Introduction Flashcards
What is formalized curiosity?
Research
Poking and prying with a purpose
What is disinformation?
How does this affect us as nurses?
o Deliberately deceptive and propagated information
o Includes inaccurate, incomplete, misleading, false, or selective half-truths
o We know biased and wrong information is out there
o If information accuracy has consequences, like in nursing practice, we need to do more formal research
What is deliberately deceptive and propagated information that is inaccurate, incomplete, misleading, false, or selective half-truth?
Disinformation
What are the 3 types of knowledge?
Propositional - facts, theories etc.
Procedural - knowing how
Personal - from our experiences
Philosophically, propositional knowledge (the facts) is divided into 2 ways of knowing. What are they?
Rationalism – comes to us through the use of reason
* “I think, therefore I am” = Descartes
* Top down thinking
Empiricism – is derived from our experiences of the world
* “tabula rasa” the blank slate – Aristotle
* Occurs by sensation and then reflection
* Bottom up thinking
What type of knowledge is based on knowing facts, theories, laws etc.?
Propositional knowledge
What type of knowledge is knowing how to do something?
Procedural knowledge
What type of knowledge is knowing something because we have experienced it?
Personal
What are theories?
How does new research affect theories?
- Tie together all of the propositional knowledge we have about a topic
- Aim is to be able to describe or explain something in the world
- Findings of research can support a theory of find it to be false
What is research?
Systematic inquiry that uses disciplined methods to answer questions and solve problems
Involves
o Collecting
o Analyzing
o Interpreting
What are the two purposes of research?
Basic - extends the base of knowledge of a discipline
Applied - finds answers/solutions to practical problems, so for us clinical practice
What type of research aims to extend the base of knowledge of a discipline?
Basic research
What type of research aims to find answers to a clinical problem?
Applied research
Define basic research
Extends the base of knowledge of a discipline
Produces more knowledge for the discipline
Capable of producing theories that can then be tested
Define applied research
Finds answers or solutions to practical problems (clinical practice)
What are the 2 types of reasoning?
Inductive - bottom up
Deductive - top down
Define inductive reasoning.
What is the focus?
- Bottom up
- Starts by making many observations like seeing all the pieces of a puzzle
- Look for patterns and connect concepts
- Produces tentative theories
Define deductive reasoning.
What is the focus?
- Top down
- Takes theories and makes hypotheses about an outcome
- These are tested and then confirmed
- Focuses on 1 piece of the puzzle
What does it mean when we say that research is an iterative process?
o The process involves a lot of circular and back-and-forth movement between decisions
o May have to go back to concept stage such as altering the research question
What is the purpose of nursing research?
o To inform practice
o Improve patient care
o Improve service delivery
What is generalizability?
What type of research allows for this?
generalize findings to wider populations
Quantitative research
What is transferability?
What type of research allows for this?
Findings that are likely to be transferable to other, similar patient groups or settings
Qualitative research
What is a significant factor that contributes to a studies generalizability/transferability of findings?
Representativeness of the sample
What are the levels of evidence from the least reliable to most reliable?
- Opinion – authority or expert committees
- A single descriptive quantitative or qualitative study
- Systematic reviews of descriptive studies (qualitative/quantitative)
- Well-designed case-control or cohort studies
- Well-designed controlled trials (e.g. quasi-experimental)
- One well-designed randomized controlled trials (RCT)
- Systematic review/meta-analysis of RCTs
What is nursing research?
Scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences evidence-informed nursing practice
What are key aspects of nursing research?
o Systematic
o Formal disciplined methods
o Focuses on what is important to nursing (practice/education/management)
Define clinical nursing research
o Designed to produce knowledge that guides practice
o Research questions are derived from a practice situation
What is outcomes nursing research?
o Focuses on effectiveness of healthcare services and results of patient care
What are the main goals for nursing research?
Promote evidence informed nursing practice
Ensure credibility of the nursing profession
o One of the goals that led to the development of nursing research in the 50’s
Provide accountability for nursing practice
Document the cost effectiveness of nursing care
Remember: PACE
-practice that is evidence informed
-accountability of nursing practice
-credibility of nursing profession
-effective budgeting
What was Florence Nightingale’s contribution to nursing research?
She was the pioneer of it
Released “Notes on Research” in 1859
Known for her pie charts (her dad was a statistician)
Because of her place in society, shew as able to influence society to make changes within healthcare
What was the first journal specific to nursing created? What was it called
1950s
Nursing Research (unique lol)
What happened to nursing research in 1999?
