This PPT is a brief lecture on research methodology!

1. By: Agegnehu B. (BSc, MSC)
Unit One
Introduction to Research
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2. Learning objectives
After completing this chapter, the student should
be able to:
Define research in general and nursing research in
particular
 Enumerate the characteristics of research
Identify the different types of research
Describe the historical perspective of nursing
research
Explain the roles of nursing research
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3. Definition
Research is a scientific inquiry aimed at learning
new facts, testing ideas.
It is the systematic collection, analysis and
interpretation of data to generate new
knowledge and answer a certain question or
solve a problem. 12/18/2022
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4. Characteristics of research
It demands a clear statement of the problem
It requires a plan (it is not aimlessly “ looking” for
something in the hope that you will come across a
solution)
It builds on existing data, using both positive and
negative findings
New data should be collected as required and be
organized in such a way that they answer the
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5. Types of research
 The classical broad divisions of research are:
Basic research: is necessary to generate new
knowledge and technologies to deal with major
unresolved health problems.
Applied research: is necessary to identify priority
problems and to design and evaluate policies and
programs that will deliver the greatest health benefit,
making optimal use of available resources.
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6. Quantitative Vs Qualitative Research
 Quantitative research, concerned with questions
about:
How much?
How many?
How often?
To what extent? etc
 Qualitative research is concerned with questions
which begin with:
why?
How?
In what way?
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7. Overview of Nursing research
 Nursing research is systematic inquiry designed to
develop knowledge about issues of importance to the
nursing profession, including nursing practice, education,
administration, and informatics.
 It is the application of scientific inquiry to phenomena of
concern to nursing.
 The systematic investigation of patients and their health
experience is the primary concern of nursing.
 Clinical nursing research
research designed to guide nursing practice and to
improve the health and quality of the life of nurses’ and
clients.
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8. Cont…
Nurses are managing their clinical responsibilities
at a time when the nursing profession and the
larger health care system require an extraordinary
range of skills and talents of them.
Nurses are increasingly expected to become
producers of new knowledge through nursing
research.
Nurses must become lifelong learners, capable of
reflecting on, evaluating, and modifying their
clinical practice based on new knowledge.
Nurses are increasingly engaged in disciplined
studies
that benefit the profession and its patients,
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9.  Aim of Nursing Research
 Identification and understanding of knowledge
relevant to the client and the experience of health.
 Purpose of Nursing Research
 to develop a unique body of nursing knowledge for
the eventual improvement of the nursing care that
clients receive.
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10. Goals of Nursing Research
 To produce an understanding of human
responses, across the life span, to health and
illness states in ever-changing environments.
 To improve the quality of nursing care and
promote health through the application of
research methods.
 To enhance the recognition of nursing as a
science.
 To enable nursing, as a practice discipline, to
control the provision of its services.
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11. Requirements to Do Research in Nursing
 Intellectual integrity
 Curiosity
 Knowledge of the scientific method
 A belief that nursing is important enough to warrant
investigation
 Evidence needs to be produced if we want to argue that:
 nursing makes a difference, that
 our interventions are cost-effective and efficacious and
 our services socially relevant.
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12. Historical Perspective of Nursing Research
Nineteenth Century – After 1850
 Began with Nightingale and Crimean War- mid 1800s
 Nightingale’s Notes on Nursing was published.
Nightingale
 originated the concepts which have contributed to and are
congruent with the present priorities of nursing research
(promotion of health, prevention of disease and care of the
sick)
 believed that the systematic collection and exploration of
data were necessary for nursing.
 also noted the need for measuring outcomes of nursing
and medical care 12
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13. Historical Perspective of Nursing Research cont…
Twentieth Century- Before 1950
1900: the American Journal of Nursing was published
 Research focused mainly on nursing education, but some
patient-and technique- oriented research was evident
 Pioneering works consist of documentation gathered for
the purpose of reforming nursing education and
establishing nursing as a profession.
 Clinically oriented research in the early half of the century
centered on morbidity and mortality rates; led to the
development of patient care protocols and the employment
of nurses in community settings.
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14. Historical Perspective of Nursing Research cont…
1920 -nursing research course started
1948- reemphasis in educational preparation in nursing
and the need to move into university setting; included
an updated description of nursing practices.
1950- ANA established a Master Plan for Research
1952-Journal of Nursing Research was established
 Nursing schools increased (undergrad and graduate
levels)
 Graduate programs included research courses
1954- ANA Committee on Research and Studies was
formed. 12/18/2022
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15. Cont…
Twentieth Century- After 1950
Research priorities began to be reordered and
practice-oriented research was targeted
 Nurses attained educational preparation in
research design to teach research and conduct
own research
 Clinical studies on infection control, sensory
deprivation were started.
 Studies on nurses and nursing continued and
some theorists called for the development of12/18/2022
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16. 1960s
Collaborative efforts led to researches on the
effects of patient teaching and communication on
events such as hospitalization, surgery, labor and
among dying patients.
Knowledge development through research in nursing
began only about 40 years ago, in the 1960s.
Nursing leaders began to express concern about the lack
of research in nursing practice.
Practice-oriented research on various clinical topics
began to emerge in the literature.
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17.  The International Journal of Nursing Studies
began publication in 1963, and the Canadian
Journal of Nursing Research was first published
in 1968.
 The 1960s was the period during which terms
such as:
 conceptual framework,
 conceptual model,
 nursing process, and
 theoretical base of nursing practice began to
appear in the literature and to influence views
about the role of theory in nursing research.
Nursing research began to advance worldwide in
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18. Nursing Research in the 1970s
 new growth in the number of master’s and doctoral
programs for nursing.
 nursing journals supported nurses’ learning in the
research process and in producing research to
enhance quality care.
 Several additional journals were established:
 Advances in Nursing Science, Research in Nursing &
Health, the Western Journal of Nursing Research, and
the Journal of Advanced Nursing.
 there was a decided change in emphasis in
nursing research from areas such as teaching,
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19. Nurses also began to pay attention to the utilization of
research findings in nursing practice.
A seminal article by Stetler and Marram (1976) offered
guidance on assessing research for application in
practice settings.
The availability of both predoctoral and postdoctoral
research fellowships facilitated the development of
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20. 1980’s
had an extended growth among upper-level
programs in nursing, especially at the doctoral
level
 many centers for nursing research developed in
educational settings and hospitals.
mechanisms for communicating research
increased, such as journals and reviews
 nursing organizations had formed research
sections
For example, the first volume of the Annual
Review of Nursing Research was published in
1983.
1986
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21.  1990’s
 At the university level, nursing leaders developed
mechanisms for faculty to develop and implement
research.
 Centers of excellence developed in several
academic settings.
 Growth in the number, quality, and depth of
research available for potential use in practice,
 Several research journals were established: including
Qualitative Health Research, Clinical Nursing
Research, Clinical Effectiveness, and Outcomes
Management for Nursing Practice.
1993
the National Center for Nursing Research (NCNR)
became 12/18/2022
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22. Future Directions for Nursing Research
 Broadly speaking, the priority for nursing research in
the future will be the promotion of excellence in
nursing science.
 Certain trends for the beginning of the 21st century
are evident from developments taking shape in the
1990s:
Increased focus on outcomes research.
Increased focus on biophysiologic research.
Promotion of evidence-based practice. 12/18/2022
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23. Importance of Research in Nursing
1. Practice
a. Understand client’s experiences
b. Quality of care and outcomes
c. Cost effectiveness of care
2. Professionalism
a. Scientific base for practice
b. Body of knowledge that is distinct from other profession
3. Accountability
a. Base decisions and actions in practice, administration
and education on scientifically documented knowledge
b. Seek scientific answers to professional issues
c. Read the scientific literature for new knowledge and
apply to nursing practice, administration and education
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24. 4. Social relevance of nursing
 Nursing, more than ever, is required by
consumers and sources of reimbursement to
document its role in the delivery of health
services
 Of what benefit is nursing ?
 Can it be documented that nursing care
makes a difference ?
 Of what social and practical relevance is
nursing ?
 Without research programs to build its
knowledge, a profession is limited to existing
knowledge that is often inadequate, or
 knowledge developed by other discipline as
and may not be appropriate to the problems of
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25. Over review of the research process
Unit Two
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26. Learning objectives
After completing this chapter, the student should
be able to:
 Define basic research terminology
 Discuss the major steps in the research process
 Discuss how to organize a research project
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27. Basic research terminology
 Subjects/study participants: the people who are
being studied.
 Respondents/informants: Subjects who provide
information to researchers by answering questions
directly e.g., by filling out a questionnaire.
 Researcher/investigator: The person who
undertakes the research.
 Collaborative research: Studies undertaken by
several people rather than by a single
researcher(involving different members of a health
care team) 12/18/2022
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28.  Project director or principal investigator (PI): the
person directing the investigation when a study is
undertaken by a research team.
 Co-investigators: Two or three researchers collaborating
equally.
 Consultants: a specialized expertise on a short-term
basis participating on a study (e.g., for statistical
analysis)
 Reviewers: are senior experts who perform critique
various aspects of a study and offer feedback.
 Funder or sponsor: organization providing the money for
research costs
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29.  Mentors/Advisors: senior researchers who provide advice and
support for student and/or young researchers.
 Variables/Phenomena; the issue which is being investigated or
a characteristic that takes on different values.
 Data: Information Gathered(Numerical or narratives).
 Research Settings: the overall location for the research
 it could be an entire community, an institution.
 Replications: are attempts to validate the findings from one
study in an independent inquiry.
o Replication is, in effect, a form of triangulation
o the use of multiple sources and referents (multiple findings) to
draw conclusions about the validity or truth of findings.
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30. Overview of the Research Process
The progression of activities differs for:
 Qualitative And
 Quantitative Researchers
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31. Major Steps In Quantitative Study
Phase 1: The Conceptual Phase:
Step 1: Formulating and Delimiting the Problem
Step 2: Reviewing the Related Literature
Step 3: Undertaking Clinical Fieldwork
Step 4: Defining the Framework and Developing
Conceptual Definitions
Step 5: Formulating Hypotheses
Phase 2: The Design and Planning Phase
Step 6: Selecting a Research Design
Step 7: Developing Protocols for the Intervention
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32.  Step 8: Identifying the Population to be Studied.
 Step 9: Designing the Sampling Plan.
 Step 10: Specifying Methods to Measure the
Research Variables.
 Step 11: Developing Methods for Safeguarding
Human/Animal Rights.
 Step 12: Finalizing and Reviewing the Research Plan.
Phase 3: The Empirical Phase
 Step 13: Collecting the Data
 Step 14: Preparing the Data for Analysis
Cont.…
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33. Phase 4: The Analytic Phase
 Step 15: Analyzing the Data
 Step 16: Interpreting the Results
Phase 5: The Dissemination Phase
 Step 17: Communicating the Findings
 Step 18: Utilizing the Findings in Practice
Cont.….
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34.  Setting up a timetable in advance for steps of the
research process.
 Almost all research projects are conducted under
some time pressure.
Organization of a Quantitative Research
Project
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35. 12/18/2022
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36. Activities In A Qualitative
Study
 The flow of activities in a qualitative study is more
flexible and less linear.
 Conceptualizing and Planning a Qualitative Study
 Identifying the Research Problem
 Doing Literature Reviews
 Selecting and Gaining Entry Into Research Sites
 Research Design in Qualitative Studies; emergent
design
 Addressing ethical issues
 Conducting the qualitative study; data saturation
 Disseminating Qualitative Findings
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37. Research Cycle
Application-
turning into
action
Disseminating
findings
Implementing
research
Planning
Research
Problem
Identification
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38. Planning Research (Developing
Proposal)
A written proposal is important:
 To clearly define the problem under study
 To avoid reinventing the wheel
