Chapter 17 Understanding Research Findings Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. * Learning Outcomes Discuss the difference between the “Results” section of a study and the “Discussion” section Identify the format of the “Results” section Determine whether both statistically supported and statistically unsupported findings are discussed Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. * Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. * Learning Outcomes Determine whether the results are objectively reported Describe how tables and figures are used in a research report List the criteria of a meaningful table Identify the format and components of the “Discussion” section Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. * Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. * Learning Outcomes Determine the purpose of the “Discussion” section Discuss the importance of including generalizations and limitations of a study in the report Determine the purpose of including recommendations in the study report Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. * Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. * Learning Outcomes Discuss how the strength, quality, and consistency of evidence provided by the findings are related to a study’s limitations, generalizability, and applicability to practice Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. * Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. * Findings Results, conclusions, interpretations, recommendations, generalizations, and implications for future research and nursing practice Presented in two major areas: Results Discussion of the results Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. * Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint of Elsevier Inc. * Findings are the results, conclusions, interpretations, recommendations, generalizations, and implications for future research and nursing practice Presented in two major areas: the Results and the Discussion of the results. The “Results” section focuses on the results or statistical findings of a study“Discussion” section focuses on the remaining topics Results Section Also called: Statistical analyses Data analysis Analysis Should reflect analysis of each research question or hypothesis tested Identifies tests used Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986 by Mosby, an imprint ...

1. Chapter 17
Understanding Research Findings
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by Mosby, an imprint of Elsevier Inc.
*
Learning Outcomes
Discuss the difference between the “Results” section of a study
and the “Discussion” section
Identify the format of the “Results” section
Determine whether both statistically supported and statistically
unsupported findings are discussed
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by Mosby, an imprint of Elsevier Inc.
*
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*

2. Learning Outcomes
Determine whether the results are objectively reported
Describe how tables and figures are used in a research report
List the criteria of a meaningful table
Identify the format and components of the “Discussion” section
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Learning Outcomes
Determine the purpose of the “Discussion” section
Discuss the importance of including generalizations and
limitations of a study in the report
Determine the purpose of including recommendations in the
study report
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3. Learning Outcomes
Discuss how the strength, quality, and consistency of evidence
provided by the findings are related to a study’s limitations,
generalizability, and applicability to practice
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Findings
Results, conclusions, interpretations, recommenda tions,
generalizations, and implications for future research and
nursing practice
Presented in two major areas:
Results
Discussion of the results
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Findings are the results, conclusions, interpretations,
recommendations, generalizations, and implications for future
research and nursing practice
Presented in two major areas: the Results and the Discussion of
the results. The “Results” section focuses on the results or

4. statistical findings of a study“Discussion” section focuses on
the remaining topics
Results Section
Also called:
Statistical analyses
Data analysis
Analysis
Should reflect analysis of each research question or hypothesis
tested
Identifies tests used
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Where the quantitative data or numbers generated by the
descriptive and inferential statistical tests are presented
The results section may also be called theStatistical analyses
Data analysis Analysis
Should reflect analysis of each research question and/or
hypothesis tested.
The tests used to analyze the data should be identified. If the
exact test that was used is not explicitly stated, then the values
obtained should be noted.
Results Section
Relevance or usefulness of findings:

