Copyright © 2012 Wolters Kluwer Health Lippincott Williams.docx

Copyright © 2012 Wolters Kluwer Health | Lippincott Williams
& Wilkins
Chapter 8
Planning a Nursing Study
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Question
Tell whether the following statement is true or false:
The major methodologic challenge in designing a qualitative
study is that it is reliable and valid.
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Answer
False
Researchers face numerous conceptual, practical, ethical, and
methodologic challenges in planning a study. The major
methodologic challenge is designing a study that is reliable and
valid (quantitative studies) or trustworthy (qualitative studies).

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Question
Validity refers to the accuracy and consistency of information
obtained in a study.
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Answer
False
Reliability refers to the accuracy and consistency of information
obtained in a study. Validity is a more complex concept that
broadly concerns the soundness of the study’s evidence.
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Key Challenges of Doing ResearchConceptualFinancial
Administrative Practical Ethical ClinicalMethodologic
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Major Methodologic Challenge

Designing studies that are: Reliable and valid (quantitative
studies)Trustworthy (qualitative studies)
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Criteria for Evaluating Quantitative Research Reliability
The accuracy and consistency of obtained information
Validity
The soundness of the evidence—whether findings are
convincing, well-grounded
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Question
Confirmability refers to evidence of the researcher’s
objectivity.
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Answer
True
Confirmability refers to evidence of the researcher’s
objectivity.
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Dimensions of Trustworthiness in Qualitative
StudiesCredibilityConfirmabilityDependabilityTransferabilityA
uthenticity
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TriangulationMultiple sourcesDraw conclusionsOne approach to
establish credibility
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Bias
An influence producing a distortion in study results
Examples of factors creating bias:Lack of participants’
candorFaulty methods of data collectionResearcher’s
preconceptionsFaulty study design

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Research Control in Quantitative Studies
Achieved by holding constant factors (extraneous variables) that
influence the dependent variable in order to better understand
its relationship with the independent variable
Randomness: an important tool for achieving control over
extraneous variables
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RandomnessHaving certain features of the study established by
chance rather than by design or personal preference
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ReflexivityProcess of reflecting critically on the self and of
scrutinizing personal values that could affect data collection

and interpretation
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Generalizability and Transferability
Generalizability (quantitative research): the extent to which
study findings are valid for other groups not in the study
Transferability (qualitative research): the extent to which
qualitative findings can be transferred to other settings
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Overview of Research Design Features
Comparisons:
Comparison among two or more groups
Comparison of one group’s status at two or more points in time
Comparison of one group’s status under different circumstances
Comparison based on relative rankings
Comparison with other studies
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Research LocationSite selectionsSite visits
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DesignCross-sectional: involves data collection at one point in
timeLongitudinal: involves data collection at two or more points
over an extended period
– Trend studies
– Panel studies
– Follow-up studies
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Retrospective Design versus
Prospective DesignRetrospective design: involves the collection
of data about an outcome in the present and about possible
causes or antecedents in the pastProspective design: involves
having information about a cause or antecedent first and then

the subsequent collection of information about outcomes
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Self-ReportDirect questioning of people about phenomena of
interestVersatilePowerfulRespondents’ deliberate or inadvertent
misrepresentations
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Biophysiologic MeasuresHigh-quality dataObjectiveValidCost-
efficient
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RecordsEconomical sourceBias:Selective depositSelective
survival
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Pilot Study (Feasibility Study)Small-scale version or trial run
designed to test methods to be used in a larger, more rigorous
study (the parent study)

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Chapter 7
Ethics in Nursing Research
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Question
An ethical dilemma occurs when a situation in which the rights
of study participants are in direct conflict with requirements for
a rigorous study.
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Answer
True
An ethical dilemma is situation in which the rights of study

participants are in direct conflict with requirements for a
rigorous study.
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Ethical Dilemma in Conducting ResearchA situation in which
the rights of study participants are in direct conflict with
requirements for a rigorous study
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Question
The Nuremberg Code serves as the basis for regulations
affecting research sponsored by the U.S. government.
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Answer
False
The Belmont Report serves as the basis for regulations affecting
research sponsored by the U.S. government. The Nuremberg
Code was an international effort to establish ethical standards.

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Code of EthicsNuremberg Code Declaration of Helsinki
Belmont Report Codes for professional disciplines (e.g., by the
American Nurses Association, American Psychological
Association)
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Question
What is nonmaleficence?
Performance of some good
Protection from physical and psychological harm and
exploitation
Participants right to self-determination
Freedom to control their own actions
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Answer
B
Beneficence involves the performance of some good, and the
protection of participants from physical and psychological harm
and exploitation is nonmaleficence. Respect for human dignity
involves participants’ right to self-determination, which means
they have the freedom to control their own actions.

