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NURS 2031
Why is nursing research important?
- provides validity to our profession
- gives credit to the profession
- shows that nursing research and work is important
- gives results specific to nursing and our patients Define Research. A systemic process of enquire that aims to generate new scientific knowledge. Define Health Research. Any research that is relevant to health, incorporating a diverse number of methodologies. What are the Four Pillars of Health?
- Biomedical
- Clinical
- Health services and policy
- Social, cultural, environmental and population health What does the Biomedical pillar of health entail? Looks at research surrounding disease at a cellular, body systems level (ie. medication trials).
What does the Clinical pillar of health entail? Looks at research concerning patients, and what we can do for them (ie. changes in nursing practices, assessment techniques, etc.). What does the Health Service and Policy pillar of health entail? Looks at research concerning how care is given by the system and policies that effect patients (ie. waiting times in ER departments, etc.). What does the Social, Cultural, Environmental and Population Health pillar of health entail? Looks at research surrounding populations, and health determinants and how they affect health care delivery and patients (barriers to healthcare such as rural populations, etc.). What are the three main purposes of Health Research? To describe (comparisons between people and groups, healthcare policies, and illustrate differences in health care opportunities, etc.), to explain (how disease develops, what factors lead to disease, why certain populations are more at risk, etc.) and to predict and control (using results to develop and evaluate strategies to mitigate health problems, development of policy to improve outcomes, and collaborate with policy makers and researchers). What are four main milestones in health research?
- Discovery of the gene for cystic fibrosis
- Development of the polio vaccine
- Discovery and production of insulin
- Addition of vitamin d to milk to prevent rickets What are the four main roles of nurses in health research?
- tried to make things generalized
- believes that there is only ONE reality
- tries to create theories about why something is happening Describe the Epistemological foundation Interpretivism.
- believe that everyone experiences things in their own way through personal experience
- says that each person has a different view on reality
- does not try to generalize results because everyone experiences reality differently Describe the Epistemological foundation Critical Realism.
- says that sometimes things just cannot be explained, measured or observed
- try's to use theory but it cannot always be used
- emphasize context and that it can change any situation What are the 2 types of Ontology?
- Objectivism/Objectivist
- Constructivism/Constructivist Describe the Ontology of Objectivist/Objectivism Researcher study phenomena that exist as external objects, things that they cannot change of control (weight, height of an individual) Describe the Ontology of Constructivist/Constructivism. Socially constructed objects, beliefs, behaviours, etc. (Ie. sexuality, gender, etc.).
What are the two main links of paradigms that are most commonly put together? Positivism - Objectivism - Quantitative Interpretivism - constructionalism - qualitative What are some common methodologies of Qualitative research?
- one on one interviews with people
- focus groups
- analysis of written or visual material
- open ended questions requiring personal opinions/answers
- close contact with participants by the researcher What are some common methodologies for quantitative research?
- relies on numerical data and statistical analysis
- testing and measuring hypotheses
- assessing correlations and causality What is Deduction? Testing a pre-existing hypotheses and testing/collecting data for that hypotheses and pre-existing theory What is Induction? Coming up with theories on your own and developing new hypotheses that can be used in other projects.
Ask, gather, assess/appraise, act, evaluate What does the Abstract of a research article include? A short, comprehensive summary of the study at the beginning of the article focusing on the main points of the study. What does the Introduction of a research article include? A brief background to the subject and why it would be important to practice. What is Evidence-Based practice vs. Evidence-Informed practice? Evidence Based = scholarly literature supported, looking at what the research says about something and what studies say to do Evidence Informed = personal experience to draw from in order to give care based on acquired/past knowledge. More patient centred. What are some of the Administrative responsibilities of a researcher in a study?
- establishing a budget for the study that is feasible and realistic
- develop a timeline that is realistic
- keep records
- supervise all individuals working on/with the study
- comply with agency, organizational, and institutional rules, regulations, policies, and procedures What are some of the study-specific responsibilities of a researcher in a study?
- develop a research question
- select a design
- ensure that the study is ethically sound
- collect data/decide how it will be collected
- analyze the date/what tests can be used to analyze
- prepare the study's findings
- develop a new/more refined research question What are the 12 steps to the Research Process?
- Find the research topic, idea or problem that is right for you
- Research existing literature on the topic
- define the problem
- develop a research question
- generate a hypothesis
- choose an appropriate study design
- define the variable and other key terms
- identify the participants/subjects
- conduct the study
- analyze the data
- writing about the study
- amend the existing research question or create a new one What does PICOT stand for and what is it used for? P - Problem/Population I - Intervention C - comparison O - Outcome (of interest) T - time frame
qualitative = derives data from observation, interviews or verbal interactions and focuses on meaning and interpretation of participants. quantitative = is based on collected objective data that can be subjected to statistical analysis Independent variable vs. dependent variable. independent: manipulated or controlled dependent: variable being tested or measured What is a control/situational variable? it holds constant throughout the study, it is not aloud to vary in any way What are the two types of definitions that can be used in a research study and what do they mean? Conceptual Definition - a vague definition, one you would usually find in a dictionary Operational Definition - defines a variable according to its unique meaning within a study How are Independent and Dependent variables operationally defined? IV = defined based on how it is manipulated DV = defined by how it will be measured What is a subject vs. a participant? Subject = individual in an experimental research study Participant = non-experimental study
What are the three types of assignment in research studies? Random Assignment - everyone has an equal chance of being placed in groups Blind Assignment - the researcher knows where each subject is going but the subject does not Double Blind Assignment - neither the researcher or the subjects know who belongs to which group What is a placebo? when an inactive or "fake" substance is given to a subject without them knowing it is fake. Used to assess effectiveness of real drug vs. no drug without bias. What are the three types of methodology that can be used in a study? Quantitative, Quantitative and Mixed Methods What is a literature review?
