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    3. types of research study 3. types of research study Presentation Transcript

    • TYPES OF RESEARCH & RESEARCH DESIGNS 1Dr. R S Mehta, MSND, BPKIHS Which is the best type of Research Design?
    • Types of Study Design: • There is no best type of study design • The context, assumptions, paradigms and perspectives decide the type of research methodology Dr. R S Mehta, MSND, BPKIHS 2
    • Selecting a Research Design 1. Level of knowledge 2. Nature of the research phenomenon 3. Nature of the research purpose 4. Ethical considerations 5. Feasibility 6. Validity and availability of data 7. Precision 8. Cost 3Dr. R S Mehta, MSND, BPKIHS
    • 4 1. Define the problem ( Characteristics) 2. Specify the objectives (Hypothesis) 3. Select design or type of study 4. Select study population 5. Collect data 6. Analyze data 7. Determine conclusions Anatomy of Research Dr. R S Mehta, MSND, BPKIHS
    • Dr. R S Mehta, MSND, BPKIHS 5 Select design or type of study
    • Types of Research From the view point of Application Pure Research Applied Research Objectives Exploratory Research Descriptive Research Correlation Research Explanatory Research Type of Information Sought Quantitative Research Qualitative Research 6Dr. R S Mehta, MSND, BPKIHS
    • 7 TYPE OF STUDIES Observational 1. Correlational study 2. Case reports and case series 3. Cross sectional survey 4. Case-control study 5. Cohort study Experimental 1. Community trials 2. Clinical trials – individuals
    • Study Designs 8 1. Descriptive Studies 2. Cross-Sectional Studies 3. Cohort Study 4. Case Control 5. Randomized Controlled Trials 6. Survey Research Dr. R S Mehta, MSND, BPKIHS
    • Health Sciences and Nursing Research Non-interventional Interventional Explorative Descriptive Analytical Pre-experimental Quasi- experimental True-Experiment - Case study - Cross-sectional - Longitudinal - Etc. - Cross- sectional - Case control - Cohort - Etc - CRD - RBD - FD - etc 9Note: CRD-complete random design, RBD-random block design, FD- factorial design
    • 4 Types of Research • Basic research • Applied research • Action research • Evaluation research 10Dr. R S Mehta, MSND, BPKIHS
    • Basic Research • Also known as fundamental research (sometimes pure research) is research carried out to increase understanding of fundamental principles. • Many times the end results have no direct or immediate commercial benefits • Basic research can be thought of as arising out of curiosity. • However, in the long term it is the basis for many commercial products and applied research. • Basic research is mainly carried out by universities 11Dr. R S Mehta, MSND, BPKIHS
    • Applied Research • Concern with addressing problem of the world as they are perceived by participants, organization or group of people • Action oriented and aims to assess, describe, document or inform people concerned about the phenomenon under investigation • Findings are intended to have immediate and practical value • In the field of education, policy, evaluation and contract are all examples of applied research 12Dr. R S Mehta, MSND, BPKIHS
    • Action Research Action Research is simply a form of self-reflective enquiry undertaken by participants in social situations in order to improve the rationality and justice of their own practices, their understanding of these practices, and the situations in which these practices are carried out. Wilf Carr and Stephen Kemmis (1986) 13Dr. R S Mehta, MSND, BPKIHS
    • Evaluation research • Major concern is practical application • Tends to be viewed as an isolated case study though the methodologies may be transferable • Rooted in values and politics • Is immediately prescriptive based upon logic and experience • Reports are written for implementers, users and other interested people • The extent of dissemination is controlled by sponsor 14Dr. R S Mehta, MSND, BPKIHS
    • RESEARCH DESIGNS QUANTITATIVE QUALITATIVE • Experimental study • Quasi-experimental • Survey study • Correlational study • Ethnography • Case study • Historical study 15Dr. R S Mehta, MSND, BPKIHS
    • Types of Study Design: Details Dr. R S Mehta, MSND, BPKIHS 16
    • 1. Descriptive Studies: Person, Place and Time 17Dr. R S Mehta, MSND, BPKIHS
    • Descriptive Epidemiology • Includes activities related to characterizing the distribution of diseases within a population 18 • Concerns activities related to identifying possible causes for the occurrence of diseases Dr. R S Mehta, MSND, BPKIHS