 To clearly depict the methodology to be used
 To be cost and time conscious
 To be clear about what to expect in the end
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39. Components of Research
Proposal
1. Summary
2. Introduction/Statem
ent of the Problem
3. Literature review
4. Justification of the
study
5. Objectives
6. Methodology
7. Ethical
Considerations
8. Work plan
9. Dissemination and
Utilization of Results
10. Cost of the Project
11. References
12. Assurance of the
investigator
13. Advisor (approval)
14. Annex
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40. Selecting and identifying a
nursing research problem
Unit Three
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41. Learning objectives
 At the end of this unit students will be able to:
 Identify Sources of problem
 Developing and refining a research topic
 Discuss criteria's for evaluating research
problem
 write Statement of the research problem
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42. Overview of Research Problems
Studies begin as problems that researchers
want to solve or as questions they want to
answer.
This chapter discusses the formulation and
development of research problems.
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43. Definitions of basic terminologies
 Topic: is a phenomenon of interest a researcher
selects at the most general level on which to focus.
Within each of these topics are many potential research
problems.
Research problem is a perplexing/confusing, or
troubling/distress condition.
 Problem statement articulates the problem to be
addressed and indicates the need for a study.
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44. Cont.…
 Research questions are the specific queries
researchers want to answer in addressing the
research problem.
 Research aims or objectives: the specific
accomplishments the researcher hopes to achieve by
conducting the study.
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45. 12/18/2022
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46. Sources of Research Problems
 Where do ideas for research problems come from?
 How do researchers select topic areas and develop
research questions?
 Ans: At the most basic level, research topics originate with
researchers’ interests.
 Because research is a time consuming enterprise, curiosity
about and interest in a topic are essential to a project’s
success.
 Explicit sources that might fuel researchers’ curiosity
include experience, the nursing literature, social issues,
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47. Sources Of Research Problems cont.…
1. Experience and Clinical Fieldwork
 The nurse’s everyday clinical experience is a
rich source of ideas for research problems.
 You may be well along the way to developing a
research idea if you have ever asked the following
kinds of questions:
o Why are things done this way?
o What information would help to solve this problem?
o What is the process by which this situation arose?
o What would happen if ... ?
o How things could be improved if something were
to change.
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48. 2. Nursing Literature
 Ideas for research projects often come from reading
the nursing literature.
 Beginning nurse researchers can profit from regularly
reading nursing journals, either clinical specialty
journals or research journals.
Eg: Stranahan (2001) studied the relationship
between nurse practitioners’ attitudes about
spiritual care and their spiritual care practices.
She made several recommendations for further
research in her report, such as the following:
“Studies should be conducted to determine reasons why
nurse practitioners do not practice spiritual care in the
primary care setting”
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49.  Inconsistencies in the findings reported in nursing
literature sometimes generate ideas for studies.
 Eg, there are inconsistencies regarding which type of
tactile stimulation or touch (e.g., gentle touch, stroking,
rubbing) has the most beneficial physiologic and
behavioral effects on preterm infants.
 Such discrepancies can lead to the design of a study
to resolve the matter.
 Researchers may also wonder whether a study similar
to one reported in a journal article would yield
comparable results if applied in a different setting or
with a different population.
 Replications are needed to establish the validity and
generalizability of previous findings.
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50. 3. Social Issues
 Sometimes, topics are suggested by more global
contemporary social or political issues of relevance
to the health care community.
 Eg.
 sexual harassment,
 domestic violence, and
 gender equity.
 Thus, an idea for a study may stem from a
familiarity with social concerns or controversial
social problems.
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51. 4. Theory
 Research problems lies in the theories and conceptual
schemes that have been developed in nursing and
related disciplines.
 To be useful in nursing practice, theories must be tested
through research for their applicability to hospital units,
clinics, classrooms, and other nursing environments.
 Essentially, researchers must ask the following
questions:
 If this theory is correct,
what kind of behavior would I expect to find in certain
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52. 5. Ideas From External Sources
In some cases, a research topic may be given as a
direct suggestion.
 For example:
a faculty member may give students a list of topics from
which to choose or may actually assign a specific topic to be
studied.
Organizations that sponsor funded research.
websites on the internet .
priorities that are established within the nursing
profession.
By discussing with peers, advisers or mentors, or
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53. Tips on choosing a research topic?
 Career development
 Priority research areas
 Relevance
 Avoidance of duplication
 Feasibility
 Political acceptability
 Applicability
 Urgency of data needed
 Ethical acceptability
 Resource availability
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54. Cont.…
 The research topic or title should be specific and
clear.
The topic should indicate the WHO/WHAT,
WHEN, WHY, WHERE and HOW clearly.
It is the focus of your research.
EG. Title: Sero-prevalence and associated risk factors
for HIV/AIDS among Arba Minch University students,
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55. Cont.…
 A good title is usually a compromise between conciseness
and explicitness.
 Titles should be comprehensive enough to indicate the
nature of the research.
 One good way to cut the length of titles is to avoid words
that add nothing to a reader's understanding, such as
"Studies on...," "Investigations...," or "Research on Some
Problems in...."
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56. Articulating Topic/Title
Titles should: Titles should NOT:
 Describe contents clearly and
precisely, so that readers can
decide whether to read the
report
 Provide key words for indexing
 Include wasted words such as
"studies on," "an investigation
of"
 Use abbreviations and jargon
Good Titles Poor Titles
 The Relationship of Luteinizing
Hormone to Obesity in the
Zucker Rat
 An Investigation of Hormone
Secretion and Weight in Rats
 Fat Rats: Are Their Hormones
Different?
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57. Assignment(10%)
Select a Nursing Research Title
Identify the source of the title
Write clinical scenario or Indicate the reference
Describe the relevance of the topic
List related topics
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58. What is the function of Introduction section??
Acquaints(introduces) reader with the topic
Outlines the general field of interest and how your
chosen topic fits within it.
Raises the interest of the reader(The first few lines in the
paper may attract or put off the reader).
Investigators are advised to convey their enthusiasm but
not to exaggerate.
May begin with a brief historical overview (Background)
Writing the Introduction for proposal
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59. 12/18/2022
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60. Cont.…
 Move from general to specific
 Engage your reader: answer the questions, "What did you
do?" "Why should I care?"
 Make clear the links between problem and solution, question
asked and research design, prior research and yours.
 Be selective, not exhaustive, in choosing studies to cite and
amount of detail to include.
 (In general, the more relevant an article is to your study,
the more space it deserves and the later in the introduction
it appears.) 12/18/2022
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61.  Start the section with a general background of the
topic.
 Add 2-3 paragraphs that discuss previous work.
 Point out issues that are being addressed in the
present work.
 Write summaries of relevant literature in the
Cont.…
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62. Introduction cont.…
Questions to address: How to address them:
What is the problem?  Describe the problem investigated.
 Summarize relevant research to provide context, key
terms, and concepts so your reader can understand the
research area.
Why is it important?  Review relevant research to provide rationale. (What
conflict or unanswered question, untested population,
untried method in existing research does your study
address? What findings of others are you challenging or
extending?)
What solution (or step
toward a solution) do
you propose?
 Briefly describe your problem: hypothesis(es),
research question(s); general research design or
method; justification of method if alternatives exist.
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63. Statement of the research problem
A problem statement is an expression of the
dilemma or disturbing situation that needs
investigation for the purposes of providing
understanding and direction.
A problem statement identifies the nature of the
problem that is being addressed in the study and,
typically, its context and significance.
In general, the problem statement should be:
 broad enough to include central concerns, but
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64. Cont.…
It is a concise description of the nature of the
problem- what is it, magnitude, distribution (who,
where, when), severity and consequences.
Systematically elucidate why the proposed
research should be undertaken.
 Brief description of any attempts to solve the
problem in the past- successes, failures and
challenges.
 Provide convincing argument that available
knowledge is insufficient to solve the problem
under study.
 Describe the significance of the proposed
study- what you hope to achieve with the
study results. 12/18/2022
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65. Example of a problem statement from a
quantitative study:
Title: Infant development among at-risk children.
Statement of the problem:
 Women account for an increasing percentage of
adults with human immunodeficiency virus (HIV)....
 Most of these HIV-infected women are in their
childbearing years.
 As a result, approximately 7,000 infants are exposed
prenatally each year.... All infants exposed to HIV
prenatally are at risk for developmental problems....
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66. Example cont..
Little is known about the quality of parental
caregiving for infants of mothers with HIV, because
few studies have examined parenting in this
vulnerable group.
.... The purpose of this report is to describe the
development of infants of mothers with HIV and to
determine the extent to which:
Child characteristics,
Parental caregiver characteristics,
Family characteristics, and
Parenting quality influence development.
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67.  Problem statements usually appear early in a research
report.
 The sources of writing statement of the problem could
be
The literature(Previous researches),
Reports of Governmental, National and International
organizations(MoH, WHO, UNAIDS, etc)
Magazines, news papers and broad casts(Television and
radio)
Any source which provides context by documenting
knowledge gaps.
 But Note that you should have reference for every
statement you are writing.
 Finally, state the need of study(if any) to answer the
Statement of the research problem cont.…
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68. Criteria for prioritizing problems for
research
 If the answer to the research question is obvious, we are
dealing with a management problem that may be solved
without further research
 Each problem that is proposed for research has to be
judged according to certain guidelines or criteria.
 Before deciding on a research topic, each proposed topic
must be compared with all other options.
Criteria for selecting a research topic
Relevance
 The topic you choose should be a priority problem:
 Questions to be asked include:
 How large or widespread is the problem?
 Who is affected?
 How severe is the problem?
Avoidance of duplication 12/18/2022
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69. Feasibility
Consider the complexity of the problem and the
resources you will require to carry out the study
Political acceptability
It is advisable to research a topic that has the interest
and support of the authorities.
Applicability of possible results and
recommendations
 blessing of the authorities
 the availability of resources for implementing the
recommendations.
Urgency of data needed
 How urgently are the results needed for making a
decision?
 Which research should be done first and which can be
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70. Scales for rating research
topics
Relevance
 1 = Not relevant
 2 = Relevant
 3 = very relevant
Avoidance of duplication
 1 = Sufficient information already available
 2 = Some information available but major issues not
covered
 3 = No sound information available on which to base
problem-solving
Feasibility
 1 = Study not feasible considering available resources
 2 = Study feasible considering available resources
 3 = Study very feasible considering available resources
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71.  Political acceptability
 1 = Topic not acceptable
 2 = Topic somewhat acceptable
 3 = Topic fully acceptable
 Applicability
 1 = No chance of recommendations being implemented
 2 = Some chance of recommendations being implemented
 3 = Good chance of recommendations being implemented
 Urgency
 1 = Information not urgently needed
 2 = Information could be used but a delay of some months
would be acceptable
 3 = Data very urgently needed for decision-making
 Ethical acceptability
 1 = Major ethical problems
 2 = Minor ethical problems
 3 = No ethical problems
 N.B. The above rating should be based on the
existing data and not on mere assumptions.
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72. Locating and summarizing
existing information on a
problem
Unit Four
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73. After completing this chapter, the student should be
able to:
 Describe the reasons for reviewing available literature
and other information during the preparation of a
research proposal.
 Describe the resources that are available for carrying out
such a review.
 Record (organize) information obtained from literature
on an index card.
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74. The Literature review
Studies are usually undertaken within the context of an
existing knowledge base.
Researchers undertake a literature review to
familiarize themselves with that knowledge base.
NB: Some qualitative researchers deliberately bypass an
in-depth literature search before entering the field to
avoid having their inquiries constrained or biased by
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74

