CRIS LUTHER's RESEARCH METHODOLOGIES COMPILATION

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RESEARCH METHODOLOGIES
by Cris Luther, B.S.N.,R.N.

This material is a compilation of various information on generally acceptable knowledge, concepts, principles, theories and practices in RESEARCH. It adapts contents from various publicly acknowledged publications, authors, theorists, authorities and practitioners whose works are commonly utilized in the academe and practice, and are frequently-tested competencies locally and abroad.

The works of these authors, theorists, authorities and practitioners are indispensable in learning research methodologies as they are indispensable in the completeness of this compilation.

Care has been taken to confirm accuracy of the information presented and describes generally accepted practices. However the student who prepared this material is not responsible for errors or omissions or for any consequences from application of the information in this compilation.

The primary goal of the student is to familiarize concepts in the subject RESEARCH METHODOLOGIES based on the COURSE OUTLINE provided by his Graduate School Professor DR. HELEN B. AGGABAO. It is not intended for commercial publication and resources were acquired legally.

It is his great pleasure that this compilation be reproduced for reference of other students aiming to thoroughly understand RESEARCH METHODOLOGIES.

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CRIS LUTHER's RESEARCH METHODOLOGIES COMPILATION

  1. 1. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 1 RESEARCH METHODOLOGY Course Outline Provided by DR. HELEN B. AGGABAO On the Subject, RESEARCH METHODS Philippine Colleges of Health Sciences, Inc., Manila School of Graduate Studies Prepared by CHRISTIAN LUTHER FABIA, B.S.N.,R.N. Master of Arts in Nursing Major in Psychiatric and Mental Health Nursing Scan with Qr Barcode (Android/iOS free App) to directly send email to the student
  2. 2. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 2 As a Registered Nurse and a student at PCHS-Graduate School, I am expected to understand the basic to complex processes of scientific research in preparation to conduct my own scientific investigation in the future. This quest for higher learning I believe is intended to base professional practice on emerging evidences from research, that is, to adopt an evidence- based practice (which is broadly defined as the use of best clinical evidence in making patient care decisions), and such evidences typically come from research conducted by nurses and other health care professionals. Through the guidance of my mentors at the Philippine Colleges of Health Sciences, I am certain that I will be able to make a significant contribution to my profession through research. And, the realization of this aspiration begins with thoroughly understanding the concepts in Research Methods. The Student About the Compilation This compilation of various information on generally acceptable knowledge, concepts, principles, theories and practices in RESEARCH. It adapts contents from various publicly acknowledged publications, authors, theorists, authorities and practitioners whose works are commonly utilized in the academe and practice, and are frequently-tested competencies locally and abroad. The works of these authors, theorists, authorities and practitioners are indispensable in learning research methodologies as they are indispensable in the completeness of this compilation. Care has been taken to confirm accuracy of the information presented and describes generally accepted practices. However the student who prepared this material is not responsible for errors or omissions or for any consequences from application of the information in this compilation. The primary goal of the student is to familiarize concepts in the subject RESEARCH METHODOLOGIES based on the COURSE OUTLINE provided by his Graduate School Professor DR. HELEN B. AGGABAO. It is not intended for commercial publication and resources were acquired legally. It is his great pleasure that this compilation be reproduced for reference of other students aiming to thoroughly understand RESEARCH METHODOLOGIES.
  3. 3. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 3 - Contents - Part 1: Introduction to research and research utilization Definition and significance of research Link between research and practice Overview of research utilization Interdisciplinary and collaborative research Overview of research methods Part 2: Initial steps of the research process Purpose and problem statements Variables of the Study Literature review Framework and Paradigm of the Study Research questions and hypotheses Part 3: Research Design Ethical design of research Sampling Designing the Research Instrument Study validity and elements of good design Validity and Reliability of the Research Instrument Part 4: Measurement and data collection Measurement concepts and strategies Data Collection Part 5: Data analysis Statistical theory review Types of statistics and their uses Qualitative analyses Interpretation of findings Part 6: Communication of Findings and Utilization of Research Ways to communicate research Critiquing research Theories of utilization Barriers and solutions to utilization Role in research utilization Part 7: Preparing the Research Report Technical Details: Style, Format, and Organization of the Research Report. Check these helpful Graphical Bullets: Means the concept proceeding is significant to Nursing Means the proceeding concept is important
  4. 4. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 4 PART 1: INTRODUCTION TO RESEARCH AND RESEARCH UTILIZATION 1.1 Definition and Significance of Research The word research is derived from the old French word cerchier, meaning to seek or search. The prefix “re” means “again” and signifies replication of the search. One seeks new knowledge or to directly utilize knowledge specific to life situations. It is a systematic inquiry that uses disciplined methods to answer questions or problems. Research is also defined as a studious inquiry or examination, investigation or experimentation aimed at the discovery and interpretation of facts, revision of accepted theories or laws in the light of new facts or practical applications of such new or revised theories or laws. Research in the broadest sense is an attempt to gain solutions to problems so that its ultimate goal is to develop, refine and expand a body of knowledge. The Philippine Nurses Association defines research as: “An honest, scientific investigation undertaken for the purpose of discovering new facts or establishing new relationships among facts already known which will contribute to the present body of knowledge and can lead to an effective solution of existing problems. It involves careful or critical thinking to revise or revalidate accepted conclusions and previously held concepts or to establish generalizations or principles (PNA, 1995)”. Nursing research is a tool of science, its components are: a. Order and system- process wherein the researcher moves in a systematic fashion, from identification of the problem to the conclusions and recommendations. b. Control- means the imposition of conditions in the research situation, to minimize bias and maximize the precision and validity of data gathered. c. Empiricism- refers to the gathering of evidence and relying on one’s own senses. d. Generalizations- means that the research findings may be applied to a situation or population larger than the one studied. 1.2 Link between research and practice Research and its Significance to Evidence-based Practice (EBP) The ultimate goal of nursing is to provide evidence-based practice that provides quality outcomes for patients, healthcare providers and the healthcare system (Craig and Smythe 2007; Pearson et al., 2007). Evidence-based Practice is the conscientious use of current best evidence of making clinical decisions about patient care. It evolves from the integration of the best research evidence with clinical expertise and patient needs and values (Institute of Medicine 2001; Sachett, et al., 2000) It is a problem-solving approach to clinical practice that integrates: Research- answering clinical questions utilizing relevant evidences (patient history, assessment methods, healthcare resources) and scientific approaches; Clinical expertise; Patient’s preferences and values Ultimately, the significance of research in nursing practice is to provide an evidence-based clinical decision for better patient outcomes and create best practices. Research and its Significance to Quality Assurance (QA) The goal of QA programs is to continually monitor the quality of care in an institution and thereby generate data that can be used as basis for determining institutional policies and procedures, administrative decisions and budget justifications. This database can be used for future planning.