    • Descriptive Epidemiology 19 PERSON PLACE TIME Think of this as the standard dimensions used to track the occurrence of a disease. Dr. R S Mehta, MSND, BPKIHS
    • Descriptive Research Design: –Describe facts –Discover new facts –Not invent new theory and methods –Largest effort given on data collection –It answers questions: satisfy curiosity –Solve problems 20Dr. R S Mehta, MSND, BPKIHS
    • 2. Cross-Sectional Studies 21Dr. R S Mehta, MSND, BPKIHS
    • Features of C-S Studies 22 • Snapshot in time –e.g. - cholesterol measurement and ECG measured at same time • Determines prevalence at a point in time • Therefore, C-S is a prevalence study Dr. R S Mehta, MSND, BPKIHS
    • Advantages of C-S Studies 23 • Short term • Fewer resources required • Less statistical analysis • More easily controlled • Design less complex Dr. R S Mehta, MSND, BPKIHS
    • Advantages of C-S Studies (Cont.) 24 • Provide relationship between attributes of disease and characteristics of various groups, e.g. elderly group • Data is useful for planning of health services and medical programs Dr. R S Mehta, MSND, BPKIHS
    • Disadvantages of C-S Studies 25 • Represent only those who are surveyed • Identify prevalence, not incidence necessarily –excludes cases that died before study was done • Show association with survival - not risk of development Dr. R S Mehta, MSND, BPKIHS
    • Disadvantages of C-S Studies (cont.) 26 • People who are ill may not show up for survey -*Healthy Person Effect • Often, not possible to establish temporal relationship between exposure and onset –e.g. does high cholesterol precede CHD? • Not too effective if disease levels are low, as difficult to establish a causal relationship Dr. R S Mehta, MSND, BPKIHS
    • Cross-Sectional Study 27 ineligible physically active & CHD physically active & no CHD physically inactive & CHD physically inactive & no CHD participation no participation eligible Farmers Dr. R S Mehta, MSND, BPKIHS
    • Cross-Sectional Study 28 Disease Exposure yes no total yes a b a + b no c d c + d Dr. R S Mehta, MSND, BPKIHS
    • 3. Cohort Study 29Dr. R S Mehta, MSND, BPKIHS
    • 30 Group by common characteristics Start with a group of subjects who lack a positive history of the outcome of interest yet are at risk for it (cohort).  Think of going from cause to effect. The exposure of interest is determined for each member of the cohort and the group is followed to document incidence in the exposed and non-exposed members. Cohort Studies Dr. R S Mehta, MSND, BPKIHS
    • When is a cohort study warranted? 31 • When good evidence suggests an association of a disease with a certain exposure or exposures. Dr. R S Mehta, MSND, BPKIHS
    • 32 Changes and variation in the disease or health status of a study population as the study group moves through time. “Generation effect” Cohort Effect Dr. R S Mehta, MSND, BPKIHS
    • 33 • Prospective (concurrent) • Retrospective (historical) • Restricted (restricted exposures) Types of Cohort Studies Dr. R S Mehta, MSND, BPKIHS
    • 34 Types of Cohort Studies Prospective – cohort characterized by determination of exposure levels (exposed vs. not exposed) at baseline (present) and followed for occurrence of disease in future  Groups move through time as they age Retrospective - makes use of historical data to determine exposure level at some baseline in the past and then determine subsequent disease status in the present. Restricted - limited exposure, narrow behavior (e.g. military) Dr. R S Mehta, MSND, BPKIHS
    • Advantages of Prospective Cohort Studies 35 • Large sample sizes • Certain diseases or risk factors targeted • Can be used to prove cause-effect • Assess magnitude of risk • Baseline of rates • Number and proportion of cases that can be prevented Dr. R S Mehta, MSND, BPKIHS
    • Advantages of Prospective Studies (cont’d) 36 • Completeness and accuracy • Opportunity to avoid condition being studied • Quality of data is high • Considers seasonal and other variations over a long period • Tracks effects of aging process Dr. R S Mehta, MSND, BPKIHS
    • Disadvantages of Prospective Cohort Studies 37 • Large study populations required – not easy to find subjects • Expensive • Unpredictable variables • Results not extrapolated to general population • Study results are limited • Time consuming/results are delayed • Requires rigid design and conditions Dr. R S Mehta, MSND, BPKIHS
    • Disadvantages of Prospective Studies (cont’d) 38 • Subjects lost over time (dropouts) • Costs are high • Logistically demanding • Maintaining quality, validity, accuracy and reliability can be a problem Dr. R S Mehta, MSND, BPKIHS