Nursing research fund
25 million federal endowment for 10 years
When was the Cochrane nursing care field established?
2010
What journal began to be published in 1994?
Journal of Qualitative Health Research
What are some of the future directions for nursing research?
- Heightened focus on evidence-informed practice
- Expanded local research in health care settings
- Increased trans-disciplinary collaboration
- Greater focus on outcomes research
- Focus on older adult population
- The use of technology in health care
- Increased use of multiple confirmatory strategies and replication
- Greater stress on integrative reviews
- Expended dissemination of research findings
- Greater focus on diversity issues and health disparities
- Focus on increased incidence of chronic illness
- Nursing in wars and disasters
Why is evidence so important to nursing practice?
- Improves patient health outcomes at individual and population level
- Improves population health outcomes
- Cost containment
- Focuses on quality improvement
- Promotes accountability in care
- Responsiveness to care is promoted
What are evidence sources for nursing research?
Traditional nursing interventions - what we’ve always done
Clinical experience
Assembled information - surveys/studies but they may not provide evidence for guiding practice
Disciplined research - nursing research - based on questions from practice and solutions that can be implemented in practice
Describe traditional nursing interventions in the context of evidence sources for nursing research
What are some examples?
Based on unit culture (what nurses have done forever on a unit) but no research to verify what they have been doing
Includes
Authority person
Policy/procedure
Describe clinical experience in the context of evidence sources for nursing research
What are some examples?
Based on personal experience what works/doesn’t work but no research to support the conclusions
Includes
Trial and error
Personal experience
Intuition
Describe assembled information in the context of evidence sources for nursing research
What are some examples?
Important surveys and studies but may not provide evidence for guiding practice
Can determine need for practice change but no follow up research to verify the conclusion
Includes
Quality improvement data (such as med error reports)
Describe disciplined research in the context of evidence sources for nursing research
What are some examples?
Based on questions that arise from practice and offers solutions that can be implemented in practice
Includes
Nursing research
Describe evidence based practice
How does evidence informed practice differ?
The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients
An approach to healthcare that promotes the collection, interpretation, and integration of valid, important and applicable patient-reported, clinician-observed and researched-derived evidence
Evidence informed practice integrates the research evidence with clinical experience/expertise, patients values, concerns, and preferences
Describe evidence informed practice.
What does this combine?
The evolution of evidence-based practice
Integration of:
Clinician
Clinical experience
Non-research evidence
* Quality improvement
* Risk management data
* Local, regional, national standards
* Chart reviews
Evidence
Clinical research
Patient
Values
Concerns
Preferences
History
What are the 3 types of research utilization?
Conceptual - changes in opinion of the individual nurse
Instrumental - concrete application of research
Persuasive - used to persuade others i.e. changing policies
Describe conceptual research utilization
o Changes of opinion or changes in how the nurse thinks about a particular clinical situation because of the research although it may not result in a direct change
Describe instrumental research utilization
o Concrete application of research findings such as in practice or policy guidelines
Describe persuasive research utilization
o Use of research to persuade others, usually those who make decisions, to make changes to policies, practices, or conditions pertaining to nurses, patients, and/or the health of individuals or groups
o Least commonly used by nurses
What are the ways of knowing? How does this influence our research?
- Our world views and how we make sense of the social context
- The foundational elements that start when we conceptualize the study are influenced by our ways of knowing, or our world view, or the way we see the context in which we are living and practicing
- Research addresses questions relevant to nurses (our practice, education, and discipline)
- It is important to develop a unique body of knowledge for practice
- All approaches have limitations but they all add to a body of accumulating evidence which is important to inform the discipline/practice/education of nursing
What are paradigms?
- Our ways of knowing
- Set of norms that tells us how to think and behave
- Set of assumptions, concepts, values and practices that constitutes a way of viewing reality and from which members of community work
- Underlying assumptions and intellectual structure that direct research and development in a given field
- All research is based on our philosophical beliefs (ways of knowing)
What is the dominant paradigm in research?
Positivist perspective (quantitative)
What term is used to describe how ideas evolve?
Paradigm shift
Describe axiology
- Describes the nature of value
- Focuses on values and is a critical component to ethics in research
- Answers what is valuable to know?