  5. 5. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 5 Nursing research therefore is a tool use to expand and generate knowledge through scientific investigation of healthcare issues. By building findings of reported research, a study can be replicated or the applicability of results to practice in a given institution can be determined. 1.3 Overview of research utilization   “Research utilization is a process by which scientifically produced knowledge is transferred to practice" (Brown, 1999). Utilization of research in nursing refers to the actual systematic implementation of a scientifically sound, research- based innovation in a health care setting with an accompanying process to access the outcomes of the clinical change. Three categories of utilization are identified:  Instrumental research utilization- Is a direct use of research knowledge, it is the concrete application of research in clinical practice; either in making specific decisions about patient care, or as the knowledge guiding specific interventions.  Instrumental use- Research is often translated into a useable form (e.g., clinical practice guidelines or protocols). Conceptual research utilization is the cognitive use of research where the research may be used to change opinion or mind set about a specific practice area, but not necessarily particular actions. This indirect application of research is believed to occur more often in practice than instrumental use, but in a less perceivable way.  Symbolic (or persuasive) research utilization- Addresses the use of research knowledge as a political tool in order to influence or legitimate policies and decisions. Important: Although, I have discussed in the previous section about the significance of research to Evidence-based practice as a tool of investigation, nurse researchers should not confuse EBP (Evidence Based Practice) with research utilization. While research utilization overlaps with some of the same philosophic threadworks of EBP, EBP goes beyond just the rigorous scientific research steps.  Research Utilization refers to the review and critique of scientific research, and then the application of the findings to clinical practice.  Evidence-Based Practice (EBP) represents a broader concept. When clinicians use the EBP approach, they go beyond the expertise of clinicians and researchers, and consider the patient's preferences and values to guide patient care. 1.4 Interdisciplinary and collaborative research Interdisciplinary involves the combining of two or more academic disciplines into one activity (e.g. a research project). It is about creating something new by crossing boundaries, and thinking across them. It is related to an interdiscipline or an interdisciplinary field, which is an organizational unit that crosses traditional boundaries between academic disciplines or schools of thought, as new needs and professions have emerged. Originally, the term interdisciplinary is applied within education and training didactics to describe studies that use methods and insights of several established disciplines or traditional fields of study. Interdisciplinary involves researchers, students, and teachers in the goals of connecting and integrating several academic schools of thought, professions, or technologies - along with their specific perspectives - in the pursuit of a common task. For instance, the epidemiology of AIDS or global warming require understanding of diverse disciplines to solve neglected
  6. 6. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 6 problems. Interdisciplinary may be applied where the subject is felt to have been neglected or even misrepresented in the traditional disciplinary structure of research institutions, for example, women's studies or ethnic area studies. The adjective interdisciplinary is most often used in educational circles when researchers from two or more disciplines pool their approaches and modify them so that they are better suited to the problem at hand, including the case of the team-taught course where students are required to understand a given subject in terms of multiple traditional disciplines. For example, the subject of land use may appear differently when examined by different disciplines, for instance, biology, chemistry, economics, geography, and politics. Interdisciplinary and collaborative research is needed in most nursing researches. Nurse researchers conduct studies that deal with human, his behavior, the environment and other factors affecting health in which, he needs ideas and information by other healthcare disciplines. 1.5 Overview of research methods Experimental and Non-Experimental Research Methods in Brief o Experimental research: In experimental research, the aim is to manipulate an independent variable(s) and then examine the effect that this change has on a dependent variable(s). Since it is possible to manipulate the independent variable(s), experimental research has the advantage of enabling a researcher to identify a cause and effect between variables. For example: The research subject is composed of 100 students completing a comprehensive exam in Nursing Management where the dependent variable was the exam mark (measured from 0 to 100), and the independent variables were completion time (measured in hours) and intelligence (measured using IQ score). Here, it would be possible to use an experimental design and manipulate the completion time of the students. The instructor could divide the students into two groups, each made up of 50 students. In "group one", the instructor would allow the students to complete the exam indefinitely. Alternately, "group two" could be asked to complete the exam in a definite time (eg. 1 hour maximum). The instructor could then compare the marks that the students achieved. o Non-experimental research: In non-experimental research, the researcher does not manipulate the independent variable(s). This is not to say that it is impossible to do so, but it will either be impractical or unethical to do so. For example, a researcher may be interested in the effect of illegal, recreational drug use (the independent variable(s)) on certain types of behavior (the dependent variable(s)). However, whilst possible, it would be unethical to ask individuals to take illegal drugs in order to study what effect this had on certain behaviors. As such, a researcher could ask both drug and non-drug users to complete a questionnaire that had been constructed to indicate the extent to which they exhibited certain behaviors. While it is not possible to identify the cause and effect between the variables, we can still examine the association or relationship between them.
  7. 7. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 7 PART 2: INITIAL STEPS OF THE RESEARCH PROCESS 2. 1 Purpose and Problem Statements Introduction: Guidelines in the Formulation of a Research Problem The initial step in the research process involves the formulation of the problem which includes the conceptualization of the topic the researcher wants to study. There are two types of research problems, those which relate to states of nature and those which relate to relationships between variables. At the very outset the researcher must single out the problem he wants to study, he must decide the general area of interest or aspect of a subject-matter that he would like to inquire into. A topic may be conceptualized in various ways, major of which are:  Natural curiosity- a burning interest in a particular area may lead to formulation of a problem.  Intellectual curiosity- enables the researcher to conduct study in the most creative and productive ways.  Literature- the vast availability of literature allows the researcher to seek answers to questions and problems others have already identified.  Phenomena- in the nursing profession, topics are vast, such as those experienced in hospitals, communities or clinics- where the patients are cared for. Specific topics may focus on the kind of patient care being given in obstetrics, pediatrics, psychiatric, etc.. Other issues may involve health care costs, student training and continuing education of practitioners. A chosen research problem should satisfy the following criteria: 1. Feasibility- Means the probability for the study to be accomplished is great. This is determined by the following factors: a. Availability of the Study Subjects- The type and number of study subjects must be defined and their consent and willingness to participate in the study must be secured. In research studies involving the nursing profession, the subjects decision to participate most especially in health care institutions, depends to a large extent on the explanation the researcher gives. Informed Consent- includes the explanation of benefits and risks involved. The subject must be an adult of sound mind who can give consent freely and voluntarily. Mentally-ill, vulnerable, unconscious and children should have the consent of their guardian or significant other. b. Funding- Adequate supplies, tools and facility must be available. Possible expenses would include transportation, allowances, cost of materials, etc. c. Cooperation of Others- Cooperation of other personnel within the study setting can be easily gained if they view the study as important to them or their welfare. Full support of the people involved must be secured. d. Approval from Higher Authorities- If the study subjects are within the control of an institution (eg. Learning, Healthcare), permission must be sought from the highest authority within that agency. e. Adequate Time- Before a study is conducted, the amount of the time needed to finish the study should be estimated, factors are: - Type, number and availability of study subjects - Research design - Methods of collecting data - Study completion - Research report writing f. Other considerations- possible danger to the lives or physical and mental well-being of the subjects involved in the study. 2. Significance to One’s profession- It is important to conduct study within one’s specialty- eg. Nurses conduct researches that deal with healthcare delivery, diseases, drugs, etc. whereas teachers conduct study concerning student behaviors, learning styles, etc. 3. The concept to be studied must relate to observable events: Overt behavior- objectively verified (both by the researcher and other persons) Covert behavior- elicited by reliable instruments developed for that purpose 4. The findings of a good researchable problem may be generalized in other areas- The problem is derived from a sound conceptual framework or models to confirm, support, modify or reject the existing framework. 5. The purpose of the study is clearly defined- The study may possibly add to the field of nursing knowledge or new approaches in handling misbehaved elementary students. Whichever the case is, the problem should clearly state its purpose- to contribute knowledge, develop new procedures or replicate studies to confirm or modify findings. 6. The researcher must be interested and qualified to do the study- Competence, technical skills in research methodologies, sound judgment in coping with many decisions that have to be made throughout the research process and innovativeness are vital attributes of a qualified researcher.
  8. 8. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 8 A. PROBLEM STATEMENT Initially the problem may be stated in a broad general way and then the ambiguities, if any, relating to the problem be resolved. Then, the feasibility of a particular solution has to be considered before a working formulation of the problem can be set up. The formulation of a general topic into a specific research problem, thus, constitutes the first step in a scientific inquiry. Essentially two steps are involved in formulating the research problem, understanding the problem thoroughly and rephrasing the same into meaningful terms from an analytical point of view. Statement of the Tentative Problem A research problem is an enigmatic, perplexing or troubling condition, the purpose of which is to solve the problem or contribute to its solution. It articulates the issues to the addressee and indicates the need for a study. It indicates the specific research questions the researcher wants to answer or address Problem statement should be formulated as specifically as possible. It should represent an action or change. It may be geared toward practical real-life situation or it may represent a theoretical situation that would expand nursing knowledge. The problem may be stated in following ways: 1. A question and/or several questions An Example of a single-question: Do patients in open wards in general hospitals receive more nursing care than those in private rooms? An Example of Single question followed by a series of questions: What are the common methods of contraception practiced by 100 selected mothers in Brgy. X? 1. Is the selection of a particular method influenced by religion, socioeconomic status or education? 2. What implications does this study have for public health nurses in the area? 2. Sentence/ declarative form An Example of a single statement: The study aims to determine the knowledge of cancer, attitudes towards cancer care and cancer care practices among primary caregivers in Hospital G. An Example of series of declarative sentences This study seeks to assess the clinical learning experiences of nursing students of the college of nursing in two affiliated hospitals. Specifically it aims to determine: 1. The extent to which the hospitals complied with the requirements of the nursing school program in terms of philosophy and objective. 2. The extent to which clinical instructors have synchronized the learning experiences from classroom to clinical areas. 3. Declarative sentence followed by a series of questions: Eg.: The study seeks to determine the professional continuing education of nurses in Hospital Z. Speciafically, the study seeks to answer the following: 1. What are the professional and personal characteristics of nurses in Hospital Z? 2. What programs could be proposed for adoption by continuing education providers in Hospital Z?