    • 4. Case Control Study 39Dr. R S Mehta, MSND, BPKIHS
    • CASE-CONTROL STUDIES SOME KEY POINTS 40 • Frequently used study design • Participants selected on the basis of whether or not they are DISEASED (remember in a cohort study participants are selected based on exposure status) • Those who are diseased are called CASES. • Those who are not diseased are called CONTROLS. Dr. R S Mehta, MSND, BPKIHS
    • Case-Control Design 41 Subjects With Outcome of Interest Design Appropriate Control Group Without Outcome Of Interest Measure factors Compare factors Dr. R S Mehta, MSND, BPKIHS
    • MATCHING 42 • CHARACTERISTICS OFTEN USED –age –gender –body mass index (weight / height2) –smoking status –marital status Dr. R S Mehta, MSND, BPKIHS
    • MATCHED PAIRS EXAMPLE 43 CASE CONTROL CASE CONTROL Dr. R S Mehta, MSND, BPKIHS
    • Example: Hypothetical data 44 Cases Controls Exposed 141 133 Unexposed 1250 4867 Total 1391 5000 ODDS RATIO = 141 * 4867 = 4.13 133 * 1250Dr. R S Mehta, MSND, BPKIHS
    • Interpretation of the Odds Ratio… 45 If: OR = 1 then exposure is NOT related to disease OR>1 then exposure is POSITIVELY related to disease OR<1 then exposure NEGATIVELY related to disease Dr. R S Mehta, MSND, BPKIHS
    • Interpretation: 46 The odds that those with the outcome had the exposure is 4.13 times greater than those who do not have the outcome Dr. R S Mehta, MSND, BPKIHS
    • Strengths: 47 1. Quick and inexpensive 2. Well-suited to the evaluation of outcomes with long latent periods 3. Optimal for the evaluation of rare diseases 4. Can examine multiple etiologic factors for a single disease Dr. R S Mehta, MSND, BPKIHS
    • Limitations: 48 1. Cannot directly compute incidence rates of disease 2. Temporal relationship between exposure and disease may be difficult to establish 3. Prone to bias 4. Insufficient to evaluate rate exposure Dr. R S Mehta, MSND, BPKIHS
    • 5. Randomized Controlled Trials 49Dr. R S Mehta, MSND, BPKIHS
    • Randomized Controlled Trials 50 • Similar groups of individuals from same source population are allocated at random to receive or not to receive an intervention, then observed for occurrence of outcome(s). DESIGN Subjects with condition of Interest Experimental Group Control Outcome Outcome Dr. R S Mehta, MSND, BPKIHS
    • 51 A Factorial RCT for Two Studies for the Price of One Dr. R S Mehta, MSND, BPKIHS
    • Randomized Controlled Trial : Advantages 52 1. Comparability due to randomization and same effect of known and unknown confounders gets eliminated 2. Experiments provide strong evidence of cause and effect. 3. Allows standardization of eligibility criteria, maneuver and outcome assessment. 4. Allows use of statistical methods with few inbuilt assumptions. Dr. R S Mehta, MSND, BPKIHS
    • Randomized Controlled Trial : Disadvantages 53 1. May be expensive in terms of time, money and people. 2. Many research questions are not suitable due to ethics, likely co-operation or rarity of outcome. 3. To a greater or lesser extent RCT tends to be an artificial situation. Dr. R S Mehta, MSND, BPKIHS
    • 6. Survey Research 54Dr. R S Mehta, MSND, BPKIHS
    • Planning a Survey 55 • Deciding on a research question • Choosing the format of your questions* • Choosing the format of your interview--if you use an interview* • Editing your questions* • Sequencing your questions* • Refining your survey instrument* • Choosing a sampling strategy* Dr. R S Mehta, MSND, BPKIHS
    • Editing Questions: Nine Mistakes to Avoid 56 1. Avoid leading questions 2. Avoid questions that invite the social desirability bias 3. Avoid double- barreled questions 4. Avoid long questions 5. Avoid negations 6. Avoid irrelevant questions 7. Avoid poorly worded response options 8. Avoid big words 9. Avoid ambiguous words & phrases Dr. R S Mehta, MSND, BPKIHS
    • 7. Case Study • Explores in depth a program, event, activity, process, or one or more individuals • Bounded (separated out for research) by time, place and activity • Researcher collects detailed information using a variety of data collection procedures over a sustained period of time (Stake, 1995; Creswell, 2007) • A method of learning about a complex instance based on a comprehensive understanding of that instance obtained by extensive description and analysis of that instance taken as a whole 57Dr. R S Mehta, MSND, BPKIHS
    • 8. Historical Study • Focuses primarily on the past • Persuing documents of the period • Examining relics (reminders) • Interviewing individuals who lived during that time • Reconstruct what happened during that time as completely as possible • Systematic collection and evaluation of data to describe, explain, and thereby understand actions or events that occurred in the past • No manipulation or control of variables 58Dr. R S Mehta, MSND, BPKIHS