75. Purposes of a Literature Review
 Orientation to what is known and not known about an area
of inquiry
 to ascertain what research can best make a contribution to
the existing base of evidence.
 Identification of a research problem and development or
refinement of research questions or hypotheses.
 Determination of any gaps or inconsistencies in a body
of research(inspire new research ideas).
 Determination of a need to replicate a prior study in a
different setting or with a different study population.
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76. Cont.…
Identification of relevant theoretical or conceptual
frameworks for a research problem.
Identification of suitable designs and data collection
methods for a study.
Identification of experts in the field who could be used as
consultants.
Assistance in interpreting study findings and in developing
implications and recommendations(To discuss your
results by comparing and contrasting with previous
studies).
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76

77. How to work up Literature review
Search Widely
 Library
 Electronic Search Engines
Evaluate The Relevance Of The Literature To
Your Study
Include Information Directly Relevant To Your
Study
Be Concise
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78. Types of Information to Seek
 In writing your literature review, you face wide range
of material and, therefore, you have to decide what to
read or what to include in a written review.
 This depends on:
 The appropriateness of a reference concerns both its
content (i.e., its relevance to the topic of the review) and
 The nature of the information it contains(findings from
empirical investigations).
 Rely mostly on primary source(original
researchers) research reports.
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79. Include:
 Detailed account of the subject matter you want to
research.
 The extensiveness of the review depends on a
number of factors.
 Entertain confounding factors and other related
matter only pertaining to the current research.
Avoid repetitions and lengthy statements.
(Max 3-4 pages)
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80. Literature Review advantages
 Avoid reinventing the Wheel/avoidance of
duplicating previous work
 It increases your knowledge on the problem you
want to study and this may assist you in refining
your "statement of the problem".
 Learn the gaps
 Learn the various methods used
An opportunity to develop professional
confidence in the field of study!!
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81. Steps of literature
review
 Step 1: Begin by identifying key words or phrases
useful in locating materials in an academic library
at a college/university and/or websites.
 Step 2: With these key words or phrases in mind,
next go to the library and begin searching the
library catalog for holding (i.e. journals and books).
Or go to internet center for searching.
 Step 3: You would initially try to locate about 20
reports of research in articles or books related to
research on your topic.
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82.  Step 4: Using this initial group of articles, you would
then look at the articles and select those central to your
topic.
 In the selection process, you would look over the abstract
and skim the article or chapter.
 Step 5: As you identify useful literature, you may begin
designing the literature map on your topic.
 Step 6: Organize the literature into your literature
map.
 Continue to draft summaries of the most relevant articles.
 Summaries are then combined into the final literature
review that you write for proposal.
Cont.….
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83. 12/18/2022
83

84. Eg of Literature review statement:
“Although noise-induced hearing loss is preventable
through appropriate use of hearing protection
devices, studies among farmers consistently show a
low level of use(Broste et al., 1989; Engstrand, 1995;
Hallet, 1987; Karlovich et al.,1988; Langsford et al.,
1995).” 12/18/2022
84

85. Justification of the Study
Questions addressed before writing the significance
of the study:
 Are there gaps in evidence?
 Will results influence programs, methods, and/or
interventions?
 Will results contribute to the solution of the
problems?
 Will results influence the decision making of
organizations or companies?
 What will be improved or changed as a result of the
research? 12/18/2022
85

86. Unit Five: Objectives
General objective: aim of the study in general terms
 Summarizes what is to be achieved by the study
 Should be clearly related to the Title and statement
of the problem.
Specific objectives: measurable statements on the
specific questions to be answered
 logically connected parts of the general objective
 focus the study on the essentials
 direct the design of the investigation
 Orient collection, analysis and interpretation of the
data 12/18/2022
86