  9. 9. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 9 B. PURPOSE The problem deals with “what” is to be studied, and the PURPOSE with “WHY” the study is being undertaken. Therefore, the purpose is the reason or justification why the study is being carried out. The purpose statement establishes the general direction of the inquiry and captures usually-in one or two clear sentences- the essence of the study In the nursing profession, the purpose of a research study may be to contribute to nursing education or administration. The objective differs from the purpose as it relates to realistic short-term goals but both evolve from the statement of the problem. Stating the Purpose of the Study The purpose of the study is usually expressed as a declarative statement. Sometimes the investigator combines “what” is being done and “why” it is being done. The purpose must be precise, clear, concrete and easy to communicate. The statement usually contains an ACTIVE VERB preceded by the preposition “to”. Thus it is common that purposes begin with “to assess”, “to provide” and “to gain insight.” It is usually easy to identify a purpose statement because the word “purpose” is clearly stated (other explicitly used words are “aim”, “goal”, “objective” and “intention”. Statement of Purpose in a Quantitative Study A statement of purpose identifies the key study variables and their possible interrelationships, as well as the nature of the population of interest. Example- “The purpose of this study was to examine the incidence and prevalence of lipodystrophy-related symptoms in persons with HIV and to determine the impact of these symptoms on health-related quality of life” Statement of Purpose in a Qualitative Study: In qualitative studies, the statement of purpose indicates the nature of inquiry, the key concept or phenomenon, and the group, community or setting under study. Example- “The purpose of this study was to explore the memories of patients who had a short term admission to the ICU, with particular focus on dreams, nightmares and confusion” Other Examples: “The purpose of this study is to determine if a specifically planned program of reality orientation would decrease the degree of confusion among elderly patients experiencing progressive dementia”. “To assess the post-surgical patient’s knowledge in caring for his colostomy bag”. “To provide information on how underlicensed nurses are being utilized in private hospitals”. “The purpose of this study is to investigate the effectiveness of health teaching to hospitalized cardiac patients at Philippine Heart Center.”
  10. 10. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 10 2. 2 VARIABLES OF THE STUDY A. QUALITATIVE AND QUANTITATIVE VARIABLES 1. Quantitative variable is a variable that can be measured numerically, two types are:  Discrete- Values are countable; can assume only certain values with no intermediate values (whole numbers); A quantitative variable with possible values of only specific points on a scale; (Eg.: number of nursing personnel; bed capacity; frequency of patient visit; heart rate 110 bpm)  Continuous- Can assume any numerical value over a certain interval; variable where the scale is continuous and not made up of discrete steps or distinct points on a scale; the values between the data have meaning; the data can be broken into parts; (Eg: Temperature- 37.8 deg celcius; age- 25.4 years; height 150.7 cm) 2. Qualitative/ categorical variable is a variable that cannot assume a numerical value but can be classified into two or more nonnumeric categories.  Nominal variables are variables that have two or more categories, but which do not have an intrinsic order; considered as the lowest level of measurement used when the data can be recognized but categories cannot be compared or ranked; for mutual exclusive, but not ordered, categories. Examples: gender, race, marital status, diagnoses  Dichotomous variables are nominal variables which have only two categories or levels. Examples: Sex-Male and Female ; Survey question like “Are you satisfied with the current policies and hospital procedures” having only two answers “yes” or “no”).  Ordinal variables are variables that have two or more categories just like nominal variables only the categories can also be ordered or ranked. Data may be arranged in some order but differences between data values either cannot be determined or are meaningless; the order matters but not the difference between values Example: If a nurse researcher inquires is the nursing staff liked the new policies of the Nursing Service on work schedules, responses on the list are: "Not very much", "They are OK" or "Yes, a lot" then you have an ordinal variable. Why? Because you have 3 categories, namely "Not very much", "They are OK" and "Yes, a lot" and you can rank them from the most positive (Yes, a lot), to the middle response (They are OK), to the least positive (Not very much). For example, you ask patients to express the amount of pain they are feeling on a scale of 1 to 10. A score of 7 means more pain that a score of 5, and that is more than a score of 3. But the difference between the 7 and the 5 may not be the same as that between 5 and 3. The values simply express an order. Related concepts: Other Levels of Measurement*  Interval is like the ordinal, with the additional property that meaningful amount of differences between data can be determined. For example, in measuring the patient’s body temperature, The difference between a temperature of 36.5 degrees and 37.5 degrees is the same difference as between 38 degrees and 90 degrees.  Ratio is the interval level modified to include the inherent zero starting point. For values at this level, differences and ratios are meaningful; has all the properties of an interval variable, and also has a clear definition of 0.0. When the variable equals 0.0, there is none of that variable. Variables like height and weight are ratio variables. Examples: - A weight of 4 grams is twice a weight of 2 grams, because weight is a ratio variable. - A temperature of 100 degrees C is not twice as hot as 50 degrees C, because temperature is not a ratio variable. (*There will be a more comprehensive discussion of these concepts in the proceeding sections)
  11. 11. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 11 B. VARIABLES IN A HYPOTHESIS A variable in a hypothesis is a quality, property or characteristic of the person or thing to be studied that can be quantitatively measured. It is any factor that varies. Common specific variables used in conducting nursing clinical researches include temperature, vital signs, health status and anthropometric data. In a hypothesis, there is an INDEPENDENT VARIABLE (cause) and a DEPENDENT VARIABLE (effect). The independent variable is the one manipulated by the investigator while the dependent variable is the response. When a STIMULUS (INDEPENDENT) is applied to an ORGANISM (target population) will produce a RESPONSE (DEPENDENT). *Independent and Dependent Variables will be identified in the examples presented under hypothesis section. 2. 3 LITERATURE REVIEW The literature review is an organized written presentation of what has been published on a topic. Broadly, the review covers previous studies in the identified problem, background, studies, significance of the study and related theories. Significant terms: a. Theoretical literature- consists of concept analyses, models, theories and conceptual frameworks that support a research problem and a purpose. b. Empirical literature- comprises relevant studies in journals and books including unpublished studies such as master’s theses (M.A. course requirement) and dissertations (extensive and original research project as a final requirement for doctoral degree). c. Abstract- summary of the study usually found at the beginning of the research study, it includes: 1. The introduction and objective 2. The research problem 3. The rationale for the study and the hypothesis The methodology used is also included in the abstract and states the number and characteristics of the participants; the setting of the study (location); the research design and how the study was conducted. The abstract shows the relevance of the study to the one currently undertaken by the researcher in terms of methodology, as matched to the research question, the selection of the participants and the outcomes. What questions must be addressed? 1. What is known about the topic? 2. What research evidence is lacking, inconclusive or too limited? 3. What directions for the study are indicated by the works of other researchers? 4. What are the existing theories in the field of study? 5. What views need further testing? 6. What contribution can the present paper be expected to make? 7. What appropriate methods/ designs of previous studies seem unsatisfactory?
  12. 12. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 12 Process of Literature Review 1. Initial review- is done to have an overview of the problem area and eventually develop a frame of reference (ideas, understandings, and background within which research will be done). A thorough review covers studies that are published for the last five years. There should be full awareness of the basic facts and issues on which there is agreement or disagreement, as well as on the theories that have attempted to explain behavior and interactions in the problem area. 2. Second review- should focus on tested research approaches and methods, data collection instruments and techniques of data analysis. Purposes: a. To define research questions, methods and tools that may prove useful in problem identification, research design and instrument development. b. To reveal difficulties experienced by previous researchers. c. To provide clear information on the tasks carried out by previous researchers. d. To locate findings that may be included in a similar study to confirm or refute earlier findings. e. To provide comparative data in the analysis and interpretation of one’s own. f. To identify studies that may be replicated or re-tested . g. To compare one’s findings with other theoretical and conceptual frameworks. Sources of Literature Review: a. Primary source- written by a person who originated and is responsible for generating the ideas published (eg: the person who conducted a research authors an article in a publication). b. Secondary source- summarizes or quotes content from primary sources (eg: authors paraphrase the works of researchers and theorists) For Nurse Researchers, there are three especially useful electronic databases: 1. CUMMULATIVE INDEX TO NURSING AND ALLIED HEALTH LITERATURE (CINAHL) 2. MEDICAL LITERATURE ON LINE (MedLINE) 3. INSTITUTE FOR SCIENTIFIC INFORMATION (ISI) Web of Knowledge Other helpful resources are: Journal of Advanced Nursing Practice; American Journal of Nursing; Nursing Research; American Journal of Nursing 2. 4 Framework and Paradigm of the Study Defining Theories, Models and Framework Many terms have been used in connection with conceptual context for research, including theories, models, frameworks, schemes and maps. There is some overlap in how these terms are used, partly because they are interrelated. 1. Theory (the terms is used in many ways). Theory in its broadest sense simply denotes an abstraction. Further, theory refers to an abstract generalization that offers a systematic generalization about how phenomena are interrelated. For example, nursing instructors and students frequently use the terms to refer to the content covered in subject areas, as opposed to the actual practice of performing nursing activities. Two Types of theories are:  Traditional Theory- Scientific theories that involve a series of propositions regarding interrelationships among concepts; two subtypes are: Grand theories/ macrotheories: account for large segment of human experience (eg.: Nursing Process) Middle-range theories: more restricted in scope; focusing narrow range of experience (eg.: Stress, self-care, health-promotion)
  13. 13. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 13  Descriptive Theory- Less restrictive definition in which a theory can account for a single phenomenon and plays an important role in qualitative researches; describe or classify characteristics of groups, specimen, situations or events by describing commonalities found in discrete observations. 2. Model represents some aspects of reality, concrete or abstract, by means of a likeness that may be structural, pictorial, diagrammatic or mathematical. It does not focus on phenomena but rather on their structure or function. It is a symbolic representation of an idea, it may be complete but does not show how and why the parts are interrelated.  Conceptual Models (syn.: Conceptual Frameworks, Conceptual Schemes) Represent a less formal attempt at organizing phenomena than theories, like theories conceptual models deal with abstractions (concepts) that are assembled by virtue of their relevance to a common theme. These models provide a perspective interrelated phenomena, but are more loosely structured than theories Much of the conceptual work that has been done in connection with nursing practice falls into the category of CONCEPTUAL MODELS. These models represent conceptualizations of the nursing process and the nature of nurse-client relationships.  Conceptual Paradigm/ Schematic Models are often used in connection with symbolic representations of a conceptualization. These are visual representation of some aspect of reality. These models use concept as building blocks, but with minimal use of words. A visual symbolic representation of a theory or conceptual framework often helps to express abstract ideas in concise and readily understandable form. Maslow’s Hierarchy of Needs, an example of schematic model 3. Framework Not every study is based on a formal theory or conceptual model, but every study has a framework- a theoretical rationale. In study based on a theory, the framework is referred to as theoretical framework; whereas in study that has its roots in a specified conceptual model, the framework is called conceptual framework. ________________________________________ The Five-step Process for Developing Conceptual (theoretical) Definitions: a. Develop preliminary definition b. Review relevant literature c. Develop or identify exemplars (good example/ model) d. Map the concept’s meaning e. State the developed conceptual definitions Criteria for Judging a Theory: It is suggested that a theory be evaluated before it is used as basis for a research project. The theory must be evaluated based on the following questions: 1. What is the significance of a theory? Does it address a problem of a particular interest to my profession and the society? 2. Does the theory offer the possibility of explaining or systematically describing some phenomena? 3. Is the theory testable? Can the concepts be observed and measured Internal and External Criticism in Evaluating a Theory (Stevens) Internal Criticism a. Clarity- theory is presented in such a way that concepts and propositions and their relationships are easily understood. b. Consistency- theory is must be consistent with the meaning of terms, interpretations, principles and methods of reasoning. c. Logical development- the reasoning process must lead logically to its conclusion. d. Level of theory development- the theory is understood within the context of existing knowledge about the subject. External Criticism If the criticism is used in nursing research, the theory is evaluated based on how it relates to the world of people, health environment and nursing.