- a systemic summary and critical evaluation of scholarly literature on a topic
- represents the positive and negative findings of an area
- a synthesis of researcher literature What is the point of a literature review?
- MAIN = to discover what is known about a topic already
- for knowledge (reading to learn)
- for a study (seeing the known vs. unknown, gaps in the topic, helping to generate questions and hypothesis, etc.)
Used to aid in literature searching:
- "and" = requires that both subjects be included in the results of the search
- "or" = allows the grouping of like-terms or synonyms
- "not" = eliminates terms from your search results What is the purpose of a research design?
- provides a plan to aid in solving problems, answering questions and testing hypotheses
- involves a plan, a structure and a strategy
- allows the researcher to apply different levels of control (confirms that it was the independent variable that made the dependant variable change) What is the difference between basic research and applied research? Basic = its motivation is to expand nursing knowledge Applied = its designed to solve clinical problems and improve patient health What are the five elements of a research design?
- Who (the participants)
- What (the observations)
- When (measurement of time)
- Where (selection of subjects)
- Role of the investigator What are some components of optimal research design?
- driven by a study question
- available population for the study
- resources included
- the current state of the research What is a Study Design? how one chooses or samples and measures the exposures and diseases outcome states. Also called the plan for answering research question What are the 3 must-have characteristics of an Experimental Design?
- Randomization - subjects being randomly assigned to the control and treatment/intervention groups, everyone has an equal chance
- Control - the introduction of one or more constants into the experiment (control group/experimental group)
- Manipulation of the independent variable What is Internal Validity? the degree to which the experimental treatment, not an uncontrolled condition, resulted in the observed effects in the experiment What are the 6 threats to internal validity?
- History Threat = a specific event that may affect the dependent variable
- Maturation Effects = developmental, biological or psychological processes that operate within the individual as a subject of time (subjects change)
- Testing Effects = taking a test repeatedly
- Instrumental Threats = measurements or instruments of the study malfunction (ie. elevator stops working)
- Mortality or Attrition = loss of participants
What are the advantages and disadvantages of a Quasi-Experimental design? Pros: more feasible/practical, some generalizability Cons: may not be able to randomize, therefore making groups potentially unequal, and difficult to make clear cause-and-effect statements (lack of control) What are Non-Experimental Designs?
- there is no intervention/manipulation of the independent variable as it is constant and cannot be manipulated (already exists)
- said to be observational studies Why are Non-Experimental designs used?
- to construct a picture of a phenomena at one point or over a period of time
- explore people, places, events or situations as they naturally occur
- test relationships and differences among variables What are the advantages and disadvantages of non-experimental designs? Pros: important in developing a knowledge base on the phenomena of interest, useful in forecasting and making predictions, important when the three characteristics of an ED cannot be used and useful in testing theoretical models or how variables interact in different situations Cons: difficult to explain cause and effect relationships What are the three examples of Non-Experimental design? Cohort studies, cross-sectional studies and Case Control Studies
What is a Cohort study design?
- a prospective study design
- may have control and experimental groups but are named as either exposed or not exposed
- exposure is measured before the study begins and then time occurs, and the outcome is whether or not the individuals have disease or not and whether or not they were exposed in the first place
- possible in looking at risk and rates of disease in each group
- possible confounding varibale must be dealt with before Are retrospective or prospective studies "stronger" prospective because retrospective are more prone to selection and recall bias What is a Case-Control study? Retrospective study that studies a group of people with the disease and without the disease and tries to determine associations between risk factors and disease occurrence, tries to determine what the exposures were
- used to study rare or uncommon disease
- usually cheaper and faster than cohort studies
- more vulnerable to bias
- measured for odds ratio What are Cross-Sectional studies?
- a sample of a population is chosen and grouped into diseased/unexposed, disease/exposed, no disease/exposed and no disease/not exposed
- measured in odds ratio
- cheap and fast to conduct
- occurs at one point in time and not over time (limitations there)
What is Secondary Analysis? a researcher reanalyzes the data from a study for a completely different purpose What are Qualitative researchers interested in/not interested in?
- not interested in the relationships between IV and DV or measurement of variables
- interested in what is going on, the nature of something from the perspective of people
- interested in using more in-depth interviews, focus groups, and less structured process than quantitative What is a systemic review? The systemic review involving collation of all relevant studies that answer a specific question
- attempts to minimize bias through standardized process
- synthesizes all relevant studies
- it is a reliable enough that conclusions and decisions can be based from it What is the Cochrane Collaboration? An international organization that prepares and maintains a body of systematic reviews that focus on health care interventions. What is the Campbell Collaboration? An organization that promotes positive social and economic change through the production and use of systemic reviews and other evidence synthesis for evidence based policy and practice
What are the nine steps of conducting a systemic review?
- defining the research question
- identifying inclusion and exclusion criteria
- searching for studies
- selecting studies
- assessing methodological quality
- extracting relevant data
- analyzing data
- interpreting the results
- drawing conclusions What is Inclusion vs. Exclusion criteria? Inclusion = identifies what a study needs to address in order to be included in their review as well as type of research designs and timeframes Exclusion = identifies situations and circumstances in which a study will not be included What is grey literature? Research that has not been commercially published. What are Drop Outs in a study? Participants that do not complete the study and leave early How do systemic reviews assess potential studies for Methodological quality?
- assess for risk of bias = determine the extent to which studies have assessed intervention effectiveness correctly