87. Criteria for setting research objectives
 Focused, each covering a single point
 Ordered in a logical sequence
 Realistic and feasible to answer
 Operational, using action verbs such as:
 determine - verify -identify
 describe
 assess - compare
 calculate - establish -explore
 Avoid the use of vague non-action verbs such as;
o - to appreciate
o - to understand
o - to study
o - to believe
 Measurable outcomes at the end of the
research
 Specific objectives should be
SMART(Specific, Measurable, Attainable,
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88. Importance of developing
objectives
 Focus the study
 Avoid the collection of data which are not strictly
necessary
 Properly formulated specific objectives facilitate the
development of research methodology and help to
orient the collection, analysis, interpretation and
utilization of data. 12/18/2022
88

89. Research questions vs hypotheses
 Research questions are formulated when the
investigators do not have enough insight into the
problem being studied.
 A hypothesis requires sufficient knowledge of the
problem to be able to predict relationships among
factors which then can be explicitly tested.
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90. Examples of research hypothesis
1. Older patients are more at risk of experiencing a fall
than younger patients(Directional hypothesis).
2. There is a relationship between the age of a patient
and the risk of falling(non directional) .
3. There is no relationship(Null Hypothesis) between the
age of a patient and the risk of falling.
4. The risk of falling increases with the age of the
patient(Directional hypothesis).
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91. Formulating Objectives cont…
 Explicit hypothesis: requires sufficient knowledge
of the problem to be able to predict relationships
among factors which
then can be explicitly tested.
E.g. Post-menopausal women who received hormone
replacement therapy are more likely to develop
endometrial cancer than post-menopausal women
who did not receive such therapy
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92. Research Methods
Unit Six
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92

93. Learning objectives
After completing this unit, the student should be able
to:
Identify the pertinent questions to consider when
developing the methodology of a research proposal
Describe and understand the various components of
the methods section in a research proposal
Explain the cyclical nature of the different steps in
designing the methodology. 12/18/2022
93

94. Introduction
 Research method indicates the
methodological steps you will take to answer
 Every question or to test every hypothesis
or
Specific objective stated in your study.
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95. Study Design and Populations
 What is the choice of the study design?
 What would be the study population?
 What would be the required size of study subjects?
 How are the samples going to be selected?
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96. Study Designs
A study design is the process that guides researchers
on how to collect, analyze and interpret observations.
It is a logical model that guides the investigator in
the various stages of the research.
Several classifications of study types are possible,
depending on what research strategies are used.
Non-intervention (Observational) studies
 the researcher just observes and analyses researchable
objects or situations but does not intervene
Intervention studies
 the researcher manipulates objects or situations and
measures the outcome of his manipulations
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97. Choice of Design
Depends on:
Status of existent knowledge
Research Questions or Objectives
Researcher Beliefs and Values
Researcher Skills
Time and Funds/resources
Occurrence of disease
Nature and availability of information
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97

98. Hierarchy of Epidemiologic(Quantitative) Study
Designs
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98

99. Types of Quantitative Study Design
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99

100. Study designs could be exploratory, descriptive or
analytical
Exploratory study: is a small-scale study of relatively
short duration, which is carried out
£ when little is known about a situation or a problem
£ It may include description as well as comparison
Descriptive studies: defined as studies that
describe the patterns of disease occurrence and
other health-related conditions by person place
and time.
Uses of descriptive studies
 They can be done fairly quickly and easily.
 Allow planners and administrators to allocate resources
 Provide the first important clues about possible
determinants of a disease (useful for the formulation of
hypotheses) 12/18/2022
100

101. Types of descriptive studies
1. Case reports and case series
 Case report: a careful, detailed report by one or more
clinicians of the profile of a single patient.
 The individual case report can be expanded to a case
series, which describes characteristics of a number of
patients with a given disease.
Uses
 Important link between clinical medicine and epidemiology
 One of the first steps in outbreak investigation
 Often useful for hypothesis generating and examining new
diseases,
 but conclusions about etiology cannot be made
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102. 2. Ecological studies
 Data from entire populations are used to compare
disease frequencies between different groups during
the same period of time or in the same population at
different points in time.
 Ecological studies are usually quick and easy to do and
can be done with already available information.
 Since ecological studies refer to whole populations
rather than to individuals, it is not possible to link an
exposure to occurrence of disease in the same person.
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103. 3. Cross-sectional studies
 A cross-sectional (prevalence) study provides
information concerning the situation at a given time.
 The status of an individual with respect to the
presence or absence of both exposure and disease is
assessed at the same point in time.
 Usually involve collection of new data.
measure prevalence rather than incidence
 Not good for studying rare diseases or diseases with
short duration
not ideal for studying rare exposures. 12/18/2022
103

104. Uses of cross-sectional study
 Estimation of the magnitude and distribution of a
health problem.
 Hypothesis generation
 Intervention planning
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104

105. Analytic studies
 Analytic studies are used to test hypotheses concerning
the relationship between a suspected risk factor and an
outcome
 measure the magnitude of the association and its
statistical significance.
 Analytic study designs can be divided into two broad
design strategies:
Observational and
Interventional 12/18/2022
105

106. Observational studies
 No human intervention involved in assigning study
groups;
 simply observe the relationship between exposure and
disease.
 Subject to many potential biases, but by careful
design and analysis, many of these biases can be
minimized.
 Eg:
 comparative cross-sectional, 12/18/2022
106

107. Comparative cross-sectional
studies
 Depending on the purpose of a given study, a
cross-sectional surve
 y could have an analytical component
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107

108. Cohort Studies
 In a cohort study, subjects with an exposure to a
causal factor are identified and the incidence of a
disease over time is compared with that of controls
(persons who do not have the exposure).
 In a longitudinal study, subjects are followed over
time with continuous or repeated monitoring of risk
factors or health outcomes, or both.
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109. Cohort Studies
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109

110. Cohort Study
 Directionality: Always forward
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110

111. Strengths and limitations of the cohort study design
Strengths:
 Is of particular value when the exposure is rare
 Can examine multiple effects of a single exposure
 Allows direct measurement of incidence of disease
in the exposed and non-exposed groups.
Limitations:
 Is inefficient for the evaluation of rare diseases
 Expensive and time consuming
 Validity of the results can be seriously affected by
losses to follow-up.
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112. Case-control studies
 Case-Control Studies identify existing disease/s and
look back in previous years to identify previous
exposures to causal factors.
 Cases are those who have a disease
 Controls are those without a disease
 Analyses examine if exposure levels are different
between the groups.
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113. Case-Control studies
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113

114. Case-Control Study
 Directionality: Always backwards
 Timing: Always Retrospective 12/18/2022
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115.  Strengths and limitations of the case-control study
design
Strengths:
 Is relatively quick and inexpensive
 Is optimal for the evaluation of rare diseases.
 Can examine multiple etiologic factors for a single
disease.
Limitations:
 Is inefficient for the evaluation of rare exposures
 Cannot directly compute incidence rates of disease in
exposed and non- exposed individuals.
 Is particularly prone to bias compared with other analytic
designs, in particular, selection and recall bias.
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116. Intervention studies
 the researcher manipulates a situation and measures
the effects of this manipulation
 Usually (but not always) two groups are compared,
one group in which the intervention takes place (e.g.
treatment with a certain drug) and another group that
remains untouched’ (e.g. treatment with a placebo).
 The two categories of intervention studies are:
1. experimental studies and
2. quasi-experimental studies
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117. Experimental studies
 An experimental design is a study design that gives the
most reliable proof for causation.
 In an experimental study, individuals are randomly
allocated to at least two groups.
 One group is subject to an intervention, or experiment,
while the other group(s) is not.
 The outcome of the intervention (effect of the
intervention on the dependent variable/problem) is
obtained by comparing the two groups.
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118. Quasi-experimental studies
 In a quasi-experimental study, one characteristic
of a true experiment is missing, either
randomisation or the use of a separate control group.
 A quasi-experimental study, however, always includes
the manipulation of an independent variable which is
the intervention.
 One of the most common quasi-experimental designs
uses two (or more) groups, one of which serves as a
control group in which no intervention takes place.
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119. Cont…
 Both groups are observed before as well as after the
intervention, to test if the intervention has made any
difference.
 This quasi-experimental design is called the ‘non-equivalent
control group design’ because the subjects in the two
groups (study and control groups) have not been randomly
assigned.
 Another type of design that is often chosen because it is
quite easy to set up uses only one group in which an
intervention is carried out.
 The situation is analysed before and after the
intervention to test if there is any difference in the observed
problem. 12/18/2022
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120. Clinical trial studies
Blinded Not blinded
Randomised Not randomised
Controlled Not controlled
Trial
12/18/2022 120

121. Summary
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122. Cont.…
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122

123. Cont.…
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123

124. Qualitative Research Design
 Quantitative researchers carefully specify a research
design before collecting even one piece of data, and
rarely depart from that design once the study is underway
 In qualitative research, by contrast, the study design
typically evolves over the course of the project.
 Qualitative studies use an emergent design: a design
that emerges as researchers make ongoing decisions
reflecting what has already been learned
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124

125. Characteristics of Qualitative Research
Design
 Flexible, elastic, capable of adjusting
 Merging together of various data collection
strategies
 Holistic, understand the whole
 Research intensely involved
 Research to become the research instrument
 Requires ongoing analysis of data to formulate
subsequent strategies and to determine when field
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125