  14. 14. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 14 In general, the following are criteria in making an external criticism of a theory: a. Adequacy- adequacy of principles, interpretations and methods b. Utility- the theory is must be useful in education, research or practice, it must be operational and testable c. Significance- the theory must address issues that are basic and relevant to one’s profession and aim towards increasing knowledge d. Discrimination- the theory must clearly relate to one’s profession (Eg.: In nursing research, the theory must clearly discriminate between what nursing is and must be what it is not) e. Scope- the scope indicates whether the theory has a narrow or broad focus f. Complexity and Parsimony:  Complexity in a theory examines the relationships among many variables.  Parsimony is the decision criterion in which, when two or more theoretically sound solutions exist, the least complex solution with the fewest assumptions should be selected. 2. 5 Research Questions and Hypotheses A. RESEARCH QUESTIONS Research questions are, in some cases, direct rewordings of statements of purpose, phrased interogatively rather than declaratively. The Question form has the advantage of simplicity and directness and it invites and answer and help to focus attention on the kind of data that would have to be collected to provide that answer. Some research reports thus omit a statement of purpose and state only research questions. Other researchers use a set of research questions to clarify or lend greater specifity to a global purpose statement. Research questions are phrased interogatively rather than declaratively: Declarative The purpose of this study is to assess the relationship bewteen the dependency level of renal transplant recipients and their rate of recovery. Interrogative What is the relationship between the dependency level of renal transplant recipients and their rate of recovery? B. Defining Research Hypotheses A hypothesis is a sharp guess or inference that is formulated and provisionally adopted; It is a statement between the phenomenon and the variables being studied. Broadly: a. A supposition or proposed explanation made on the basis of limited evidence as a starting point for further investigation. b. A proposition made as a basis for reasoning, without any assumption of its truth. A hypothesis is a prediction about the relationship between two or more variables. A hypothesis thus translates a quantitative research question into a precise prediction of expected outcomes; whereas in qualitative studies, researchers do not begin with a hypothesis. In part because there is too little known about the topic to justify a hypothesis, and in part, in qualitative studies, researchers want the inquiry to be guided by participants’ viewpoint rather than their own. (Based on the above explanation, the following discussion focuses on hypothesis in a quantitative research Its purposes are:  To explain observed facts or conditions and to guide further investigation.  To translate problem statements into predictions of expected outcomes and is a technique in answering a problem. Hypothesis is tested, and if found to be true, accepted. If not, rejected. It is not proved, it is only tested. Once proved, it becomes a theory.
  15. 15. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 15 Attributes of a good hypothesis: 1. It is strong enough to compel an inquiry and serve as its focus. 2. When substantiated through research, it moves to the domain of theory. 3. It can be used to guide phenomena, guide actions and predict outcomes. 4. It adequately explains observed facts. 5. It offers the simplest explanation under the circumstances. 6. It offers an explanation that is complex as necessary under the circumstances. 7. It can be brought into an agreement or disagreement with observations. 8. Is easily understood, specific, conceptually clear and tangibly measured. 9. It should be related to a body of theories so that the findings will be relevant and can provide valuable information. Derivation of Hypotheses: Inductive and Deductive Inductive hypothesis is a generalization inferred from observed relationships. Researchers observe certain patterns, trends or association among phenomena and then use the observations as a basis for predictions; begin with specific observations and move toward generalizations. Example of the use of inductive hypothesis: A nurse might notice that presurgical patients who ask a lot of questions relating to pain or who express many pain-related apprehensions have a more difficult time. The nurse could then formulate a testable hypothesis such as: “Patients who are stressed by fear of pain will have more difficulty in deep breathing and coughing after their surgery than patients who are not stressed” Deductive hypothesis has starting point theories that are applied to particular situations. Since theories of how phenomena behave and interrelate cannot be tested directly, a researcher can develop hypotheses based on general theoretical principles. The following reasoning illustrate the process: 1. All human beings have red and white blood cells 2. Kris is a human being 3. Therefore, kris has red and white blood cells Example of the use of deductive hypothesis: In a qualitative study of PTSD due to childbirth, one of the researcher’s finding was that mothers suffering from PTSD were bombarded with terrifying flashbacks in which they relived their traumatic births. A hypothesis that can be formulated from this qualitative finding can be: “ Women who experience PTSD due to birth trauma experience more flashbacks of their labor and delivery than women who do not experience a traumatic birth” Sources of hypotheses: a. Observation of phenomenon within the environment (In nursing, sources of hypothesis can be hospital settings, drugs, healthcare delivery system, healthcare cost, nursing staff, etc.) b. Experiences c. Other hypothesis that have been tested Types of hypothesis: Type Description Example (underlined- IV/ in bold- DV) Associative Identifies the variables that occur or exist together in practice. Performance in the college of nursing is related to success in the NLE. Analysis: This merely states that there is a relationship between the two variables but it does not specify what it is (it does not specify passing or failing). Hence, this is a non-directional hypothesis. Causal Specifies the cause and effect between two or more variables. It is directional in nature People who smoke are more likely to have lung cancer than people who do not smoke. Analysis: While not all smokers get lung cancer, the hypothesis predicts the relationship between smoking and lung cancer. Hence, this is a directional statement Both associative and causal hypotheses predict relationships between the variables being studied. However, while the associative hypothesis merely states there is a relationship (non-directional), the causal hypothesis specifies the prediction that the IV produces effects on the DV (directional).