5. Statistically significant findingsDesign strengthLimitations
identifiedBias controlled
Unsupported hypothesisTesting existing practiceBasis for
continued research
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If a hypothesis is not supported statistically, or it is only
partially supported, the study is still relevant.
Unsupported studies can be used to identify limitations
(problems with the study’s validity, bias, or study weaknesses).
Data from unsupported studies may suggest that current modes
of practice or current theory in an area may not be supported
and should be reexamined and researched further.
Role of Tables and Figures
To report results with some detail that the investigator does not
explore in the text
A good table is one that meets the following criteria:
Supplements and economizes the text
Has precise titles and headings
Does not repeat the text
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6. *
Discussion Section
Discussion of the findings
The study’s limitations
Recommendations for
Practice
Future research
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Contains theDiscussion of the findingsThe study’s limitations
Recommendations for practice Recommendations for future
research
Enables the research consumer to judge the validity of the
interpretations drawn from the data and the general worth of the
study
Recommendations Section
Suggestions for application to:
Practice
Theory
Further research
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The investigator’s suggestions for the study’s application to
practice, theory, and further research:What contribution to
nursing does this study make?What are the strength, quality,
and consistency of the evidence provided by the findings?Does
the evidence provided in the findings validate current practice
or support the need for change in practice?
Critiquing Criteria for Research Findings
Are the results of each of the hypothesis presented?
Is the information regarding the results concisely and
sequentially presented?
Are the tests that were used to analyze the data presented?
Are the results presented objectively?
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Critiquing Criteria for Research Findings
If tables or figures are used, do they meet the follow ing
standards?
They supplement and economize the text.

8. They have precise titles and headings.
They are not repetitious of the text.
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Critiquing Criteria for Research Findings
Are the results interpreted in light of the hypothesis and
theoretical framework, and all of the other steps that preceded
the results?
If the data are supported, does the investigator provide a
discussion of how the theoretical framework was supported?
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Critiquing Criteria for Research Findings
How does the investigator attempt to identify the study’s
weaknesses (i.e., threats to internal and external validity and
strengths) as well as suggest possible solutions for the research

9. area?
Does the researcher discuss the study’s clinical relevance?
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Critiquing Criteria for Research Findings
Are any generalizations made, and if so are they within the
scope of the findings or beyond the findings?
Are any recommendations for future research stated or implied?
What is the study’s strength of evidence?
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The ultimate goal of nursing research is to do what?
Develop nursing knowledge and evidence-based nursing
practice
Get nurses into the practice of research
Increase the amount of quantitative nursing studies

10. Develop clinical evidence for practice
Prove standards of care
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ANSWER: A
RATIONALE: Developing nursing knowledge and evidence-
based nursing practice is the goal of nursing research, thereby
supporting the scientific basis of nursing.
*
Where are the data points interpreted in the research report?
Findings
Results
Recommendations
Discussion
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ANSWER: D
RATIONALE: Discussion; the data points are presented in
“Results” but interpreted in “Discussion.”
*

11. Chapter 3
Gathering and
Appraising the Literature
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Literature Review
A systematic and critical appraisal
Provides the development and foundation of a research study
Provides the development and foundation of the theoretical
framework
ESSENTIAL to evidence-based nursing practice
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Literature Review
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12. *
Theoretical or Conceptual Framework
The basis for the development of research questions or
hypotheses
Can be viewed as a map for understanding the relationships
between or among the variables in quantitative studies
Presents the context for studying the problem
Often illustrated using a diagram
Integral to practice and research
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Sources for Literature Review
Primary: Research articles and books by the original author
Secondary: Published articles or books that are written by
persons other than the individual who conducted the research
study or developed the theory
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Literature Review: Components of Research Process
Research question and hypothesis
Design and method
Outcome of the analysis
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Outcome of the Analysis
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14. Goal of the Literature Review
Researcher
Develop the knowledge foundation necessary to design a sound
study
Generate research questions and hypotheses
Consumer
Answer a clinical question or solve a problem to improve
patient outcomes
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Literature Review: Researcher’s Perspective
Facilitates understanding of the problem by identifying a
theoretical or conceptual framework to provide a context
Discover what is known and not known to refine the research
question and hypothesis
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15. Literature Review: Researcher’s Perspective
Assists in the design and methods to be used
Allows interpretation and discussion of the outcome of the
analysis by comparison with previous studies
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Literature Review: Consumer’s Perspective
Answer a clinical question or solve a problem to improve
patient outcomes by:
Identifying and gathering evidence
Critically appraising and synthesizing evidence
Assessing the usefulness of the evidence in changing practice
Changing practice to improve outcomes or justify current
interventions
Developing evidence-based practice projects
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16. *
Literature Review: Consumer’s Perspective
First three steps of evidence-based practice process:
Asking clinical questions
Identifying and gathering evidence
Critically appraising and synthesizing the evidence or literature
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PICO Format
n; what intervention or event will be studied?
be compared?
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17. Hierarchy of Preappraised Evidence
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Computerized Decision Support System
Integrates evidence-based clinical information into an electronic
medical record. In these systems, specific patient data can be
entered and then matched against a knowledge base to generate
patient-specific recommendations or assessments.
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Summaries
Clinical practice guidelines and electronic evidence-based
textbooks