126. Qualitative Research Traditions
(1) Ethnography
(2) Phenomenology
(3) Grounded Theory
(4) Historical Research
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126

127. Ethnography
 Research tradition in anthropology
 Provides a framework for studying meanings, patterns,
and experiences defined by a cultural group in a holistic
fashion
 Ethnoscience (Cognitive Anthropology): focuses on
the cognitive world of a culture; semantic rules and shared
meanings that shape behavior
 Focus: the culture of a group of people
 Assumption: every human group evolves a culture that
guides members view of the world and the way they
structure their experiences
 Aim: to learn from rather than study members of a
cultural group
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128. Phenomenology
 Phenomenology is both philosophy and a research method
 Purpose of this research method is to describe experiences
as they are lived
 Used to capture the “lived experience”
 Developed by Husserl & Heidegger: an approach to
thinking about people’s life experiences.
 Assumption: there is an “essence: an essential variant
structure that can be understood.
 Investigates subjective phenomena
 Belief that truths about reality are grounded in peoples’ lived
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129. Phenomenology Cont’d
 Data sources:
 In-depth conversations
 Researcher helps the participant to describe lived experiences
without leading the discussion
 Two or more interviews/conversations are needed
 Usually small number of participants (ie. 10 or less)
 May use participation, observation and introspective reflection
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130. Grounded Theory
 Is an inductive research technique developed for
health-related topics by Glaser & Strauss (1967)
 Emerged from the discipline of sociology
 “Grounded”: means the theory developed from the
research is grounded or has it roots in the data from
which is was derived
 Is an approach to study the social processes and social
structures
 Focus: is the evolution of a social experience:the
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131. Grounded Theory Cont’d
 Methodology:
- does not begin with a focused research question
- the question emerges from the data
- fundamental structure feature –
is the “data collection”
is the “data analysis”
Is the sampling of participants occurs
simultaneously
This procedure is referred to as “constant
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132. Grounded Theory Cont’d
 Philosophical Orientation:
Based on symbolic interaction theory
Explores how people define reality and how their beliefs
are related to their actions
Meaning is expressed through – symbols – such as
words, religious objects, and clothing
Symbolic meanings are different for each of us
In social life - meanings are shared by groups –
socialization process
Group life is based on consensus and shared meanings
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133. Grounded Theory Cont’d
Constant Comparison: is used to develop and
refine theoretically relevant categories and to
identify the basic problem
 Categories that are elicited from the data are
constantly compared with data obtained earlier so
that “commonalities” and “variations” can be
determined
 Categories can be “condensed” and “collapsed”
Data Sources:
- in-depth interviews are most common
- Observational methods
- Existing documents
- Usually a sample of 25 to 50 informants
- Has contributed to the development of middle range
nursing theories
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134. Historical Research
 Historiography examines events of the past
 Historians believe the greatest value of historical
knowledge is an increased self-understanding
 Philosophical Orientation:
A very old science
Primary question “Where have we come from, who are we,
and where are we going?”
Myths, past, present and future are not distinguishable
Myths are a form of story telling
History moves beyond the myth
Chronicling events, deeds, victories and stories about people
and civilizations
Comparing histories, identifying patterns
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135. Historical Research Cont’d
 Aim:
 to discovery new knowledge
 Seeking to answer questions concerning causes, effects
and trends relating to past events
 To shed light on present behaviors and practices
 Assumptions:
(a) There is nothing new under the sun
(b) One can learn from the past
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136. Sampling
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136

137. Learning objectives
At the end of the session you should be able to:
Define the population(s) to be studied
Identify common methods of sampling
Discuss problems of bias that should be avoided when
selecting a sample
Decide on the sampling method(s) and sample size(s)
most appropriate for the research design you are
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138. What is sampling?
 Sampling involves the selection of a number of study
units from a defined study population.
 The population is too large for us to consider collecting
information from all its members.
 Instead we select a sample of individuals hoping that
the sample is representative of the population.
When taking a sample, we will be confronted with
the following questions:
What is the group of people from which we want to draw a
sample?
How many people do we need in our sample?
How will these people be selected?
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139. Defining Populations in Research
 Source/Target population: The population that you would
like to make inferences about, based on what you see in
your sample.
 Study population: a group of people we are interested in
from which we draw a sample.
 Sample: The representative group of people from which
data will be collected.
 Sampling unit: The smallest tool for labeling and
addressing the study subjects.
 The unit of selection in the sampling process.
 For example, in a sample of districts, the sampling unit is a
district; in a sample of persons, a person 12/18/2022
139

140. Cont.….
Study unit: The single object of our study(individual,
house hold etc)
N.B. The sampling unit is not necessarily the same as
the study unit.
Sampling frame: A list of sampling units from which
sampling is done. Eg. Telephone directory, List of five star Hotel,
List of student
 Sample design: The scheme for selecting the sampling
units from the study population.
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141. SAMPLING BEAKDOWN
All university in Ethiopia
All university SNNPR
List of SNNPR university
Two university in SNNPR
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141

142. Sample
TARGET POPULATION
SAMPLE UNIT
SAMPLE
• A population can be defined as including all people oritems
with the characteristic one wishes to understand.
• Because there is very rarely enough time or money to gather
information from everyone or everything in a population,the
goal becomes finding a representative sample (or subset) of
that population.
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143. Why Sample?
 Get information about large populations
 Lower cost
 More accuracy of results
 High speed of data collection
 Availability of Population elements
 Less field time
 When impossible to study the whole population
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144. Sampling methods
 Probability sample
 amethod of sampling that usesrandom selection
 all units/cases in the population have an equal
probability of being chosen.
 Non-probability sample
 does not involve random selection
 methods are not based on the rationale of
probability theory.
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145. 12/18/2022
145

146.  Probability (Random) Samples
 Simple random sample
 Systematic random sample
 Stratified random sample
 Cluster sample
Probability
Sampling
Simple
Random
Sampling
Systematic
Sampling
Stratified
Random
Sampling
Proportionate
Dis Proportionate
Cluster
Sampling
One-
Stage
Two
Stage
Multi-
Stage
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147. Simple Random Sampling (SRS)
 Every subset of a specified size n from the population has an
equal chance of being selected
 Make a numbered list of all the units in the population from
which you want to draw a sample.
 Each unit on the list should be numbered in sequence from
1 to N (Where N is the Size of the population).
 Decide on the size of the sample
 Select the required number of sampling units, using
 “lottery” method
 table of random numbers
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148. SRS…
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148