  16. 16. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 16 Simple Predicts the relationship between one IV and one DV. (It may be associative or causal) Pre-operative instructions minimize the pre-operative anxieties of patients facing major surgery. (directional) Pre-operative instruction is related to operative anxieties of patients scheduled for major surgery. (non-directional) Complex Predicts the relationship between two or more variables IVs and DVs. Heredity, home environment and quality of instruction are related to intelligence, motivation and performance in school. Null Is an assumption that there is NO DIFFERENCE between the studied variables. It is used for statistical testing outcomes. (It can be simple or complex/ associative or causal. There is no relationship between smoking and lung cancer. (Causal null hypothesis - the IV has no effect on the DV) No significant difference in the test measure will be found among students having a hospital clinical experience and those having a free day prior to test administration. (The researcher hopes to reject the statement of no difference) Testing the hypothesis The ultimate value of hypothesis is derived from whether or not it can be tested in real-life situation. A testable hypothesis contains variables that can be measured or manipulated in practice. a. Associative- tested and evaluated using statistical analysis b. Correlational- tested using analysis of ordinal level data, interval and ratio c. Null- tested to determine whether the IV has a significant effect on the DV. Research findings do not prove the hypothesis to be true or not- instead, the results of the research hypothesis are described as being supported or not supported. Findings can be:  Accepted is results indicate NO relationship exists  Rejected if there is difference/ relationship that exists
  17. 17. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 17 PART 3: RESEARCH DESIGN Defining Research Design The research design is a blueprint that delineates the factors that would interfere with a study’s design outcome. It is a detailed outline of how an investigation will take place. A research design typically include how data will be collected, what instruments will be employed, how the instruments will be used and the intended means for analyzing data collected. The choice of the research design depends upon the problem, the purpose of the study, the researcher’s expertise and the desire to generalize the findings. In broadest sense, the type of design directs the selection of a population sampling procedure, methods of assessment and a plan for data collection and analysis (Burns and Grave, 2009) ______________________________________________ A. QUANTITATIVE RESEARCH Quantitative research is a formal, objective and systematic process in which the numerical data are used to obtain information. It is a scientific method of research which is based on logical empiricism in which the researcher has no active interaction with the subjects to prevent bias. It is used to describe variables, examine relationships among variables, and determine the cause and effect interactions between variables. Quantitative research the most predominantly used method of scientific investigation in nursing. Quantitative research requires the use of the following that generate NUMERICAL DATA: a. Structured interviews, questionnaires or observations b. Scales c. Physiological instruments (eg: BP Apparatus) Statistical analyses are conducted to reduce and organize data, determine significant relationships and identify differences among groups. This process ensures that research findings may be applied not only to the study’s sample but to a larger population or from the sample situation to a larger situation. Types of Quantitative Research: Descriptive (Non- experimental) Is a very popular research approach. It provides an accurate portrayal or account of characteristic of particular individuals, situations or groups. It offers researchers a way to discover new meaning, describe what exists, describe the frequency of a phenomenon or categorize information. 1. SURVEYS Through a survey, data are gathered from a relatively large number of cases at a particular time. Subtypes of surveys and purposes a. Community Survey- to determine the trends and possibly carry out improvements b. Normative Survey- conducted to determine the normal or typical condition of situations and people c. Social Survey- aim to study and diagnose current problem, situation or population within a definite place so as to formulate a social reform or constructive program
  18. 18. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 18 d. School Survey- instruments for evaluating and planning school progress; seeks to formalize administrative planning for determining the next steps in school system and for evaluating efficiency of the system and its personnel; 3 three types of school survey are: Outside expert surveys- conducted exclusively by the research staff of a university/ institution in a particular school Self-surveys- conducted by members of a local school within the institution Combined surveys- joint efforts of the local school and an outside consultant 3 kinds of topics in school survey can be: Comprehensive- nature of pupils and their achievements, the curriculum, methods and instructional aides Educational- covers school activities related to the instructional program, policies and procedures, the setting and the learning conditions Building/ Structure- includes school plans and items such as location, lighting, ventilation, canteen, library, play area, etc. ___________________________________________ 2. Analytical Studies a. Job and Activity Analysis- This method describes the activities of persons who are observed, classified and analyzed. b. Document Analysis- This is a critical analysis of the content of written and printed materials as sources of data. (Eg.: The use of concurrent chart audit to determine if nurses comply with the set standards of quality nursing care) c. Causal Comparative Studies- This is to discover the factors that contribute to some observable facts. The method begins with the presence of several factors affecting certain observations from which the researcher selects some for analysis. Correlational Research Methods (Non- experimental) Correlational research examines relationship between two or more variables and determines the type (POSITIVE OR NEGATIVE) or degree (STRENGTH) of relationship: a. Ranges from -1 (perfect negative correlation) to; b. +1 (perfect positive correlation) c. 0 (indicates NO relationship) Positive relationship indicates that the variables either increase or decrease together Negative/ inverse indicates that the variables vary in opposite directions Eg.: There is a correlation between the leadership behavior of nurse managers and the performance of nursing staff Experimental Design In an experimental design, the researcher structures the situation so there will be a sound basis for determining the effect of the independent variable and how much is due to change. In an experimental research, the study subjects belong to either:  CONTROL group- subjects or group of elements NOT subjected or exposed to the experimental treatment (point of reference).  EXPERIMENTAL group- is the subject exposed to the experiment/ intervention. It has FOUR distinguished strategies: a. Manipulation of the independent variables. b. Random selection of sample members of the control or experimental groups. c. Use of an experimental group that is exposed to the independent variable or experimental factor and another group that is not exposed to the independent variable or experimental factor. d. Measurement of the effects of the independent variable on the dependent variable before and after the manipulation of the independent variable. Common types of Experimental Research: 1. AFTER-ONLY EXPERIMENTAL TECHNIQUE In this technique, the investigator assigns the subjects to an experimental group and a control group but collects the data only at the end of the treatment or exposure to the independent variable. 2. BEFORE AND AFTER EXPERIMENTAL TECHNIQUE a. Single Group Design/ One-group Uses only one group of subjects, involving the following steps: i. pre-testing of the DV ii. exposure of the subjects to the experimental variable iii. post-testing of the subjects; and iv. comparison of the results of the two tests to determine the effect of the IV
  19. 19. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 19 b. Two-group Before and After Technique This second type of group experimentation involves two or more groups that are AS NEARLY EQUIVALENT AS POSSIBLE. It makes use of two groups however, the EXPERIMENTAL GROUP is exposed to the experimental factor and the CONTROL GROUP to the ordinary treatment. This parallel-equated technique involves the following steps: i. matching the subjects on the basis of a matching variables ii. exposing the experimental group to the experimental factor and the control group to the ordinary treatment iii. testing both groups on the dependent variable, and; iv. comparing the results to determine the effect of the experimental factor *Diagrammatic examples are provided on the presentation for further understanding. Quasi- experimental Research (Experimental) The purposes are: a. identify causal relationships b. to determine the significance of causal relationship c. clarify why certain events happen (or a combination of above mentioned) In nursing research, these studies test the effectiveness of nursing interventions that can be implemented to control patient and family outcomes in nursing practice. Distinguished feature: There is NO CONTROL GROUP and the signature is the absence of randomization. Researchers are commonly UNABLE to manipulate or control certain variables when studying human behavior or in nursing research, clinical areas. Subjects are NOT randomly selected and are selected based on convenience. So that, it has lower level of control in at least one of these areas: - manipulation of the treatment or independent variable - manipulation of setting - selection of the subjects Concepts Relevant to Quantitative Research: 1. Pure or basic research- The search for new knowledge includes establishment of fundamental theories or relationships among facts not intended for immediate use in real-life situations. It usually precedes or is the basis for applied research. Eg.: Studies on newly-proposed interventions conducted on animals in laboratories (Cancer treatment tested in guinea pigs). 2. Applied Research- In nursing research, applied or practical research is common as it scientifically investigates to generate knowledge that will directly influence or improve a clinical situation, make a decision, develop or evaluate procedure, program or product. Eg.: A nurse researcher studies the implementation of quality assurance programs in the nursing services of hospitals X and Y. ______________________________________________ B. QUALITATIVE RESEARCH Qualitative research is a systematic, interactive and subjective approach used to describe life experiences and give them meaning. It is an interpretative methodological approach to produce more of a subjective science than quantitative research. It evolves on behavioral and social sciences as a method of understanding the unique, dynamic and holistic nature of human beings. Its philosophical base is interpretative, humanistic and naturalistic.
  20. 20. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 20 It believes that truth is both complex and dynamic and can be found only by studying persons as they interact with and within the sociohistorical settings (Marshall & Rossman, 2006; Munhall, 2001). In nursing research, it is commonly conducted to describe and promote understanding of human experiences such as pain, caring and comfort. The focus is broad and the researcher is an active participant in the study. It intends to give meaning to the whole and the researcher’s values and perceptions influence the findings. Distinguished characteristics are as follows: a. Uses unstructured observations and interviews to gather data. b. There is a shared interpretation of the researcher and the subject and no attempts to control the interaction. c. Data are collected and are analyzed in terms of individual responses, descriptive summaries or both. d. The findings are unique to the study and are not intended to be generalized to apply to a larger population. Types of Qualitative Research Phenomenological Research Is a humanistic study of a study phenomenon that is conducted in a variety of ways according to the philosophy of the researcher. The purpose is to explore an experience as it is lived by the study participants and interpreted by the researcher. During the study, the researcher’s experiences, reflections and interpretations influence the data collected from the study participants. Thus, the participants’ lived experiences are expressed through the researcher’s interpretation. In nursing research, this method is effective in discovering the meaning of a complex experience as it is lived by person, such as dealing with chronic illness and pain. Grounded Theory Research An inductive research method and is useful in discovering what problems exist in a social setting and the process people use to handle them. It emphasizes observation and the development of practice-based intuition to formulate, test and re-develop prepositions until theory evolves. The theory developed is “grounded” or has “roots” in the data from which it was derived. Ethnographic Research “portrait of a people” Provides mechanism for studying one’s own culture and that of others. It has been regarded as part of various disciplines in social psychology, sociology, education, political science and nursing. Ethnography describes and analyzes aspects of the way of life of a particular culture, subculture or subculture group. It enables the researcher to acquire new perspectives beyond his own ethnocentric perspective. In nursing, one of the major contributions of ethnography may be to promote culturally- specific care. Historical Research Is used if the researcher believes that the answer to his research lies in the past. It is believed that the greatest value of historical knowledge is greater self-understanding. This is valuable in community planning that leaders will be able to consider the relationships exist within a community- from its simple communal living to today’s complex living situations. Historical nursing research increases nurses’ understanding of their profession. Sources of data:  Primary- first-hand information serves as a clear evidence about the past (remains, relics, oral/written testimonies)  Secondary- second/third-hand accounts (history books, encyclopedias) Tools for Evaluation:  External criticism- authenticity/ genuineness of evidence/ originality (physical)  Internal criticism- credibility, validity and the trustworthiness of statements and facts in relation to the truth Case Analysis Involves an in-depth investigation of a single unit of study, such as person, family, group, community or institution or a small number of subjects who are examined intensively. The case itself is central, it focuses on study determining the dynamics of why an individual thinks, behaves or develops in a particular manner. This requires detailed study overtime.