- We need to know what a good researcher is and what is worthwhile to explore
Describe ontology
- Study of being or existing
- Answers the question of what is reality?
- Is the driver for ways of knowing
- Focuses on where and how we sit in the world
- Ontology continuum ranges from realism to relativism
Describe realism
MEMORY: really INDEpendent
- The view that things exist and are independent of whether anyone is perceiving them
- That reality can be accessed through research
- Example: randomized controlled trials
Describe relativism
MEMORY: relatively relational, like our relational practice, everything depends on context
- Things are dependent on context
- Example: narrative stories
Describe epistemology
- Focuses on nature of knowledge
- Answers what is knowledge, what does it mean to know? How is knowledge created? What is the relationship between the knower and what is known? How do we learn?
- Example: good relations form the basis of indigenous culture and drives our relational epistemology which focuses on sharing and generosity and respecting the earth
What is the nature of value that is particularly important to ethics research?
Axiology
What is the study of being or existing?
Ontology
Describe realism
- The view that things exist and are independent of whether anyone is perceiving them
- That reality can be accessed through research
- Example: randomized controlled trials, generally quantitative
Describe relativism
- Things are dependent on context
- Example: narrative stories, generally qualitative
What is the theory of knowledge?
Epistemology
Describe epistemology
- Theory of knowledge, especially with regard to its methods, validity, and scope
- Answers what is knowledge, what does it mean to know? How is knowledge created? What is the relationship between the knower and what is known? How do we learn?
- Example: good relations form the basis of indigenous culture and drives our relational epistemology which focuses on sharing and generosity and respecting the earth
Describe the positivism epistemology
- Dominant paradigm for many years
- Developed during enlightenment
- Based on the assumption that there is one single reality
- Tests hypothesis or theories using rigorous quantitative research methods with large sample seizes
- Research is detached from the participant to avoid bias and is blinded to the specific conditions of the research study
- Researcher must be completely objective
- Objectivity produces data that is predictive to the generalized population
- Uses deductive reasoning
Criticisms
o Not always possible for the researcher to be impartial/objective
o Laws about human behaviour cannot be generated in the same way as they can for objects in the natural world
Describe the post-positivism epistemology
- Similar to positivism but more moderate
- Belief that there is a single reality but we can’t know that for sure
- Epistemology recognizes that complete objectivity is not possible but objectivity is valued
- One reality
- Context is minimized
- Value-free
- Methodology is quantitative
- Aim of research is to describe, explain, predict or control
- Understands it is impossible to predict human behaviour in every situation
- Generalizations are valued but these are dependent on context
- Behavioural observations of humans can be measured but we know that unobservable phenomena like thoughts and feelings also exist
- Objectivity
o Still valued but researcher is considered more neutral
o Understanding that we are biased by our own lens
o No one is truly objective - Repeated testing helps to ensure interpretations are as objective as possible
What are the basic features of a positivism/post positivism epistemology?
- Systematic inquiry – the scientific method
- Scientists are influenced by their interests, cultural experiences, world views
- Observation and measurement
o Phenomena are reduced to entities that can be measured - Multiple measures and observations
o Repeated testing
o Replication - Control of variables that may interfere
- Knowledge generation through explanation and descriptions
- Objective knowledge
o Gained from direct observation and experience
o Fallible and subject to revision by repeated measures - Large sample sizes
- Generalize results to the wider population in a given context
- Determining the probability that a hypothesis is true/false (not proving)
- Development of theories that can only be approximately true
Describe the epistemology of interpretivism/ constructionism
- May also be called naturalistic
- Reality is viewed as subjective and views from person to person
- Context is emphasized
- Uses inductive reasoning
- Qualitative research with small sample are used for rich, in depth data looking at experiences
- Aim is to understand the perspective of the individuals in the study
- Participants have active involvement
o Research involves interaction between researcher and participants
o Participants seen as co-researchers - Researcher
o Involved in the participants world
o Acknowledges their own biases and uses self-reflection - Similar to relational practice in nursing
- Methodology is qualitative
- Interactive data collection methods
- Aim of research is
o To describe or understand
o Interpret meanings participants have of the world - Knowledge developed through description, exploration, understanding, and interpretation
- Interpret words to gain understanding
- Outcomes are patterns of meaning, themes or theory
- Generalizable results are not an aim
Describe the pragmatist epistemology
- Focuses on problems rather than philosophical position
o View traditional paradigms as prescriptive in approach - Tries to avoid a single ontological or epistemological approach
- Methodology – uses both quantitative and qualitative methods
Describe the transformative/participatory/advocacy epistemology
- Focused on raising awareness and promoting social change
- Purpose is to empower marginalized groups and investigate inequalities or social injustices
- Aim to change a situation by challenging the current situation and planning change
- Questions/issues are concerned with important social issues of the day
- Research inquiry needs to be intertwined with politics and political agenda
- Working with others
o Collaboration through all stages of the research - Researcher embedded in the research group
- Highly contextualized knowledge
- Ontological position is historical realism
- Epistemological position is social constructivism
- Advocacy/participatory
o Draw on work of critical theorists
o Focus on concepts of enablement, empowerment, and emancipation
What are some social justice ideological frameworks and what epistemological view are they associated with?