149.  Similar to simple random sample.
 No table of random numbers
 select directly from sampling frame.
 Ratio between sample size and population size
Systematic Sampling
Define
population
Develop
sampling
frame
Decide the
sample size
Select
according to
fraction (100
sample from
1,000 frame then
10% so every
10th unit)
First unit
select by
random
numbers
then every
nth unit
selected
(e.g. every
10th)
Work out what
fraction of the
frame the
sample size
represents
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150. Systematic Sampling
ADVANTAGES:
 Sample easy to select
 Suitable sampling frame can be identified easily
 Sample evenly spread over entire reference population
 Cost effective
DISADVANTAGES:
 Sample may be biased if hidden periodicity in population
coincides with that of selection.
 Each element does not get equal chance
 Ignorance of all element between two n element
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151. Systematic sampling
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152.  The population is divided into two or more groups called
strata, according to some criterion, such as geographic
location, grade level, age, or income, and subsamples are
randomly selected from each strata.
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153. Cont.…
Stratified random sampling can be classified in to
a. Proportionate stratified sampling
 It involves drawing a sample from each stratum in
proportion to the letter‟sshare in totalpopulation
b. Disproportionate stratified sampling
 proportionate representation is not given to strata it
necessery involves giving over representation to some
strata and under representation to other.
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154. Stratified Sampling……
Advantage
Enhancement of representativeness to each sample
Higher statistical efficiency
Easy to carry out
Disadvantage
 Classification error
 Time consuming and expensive
 Prior knowledge of composition and of
distribution of population
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155.  Cluster sampling is an example of 'two-stage sampling' .
 First stage a sample of areas is chosen;
 Second stage a sample of respondents within those areas is
selected.
 Population divided into clusters of homogeneous units,
usually based on geographical contiguity.
 Sampling units are groups rather than individuals.
 A sample of such clusters is then selected.
 All units from the selected clusters are studied.
 The population is divided into subgroups (clusters) like
families.
 A simple random sample is taken of the subgroups and then
all members of the cluster selected are surveyed
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156. Cluster sampling
Section 4
Section 5
Section 3
Section 2
Section 1
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157. Multi-stage sampling
 appropriate when the population is large and widely
scattered.
 The number of stages of sampling is the number
of times a sampling procedure is carried out.
 The primary sampling unit (PSU) is the sampling
unit (or unit of selection in the sampling procedure)
in the first sampling stage
 The secondary sampling unit (SSU) is the sampling
unit in the second sampling stage,
 e.g. After selection of a sample of clusters (e.g.
household), further sampling of individuals may be
carried out within each household selected.
 This constitutes two-stage sampling, with the PSU
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158. Non-Probability Samples
 Convenience samples (ease of access)
 sample is selected from elements of a population
that are easily accessible
 Purposive sample (Judgmental Sampling)
 You chose who you think should be in the study
 Quota Sampling
 Snowball Sampling (friend of friend….etc.)
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159. Convenience Sampling
 Sometimes known as grab or opportunity
sampling or accidental or haphazard sampling.
 Selection of whichever individuals are easiest to
reach
 It is done at the “convenience” of the researcher
 Advantage:
 A sample selected for ease of access, immediately
known population group and good response rate.
 Disadvantage
 cannot generalize findings (do not know what
population group the sample is representative of) so
cannot move beyond describing the sample. 12/18/2022
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160. Judgmental sampling or Purposive sampling
 The researcher chooses the sample based on who they think
would be appropriate for the study.
 This is used primarily when there is a limited number of
people that have expertise in the area being researched
 Selected based on an experienced individual‟s belief
 Advantages
Based on the experienced person'sjudgment
 Disadvantages
Cannot measure the respresentativeness of the sample
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161. Quota Sampling
 The population is first segmented into mutually exclusive sub-
groups, just as in stratified sampling.
 Then judgment used to select subjects or units from each segment
based on a specified proportion.
 For example, an interviewer may be told to sample 200 females
and 300 males between the age of 45 and 60.
 In quota sampling the selection of the sample is non-random
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162. Based on prespecified quotas regarding demographics,
attitudes, behaviors, etc
 Advantages
Contains specific subgroups in the proportions desired
May reduce bias
easy to manage, quick
 Disadvantages
Dependent on subjective decisions
Not possible to generalize
only reflects population in terms of the quota, possibility o
fbias
in selection, no standard error
Quota sampling Cont.….
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163. Snowball Sampling
 Useful when a population is hidden or difficult to gain access to.
 The contact with an initial group is used to make contact with others.
 Respondents identify additional people to included in thestudy
Advantages
 Identifying small, hard-to reach uniquely defined target population
 Useful in qualitative research
 access to difficult to reach populations (other methods may n
o
t
yield any results).
Disadvantages
 Bias can be present
 Limited generalizability
 not representative of the population and will result in a biased sample as it is
self-selecting.
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164. Errors in Sampling
 When we take a sample, our results will not be exactly
equal to the correct results for the whole population.
 That is, our results will be subject to errors.
The two types of errors in sampling:
Sampling error (random error)
Non-sampling error (bias)=systematic error
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165. Sampling error (random error)
 A sample is a subset of a population.
 Because of this property of samples, results obtained
from them cannot reflect the full range of variation found
in the larger group (population).
 This type of error, arising from the sampling process itself,
is called sampling error, which is a form of random error.
 Sampling error can be minimized by increasing the size of
the sample.
 When n = N  sampling error = 0 12/18/2022
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166. Non-sampling error (bias)
 It is a type of systematic error in the design or conduct of a
sampling procedure which results in distortion of the sample,
 so that it is no longer representative of the reference
population.
 We can eliminate or reduce the non-sampling error (bias) by
careful design of the sampling procedure
 We can not eliminate by increasing the sample size.
 Eg: If you take male students only from a student dormitory in
Ethiopia in order to determine the proportion of smokers,
 You would result in an overestimate, since females are less
likely to smoke.
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167. Non-sampling error (bias) cont…
 There are several possible sources of bias in sampling
(eg., accessibility bias, volunteer bias, etc.)
 The best known source of bias is non response. It is the
failure to obtain information on some of the subjects
included in the sample to be studied.
 Non response results in significant bias when the
following two conditions are both fulfilled.
 When non-respondents constitute a
significant proportion of the sample (about
15% or more)
 When non-respondents differ significantly
from respondents. 12/18/2022
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168. There are several ways to deal with this problem and reduce
the possibility of bias:
 Data collection tools (questionnaire) have to be pre-tested.
 If non response is due to absence of the subjects, repeated
attempts should be considered to contact study subjects who
were absent at the time of the initial visit.
 To include additional people in the sample, so that non-
respondents who were absent during data collection can be
replaced
 make sure that their absence is not related to the topic being
studied.
 NB: The number of non-responses should be documented
according to type, so as to facilitate an assessment of the extent
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169. Sample Size determination
 It is a widespread belief among researchers that the
bigger the sample, the better the study becomes.
 This is not necessarily true
 In general it is much better to increase the
accuracy and richness of data collection
(for example by improving the training of interviewers or by
better pre-testing of the data collection tools)
 Also, it is better to make extra efforts to get a
representative sample rather than to get a very
large sample.
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170. Cont…
 Sample size may be determined by using:
 Subjective methods (less sophisticated methods)
The rule of thumb approach: eg. 5% of population
Conventional approach:
eg. Average of sample sizes of similar other studies;
Cost basis approach: The number that can be studied with the
available funds;
Depending on the number of independent variables
 Statistical formulae (more sophisticated methods)
 Confidence interval approach. 12/18/2022
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171. Sample size determination using statistical formulae:
 To determine sample sizes using statistical formulae, researchers
use the confidence interval approach based on the following
factors:
– Desired level of data precision or accuracy;
– Amount of variability in the population (homogeneity);
– Level of confidence required in the estimates of population
values.
 Availability of resources such as money, manpower and time
may prompt the researcher to modify the computed sample size.
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172. Sample size calculations
 In quantitative studies, researchers will perform sample
size calculations before embarking on the project to find
the desirable sample size.
 The formulae for calculating a desired sample are divided
into two categories, depending on whether the study:
 seeks to measure one single variable (e.g. a mean, a rate or
a proportion) in one group with a certain precision, or
 tries to demonstrate a significant difference between two
groups.
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173. Sample size for single population
proportion
 If the study aims to be conducted on single
population, then we need the following:
What is the probability of the event occurring?
How much error is tolerable (confidence interval)? How
much precision do we need?
How confident do we need to be that the true population
value falls within the confidence interval?
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174. Cont..
 n= the desirable calculated sample size
 Z =95% confidence level= 1.96
 p= proportion
If you don’t have any information about P, take it as
50% and get the maximum value of PQ which is 1/4
(i.e., 25%)
 d= degree of accuracy desired setting at (5%)
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175.  If the above sample is to be taken from a relatively
small population (N ≤ 10,000)
 The required minimum sample will be obtained from
the above estimate by making some adjustment.
After calculating the sample we have to
add 5-15% of the sample for non response
rate (NRR).
Reading assignment:
 Estimating a mean
 Comparison of two proportions
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176. Variables
√ A variable is a characteristic of a person, object or
phenomenon which can take on different values.
√ ‘What information are we going to collect in our study to
meet our objectives?’
√ The information may be in the form of numbers (e.g., age)
or non-numerical characteristics (e.g., sex).
√ Numerical Variables: the values of the variables are
expressed in numbers.
√ Categorical Variables: where the variables are expressed
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177. Examples of Numerical variables
 A simple example of a variable in the form of numbers
is ‘a person’s age’.
 The variable ‘age’ can take on different values since a
person can be 20 years old, 35 years old and so on.
 Other examples of variables are:
weight (expressed in kilograms or in pounds);
home - clinic distance (expressed in kilometres or in
minutes walking distance);
monthly income (expressed in dollars, Birr, etc
 number of children (1, 2, etc.).
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178.  Numerical variables can either be continuous or
discrete
 Continuous
 With this type of data, one can develop more and more
accurate measurements depending on the instrument used.
e.g.:
 height in centimeters (2.5 cm or 2.546 cm or 2.543216 cm)
 temperature in degrees Celsius (37.20C or 37.199990C etc.)
 Discrete
 These are variables in which numbers can only have full
values, e.g.: 12/18/2022
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179. Examples of categorical variables
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179

180. Categorical variables can either be ordinal or
nominal
Ordinal variables
These are grouped variables that are ordered or
ranked in increasing or decreasing order:
 For example:
 Monthly income: High income, Middle income and Low
income Disability: no disability, partial disability, serious or
total disability
 Seriousness of a disease: severe, moderate, mild
 Agreement with a statement: fully agree, partially agree, fully
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181.  Nominal variables
 The groups in these variables do not have an order or
ranking in them.
 For example:
 Sex: male, female
 Main food crops: maize, millet, rice, etc.
 Religion: Christian, Muslem, Hindu, Buddhism, etc.
 Blood group: A, B, AB, O
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182. How can we rephrased factors as
variables
When looking at your conceptual framework you
will notice that most of what we called ‘factors’
are in fact variables which have negative values.
As we conduct our study we will try to determine
to what extent these contributing factors play a
role.
 Therefore we have to formulate them in a neutral
way, so that they can take on positive as well as
negative values.
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183. Examples Factors rephrased as variables
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183