  21. 21. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 21 Determining the Research Setting (Essential to choosing the appropriate research design) a. Natural settings- uncontrolled, real-life environments (schools, homes, communities); descriptive and correlational studies are conducted in this settings. (Eg.: A Study on the Practices on Health and Nutrition of Pregnant Mothers in Brgy. Y) b. Partially-controlled settings- the environment is modified in some way by the researcher; usually used in quasi-experimental studies. (Eg.: Fears and Anxieties of Patients and Their Relatives Towards Major Surgery at Hospital X) c. Highly-controlled setting- done in laboratories to test new innovations (drugs, chemicals, treatments) (Eg.: Animal tests to evaluate the effectiveness of a new method in attacking cancer cells done in a laboratory using mice) 3.1 Ethical Design of Research Ethics is the science that deals with the nature of actions of intelligent beings in relation to their moral qualities. As nurse, I would like to focus on ethical research concepts concerning my profession. In this regard, I will thoroughly discuss Ethical Issues in Nursing Research. Ethical Issues in Nursing Research Ethics and Research: Nursing research focuses on people- their health attitudes, experiences, values, coping behavior, support systems, community networks and environmental stress. Thus, human subjects are almost always involved in nursing research. Awareness of the rights of human subject is a major part of the nurses’ responsibility when it comes to research studies or assisting one who is conducting research or evaluating a research article. It is important that: a. The nurse researcher’s desire for scientific knowledge is compatible with dignity and right of individual and social groups. b. When performing moral judgment, the nurse researcher decides what is right or good and what he must do. c. The nurses’ primary responsibility is to preserve life at all cost (PNA,Code of Ethics, 1993), therefore nurses involved in research should bear in mind the importance of the subjects’ safety and welfare. Characteristics of Ethical Research: a. Scientific objectivity- being aware of personal values and biases without preconceived outcomes without engaging in any acts of bad faith or misconduct/fraud in doing the research. b. Cooperation with authorized review boards- means that the proposal has been reviewed and approved by the appropriate review committee in the agency or institution so that the subjects’ rights may be protected (the approval is given in writing). c. Integrity of the nature of the study- The subjects’ right to information is upheld (eg.: possible risks and discomforts). d. Equitableness- Acknowledging the works of others. e. Nobility- Advocating the rights of human subjects, the researcher protect the subject from any harm , deceit, coercion or invasion of their right to privacy. f. Truthfulness- Reflected in in the study’s purpose, procedures, methods and findings. g. Impeccability- Observance of the researcher’s role to anonymity and confidentiality. h. Honesty- Disclosure about the study’s funding and sponsorship. i. Illumination- The research should yield a fruitful result (did the study add new knowledge? solve a problem? or improve skills?) j. Courage- needed to clarify publicly any distortions that others may make of the research findings. Basic Human Rights of Research Subjects: (Burns and Grove, 2009) 1. Right to self-determination (Informed Consent is of prime importance, the four elements are- 1.disclosure of essential information; 2.comprehension; 3. Competency; 4. Volunteerism Important- consent forms are stored with the master list of the subjects’ names and code numbers (it must be locked in a safe place).
  22. 22. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 22 2. Right to fair treatment Study subjects should be treated fairly and the agreement should be respected both by the researcher and the subject (principle of justice). All subjects should receive benefits as promised and should be represented equally in the study. 3. Right to privacy It includes the privacy of one’s thoughts, opinions, physical presence and the privacy of one’s records. Important: Collection of data from observation without the subjects’ consent or knowledge is a clear violation of the right to privacy. 4. Right to confidentiality and anonymity of data Data entrusted by the research subjects must be protected and should be available ONLY to the research staff and reported anonymously for that research purpose only. Important: After the report is written, all data by which individuals can be identified should be destroyed (burned, shredded) 5. Right to be protected from discomfort and harm In the risk-benefit ratio, the risk should be outweighed by the benefits. The subjects must be well informed about the possible harm that be encountered during the process of research (physical, emotional, legal, financial, social harm). The subject has the right to refuse from participation if he experiences undue anxiety related to research activities. The 5th principle of Nuremberg’s Code* states that “No experiment should be conducted where there is a prior reason to believe that death or injury will occur, except, perhaps, in those experiments where the experimental physicians (or other health professionals) also serve as subjects. * be thoroughly discussed on presentation 3.2 Sampling Delineation of the Population/s to be Studied (SAMPLING) The researcher proceeds to define the population to be studied from which the sample subjects are selected. The sample is selected on the basis of how much it reflects the characteristics of the population to be studied.  Population refers to the largest body of individuals, in the case being researched on, that conform to a specific set of particulars or eligibility criteria; It is the entire number or totality of the groups of people, objects, events or any form of things being studied.  Sampling is a process of selecting a portion of the population to represent the entire population.  Sampling/ Eligibility Criteria include: - The list of individuals who are focused on the research - The list of characteristics essential to be a member of the target population Factors that Determine Sample Size 1. Accessibility of sample participants (a sample is taken when it is not feasible to study the whole population) 2. Cost (only a limited number may be studied if no funds are available) 3. Amount of time available (if the time is limited, only a small sample size may be gathered) A. Probability Sampling/ Sampling Methods- Developed to ensure some degree of precision to estimations of the population parameters. Technically, it refers to the fact every member or element of the population has a higher than zero probability of being selected for sample. 1. Simple Random Selection is done by chance (eg. Lottery draws) 2. Stratified Random Population is subdivided into areas/ section the random samples are taken from each area/ section (Eg.: dividing the students by year level and obtain random samples from each level)
  23. 23. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 23 3. Systematic Done by taking every nth person in the population 4. Cluster A small sample size is taken from various sections of the total population (Eg.: obtaining small sample size from each hospital in Metro Manila to study attitudes of hospital employees towards work) B. Non-Probability/ Non-Random Sampling- This kind of sampling is purposely chosen for an in- depth understanding of a particular experience, situation, cultural element or misconduct. 1. Convenience/ Accidental Data are collected from anyone most conveniently available; considered to be the weakest from of sampling 2. Snowball/ Network Subjects suggest or refer other subjects who meet the criteria/ eligibility of the researcher 3. Judgmental/ Purposive The researcher selects and studies a specific number of a special group that represents the target population with regard to certain characteristics such as age, sex or economic status. (Eg.: the researcher taps the deans of nursing colleges for nursing education studies) 4. Cross-cultural The study is conducted in variety of cultural settings (eg.: Tagalogs, Visayans, etc.) 5. Longitudinal Given group of subjects is studied for an extended period of time , which is either: Retrospective- studies from the past to the present Prospective- studies from the present to the future (Eg.: Study of a mastectomy patient from time of operation up to five years after discharge) 6. Cross-sectional Subjects are observed at a given period (Eg.: Professional preferences of Senior High School Students Upon Graduation) 7. Quota sampling The researcher identifies the population to be studied and determines the proportion needed in the population. (Eg.: selecting 80% of the class to participate in the study) 3.3 Designing the Research Instrument Defining Research Instrument Once the specific method and technique are selected, the researcher then develops the tool or instrument to gather data. An instrument in a research study is a device used to measure the concept of interest in a research project. A research instrument is a survey, questionnaire, test, scale, rating, or tool designed to measure the variable(s), characteristic(s), or information of interest, often a behavioral or psychological characteristic. Research instrument is a major tool in a research study. "Careful planning for data collection can help with setting realistic goals. Data collection instrumentation, such as surveys, physiologic measures (blood pressure or temperature), or interview guides, must be identified and described. Using previously validated collection instruments can save time and increase the study's credibility. Once the data collection procedure has been determined, a time line for completion should be established." (Pierce, 2009) Instruments can be:  Observation scales  Questionnaires  Interview schedules
