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B. 11 12. basic research concepts, history, trends & types of study.


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B. 11 12. basic research concepts, history, trends & types of study.

  2. 2. Basic Research Concepts Dr. R S Mehta, MSND, BPKIHS 2
  3. 3. Research in Nursing: 1. Thermometer: Keep Dry and Clean 2. Cheatle Forcep: keep Dry Sterile Container 3. Soup Case near sink: source of Bacteria 4. Hand washing towel: source of infection 5. Room temperature water: for cold sponge 6. Instrument in cidex : Source of infection 7. OT/Bed: Contaminated: infection rate high 3Dr. R S Mehta, MSND, BPKIHS
  4. 4. What is research? A systematic process of inquiry Goal directed Focused on uncovering new knowledge to help understand phenomena, answer questions, or address problems
  5. 5. Research• Research means “ to search again or carefully examine” (Langford 2001).• “A systematic study of problems in patient care.” - Diers Dr. R S Mehta, MSND, BPKIHS 5
  6. 6. Abdellah• “A systematic detailed attempt to discover or confirm facts that relate to a specific problem to improve the practice and profession of nursing.”
  7. 7. Polit and Hungler• “A systematic search for knowledge about issues of importance to nursing.”
  8. 8. Henderson• “A study of the problems in practice relating to the effects of nursing.”
  9. 9. What makes nursing research?Nursing research is “a scientific process that validates and refines existing knowledge and generates new knowledge, which directly and indirectly influences nursing practice” (Burns & Grove, 2005)
  10. 10. Definition of Nursing Research… ___________________________• An organized, systematic, data-based critical scientific inquiry or investigation into a specific problem, undertaken with the objective of finding answers or solutions to it. Dr. R S Mehta, MSND, BPKIHS 10
  11. 11. GOALS OF NURSING RESEARCH_________________________________1. Improve nursing care2. Improve patient care outcomes3. Improve quality of life4. Define and expand the scope of nursing practice Dr. R S Mehta, MSND, BPKIHS 11
  12. 12. Utilization of Nursing Research Findings______________________________1. To restore health.2. To prevent illness.3. To minimize the effects of acute & chronic illness & disability. Research: Synonyms of problem solving Dr. R S Mehta, MSND, BPKIHS 12
  13. 13. Inductive Approach = Observation to Idea Deductive Reasoning = General to Specific Laws HypothesisDeductive Concepts Inductive ApproachApproach Facts Empirical observations Dr. R S Mehta, MSND, BPKIHS 13
  14. 14. Tips for research projects:• Title : must be one breath• Theoretical base to support empirical data• Conceptual frame work clear• Objective maximum three• Objectives moves round the title• Title must be like dani ( bamboo stick for paddy removal using oxes)• Methodology to achieve objectives Dr. R S Mehta, MSND, BPKIHS 14
  15. 15. Tips for research projects…..• Must read books• Use multiple sources of data for validity• Include advanced development in field• Visit library, book shops regularly• Find more original articles• In literature : Killing many darlings• Basis of conceptual frame work: Literature, Theories, Experiences & Focus of research.• Use triangulation method in research: qualitative, quantitative and both. Dr. R S Mehta, MSND, BPKIHS 15
  16. 16. History of Nursing Research Dr. R S Mehta, MSND, BPKIHS 16
  17. 17. The Plight of New Graduates
  18. 18. Historical Development of nursing ResearchBefore 1850: No written documents.After 1850:• 1852: Nightingale wrote Cassandra.• 1855 – N. Studied & calculated mortality rates of British in Crimean war. (Mortality decrease by 43%)• 1859 – N. Wrote notes on hospital.• 1859 – N. Notes on nursing – published. Dr. R S Mehta, MSND, BPKIHS 18
  19. 19. • 1860 – N. Founded: St. Thomas’s Hospital School of Nursing in England.• 1899 – ICN – Organized.• 1900 – American Journal of Nursing publication begins.• 1912 – American nurses association established. Dr. R S Mehta, MSND, BPKIHS 19
  20. 20. In Nepal:1991: NHRC established Autonomous body. –Conducts Regular training on: » Research methodology. » Ethical guidelines. » Data analysis. (SPSS) » Epidemiological research. » Others: regularly. –Provide research grant –Legal authority to control Research Dr. R S Mehta, MSND, BPKIHS 20
  21. 21. – 1976 – PB BN. Started. (2033 BS) (IOM)– 1995 – MN programme started.– 1996 (2053 BS): -B. Sc. Nursing program started at BPKIHS.Research Compulsory: B.Sc. Nursing, BN, M.N./MSN, PhD Nursing Dr. R S Mehta, MSND, BPKIHS 21
  22. 22. Trends in nursing research Dr. R S Mehta, MSND, BPKIHS 22
  23. 23. Trends in nursing research• Nepal is virgin area for research.• The national future trends mainly focus in the following areas: Nursing leadership and management, primary health care, nursing education and its utilization, new technology in health, nursing curriculum and its implication, reproductive health and communicable disease Dr. R S Mehta, MSND, BPKIHS 23
  24. 24. Prone Areas of Nursing Research:Nursing Service:- Cancer- End life care/Geriatric nursing- Feeding tubes- HIV/AIDS- Diabetes- CVS disease- CKD, CLD, HTN,Pain etc Dr. R S Mehta, MSND, BPKIHS 24
  25. 25. Nursing Education:• Assessment Methods: OSCE, OSPE, OSLAR, MCQs, MRQs, RA, MEQs, TF, MINI CEX (usually we use Essay type)• Subject Placement• Attitude of Students• Problems of students• Application of Theory in to practice Dr. R S Mehta, MSND, BPKIHS 25