184. Dependent and independent
variables
 Because in the health research we often look for
associations, it is important to make a distinction between
dependent and independent variables.
 Both the dependent and independent variables together
with their operational definitions (when necessary) should
be stated.
 Dependent variable: the variable that is used to describe
or measure the problem under study
 Independent variables: the variables that are used to
describe or measure the factors that are assumed to
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185.  Background variables: such as, age, sex, educational
status, monthly family income, marital status and religion
o These are related to a number of independent variables, so
that they influence the problem indirectly.
o Hence they are called background variables or background
characteristics.
Confounding variable - A variable that is associated
with the problem and with a possible cause of the
problem is a potential confounding variable.
 It may strengthen or weaken the apparent relationship
between the problem and a possible cause.
 Composite variable - A variable based on two or more
other variables. Eg. Incidence and prevalence rates, sex
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186. Operationalizing variables by choosing
appropriate indicators
 For some variables it is sometimes not possible to find
meaningful categories unless the variables are made
operational with one or more precise INDICATORS.
 Operationalizing variables means that you make them
‘measurable’
 Eg: In many HSR studies, you want to determine the
level of knowledge concerning a specific issue in order
to find out to what extent the factor ‘poor knowledge’
influences the problem under study
 Eg. low utilization of pre-natal care by pregnant
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187.  The variable ‘level of knowledge’ cannot be measured
as such.
 You would need to develop a series of questions to
assess a woman’s knowledge,
 The answers to these questions form as an indicator of
someone’s knowledge on this issue, which can then
be categorised.
 If 10 questions were asked, you might decide that the
knowledge of those with:
— 0 to 3 correct answers is poor,
— 4 to 6 correct answers is reasonable, and
— 7 to 10 correct answers is good.
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188.  Nutritional status of under-5 year olds is another
example of a variable that cannot be measured
directly and for which you would need to choose
appropriate indicators.
 Widely used indicators for nutritional status
include:
— Weight in relation to age (W/A)
— Weight in relation to height (W/H)
— Height in relation to age (H/A)
— Upper-arm circumference (UAC) 12/18/2022
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189.  For the indicator ‘Weight/Age’, for example, children
are:
— well-nourished if they are above 80% of the standard,
— moderately malnourished if they are between 60%
and 80%, and
— severely malnourished if they are below 60%.
Reading assignment
Scale of measurements:
 Nominal
 Ordinal
 Interval
 Ratio
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190. Plan for data collection
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190
A plan for data collection should be developed so that:
 you will have a clear overview of what tasks have to be
carried out, who should perform them, and the
duration of these tasks;
 you can organise both human and material resources
for data collection in the most efficient way; and
 you can minimise errors and delays which may result
from lack of planning

191. Stages in the Data Collection
Process
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191
Three main stages can be distinguished:
Stage 1: Permission to proceed
Stage 2: Data collection
Stage 3: Data handling

192. Stage 1: permission to proceed
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192
 Consent must be obtained from the relevant authorities,
individuals and the community in which the project is to
be carried out.
 This may involve organizing meetings at national or
provincial level, at district and at village level.
 For clinical studies this may also involve obtaining
written informed consent from the participants.

193. Stage 2: Data collection
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193
 When collecting our data, we have to consider:
I. Logistics of data collection
who will collect what data?
how long will it take to collect the data
when should the data be collected? and with
what resources
II. Quality control
It is extremely important that the data we
collect are of good quality, that is, reliable
and valid.
Otherwise we will come up with false or
misleading conclusions.

194. Measures to help ensure good quality of
data
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194
 Prepare a field work manual for the research team
 Select your research assistants, if required, with care
 Train research assistants carefully in all topics covered
in the field work manual as well as in interview
techniques
 Pre-test research instruments and research procedures
 Arrange for on-going supervision
 Devise methods to assure the quality; Check for
completeness

195. Stage 3: Data Handling
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195
Once the data have been collected and checked
for completeness and accuracy,
a clear procedure should be developed for
handling and storing them.
Decide if the questionnaires are to be numbered;
identify the person who will be responsible for
storing the data; and how they are going to be
stored.

196. Data Collection Techniques
 Overview of Data Collection Techniques
 Design of Research Instruments;
Interview Guides And interview Skills
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197. Overview Of Data Collection Techniques
 Data collection is a crucial stage in the planning and
implementation of a study.
 If the data collection has been superficial, biased or
incomplete, data analysis becomes difficult, and the research
report will be of poor quality.
 Therefore, we should concentrate all possible efforts on
developing appropriate tools, and should test them several
times.
 Depending on the type of study, different data-collection
techniques may be used. 12/18/2022
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198.  Data-collection techniques allow us to systematically
collect information about our objects of study
(people, objects, phenomena) and about the settings in
which they occur.
 If data are collected haphazardly, it will be difficult to
answer our research questions in a conclusive way.
Various data collection techniques can be used such
as:
 Using available information
 Observing
 Interviewing (face-to-face)
Administering written questionnaires
 Focus group discussions
Projective techniques, mapping, scaling
cont..
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199. Using available information
 Usually there is a large amount of data that has already
been collected by others, although it may not necessarily
have been analysed or published.
 Locating these sources and retrieving the information is a
good starting point in any data collection effort.
 E.g. analysis of the information routinely collected by
health facilities can be very useful for:
√ identifying problems in certain interventions or
√ flows of drug supply, or
√ For identifying increases in the incidence of certain
diseases.
 Analysis of health information system data, census data,
unpublished reports and publications
 libraries or in offices at the various levels of health and
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200. Advantages
 they are less time consuming and relatively have
low cost.
Disadvantage
care should be taken on the quality and
completeness of the data.
 There could be differences in objectives between
the primary author of the data and the user.
Note: Usually, Available data forms part of a study in
which other data collection techniques are also used.
Cont...
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200

201. Observation
 It is a technique that involves systematically
selecting, watching and recording behaviour and
characteristics of living beings, objects or phenomena.
 Observation of human behaviour is a much-used data
collection technique.
 It can be undertaken in different ways:
Participant observation: The observer takes part in
the situation he or she observes.
 eg. a doctor hospitalized with a broken hip, who now
observes hospital procedures ‘from within.
Non-participant observation: The observer watches
the situation, openly or concealed, but does not participate.
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202.  Observations can also be made on objects.
For example, the presence or absence of latrine and its
state of cleanliness may be observed.
If observations are made using a defined scale
they may be called measurements.
 Measurements usually require additional tools.
 For example, in nutritional surveillance we measure
weight and height by using weighing scales and a
measuring board.
 We use thermometers for measuring body temperature.
Cont.
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203. Advantages
 Gives more accurate information on behaviour of
people than interviews or questionnaires.
 Used to check on the information collected through
interviews especially on sensitive topics:
 such as alcohol or drug use, or stigmatising
diseases.
 For example, whether community members
share drinks or food with patients suffering
from feared diseases (leprosy, TB, AIDS)
are essential observations in a study on
stigma.
Cont.…
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204. Disadvantages
 time consuming
 used in small-scale studies
 Investigators or observer’s own biases,
prejudice, desires, and etc.
 Needs more resources and skilled human power
during the use of high level machines.
Cont.
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205. Interviewing
It is a data-collection technique that involves oral
questioning of respondents, either individually or as
a group.
Answers to the questions posed during an interview
can be recorded by
writing them down(either during the interview itself or
immediately after the interview) or
by tape-recording the responses, or by a combination of
both.
 Interviews can be conducted with varying degrees of
flexibility.
 High degree of flexibility: The sequence of topics are
determined by the flow of discussion
A flexible method of interviewing is useful if
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205

206. Example: When studying sensitive issues such as
teenage pregnancy and abortions, the investigator
may use a list of topics rather than fixed questions.
 Low degree of flexibility: Less flexible methods
of interviewing are useful when
 the researcher is relatively knowledgeable about
expected answers or
 when the number of respondents being
interviewed is relatively large.
 Then questionnaires may be used with a fixed
list of questions in a standard sequence, which
have mainly fixed or pre-categorised answers.
Cont.…
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206