  24. 24. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 24 An instrument must have the following qualities: a. Reliability- refers to the accuracy or precision of the tool; when administered twice, the instrument should provide identical data. b. Validity- Refers to the relevance of the measurement to the study being done. c. Sensitivity- Means that the fine lines of differences among the study subjects can be determined from the measurements (eg.: ratings and thermometers) d. Meaningfulness- Means that the measurement has a practical application. e. Appropriateness- applicability to the subjects being studied f. Objectivity- the tool is free from bias g. Ethical- the tools selected does not violate the right of the human subject (discussed). Where to Locate Instruments? Realize that searching for an instrument may take a lot of time. They may be published in a book or article on a particular subject. They may be published and described in a dissertation. They may be posted on the Internet and freely available. A specific instrument may be found in multiple publications and has been used for a long time. Or it may be new and only described in a few places. It may only be available by contacting the person who developed it, who may or may not respond to your inquiry in a timely manner. There are a variety of sources that may be used to search for research instruments. They include books, databases, Internet search engines, Web sites, journal articles, and dissertations. Permission to Use Instruments: If you plan to obtain an actual copy of the instrument to use in research, you need to be concerned not only with obtaining the instrument, but also obtaining permission to use the instrument. Research instruments are copyrighted. To obtain permission, contact the copyright holder to obtain permission in writing (print or email). Written permission is a record that you obtained permission. It is a good idea to have them state in writing that they are indeed the copyright holder and that they grant you permission to use the instrument. If you wish to publish the actual instrument in your paper, get permission for that, too. You may write about the instrument without obtaining permission. If someone posts a published test or instrument without the permission of the copyright holder, they are violating copyright and could be legally liable 3. 4 Validity and Reliability of the Research Instrument Defining Validity and Reliability Validity and Reliability are two statistical properties used to evaluate the quality of research instruments (Anastasi, 1986). Hence, it is important that an instrument possess both: 1. Validity The validity of the instrument used and validity of the research design as a whole are important criteria in evaluating the worth of the results conducted. Internal validity refers to the likehood that experimental manipulation indeed was responsible for the differences observed, whereas; External validity refers to the extent to which the results of the study can be generalized to the larger population (Polit & Hungler, 1999) Four types of validity are used to judge the accuracy of an instrument: a. Content validity - High level of validity indicates that test items accurately reflect the trait being measured. Eg.: a questionnaire to assess anxiety would be high in content validity if it includes questions about known sysmptoms of which such as muscle tension and a rapid pulse rate. b. Predictive validity - An assessment measure with high predictive validity is capable of making accurate predictions of future behavior even in a different but related situation. c. Concurrent validity - If a test possess high degree of concurrent validity, then it can be expected to give results very similar to other measures of same characteristic. d. Construct validity - The extent to which a theoretical construct such as personality trait can be empirically defined.
  25. 25. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 25 2. Reliability Reliability of an instrument reflects its stability and consistency within a given context, consistency over time and giving identical results on repeated tests. For example, a scale developed to measure intelligence might not be reliable for measurement of personality. Three qualities are evaluated to test the reliability of an instrument: a. Stability (Test-retest reliability) - An aspect of reliability that is concerned with the extent to which an instrument yields the same results on repeated administration (evaluated by test-retest reliability). - refers to degree to which research participants response to change overtime. - In this method, an instrument is given to the same individuals on two occasions within relatively short duration of time; A correlation coefficient is calculated to determine how closely the participants’ responses on the second occasion matched their responses on the first occasion. b. Internal consistency (half-split reliability) Refers to the extent to which all the instrument items are measuring the same attribute. c. Notion of equivalence (interrater reliability) - Applicable when different observers are using the same instrument to collect data at the same time. - Coefficient can be calculated to see correlation of values.
  26. 26. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 26 PART 4: MEASUREMENT AND DATA COLLECTION 4.1 Measurement concepts and strategies Measurement in Quantitative Studies Measurement studies derive data through the measurement of variables. It involves the assignment of numbers to represent the amount of an attribute present in an object or person, using a specified set of rules (quantitation). Measurement involves assigning numbers to objects according to rules (eg.: measuring temperature, weight, blood pressure and other physical attributes). Rules for measuring many variables for nursing research studies however have to be invented. Whether the data are collected by observation, self-report, or some other method, researchers must specify criteria for assigning the numeric values to the characteristic of interest. Example: The nurse is studying attitudes towards distribution of condoms in school clinics and asked parents to express their extent of agreement with the following statement. “Teenagers should have access to contraceptives in school clinics.” __ strongly disagree / __disagree / __ slightly disagree / __ neither agree nor disagree __slightly agree / __ agree / __ strongly agree Responses to this question can be quantified by developing a system for assigning numbers to them. Note that any rule would satisfy the measurement- the most practical way is to assign 1 to “strongly disagree” and 7 to “strongly agree”.  Obtained scores from an instrument consist of a true score component (the value that would be obtained for a hypothetical perfect measure of the attribute, or error of measurement that represent measurement inaccuracies.  Reliability, one of two primary criteria for assessing a quantitative measurement, is the degree of consistency or accuracy with which an instrument measures an attribute. The higher the reliability of an instrument, the lower the amount of error in obtained scores. Assessment methods are: Reliability Coefficient based on the computation of relation coefficient that indicates the magnitude and direction of a relationship between two variables. Relation coefficient can range from -1.00, a perfect negative relationship through zero to +1.00, a perfect positive relationship. Higher values reflect greater reliability.  Methods The choice of instruments to be used in collecting data depends on: - The variables being studied - The sampling units to be included - The amount of time available to complete the study - The amount of resources available The instrument for data collection should be tested first before it is applied to subjects in actual study. The tests can be made with subjects, representatives or their actual counterparts. This allows sufficient time for analyzing results so that necessary changes can be made.  Pre-test A pre-test is used to validate the measures of the variables being studied by correlating them with outside criteria, and to provide a “dry-run” of the actual administration of data collecting.
  27. 27. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 27 Strategies ADVANTAGES DISADVANTAGES APPROACH/CRITERIA 1. QUESTIONNAIRE It is the most common type instrument; written form and distributed to the study subjects to secure responses: Two Types: a. OPEN-ENDED/ FREE RESPONSE - why/ what/ how - allows complete freedom in answering - difficult in terms of time and expense for tabulating and summarizing the results. b. CLOSE-ENDED/ STRUCTURED FORM - Responses are prepared; the respondent merely checks, underlines or ranks the responses as directed. - time saving - responses are limited to the ones provided - simple method - less time is required - the researcher is able to gather data from a widely scattered sample - the researcher does not have to see the respondents personally - suitable for beginners questionnaires may lack depth; probing is not possible - respondent may omit/ disregard or forced to select some responses - costly in terms of printing - respondents/ sample is limited to those who are literate In constructing the questionnaire, the researcher should determine the content or information critical to the research problem- making it too lengthy may lose the subject’s interest leaving many item unanswered, other considerations include a. The questionnaire should not have too many items or take too much time for the respondent to answer. b. It should be interesting to the subject. c. It must not be too suggestive or stimulating. d. The questions are asked in such a way that the respondent is not embarrassed. e. Questions should elicit an in- depth but well-defined responses. Order of Questions 1. Each item should relate to the subject under study. 2. Items should be organized- progression from one type to another, from the simple to the complex, more difficult and thought-provoking. 3. General questions should lead to specific ones. 2. INTERVIEW - is the second most common method for data collection: a. Interview schedule- (structured) read to the respondent b. Interview guide- unstructured; the interviewer is allowed to pursue relevant ideas in depth; mp3 recording and other modern modes of recording can be used. - complete answers are possible - misunderstand ing can be minimized when questions are explained by the researcher - some topics can be pursued in- depth - higher percentage of response is possible - subject does not have to be literate - time and resources consuming - interpersonal relationship between the subject and the researcher is different for each interview Problems that may be encountered: - Responses may only be opinions. - The respondent may attempt to seek the interviewer’s approval. Categories Interviews can be categorized into 5 groups in which researchers may prefer one or two types to use, these are: 1. Standardized- interviewer uses exact wordings of the interview schedule; structured 2. Non-standardized- the interviewers has the freedom to ask further questions as he deems fit for data gathering. 3. Semi-standardized- specific number of questions may be asked by the interviewer who may probe these questions further as needed. 4. Focused interview-the interviewer asks a series of questions based on the previous understanding and knowledge of the subjects. The interview begins with an outline of topics and it allows freedom to deviate from the prepared agenda; partially- structured/ semi-standardized interview 5. Non-directive- subject is allowed to express his feelings without being questioned and without fear of disapproval; the interviewer is not allowed to suggest ideas; and since it allows complete freedom, the interview result is more comprehensive and that the respondent’s values and thoughts are more reflected. 3. OBSERVATION - Most direct means of studying the subjects when the researcher is interested in their behavior (common in nursing research wherein the researcher assume several roles in observing - inexpensive to employ - the researcher is not dependent on subjects who consent to answer - allows complete view - accurate prediction of a situation or event to be observed is unlikely; therefore it is difficult to be always present to observe key Approaches 1. Participant observation- the investigator blends in the activity of the group study (eg.: disguise as a patient, rating not only the services he receives but all other activities). 2. Non-participant- the observer uses quantitative instruments (weighing scales, thermometers, ECG monitor, etc.). The
