Test #1 Flashcards
research
Systematic inquiry about phenomena (follows logical steps)
- Logical and rigorous
A phenomena - occurrences, circumstances, or facts, that are perceptible by the senses (eg. experience of pain)
Challenges assumptions
Knowledge development
significance of research to practice
- Expands the body of scientific knowledge
- Forms the foundation for evidence-informed decision making (EIDM)
- Enables practice to change
- Maintains the profession’s relevance
RN Role in Research
- consumer of research
- investigator
- Primary – someone leading a study (PhD or master)
- Secondary - someone involved in research but not designing research (helping role) (nurses recruit people for a research study) (collecting data)
- Partner – assisting with different parts of study, involved with carrying out the study
ways of knowing
personal ethical empirical aesthetic emancipatory
personal way of knowing
- process of self knowing
- Who you are as a person affects your behaviour, attitudes, and values both positively and negatively
- Reflection on assumptions, beliefs, etc.
- Process of reflection in order to understand how your feelings may affect your nursing care
- Assists in building therapeutic relationships.
- Can build/break relationships
- Assists in minimizing biases that interfere with caring for patients
ethical way of knowing
- About making judgements: what is good, bad, responsible
- What ought to be done
- Nurses bring to practice their own moral understandings
- Relativism – what is right varies for everyone (its relative to the person)
- Principle of beneficence (to do good) (acting for the benefit of others) (putting their needs above your own)
- Focuses on reflection, discussion, and debate of what is ethical/moral
- Important to clarify values and explore alternatives in order to gain new ethical knowledge and apply it to practice.
Aesthetic Knowledge Development
- the art of nursing
- Focuses on understanding unique situations and individual differences
- Entails drawing on experiences in health/illness; nursing; drawing from different ways of knowing (personal, ethical)
- Reflects what we know and how we do
- Ask: What does this mean? How is it significant?
- Grasping meaning of an encounter
- Establishing connection
- Performing in moral and appropriate way
- Helps us know how to deal with circumstances that are unique and unpredictable
Emancipatory way of knowing
- Critical lens to challenge and address social and political contexts to create change.
- Praxis- critical reflection and action used to achieve emancipatory knowledge
- Examining relations of power- dominance of certain ideologies, beliefs, values, or views of the world over other possible viewpoints.
- What are the barriers to equality ?
- What changes need to be made?
- Who benefits?
- What is wrong with this picture?
- Identifies the social and political barriers that prevent health and well-being for all people.
- Assists in addressing injustices and discrimination
Empirical way of knowing
- The science of nursing
- Knowledge grounded in theory, science (research)
- Expressed as theories, statement of fact, descriptions, interpretations of objects, events
- Through logical reasoning and systematic methods
- Testing hypotheses
- Generating theory
- Describing phenomenon
- Knowledge about abstracted generalities (what we can expect in a certain situation)
- Evidence for practice
Evidence Informed Decision Making
The incorporation of empirical research, clinical expertise, client preferences, and other available resources to make decisions about patients
Evidence Based Practice
Evidence based practice (EBP) is the process of collecting, processing, and implementing research findings to improve clinical practice, the work environment, or patient outcomes
EIDM Steps
1) develop a research question
2) gather evidence
3) appraise studies
4) synthesize study findings
5) adapt to practice
6) implement
7) evaluate
Don’t Go Aiming Shotguns At Idle Emo’s
PICOT
Population Intervention Comparison Outcome Time
Hierarchy of Evidence
Highest level
- Resources where evidence is rigorously processed and filtered to ensure its reliability (ie. systematic reviews, meta-analysis, guidelines)
Middle level
- Individual studies such as well conducted randomized controlled trial’s with a similar population of study, as well as observational studies
Lowest level
- Include case reports and expert opinions
Assessing Strength of Evidence
- quality
Extent to which the study design minimizes bias - quantity
Number of studies that have evaluated the research question, including sample size across studies - consistency
Degree to which studies have similar and different designs yet the same research question and similar findings
sources
Primary sources
- Studies: theory development or scholarly discussion by original author
- Peer-reviewed
Secondary sources
- Material written by individuals other than the person who conducted study or developed theory
- May be commentary or critique
History of Nursing
- Nursing has been around forever, but it wasn’t always called nursing (there has always been a need for the care they provide)
- Nurses played a role in caring for the ill since beginning of recorded history.
- Religious orders provided care. (mostly men)
- Prior to 1800’s nurses were classified as any women who cared for ill family members.
- Became less of a religious focus, became more of an untrained, very low prestige, unpaid, volunteer work (not something people aspired to do) (became women’s work)
- During this time nursing was not evidenced based, instead it was influenced by healing traditions within society.
- Did not have a body of knowledge
Lady of the Lamp (Florence Nightingale) (1850’s)
- Founder of modern day nursing
- From an upper class family, educated, fought against social norms of the time (going into nursing)
- Started working in street hospitals in London
- British Crimean War - more soldiers were dying in the hospitals than the war field
- She discovered the hospital conditions were very unclean (unhygienic), she cleaned it up and attended to the environment
- She collected data on what she was doing to the environment and the outcomes of the patients (show cause and effect that nursing and the environment has an effect on the patient) → evidence based practice
- Improved educational standards
- Started first school of nursing in London
Legacy
- Empirical knowledge
- Educational standards
- Believed nursing was distinct from medicine
1900’s-1950’s change in nursing
- loss of nightingale ideal
- apprenticeship learning was how you became a nurse
- persistence of nursing ideal-nursing leaders
Margaret newman
- Health as expanding Consciousness
- Health is about patients finding meaning/connections in their life
- Health of all persons regardless of the presence of absence of disease.
- Understanding of the whole person
Jean Watson
- Theory of Human Caring
- Caring Consciousness
- Connection of human beings through caring
Education in Nursing
Crucial to development of nursing research
1918: establishment of university courses
UBC 1919
1950-1960: master’s program
1990 -2000: doctorate
University of Alberta 1991 PhD program
2000: degree entry to practice
1969 - Canadian Journal of Nursing Research
why is history important to nursing?
Need for nursing leadership
Expand the role and scope of nurses
Encourages critical thinking
Knowing about the history of a profession is important
paradigm
- A set of beliefs and practices, shared by communities of researchers that guide the knowledge development process
- The way we think/do things
framework
Provides a general orientation to understand phenomenon
Structure of concepts and theories
Framework of concepts that make up a phenomenon (social determinants of health)
theory
to explain or predict phenomenon
Set of interrelated concepts
concepts
`things we make up to describe phenomenon