207. Administering Written Questionnaires
 also referred as self-administered questionnaire
 A written questionnaire can be administered in
different ways such as by:
 Sending questionnaires by mail with clear instructions on
how to answer the questions and asking for mailed
responses
 Gathering all or part of the respondents in one place at one
time, giving oral or written instructions, and letting the
respondents fill out the questionnaires; or
Hand-delivering questionnaires to respondents and
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208. Projective techniques
 When a researcher uses projective techniques, (s)he asks an
informant to react to some kind of visual or verbal stimulus.
 Eg. An informant may be provided with a rough outline of
the body and be asked to draw her or his perception of the
conception or onset of an illness.
 presentation of a hypothetical question or an incomplete
sentence or case/study to an informant (‘story with a gap’).
 A researcher may ask the informant to complete in writing
sentences such as:
 If I were to discover that my neighbour had TB, I would . . .;
 If my wife were to propose that I use condoms, I would . . 12/18/2022
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209. Focus Group Discussion(FGD)
 It is a group discussion of approximately 6 – 12 persons
guided by a facilitator, during which group members talk
freely and spontaneously about a certain topic.
 A FGD is a qualitative method.
 Its purpose is to obtain in-depth information on
concepts, perceptions and ideas of a group.
 A FGD aims to be more than a question-answer
interaction.
 The idea is that group members discuss the topic
among themselves, with guidance from the facilitator.
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210. Uses of FGD techniques
Focus research and develop relevant research
hypotheses by exploring in greater depth the
problem to be investigated and its possible causes.
Formulate appropriate questions for more
structured, larger scale surveys.
Help understand and solve unexpected problems in
interventions.
Develop appropriate messages for health education
programmers and later evaluate the messages for
clarity.
Explore controversial topics.
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211. How To Conduct A Focus Group Discussion
 Determine the purpose
 Situation analysis
 Recruitment of participants:
 Physical arrangements:
 Preparation of a discussion guide
 Conducting the session
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212. Functions of the facilitator in FGD
 Introduce the session
 Encourage discussion
 Encourage involvement
 Avoid being placed in the role of expert
 Control the rhythm of the meeting, but in an unobtrusive
way
 Take time at the end of the meeting to summarise,
check for agreement and thank the participants
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213. Functions of the recorder
 Items to be recorded include:
 Date, time, place, names and characteristics of participants
 General description of the group dynamics (level of
participation, presence of a dominant participant, level of
interest)
 Opinions of participants, recorded as much as possible in
their own words, especially for key statements
 Emotional aspects (e.g., reluctance, strong feelings attached
to certain opinions)
 Vocabulary used - assist in developing questionnaires or
health education materials spontaneous relevant discussions
during breaks or after the meeting has been close
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214. Functions of the recorder cont.…
 It is highly recommended that a tape-recorder be used to
assist in capturing information.
 Even if a tape-recorder is used, notes should be taken as
well
in case the machine malfunctions and so that information
will be available immediately after the session for
discussion.
 A supplementary role for the recorder could be to assist
the facilitator
 If necessary, the recorder could also help resolve conflict
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215. Mapping and scaling
Mapping is a valuable technique for visually
displaying relationships and resources.
Scaling is a technique that allows researchers
through their respondents to categories certain
variables that they would not be able to rank
themselves.
For example, they may ask their informant(s) to
bring certain types of herbal medicine and ask them
to arrange these into piles according to their
usefulness.
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216. Table: Differentiation between data collection
techniques and data collection tools
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217. Advantages and disadvantages of various
data collection techniques
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219. Design Of Research Instruments; Interview
Guides And Interview Skills
 The quality of research depends to a large extent on the
quality of the data collection tools.
 Interviewing and administering questionnaires are
probably the most commonly used research techniques.
 Therefore designing good ‘questioning tools’ forms an
important and time-consuming phase in the
development of most research proposals.
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220.  Once the decision has been made to use these tools,
the following questions should be considered before
designing them:
 What exactly do we want to know, according to the
objectives and variables we identified earlier?
 Is questioning the right technique to obtain all answers,
or do we need additional techniques, such as
observations or analyses of records?
 Of whom will we ask questions and what techniques will
we use?
 Do we understand the topic sufficiently to design a
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221.  Are our informants mainly literate or illiterate? (If
illiterate, the use of self-administered questionnaires is
out of the question)
 How large is the sample that will be interviewed?
 Studies with many respondents often use shorter,
highly structured questionnaires
 while smaller studies allow more flexibility and may
use interview guides or questionnaires with a number
of open-ended questions.
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222. Types Of Questions
 Depending on how questions are asked and recorded
we can distinguish two major possibilities:
 open-ended questions, (allowing for completely open
as well as partially categorized answers), and
closed questions.
 Completely open-ended questions
 Permit free responses which should be recorded in the
respondents’ own words
 Such questions are useful for obtaining in-depth
information on:
o facts with which the researcher is not very familiar,
o opinions, attitudes and suggestions of informants, or
o sensitive issues.
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223. Examples of open ended questions :
‘What is your opinion on the services provided in the
ANC?’
(Explain why.)
‘What do you think are the reasons some
adolescents in this area start using drugs?’
‘What would you do if you noticed that your daughter
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224. Advantages of completely open-ended
questions
 Allow you to probe more deeply into issues of interest
being raised.
 Issues not previously thought of when planning the
study may be explored, thus providing valuable new
insights on the problem.
 Information provided in the respondents’ own words
might be useful as examples or illustrations, which
add interest to the final report.
 Often, re-reading an answer in a later phase of the
analysis offers the possibility for different
interpretations in relation to other data collected,
 which would have been impossible if the answer had
been pre-categorised. 12/18/2022
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225. Risks of completely open-ended
questions
 Skilled interviewers are needed to get the discussion
started and focused on relevant issues and to record
all information collected.
 A big risk is incomplete recording of all relevant issues
covered in the discussion.
 Analysis is time-consuming and requires experience;
otherwise important data may be lost.
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226. Suggestions to improve use of completely
open-ended questions
 Thoroughly train and supervise the interviewers or
select experienced research assistants.
 Prepare a list of further questions to keep at hand to
use to ‘probe’ for answer(s) in a systematic way.
 Pre-test open-ended questions and, if possible, pre-
categorise the most common responses, leaving
enough space for other answers
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227. Closed questions
Have a list of possible options or answers from
which the respondents must choose.
most commonly used for background variables
such as age, marital status or education,
although in the case of age and education you may
also take the exact values and categories them
during data analysis.
Closed questions may be used to get the
respondents to express their opinions or attitudes
by choosing rating points on a scale.
For example: likert scale questions
‘Women who have induced abortion should be severely
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228.  Closed questions may also be used if one is only
interested in certain aspects of an issue and
 does not want to waste time obtaining more information
than one needs.
 Advantages
• It saves time
• Comparing responses of different groups, or of
the same group over time, becomes easier.
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229. Risks of closed questions
• In case of illiterate respondents, the interviewer
may be tempted to read the list of possible
answers in the given sequence, thereby
influencing the choice of response and
introducing bias.
• If there is no question to elaborate on the
informant’s reasons for choosing a certain
rating,
 uniformity in rating may still be deceptive, as there may
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230. Suggestions to minimise risk associated with using
closed questions:
• Develop picture codes can be used for illiterates as well
as literates (e.g., five, four, three, two and one stars
indicating a 5-point scale).
• First present the extremes and then the values in
between so that the respondent is straight away aware
of the range of answers.
• Ensure inclusion of follow up questions to elaborate on
reasons for choosing a given rating. 12/18/2022
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231. Steps in designing a questionnaire/
interview guide
 Designing a good questionnaire always takes
several drafts.
 In the first draft we should concentrate on the
content.
 In the second, we should look critically at the
formulation and sequencing of the questions.
 Finally we should do a test run to check whether the
questionnaire gives us the information we require
and
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232. Step 1: Content
Take your objectives and variables as a starting
point.
Decide what questions will be needed to measure
your variables and reach your objectives.
When developing the questionnaire, you should
reconsider the variables you have chosen and, if
necessary, add, drop or change some.
 You may even change some of your objectives at
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233. Step 2: Formulating questions
Formulate one or more questions that will provide
the information needed for each variable.
 Take care that questions are specific and precise
enough so that different respondents don’t interpret
them differently.
 The question therefore, as a rule, has to be broken
up into different parts and made so specific that all
informants focus on the same thing.
Check whether each question measures one thing
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234. Avoid leading questions
 A question is leading if it suggests a certain answer.
 eg: the question, ‘Do you think that people have to
give bribes at hospital X to be seen by a doctor?’
hardly leaves room for ‘no’ or for other options.
 A better question would be: ‘Have you recently
visited hospital X?’
 This would be followed by a series of other probing
questions such as, ‘By whom were you seen?’
 ‘What were the complaints?’ ‘How much were you
asked to pay?’
 ‘Do all patients have equal access to a doctor in
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235. Avoid words with double or vaguely defined meanings
or that are emotionally laden.
Ask sensitive questions in a socially acceptable way:
Questions relating to abortion, sexual practices of
adolescents, or AIDS and mental illness in the family are
usually sensitive.
Such questions should be formulated in such a way that
the question does not judge or embarrass the
respondent.
For example: ‘Many teenagers have had abortions for
unwanted pregnancies. Do you know girls who had this
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236. Step 3: Sequencing the questions
Design your interview schedule or questionnaire to
be ‘informant friendly’.
The sequence of questions must be logical for the
informant and
allow, as much as possible, for a ‘natural’
conversation, even in more structured interviews.
At the beginning of the interview a limited number of
questions concerning ‘background variables’
e.g., age, education, marital status may be asked.
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237. Start with an interesting but non-controversial
question (preferably open) that is directly related to
the subject of the study.
This type of beginning should help to raise the
informants’ interest and lessen suspicions
concerning the purpose of the interview.
Pose more sensitive questions as late as possible
in the interview.
Use simple, everyday language.
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238. Step 4: Formatting the questionnaire
 When you finalise your questionnaire, be sure that:
 A separate, introductory page is attached to each
questionnaire,
 explaining the purpose of the study,
 requesting the informant’s consent to be interviewed and
 assuring confidentiality of the data obtained.
Layout: is such that questions belonging together
appear together visually.
 If the questionnaire is long, you may use
subheadings for groups of questions.
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239. Sufficient space is provided for answers to open-
ended questions, categories such as ‘other’ and for
comments on pre-categorised questions
Boxes for pre-categorised answers are placed in a
consistent manner (e.g., on the right half of the
page).
For written questionnaires, however, clear
guidelines will have to be added on how the
answers to questions should be filled in.
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240. Step 5: Translation
If interviews will be conducted in one or more local
languages,
the questionnaire should be translated in order to
standardize the way questions will be asked.
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