  28. 28. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 28 nursing situations- a visiting strager, a patient, an eager-learner, a partipant or a non- participant one) of situation as it develops and affords inclusion of a sequence of events - can be discontinued and resumed anytime events - researcher has to wait for the spontaneous occurrence of observed situation - biases based on the observer’s cultural background and personal interpretation is likely - the presence of an observer gives the subject a quality that is normally absent - some events occur so rapidly that recoding all the details can be difficult - requires intensive training observer stands outside the phenomena being studied. 3. The use of one-way mirror or hidden cameras 4. Anecdotal records- observation and recording of situations that are as natural as possible (eg.: classroom, nursing unit), free from limiting conditions imposed by a prepared record; written down at the time of occurrence (eg: personality traits, skills, quality of work, etc); Useful in continuing individual records that can be utilized for guidance and clinical studies of students or personnel. 5. Critical Incident Technique (a new technique); requires the written account of respondents on a particular observed situation. Factors to consider when performing interview: HALO EFFECT- the observer may have the tendency to rate certain subjects as consistently high or low on everything because of the good impression the subjects give the rater. HAWTHORNE’S EFFECT- The people may deliberately change their behavior because they know they are being studied or observed. 4. RECORDS Provides readily available and valuable source of information (libraries, offices, homes, institutions; correspondences, patient’s charts, census data, diaries) - records are unbiased - covers a long period of time - inexpensive, convenient and time-saving - it may be incomplete in which the researcher cannot add on it - accuracy is unknown - records were not collected from a specific study To establish authenticity and accuracy of records, 3 major criteria are necessary: 1. Authorship- identity of the person who conceived the material. 2. Body- is the outward form of the material. 3. Function- is the purpose for which it was compiled. Considerations in the use of Records: - Employees in an organization may not want an outsider (researcher) looking at their private files. - Files may contain names of individuals that the organization may not want to disclose. - Records may require special help in interpretation. - To gain access, the researcher may have to guarantee anonymity and present a copy of research findings to the organization. PHYSIOLOGICAL MEASUREMENT Common modality in nursing research 1. Self-documentation - Is used when the subject cannot be monitored closely. This includes experiences that cannot be measured by others such as pain, or degree of mobility. This may reveal information not previously known which could build knowledge in areas not yet explored which may contribute, modify or improve management of patient care. (Eg.: the use of Ambulatory BP Monitor) 2. Laboratory Tests- Provide direct, precise and accurate measure of various physiologic conditions. Informed consent must be taken and specific instructions must be given to ensure accuracy of results.
  29. 29. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 29 4.2 Data Collection DATA COLLECTION The phenomena in which researchers are interested must ultimately be captured and translated into data for analysis. Any research project needs a high-quality data collection approach to ensure accuracy of findings. Data Sources One of the first decisions that investigators make with regard to research data concerns whether to use existing data or to collect data generated specifically for the study. Most researchers develop original data, but they often take advantage of existing information (secondary and metanalyses for example make use of data gathered by others, the same case with historical research). The major disadvantage of the use original data (obtained by the researcher) compared with the use of existing data or records is that obtaining data is expensive and time consuming. The Use Existing Data/ Record Advantages Disadvantages - Economical. - Permits Examination of trends overtime (if the data were obtained repeatedly). - Investigators do not have to rely on participant’s cooperation. - Bias in records (“selective deposit-selective deposit” by the record keeper). - Difficulty in gaining access to institutional records. - authenticity, authorship and accuracy issues The difference between using records and secondary analyses is that doing secondary analysis typically has a ready-to-analyze data set, whereas using records have to assemble the data set, and considerable coding and data manipulation usually are necessary. Major Approaches in obtaining original data Self-Reports, Observation and Biophysiologic Measures If existing data are not available for the research question, researchers must collect new data. When developing a data collection plans, researchers make many important decisions and consider multiple factors (discussed in the previous sections). In nursing research, three approaches have been used most frequently- self-reports, observation and biophysiologic measures. SELF-REPORTS (Questioning) The data collector must be able to communicate verbally. It requires directness and versatility. - A major advantage is that it yields information that would be difficult to gather by other means (Eg.: BEHAVIORS can be observed but only if the participants engage in them publicly. For example, it is usually impossible for a nurse researcher to observe behaviors as contraceptive practices). - Possibility to gather retrospective and prospective data whereas observation provides information occurring at the time of study. However, the data collector should also be aware of the limitations about the validity and accuracy of self-reports: Self-preservation happens particularly if the answers would reveal embarrassing or socially unacceptable behavior. It is one’s nature to preserve himself in the best light, and this may conflict with the truth. An effective approach to counteract this is:
  30. 30. RESEARCH METHODOLOGY, Prepared by C.LUTHER FABIA, B.S.N.,R.N. Subject: RESEARCH METHODS, Professor: DR. HELEN B. AGGABAO Philippine Colleges of Health and Sciences Inc., School of Graduate Studies | 30 Projective technique is a way of obtaining data indirectly, this is done by providing stimulus of low structure (more relaxed, less demanding data collecting technique) which allows the participant to “read in” and describe their own feelings. (Eg.: A study to describe the feelings of a sexually abused children uses in-depth analysis through interview and analysis of their drawings). OBSERVATION (an alternative to self-reports to obtain information on objective behavior and characteristics) This requires effective use of human senses or with the use of technical apparatus such as video equipment. This is effective to use when the nurse researcher gathers evidences on the effectiveness of nursing measures and practices (eg.: how a psychiatric patient reacts when he is transferred to a seclusion to manage destructive behavior). Observations may also be needed when subjects cannot describe adequately their own behaviors or unable to articulate their actions (eg.: preoperative manifestations of anxiety; young children and mentally ill A possible challenge on the use of this approach is a phenomenon called: Reactivity* in which, the subject intentionally distorts behavior due to awareness that he is being observed. This can be eliminated if the observations are made without the subject’s knowledge through some type of concealment or one-way mirror (however, a truly informed consent is an issue associated with these techniques). (This was discussed and described as HAWTHORNE’S EFFECT in the previous section) BIOPHYSIOLOGIC MEASURES (quantitative- objective) The trend in nursing research has been toward increased clinical investigations result to greater utilization of this approach. The major advantage is that since it uses instruments that are readily available in heathcare settings (eg.: BP apparatus; spirometer), the costs of this measure is minimal or nonexistent. The major strengths are objectivity, relative precision and sensitivity. (Eg.: two nurses reading the same thermometer at the same time to measure the effectiveness of a drug on fever will produce identical readings; relative precision- eg.: the subject complains of extreme pain and the he is bradycardic further confirms the intensity of pain ). Yields exceptionally high quality data. Researchers’ decision about research design usually is independent of decisions about data collection methods. For example, a researcher using an experimental design can rely on self-report data- as researcher doing an ethnography (non- experimental). The RESEARCH QUESTION may dictate which specific method of data collection to use (but researchers often have vast approaches in data collection plan and sometimes go beyond the conventional ones). BIASES may interfere with obtaining data using any of the mentioned approaches. Particularly because of involvement of emotions, prejudices, attitudes and values of the researcher, personal interest, anticipation of what is to be observed among others. Biases cannot probably be eliminated but can be minimized through careful training. Dimensions of Data Collection: Structure, Quantifiability, Researcher Obtrusiveness and Objectivity Regardless of what specific approach is used, data collection methods vary among these four important dimensions. STRUCTURE Structured- used in quantitative studies; data are easy to analyze (data can be computed in terms of percentages for example) but limited in terms of explaining the underlying meaning of responses; a formal instrument must be developed (or borrowed) such as questionnaire. Unstructured- used in qualitative studies; it provides an opportunity for an in-depth examination of a phenomenon- it allows thoughtful and deeper responses; data are difficult to analyze and is not suited for respondents who are not good in expressing themselves; no formal instrument is needed although a list of the type of information needed. RESEARCHER OBTRUSIVENESS RESEARCHER obtrusiveness is most likely to be problematic/ triggered when: a. participants have underlying vested interest in the study outcome b. participant is engaged in socially unacceptable behavior c. participant does not comply with instructions d. participant have a strong need to “look good” Researcher obtrusiveness most likely can distort data collection undermining the value of research; when such is unavoidable, researchers should make an effort to make participants at ease, stress the importance of naturalistic behavior and maintain a neutral and nonjudgmental demeanor.

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