Unit 1: Ch. 1 Flashcards
Research
Systematic inquiry that uses disciplined methods to answer and solve problems
Building knowledge
What is the ultimate goal of formal research?
To gain knowledge that would be useful for many people
Nursing research
Systematic inquiry designed to develop trustworthy evidence about issues of importance to nurses and their clients
Clinical nursing research
Research designed to guide nursing practice
Typically begins with questions stemming from practice problems
Evidence Based Practice (EBP)
Use of the best evidence in making patient care decisions
Such evidence typically comes from research conducted by nurses and other health care professionals
What is the Magnet Recognition Program?
Developed by the American Nurses Credentialing Center (ANCC) to recognize health care organizations that provide high-quality nursing care
To achieve magnet status, practice environments must demonstrate a sustained commitment to EBP and nursing research
Who are consumers of nursing research?
Nurses who read research reports to keep up-to-date on findings that may affect their practice
Who are producers of nursing research?
Nurses who actively design and undertake studies
Most people would agree that research in nursing began with ____ ____ in the mid-19th century.
Florence Nightingale
What are future directions for nursing research?
- Continued focus on EBP
- Stronger evidence through confirmatory strategies (replicating studies with same results)
- Greater emphasis on systematic reviews
- Expanded local research in health care settings
- Expanded dissemination of research findings
- Increased focus on cultural issues and health disparities
Systematic review
Rigorously integrate research information on a topic so that the conclusions about the state of evidence can be reached
A cornerstone of EBP
There is growing concern that many nursing actions are based on tradition, custom, and “unit culture” rather than on ____ ____.
Sound evidence (research)
Basically nurses just do whatever their unit or supervisor does
-the nurses should look to research
Benchmark
Rates; how often something is being done
Quality improvement (QI)
Shows where the problems are
-does not show guide to fix problems
____ ____ is considered the best method of acquiring reliable knowledge that humans have developed.
Disciplined research
Paradigm
World view, a general perspective on the world’s complexities
Positivism
Reflection of a broader cultural movement (modernism) that emphasizes the rational and the scientific
Assumption
A principle that is believed to be true without verification
Determinism
Refers to the positivists’ belief that the phenomena are not haphazard, but rather have antecedent causes
Ex: If a person has a stroke, the scientist in a positivist tradition assumes there must have been 1 or more reasons that can be potentially identified
Positivist Paradigm
Reality exists, there is a real world driven by real natural causes
Researcher is independent from those being researched
Values and biases are to be held in check; objectivity is sought
Quantitative studies come out of the positivist paradigm
Constructivist Paradigm
Reality is multiple and subjective, mentally constructed by individuals
Researcher interacts with those being researched (findings are creation of the interactive process)
Subjectivity and values are inevitable and desirable
Best methods for obtaining evidence according to Positivist Paradigm
Deductive processes –> hypotheses testing
Emphasis on discrete, specific concepts
Focus on objective and quantifiable
Corroboration of researchers’ predictions
Fixed, pre-specified design
Controls over context
Measured, quantitative information
Statistical analysis, seeks generalizations
Best methods for obtaining evidence according to Constructivist Paradigm
Inductive processes –> hypotheses generation
Emphasis on the whole
Focus on subjective and non-quantifiable
Emerging insight grounded in participants’ experiences
Context-bound, contextualized
narrative information
Qualitative analysis; seeks in-depth understanding
Research Methods
Techniques researchers use to structure a study and to gather and analyze relevant information
Quantitative
Numeric information that results from some type of formal measurement and is analyzed statically
Allied with positivism; looks at little known info
Qualitative
Narrative and subjective materials
Associated with constructivist inquiry
Scientific Method
Involves using a set of orderly procedures to gather information
Empirical Evidence
Evidence that is rooted in objective reality and gathered directly or indirectly through the senses rather than through personal beliefs or hunches
Generalizability
The ability to generalize research findings to individuals other than those who took part in the study
A goal of quantitative research
Cause Probing
Studies designed to illuminate the underlying causes of phenomena
The specific purposes of nursing research include what 5 things?
- Identification
- Description
- Exploration
- Prediction/control
- Explanation
Quantitative Research: Identification
Researchers begin with a phenomenon that has been previously studied or defined
Quantitative Research: Description
Focuses on prevalence, size, and measurable aspects of phenomena
“How prevalent is the phenomenon? How often does the phenomenon occur?”
Quantitative Research: Exploration
“What factors are related to the phenomenon? What are the antecedents of the phenomenon?”
Quantitative Research: Explanation
Theories or prior findings are used deductively to generate hypothesized explanations that are then tested
“What is the underlying cause of the phenomenon? Does the theory explain the phenomenon?”