    • 59 9. Experimental Research Designs Dr. R S Mehta, MSND, BPKIHS
    • Experimental Design • It is a collection of research designs which use manipulation and controlled testing to understand causal processes. • Generally, one or more variables are manipulated to determine their effect on a dependent variable. • Test whether an educational practice or idea makes a difference for individuals 60Dr. R S Mehta, MSND, BPKIHS
    • Aim: • The aim of experimental research is to investigate the possible cause and effect relationship by manipulating one independent variable to influence the other variable in the experimental group and by controlling the other relevant variables and measuring the effects of the manipulation by some statistical means. Dr. R S Mehta, MSND, BPKIHS 61
    • Characteristics or Features of Experimental Design 1. Manipulation 2. Control 3. Randomization Dr. R S Mehta, MSND, BPKIHS 62
    • Experimental Design • Advantages – Best establishes cause-and-effect relationships • Disadvantages – Artificiality of experiments – Feasibility – Unethical 63Dr. R S Mehta, MSND, BPKIHS
    • Types of Experimental Designs • True-Experimental (Simple) • Quasi-Experimental • Pre-Experimental 64Dr. R S Mehta, MSND, BPKIHS
    • True, Qusi, & Pre- Experimental Study Randomization, Control and Manipulation • True exp.: All 3: R C M • Quasi exp.: M + R or C • Pre exp.: M, no R & no C 65Dr. R S Mehta, MSND, BPKIHS
    • 10. Ex Post Facto Study • Variable of interest is not subject to direct manipulation but must be chosen after the fact. E.g., Define two groups of people according to a certain characteristic (e.g., history of trauma) and measure how they respond in terms of anxiety to a certain stimulus (e.g., watching violent film). • Limitation – self-selection bias, cohort effects may explain the effect. 66Dr. R S Mehta, MSND, BPKIHS
    • 11. Meta Analysis 67 • Statistically combines results of existing research to estimate overall size of relation between variables • Helps in • Developing theory • Identifying research needs, • Establishing validity • Can replace large-scale research studies • Better than literature reviews Dr. R S Mehta, MSND, BPKIHS
    • 12. Qualitative Research 68Dr. R S Mehta, MSND, BPKIHS
    • Choice of Colours • 1. What colour would you like the most? 69Dr. R S Mehta, MSND, BPKIHS
    • 2.What do you associate this colour with? Good luck love Confidence Truthfulness Lively Danger … 70Dr. R S Mehta, MSND, BPKIHS
    • 3. What is the source of this knowledge? –Own Idea –Own Belief –Own observation –Own experiences –Cultural and Traditional –Books & articles – etc 71Dr. R S Mehta, MSND, BPKIHS
    • • Not every thing can be quantified. • Some valuable ideas, opinions, perceptions, experiences, behaviours, qualities can be described only in words • These subjective things are shared between people, but the meanings may be distorted in the process of communication and recording. 72Dr. R S Mehta, MSND, BPKIHS
    • • Although subjective, these aspects often add richness and depth • The art of the doctor and the experience of being human are aspects that need a qualitative approach to investigate/research properly. 73Dr. R S Mehta, MSND, BPKIHS
    • Definitions • Quantitative Research - investigation in which the researcher attempts to understand some larger reality by isolating and measuring components of that reality without regard to their contextual setting. • Qualitative Research - investigation in which the researcher attempts to understand some larger reality by examining it in a holistic way or by examining components of that reality within their contextual setting. 74Dr. R S Mehta, MSND, BPKIHS
    • Qualitative Research • ‘Qualitative Research…involves finding out what people think, and how they feel - or at any rate, what they say they think and how they say they feel. This kind of information is subjective. It involves feelings and impressions, rather than numbers’ • Bellenger, Bernhardt and Goldstucker, Qualitative Research in Marketing, American Marketing Association 75Dr. R S Mehta, MSND, BPKIHS
    • Qualitative Research – Human understanding and interpretation define reality – Complex reality can be understood and not as simply a sum of its parts – Goal of research is to examine complex phenomena to define the reality within – To be meaningful, inquiry must be holistic and contextual 76Dr. R S Mehta, MSND, BPKIHS
