the aggregate of cases about which the researcher would like to generalize
 Sample
 Is a subset of population elements
 Element
 Is the most basic unit about which information is collected. The key consideration in assessing
a sample in quantitative is representativeness
 Pilot study
 Is a small-scale version or trial run designed to test the methods to be used in a larger, more
rigorous study, called parent study
3. Designing the Sampling Plan 
 Sampling 
 Is the process of selecting a portion of the population to represent the entire population so that
inferences about the population can be made.
 Representativeness 
 The key consideration in assessing a sample in a quantitative study

Probability Sampling
 Involves random selection of elements
1. Simple Random Sampling
 Is the most basic probability sampling design
2. Stratified random sampling
 It subdivides the population into homogeneous subsets from which an appropriate number of
elements are selected at random.
3. Cluster sampling (Multi-stage sampling)
 Involves the successive selection of random samples from larger to smaller units by either simple
random or stratified random methods.
4. Systematic Sampling
 Involves the selection of every nth case from a list, such as every tenth person on a patient list.

Non-probability Sampling
 Elements are selected by nonrandom methods.
1. Convenience/Accidental Sampling
 Entails using the most conveniently available people as study participants
2. Snowball/Network/Chain Sampling
 Is a variant of convenience sampling. Early sample members are asked to refer other people who
meet the eligibility criteria
3. Quota Sampling
 Is one in which the researcher identifies population strata and determines how many participants
are needed from each stratum
4. Purposive/ Judgement Sampling
 Judgmental sampling is a non-probability sampling technique where the researcher selects units to
be sampled based on their knowledge and professional judgement

Phase 3: The Empirical Phase

1. Collecting the Data
 Data saturation
 Involves sampling to the point at which no new information is obtained and redundancy is
achieved.
Instruments in Data Collection
 Observation
 Is way of gathering data by watching behavior, events, or nothing physical characteristics in
their natural setting
 Types of Observation: 
 Overt- Everyone knows they are observed
 Covert- No one knows they are being observed and the observer is concealed
 Types of observer:
 Non-participant, or direct, observation
 Is where data are collected by observing behavior without interacting with the participants
 Participant observation
 Is where data are collected by interacting with, and therefore experiencing, the phenomenon
being studied.
 Advantages of observation
 Collect data where and when an event or activity is occurring
 Does not rely on people’s willingness or ability to provide information
 Allows you to directly see what people do rather than relying on what people say they did
 Disadvantages of observation
 Susceptible to observe bias
 Susceptible to the hawthorne effect, that is, people usually perform better when they know
they are being observed, although indirect
 Are by the interviewer to observation may decrease this problem
 Can be expensive and time-consuming compared
   To other data collection methods
 Does not increase your understanding of why people behave as they do
 Questionnaire 
 Is a research instrument consisting of series of questions and other prompts for the purpose of
gathering information from the respondents
 Types:
 Closed-ended questions
 Is a question format that provide respondents with a list of answer choices from which they
must choice to answer the question
 E.g. Do you get well with your boss
 Open-ended questions’
 An open-ended question is designed to encourage a full, meaningful answer using the
subject’s own knowledge and/or feelings
 E.g. Tell me about your relationship with your boss
 Advantages of Questionnaires 
 Cost- less costly, less time and energy to administer
 Anonymity- offer the possibility of complete anonymity
 Interviewer Bias- absence of an interviewer ensures that there will be no interviewer bias
 Interview
 Is a conversation between two people (the interviewer and the interviewee) where questions
obtain information from the interviewee
 Types:
 Structured
 Require adherence to a very particular set of rules. Each question that is outlined should be
read word for word by the researcher without any deviation from the protocol
 Semi-structured 
 Semi-structured interviews a bit more relaxed than structured interviews 

 While researchers using this type are still expected to cover every question in the protocol,
they have some wiggle room to explore participant responses by asking for clarification or
additional information
 Unstructured 
 Have the most relaxed rules of the three
 In this type, researchers need only a checklist of topics to be covered during the interview
 There is no order and no script
 Advantages of Interview
 Response rates- tends to be high in face to face interview
 Audience- many people cannot fill up questionnaire. Interview is feasible with most of the
people
 Clarity- interviews offer some protection against ambiguous or confusing questions 
 Depth of questioning- open-ended questions are used mostly in interview
 Missing information- less likely to give missing information in interview
 Order of question- in interview, researchers have control over question ordering
 Physiological Measurements
 Weight- most objective
 Likert Scale
 Is a psychometric commonly involved in research that employs questionnaires 
 Delphi Technique
 Is a structured communication technique, originally developed as a systematic, interactive,
forecasting method which relies on a panel of experts
 Pre-existing Data
2. Preparing the Data for Analysis
Phase 4: The Analytic Phase
1. Interpreting the Results
 Interpretation is the process of studying the results and examining their implications