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Question
Justice includes the right to fair treatment and the right to
privacy.
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Answer
True
Justice includes the right to fair treatment and the right to
privacy.
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Ethical Principles from the Belmont Report
Principle of Beneficence: Above all,
do no harm.
Freedom from harm
Freedom from exploitation
Maximizing benefits to participants and society
Maintaining an appropriate risk/benefit ratio
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Ethical Principles from the Belmont Report (cont.)
Principle of Respect for Human
Dignity
Right to self-determination (absence of coercion)
Right to full disclosure (absence of deception or concealment)
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Ethical Principles from the Belmont Report (cont.)
Principle of Justice
Right to fair treatment
Right to privacy (confidentiality, anonymity)
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Informed Consent
Informed consent means that participants:Have adequate
information about the research Can comprehend that
information Have free choice in deciding whether to

participate in or withdraw from the study
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Content of Informed Consent—What Must Be
Communicated?Status as a study participant Study goals Type
of data to be collected and procedures to be used Nature of
participant’s commitment
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Content of Informed Consent (cont.)Sponsorship of the study
Participant selection Potential risks and benefits Treatment
alternatives
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Content of Informed Consent (cont.)Confidentiality pledge

Voluntary nature of participation Participant’s right to
withdraw or withhold information Information on contacting
researcher
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Vulnerable SubjectsChildren Mentally or emotionally disabled
people Severely ill or physically disabled people Terminally
ill people Institutionalized people Pregnant women
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Chapter 6
Theoretical Frameworks
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Question
A theory is an abstraction that purports to account for or
explain phenomena.
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Answer
True
A theory is an abstraction that purports to account for or
explain phenomena.
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Question
What is a descriptive theory?
An abstract generalization that systematically explains
relationships among phenomena
A theory that thoroughly describes a phenomenon, based on rich
observations of it
A theory attempt to describe large segments of the human
experience
A theory that focuses on a specific aspect of human experience

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Answer
B
Classical theory: an abstract generalization that systematically
explains relationships among phenomena
Descriptive theory: a theory that thoroughly describes a
phenomenon, based on rich observations of it
Grand theory: a theory that attempts to explain large aspects of
human experience
Middle-range theory: a theory that focuses on a specific aspect
of human experience
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Theory
An abstraction that purports to account for or explain
phenomena Classical theory: an abstract generalization that
systematically explains relationships among phenomena
Descriptive theory: a theory that thoroughly describes a
phenomenon, based on rich observations of it
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Theory (cont.)Grand theory: a theory that attempts to explain
large aspects of human experience Middle-range theory: a
theory that focuses on a specific aspect of human experience

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Question
Schematic models are graphic, theory-driven representations of
phenomena and their interrelationships using symbols or
diagrams and a minimal use of words.
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Answer
True
Schematic models are graphic, theory-driven representations of
phenomena and their interrelationships using symbols or
diagrams and a minimal use of words.
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Conceptual ModelsDeal with abstractions, assembled in a
coherent schemeRepresent a less formal attempt than theories to
explain phenomena Do not have formal propositions about
relationships among phenomena
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FrameworkTheoretical framework (based on theory) Conceptual
framework (based on a conceptual model)
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Commonalities between Theories and Conceptual ModelsUse
concepts as building blocksRequire conceptual definitions of
key conceptsCan be depicted in a schematic modelAre created
by humansAre developed inductively
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Commonalities between Theories and Conceptual Models
(cont.)Cannot be proven—they are supported to greater or lesser
degreesCan be used to generate hypotheses Can serve as a
stimulus to research

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5-Step Process for Developing Conceptual Definitions
Develop a preliminary definition.
Do an in-depth literature review.
Identify exemplary cases.
Map the concept’s meaning.
State the revised conceptual
definition.
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Conceptual Models of Nursing
Formal explanations of what nursing practice is
Four concepts central to models of nursing:Person
EnvironmentHealthNursing
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Conceptual Models Used Frequently by Nurse Researchers
Conceptual models of nursing:
Roy’s Adaptation Model
Rogers’ Science of Unitary Human Beings
Other models developed by nurses:
Pender’s Health Promotion Model (HPM)
Mishel’s Uncertainty in Illness Theory
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Examples of Non-Nursing Models by Nurse
ResearchersBecker’s Health Belief Model (HBM)Lazarus and
Folkman’s Theory of Stress and CopingBandura’s Social
Cognitive TheoryAjzen’s Theory of Planned Behavior (TPB)
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The Use of Theories or Models in Quantitative ResearchTesting
a theoryTesting two competing theoriesUsing a theory/model as
an organizing structureFitting a problem into theory Developing
an original theory/model

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Question
What type of theory do some qualitative researchers seek to
develop that provide data-driven explanations to account for
phenomena under study?
Grounded
Ethnography
Phenomenology
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Answer
A
Some qualitative researchers specifically seek to develop
grounded theories, data-driven explanations to account for
phenomena under study through inductive processes.
Ethnography is cultural theories—ideational and materialistic.
Phenomenology is the phenomenologic theory of human
experience.
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Theories in Qualitative ResearchSubstantive theory—

conceptualizations of the target phenomenaTheory embedded in
a research tradition
Grounded theory (symbolic interactionism)
Ethnography (cultural theories: ideational and materialistic)
Phenomenology (phenomenologic theory of human experience)
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Examples of Questions to Assess a
Model or TheoryClarity: Are key concepts defined? Are
definitions clear?Complexity: Is the theory sufficiently rich?
Overly complex?Grounding: Is there an empirical basis for the
theory?
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Examples of Questions to Assess a Model or Theory
(cont.)Appropriateness: Are key concepts within the domain of
nursing?Importance: Will testing the theory contribute to
nursing’s evidence base?Competition: Are there theories that
better explain the key phenomenon?

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