18. Evidence-based guidelines that provide recommendations based
on high-quality evidence
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Synopsis of Synthesis
Provides a preappraised summary of systematic review
Synopses provide a synthesis of the review; some include a
commentary related to strength of the evidence and applicability
to a patient population
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Synthesis
Systematic reviews (e.g., a Cochrane review) are a synthesis of
research on a clinical topic conducted by multiple experts.
They include quantitative summaries, meta-analysis.
Synopsis of single studies: Keep in mind that a synopsis of a

19. single study, while critically preappraised, still remains a single
study. Most often, significant practice changes are not based on
the results of a single study.
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Studies
“Synopsis of a Single Study” appraisal conducted by a single
expert
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Types of Resources
Print and electronic books, journals, indexes
Refereed or peer-reviewed journal articles are the best choice
because they contain the latest information.
Books take longer to publish than journals.
Print indexes are needed for sources not available in online

20. databases.
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What Is a Refereed or
Peer-Reviewed Journal?
A panel of scholars who are experts review submitted
manuscripts.
Usually the reviews are "blind” to promote objectivity; that is,
the manuscript to be reviewed does not include the name of the
authors.
The reviewers use a set of scholarly criteria to judge whether a
manuscript meets the publication standards of the journal.
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Types of Resources

21. Electronic databases
Used to find journals, publications of professional
organizations, and publications of government agencies
CINAHL: Cumulative Index to Nursing and Allied Health
Literature
MEDLINE
PubMed
Cochrane Library
Search engines
Electronic databases
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How Far Back?
A general timeline for most academic or evidence-based
practice papers/projects is to go back in the literature at least 3
years, and preferably 5 years.
Some research projects may warrant going back 10 or more
years.
Extensive literature reviews on particular topics or a concept
clarification methodology study helps limit the length of the
search.
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22. *
Using Electronic Databases
Find right terms to “plug in”
Controlled vocabulary
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CINAHL in the EBSCO Interface
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Venn Diagram

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Boolean Operators
Boolean operators define the relationships between words or
groups of words in a literature search.
Boolean operators dictate the relationship between words and
concepts:
“AND” requires both concepts to be located within the results
that are returned.
“OR” allows the grouping together of like terms or synonyms.
“NOT” eliminates terms from the search.
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Appraising the Evidence
Organized
Strong knowledge base

24. Quantitative (meta-analyses) and qualitative (meta-syntheses)
systematic reviews
“Does the literature search seem adequate?”
“Does the report demonstrate scholarly writing?”
The key to a strong literature review is a careful search of
published and unpublished literature.
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Clinical Guidelines
www.guidelines.gov
www.cochrane.org
Websites of national organizations, for example:
www.ons.org
www.americanheart.org
www.strokeassociation.org
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25. WARNING
Searching with Google, Ask.com, Lycos, or other search
engines is an inefficient use of time. It can be very difficult,
especially for beginners, to judge the scholarly merit of
information obtained this way.
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Librarian: Your New Best Friend
Visit your university or institution’s library and ask a librarian
for help accessing electronic databases. Librarians are experts
and usually are glad to help.
Learn to use at least two databases.
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How Far Back Should a Search Go?