    • Universal Specific Explanatory Descriptive Subjective Objective Universal ------------------------------ Specific Objective ------------------------------ Subjective Explanatory ---------------------------- Descriptive 77Dr. R S Mehta, MSND, BPKIHS
    • Characteristics of Qualitative Research • Purpose is understanding • Oriented toward discovery • Uses subjective data • Extracts meaning from data • Interprets results in context • Focus is holistic 78Dr. R S Mehta, MSND, BPKIHS
    • Disadvantages of Qualitative Research • Subjectivity leads to procedural problems • Replicability is very difficult • Researcher bias is built in and unavoidable • In-depth, comprehensive approach to data gathering limits scope • Labor intensive, expensive • Not understood well by “classical” researchers 79Dr. R S Mehta, MSND, BPKIHS
    • Organizational Structures (Types) Historical Analysis Ethnography Phenomenology Life History, Chronology, Historiography Case Study 80Dr. R S Mehta, MSND, BPKIHS
    • Ethnographic Design • Examining a group of individuals in the setting where they live and work, and in developing a portrait of how they interact • Describing, analyzing and interpreting a group’s shared patterns of behavior, beliefs and language that develop over time • Provides a detailed picture of the group, drawing on various sources of information • Describes the group within its settings, explores themes or issues that develop over time as the group interacts • Data analysis emphasize on description and explanation rather than quantification and statistical analysis (Atkinson & Hammersley, 1994) 81Dr. R S Mehta, MSND, BPKIHS
    • Phenomenology • Definition: “Phenomenology is an approach which attempts to understand the hidden meanings and the essence of an experience together with how participants make sense of these.” (Grbich 2007, p. 84). • Strengths: Phenomenology is used to explore, describe, document rich details of people’s experiences, especially changes in feelings and experiences over time. Dr. R S Mehta, MSND, BPKIHS 82
    • Phenomenology… •Epistemological position -- Interpretivism. Husserl : Experience is the source of all knowledge. •Common Research methods: In-depth Interview as well as observation and documentation. Dr. R S Mehta, MSND, BPKIHS 83
    • Advantages of Qualitative Research  In-depth Examination of Phenomena (Phenomenological Study/Research)  Uses subjective information  Not limited to rigidly definable variables  Examine complex questions that can be impossible with quantitative methods  Deal with value-laden questions  Explore new areas of research  Build new theories 84Dr. R S Mehta, MSND, BPKIHS
    • Disadvantages of Qualitative Research  Subjectivity leads to procedural problems  Replicability is very difficult  Researcher bias is built in and unavoidable  In-depth, comprehensive approach to data gathering limits scope  Labor intensive, expensive  Not understood well by “classical” researchers 85Dr. R S Mehta, MSND, BPKIHS
    • Review: Health Sciences and Nursing Research Non-interventional Interventional Explorative Descriptive Analytical Pre-experimental Quasi- experimental True-Experiment - Case study - Cross-sectional - Longitudinal - Etc. - Cross- sectional - Case control - Cohort - Etc - CRD - RBD - FD - etc 86Note: CRD-complete random design, RBD-random block design, FD- factorial designDr. R S Mehta, MSND, BPKIHS
    • Relative strength of various study designs (based on level of evidence for a cause & effect relationship) 87 Strength Design Strong Clinical trial Cohort study Case control study Cross sectional Case series Weak Case report Dr. R S Mehta, MSND, BPKIHS
    • Websites, Search Engine, and address of Journals • www.pubmed.com • www.google.com • www.yahoo.com • www.msn.com • www.rn.com • www.who.int (WHO website) • www.randamization.com • www.tnaionline.org (TNAI Journal) • www.hellis.org (NHRC library site) • www.kumj.com.np • www.nhrc.org.np • www.uicc.org (cancer website) • www.unaids.org (HIV/AIDS website) • www.ncasc.org.np (HIV/AIDS website) • www.healthinternetwork.org (HINARI: needs password) • www.blackwell-synergy.com (need passwords) • www.doaj.org (free online journal) Dr. R S Mehta, MSND, BPKIHS 88
    • Some Popular Resource Sites for Nurses • www.delicious.com • www.connotea.org • www.scribd.ocm • www.authorstream • www.zotero.org • www.scratch.mit.edu • www.myebook.com • www.forvo.com 89Dr. R S Mehta, MSND, BPKIHS
    • “The beautiful thing about learning is that nobody can take it away from you.” --BB King Thank-You 90 Dr. R S Mehta, MSND, BPKIHS