Quantitative Research: Prediction & Control
“If phenomenon X occurs, will phenomenon Y occur? Can the phenomenon be prevented or controlled?”
Qualitative Research: Identification
Looks at little known info
“What is this phenomenon? What is its name?”
Qualitative Research: Description
Describes the nature, dimensions, and salience of the phenomenon
“What are the dimensions or characteristics of the phenomenon? What is important about the phenomenon?”
Qualitative Research: Exploration
Explores the nature of little understood phenomena and to shed light on the ways in which a phenomenon is expressed
“What is the full nature of the phenomenon? What is really going on here? What is the process by which the phenomenon evolves?”
Qualitative Research: Explanation
How or why a phenomenon exists or what a phenomenon means as a basis for developing a theory that is grounded in rich, in-depth, experiential evidence
“Why does this phenomenon exist? What does the phenomenon mean? How did the phenomenon occur?”
Most EBP is quantitative except ____.
Meaning/process
Studies with a therapy purpose seek to…?
Identify effective treatments for ameliorating or preventing health problems
Studies of prognosis examine the…?
Consequences of a disease or health problem, explore factors that can modify the prognosis, and examine when the consequences are most likely.
Provide valuable info for guiding patients to making beneficial lifestyle choices or to be vigilant for key symptoms
Many health care activities can greatly benefit from understanding the ____ perspective.
Clients’
Research Process
- ID problem
- Ask questions or hypothesis
- Gather data
- Analyze data –> yields results/findings
- Interpret results/findings
- Disseminate results/findings
Why is research important to nursing?
Things are always changing in healthcare
New knowledge (need knowledge specific to our field of study –> w/o nursing research we’d only get info from other professions)
Evidence
Something used to support/negative something else
Melnick: “facts or info that indicate truth”
Evidence doesn’t exist by itself - needs to have context
What are the roles of nurses in research?
The role of nurses occurs along a continuum from producers of research to skilled consumers of research who use research as evidence in practice.
Are nursing students consumers or producers of research?
Consumers
-we use the research that others produce
Nursing Research: Past (don’t have to know specific dates)
Pioneered by Nightingale
First journal on research (Nursing Research) emerged in the 50’s
Clinical research increased in importance in the 80’s
National Institutes of Health (NIH)
National Institutes of Nursing Research (NINR) established in 1993.
Sources of evidence for nursing practice: Tradition
“We do it because we do it this way”
ex: temp and VS routinely done in evening b/c of myth that said temp rises in the evening
Sources of evidence for nursing practice: Authority
Do something b/c you’ve been told to do it that way
-ex: standing orders from doctor
Sources of evidence for nursing practice: Clinical experience
(trial and error; intuition)
“You learn by doing”
Sources of evidence for nursing practice: Logical Reasoning
Deductive logic (start w/ theory then test theory) and Inductive logic (lots of little details then build theory)
Sources of evidence for nursing practice: Assembled Info
Such as CQI data
Sources of evidence for nursing practice: Disciplined Research
Studies done with controls
Positivists vs Constructivists: What’s the nature of reality?
Positivist paradigm: ONE reality exists, real world
Constructivist: their reality is multiple, subjective, constructed by individuals
Positivists vs Constructivists: What’s the relationship between the researcher and those studied?
Positivists: independent of their subjects, try to be objective, stay outside of research situation; don’t interfere
Constructivist: researcher and participants are doing the research together; MUST interfere
Positivists vs Constructivists: What’s the role of values in research?
Positivist: values held in check, personal values separate from participant values, researcher tries to be objective
Constructivist: happy to be subjective (“subjectively inevitable”); both researcher and subject are part of study
Positivists vs Constructivists: What are the best methods of conducting research?
Positivist: use deductive methods (start w/ theory –> test hypothesis); quantitative; have fixed research design, make a plan and stick to it; seek generalizations
Constructivists: inductive; generate hypothesis; studies are qualitative; flexible in study design; seek understanding rather than generalization
Quantitative Research
Orderly procedures Prespecified plan Control over context Formal measurement Quantitative (lab studies) Seeks generalizations
Qualitative Research
Dynamic design Holistic Context-bound Humans as tools Qualitative Seeks patterns
Levels of research from weakest to strongest (4)
- Identification and description*
- Exploration
- Explanation
- Prediction and control
*weakest level; typically used when we don’t know anything (ex: when AIDS first came out)
Research purposes linked to EBP
Therapy, treatment or intervention Diagnosis and assessment Prognosis Etiology/cause/harm Meaning and processes
Specific purposes of nursing research: Quantitative and Qualitative
Quantitative:
- ID: rare
- Description, exploration, explanation, prediction and control
Qualitative:
- ID, description, exploration, and explanation
- Prediction and control: rare