26. Usually 5 years is good, but some advanced projects may
require searches that go back 10+ years.
Although systematic reviews contain secondary sources, they
can give a scholarly overview of a topic and are helpful in
deciding how far back to search.
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Critiquing the Literature Review
Are all the relevant concepts and variables included in the
literature review?
Does the search strategy include an appropriate and adequate
number of databases and other resources to identify key
published and unpublished research and theoretical sources?
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Critiquing the Literature Review

27. Are both theoretical and research literature included?
Is there an appropriate theoretical or conceptual framework that
guides the development of the research study?
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Critiquing the Literature Review
Are primary sources mainly used?
What gaps or inconsistencies in knowledge does the literature
review uncover?
Does the literature review build on earlier studies?
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Critiquing the Literature Review
Does the summary of each reviewed study reflect the essential
components of the study design?
Type and size of sample

28. Reliability and validity of instruments
Consistency of data collection procedures
Appropriate data analysis
Identification of limitations
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Critiquing the Literature Review
The critique of each reviewed study should include
Strengths
Weaknesses
Limitations of the design
Conflicts
Gaps in information
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Critiquing the Literature Review

29. Does the synthesis summary follow a logical sequence that
presents the overall strengths and weaknesses of the reviewed
studies and arrive at a logical conclusion?
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Critiquing the Literature Review
Is the literature review presented in an organized format that
flows logically?
The literature review should clearly outline the need for the
particular research study or evidence-based practice project.
Does the literature review follow the proposed purpose of the
research study or evidence-based practice project?
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Critiquing the Literature Review
Does the literature review generate research questions or

30. hypotheses or answer a clinical question?
HELPFUL HINT:
Making a table using critical appraisal criteria is a helpful way
to organize information.
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Which source provides the most information on evidence-based
practice?
CINAHL
MEDLINE
PsycINFO
Cochrane Systematic Review
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by Mosby, an imprint of Elsevier Inc.
ANSWER: D
RATIONALE: Cochrane Systematic Review according to the
Search for Evidence critical thinking decision path. CINAHL is
great for nursing research, MEDLINE is great for medical
research, and PsycINFO is used for research on human
behavior. But the systematic review, even though it is a

31. secondary source, is a higher-level information resource.
Evidence-based nursing would be a higher and better selection.
Although systematic reviews are considered to be examples of
secondary sources because they represent a body of completed
research studies that have been critically appraised and
synthesized by a team other than the original researchers, they
often represent the best available evidence on a particular
clinical issue.
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A nurse researcher finds four useful resources. What is an
appropriate next action?
Decide whether the four resources provide a strong enough
base for the topic.
Review the resources in the articles.
Talk to the librarian.
Expand the topic.
Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986
by Mosby, an imprint of Elsevier Inc.
*
Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986
by Mosby, an imprint of Elsevier Inc.
ANSWER: B
RATIONALE: Review references in the resources. Although a
few articles may be comprehensive, it is not likely. Before
talking to the librarian, review the references in the resources.
They often lead to another path of resources. And if all else
fails, you may need to expand your topic.
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32. The author of the nursing theory on which you are basing a
review is in attendance at a social function. What might you do
next?
Introduce yourself and ask a few questions about your topic.
Introduce yourself and ask for an appointment at a later date.
Listen on the fringe of the discussion.
Realize that this is a social function and do not talk “business.”
Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986
by Mosby, an imprint of Elsevier Inc.
*
Copyright © 2014, 2010, 2006, 2002, 1998, 1994, 1990, 1986
by Mosby, an imprint of Elsevier Inc.
ANSWER: B
RATIONALE: Introduce yourself and ask for an appointment at
a later date. This would be most appropriate after you explain
your intention. The theorist may prefer to discuss your project
at the function, but asking for an appointment allows the
theorist some flexibility. Never underestimate yourself by not
introducing yourself. Also, a nursing function is an opportunity
to meet other nurses and to discuss pertinent topics.
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