Inferential Statistics
 Parametric Tests
Are characterized by three attributes:
 They involve the estimation of a parameter
 They require measurement on at least an interval scale
 They involve several assumptions, such as the assumption that the variables are normally
distributed in the population
 Non-parametric tests
 They involve less restrictive assumptions about the shape of the variables distribution then do
parametric tests
Levels of Measurement
 Non-parametric:
1. Nominal
 Involves assigning numbers to classify characteristics into categories
 E.g. gender, blood type, marital status
2. Ordinal
 Involves sorting objects based on their relative ranking on an attribute 
 E.g. levels of anxiety(mild, moderate, severe and panic)
 Parametric
3. Interval 
 Occurs when researchers can specify the rank-ordering of objects on an attribute and can
assume equivalent distance between them
 E.g. Fahrenheit temperature scale
4. Ratio
 It is the highest level of measurement
 They have a rational, meaningful zero
 It provides information concerning the ordering of objects on the critical attribute, the intervals
between objects and the absolute magnitude of the attribute
 E.g. Scores in the board examination
 Measurements:
 Chi-Square Test
 Is used to test hypothesis about the proportion of cases that fall into different categories, as
when a contingency table has been created
 For non-parametric variables
 T-test
 Assesses whether the means of two groups are statistically different from each other
 This analysis is appropriate whenever you want to compare the means of two groups
 Analysis of variance (ANOVA)
 Is the parametric procedure for testing differences between means when there are three or
more groups
Descriptive Statistics
 Measures to Condense 
 Frequency distribution
 Is a systematic arrangement of values from lowest to highest together with a count of the
number of times each value was obtained
 Percentage
 Is a way of expressing a number, especially a ratio, as a fraction of 100
 
Graphic Presentation

The transformation of data through visual methods like graphs, diagrams, maps and charts is
called representation of data
 Measures of central Tendency
 Are indexes expressed as a single number that represent the average or typical value of a set of
scores
 Mode
 Most frequently occurring score value in a distribution
 Median
 Is the point in a distribution above which and below which 50% of cases fall
 Mean
 Is the sum of all scores, divided by the number of scores
 Also referred to as the average

Measures of Variability
 It shows how spread out the data
 Range
 Simply the highest score minus the lowest score in a distribution

 Standard deviation

Indicates the average amount of deviation of values from the mean
 Variance
 Is equal to the standard deviation squared
 Percentile
 Is the value of a variable below which a certain percent of observations fall

Measures of Relationship
 Pearson’s r- this coefficient is computed with variables measured on either an interval or ratio scale
 Spearman’s rho (p)- the correlation index usually used for ordinal-level measures
 Correlation coefficient 
 Indicates the magnitude and direction of a relationship between two variables
 It can range from -1.00 (a perfect negative relationship) through zero to +1.00 (a perfect positive
relationship)
Hypothesis Testing
TRUE FALSE
True (null is Correct decision Type II error (false negative)
accepted)
False (null is rejected) Type I error (false positive) Correct decision

Phase 5: Dissemination Phase

1. Communicating the Findings
 Final task of the research project is the preparation of a research report that can be shared with
others.
2. Utilizing the Findings in Practice
CRITERIA IN ASSESSING QUALITY OF RESEARCH
 Reliability 
 Refers to the accuracy and consistency of information obtained in a study

 Validity
  Is a more complex concept that broadly concerns the soundness of the studies evidence that is
whether the findings are unbiased, cogent and well grounded
 Dependability
 Refers to evidence that is consistent and stable
 Confirmability
 Is similar to objectively 
 It is the degree to which study results are derived from characteristics of participants and the
study context, not from researcher biases
 Credibility
 An especially important aspects of trustworthiness, is achieved to the extent that the research
methods engender confidence in the truth of the data and in the researchers interpretation of the
data
 Triangulation
 Is the use of multiple source or referents to draw conclusions about what constitutes the truth

ETHICS IN RESEARCH
 Nuremberg code
 Developed after the Nazi atrocities were made public in the Nuremberg trials
 The commission established by the National Research Act, issued a report in 1978that is
referred to as the Belmont Report, which provided a model for many of the guidelines adopted by
disciplinary organizations in the United States
Ethical Principles for Protecting Study Participants
 Beneficence 
 Imposes a duty on researchers to minimize harm and to maximize benefits
 The right to freedom from harm and discomfort
 The right to protection from exploitation

 The right to self-determination

The principle of self-determination means that prospective participants have the right to decide
voluntarily whether  to participate in a study, without risking any penalty or prejudicial treatment
 The right to full disclosure
 Full disclosure means that the researcher has fully described the nature of the study, the
person’s right to refuse participation, the researchers responsibilities, and likel risks and benefits
 Concealment 
 The collection of information without the participants’ knowledge or consent 
 Deception
 Either withholding information from participants or providing false information
 The right to fair treatment
 Justice
 Connotes fairness and equity, and so one aspect of the justice principle concerns the equitable
distribution of benefits and burdens of research
 The right to privacy
 Researchers should ensure that their research is not more intrusive that it needs to be and that
participant’s privacy is maintained throughout the study
 Anonymity
 The most secure means of protecting confidentially occurs when even the researcher cannot
link participants to their data.