Associated with Transformative/Participatory/Advocacy
- Critical race theory
- Queer theory
- Disability theory
- Critical theory
- Feminist theory
- Participatory action research
The indigenous conceptual framework requires an interdependent balance of specific paradigms. What are they?
Indigenous epistemology
Beliefs about knowledge creation
Indigenous ethics
Axiological premise
Indigenous community
Land and place
The experiencing self in relationship
Describe abductive reasoning
Guided by the indigenous ways of knowing
* Uniquely connected to personal experience, subjectivity, and reflexivity
* In nursing theory development research, is an approach to theoretical inquiry that uses analogy as a method for devising theory
* Synthesis of induction and deduction and looks for the simplest and most likely conclusion of a set of observations
* Creative inference (i.e. pragmatic)
* Synthesis of induction and deduction and looks for the simplest and most likely conclusion of a set of observations
* Very qualitative approach to reasoning – uses analogy of reasoning
What are the steps of the research process?
Conceptualize the Study
Design the Study
Conduct the Study
Analyze the Data
Interpret the Findings
Disseminate the Findings
What are the basic steps the to Conceptualize the Study stage of the research process?
Develop a researchable topic
o Identify the problem: Why?
o Review the literature
o Devise research question(s)
What are the basic steps the to Design the Study stage of the research process?
- Identify a methodology
- Identify population/sample
- Method of data collection
- Ethical principles
- Demonstrate rigor/trustworthiness
What are the basic steps the to Conduct the Study stage of the research process?
Obtain ethical approval
Recruit sample
Collect data
o Quantitative or qualitative
o Pilot study/pilot interview - Identifies potential problems and strategies to modify the research plan
What are the basic steps the to Analyze the Data stage of the research process?
Analyze it lol
Quantitative - statistical analysis
Qualitative - thematic analysis
What are the basic steps the to Interpret the Findings stage of the research process?
- Discuss implications for nursing and further research
- Linking findings to the question
- Focus on the meaning and implications of the result
- Discuss the findings in relation to the studies/evidence identified in the literature
- Recognize the strength and limitations of study
What are the basic steps the to Communicate the Findings stage of the research process?
- Knowledge transfer to peers and interested groups
- Publications, conferences, presentations, etc.
Describe propositional knowledge
Knowledge we have when we say that “such and such is the case”
Includes knowledge of theories, facts, and laws
Ex. Knowing what each key on the piano denotes
Philosophically, knowledge
Rationalism – comes to us through the use of reason
* “I think, therefore I am” = Descartes
* Top down thinking
Empiricism – is derived from our experiences of the world
* “tabula rasa” the blank slate – Aristotle
Occurs by sensation and then reflection
Bottom up thinking
Describe personal knowledge
o Knowledge that we have because we have experienced it
o Ex. The joy we feel when we hear a piano play
o Also entails some propositional knowledge
Describe procedural knowledge
o The knowledge of how to do something
o Ex. Knowing how to play the piano
o May entail some propositional knowledge
What are the types of statistical analysis and what are they used for?
Quantitative data analysis
Descriptive - describes participants by their demographics and pattern of response
Inferential - Determines likelihood that results of the study occurred by chance or an actual reflection of the population
What does descriptive statistical analysis tell us?
Quantitative data analysis
* Describes participants by their demographics and pattern of response
What does inferential statistical analysis tell us?
Quantitative data analysis
* Determines likelihood that results of study occurred by chance or an actual reflection of the population
What ways can the data be analyzed in a qualitative study?
o Thematic analysis
o Analyze text into codes
o Themes and concepts