  26. 26. Areas of special research1. Chronic illness experiences2. Cultural and ethnic considerations3. End-of-life/palliative care research4. Health promotion and disease prevention5. Implications of genetic advances6. Quality of life and quality of care7. Symptom management8. Telehealth interventions and monitoring: recently in Patan AHS Started. Dr. R S Mehta, MSND, BPKIHS 26
  28. 28. Types of Study Design:• There is no best type of study design• The context, assumptions, paradigms and perspectives decide the type of research methodology Dr. R S Mehta, MSND, BPKIHS 28
  29. 29. MRC MRC MRCNote: CRD-complete random design, RBD-random block design, FD- factorial design 29
  30. 30. 4 Types of Research• Basic research• Applied research• Action research• Evaluation research Dr. R S Mehta, MSND, BPKIHS 30
  31. 31. Basic Research• Also known as fundamental research (sometimes pure research) is research carried out to increase understanding of fundamental principles.• Many times the end results have no direct or immediate commercial benefits• Basic research can be thought of as arising out of curiosity.• However, in the long term it is the basis for many commercial products and applied research.• Basic research is mainly carried out by universities Dr. R S Mehta, MSND, BPKIHS 31
  32. 32. Applied Research• Concern with addressing problem of the world as they are perceived by participants, organization or group of people• Action oriented and aims to assess, describe, document or inform people concerned about the phenomenon under investigation• Findings are intended to have immediate and practical value• In the field of education, policy, evaluation and contract are all examples of applied research Dr. R S Mehta, MSND, BPKIHS 32
  33. 33. Action ResearchAction Research is simply a form of self-reflectiveenquiry undertaken by participants in socialsituations in order to improve the rationality andjustice of their own practices, their understandingof these practices, and the situations in which thesepractices are carried out. Wilf Carr and Stephen Kemmis (1986) Dr. R S Mehta, MSND, BPKIHS 33
  34. 34. Evaluation research• Major concern is practical application• Tends to be viewed as an isolated case study though the methodologies may be transferable• Rooted in values and politics• Is immediately prescriptive based upon logic and experience• Reports are written for implementers, users and other interested people• The extent of dissemination is controlled by sponsor Dr. R S Mehta, MSND, BPKIHS 34
  35. 35. RESEARCH DESIGNS QUANTITATIVE QUALITATIVE• Experimental study • Ethnography• Quasi- • Case study experimental study • Historical study• Survey study• Correlational study Dr. R S Mehta, MSND, BPKIHS 35
  36. 36. Experimental Design• Test whether an educational practice or idea makes a difference for individuals Dr. R S Mehta, MSND, BPKIHS 36
  37. 37. Randomized Controlled Trials• Similar groups of individuals from same source population are allocated at random to receive or not to receive an intervention, then observed for occurrence of outcome(s). DESIGN Experimental Outcome Subjects Group with condition of Interest Control Outcome Dr. R S Mehta, MSND, BPKIHS 37
  38. 38. A Factorial RCT for Two Studies for the Price of One 38
  39. 39. CASE-CONTROL STUDIESSOME KEY POINTS• Frequently used study design• Participants selected on the basis of whether or not they are DISEASED (remember in a cohort study participants are selected based on exposure status)• Those who are diseased are called CASES.• Those who are not diseased are called CONTROLS. Dr. R S Mehta, MSND, BPKIHS 39
  40. 40. Cross-Sectional Study DiseaseExposure yes no totalyes a b a+bno c d c+d Dr. R S Mehta, MSND, BPKIHS 40
  41. 41. Cohort StudiesGroup by common characteristicsStart with a group of subjects who lack a positivehistory of the outcome of interest yet are at riskfor it (cohort).Think of going from cause to effect.The exposure of interest is determined for eachmember of the cohort and the group is followedto document incidence in the exposed and non-exposed members. Dr. R S Mehta, MSND, BPKIHS 41
  42. 42. When is a cohort study warranted?• When good evidence suggests an association of a disease with a certain exposure or exposures e.g. Smoking & Lung Cancer. Dr. R S Mehta, MSND, BPKIHS 42
  43. 43. True, Qusi, & Pre- Experimental StudyRandomization, Control and Manipulation• True exp.: All 3: R C M• Quasi exp.: M + R or C• Pre exp.: M, no R & no C Dr. R S Mehta, MSND, BPKIHS 43
  44. 44. Correlational Study• Focus more on examining the association or relation of one or more variables within a single group of individuals• Researcher measures the degree of association or relation between two or more variables using the statistical procedure of correlational analysis• Degree of association indicates whether the two variables are related or whether one can predict another Dr. R S Mehta, MSND, BPKIHS 44
  45. 45. Survey Designs• Describe trends in a large population of individuals• Administer a survey or questionnaire to a small group of people (sample) to identify trends in attitudes, opinions, behaviors or characteristics of a larger group of people (population) Dr. R S Mehta, MSND, BPKIHS 45
  46. 46. Descriptive Research Design: • Describe facts • Discover new facts • Not invent new theory and methods • Largest effort given on data collection • It answers questions: satisfy curiosity • Solve problems
  47. 47. Qualitative Research Dr. R S Mehta, MSND, BPKIHS 47
  48. 48. Choice of Colours• 1. What colour would you like the most? Dr. R S Mehta, MSND, BPKIHS 48
  49. 49. 2.What do you associate this colour with? Good luck love Confidence Truthfulness Lively Danger … Dr. R S Mehta, MSND, BPKIHS 49
  50. 50. 3. What is the source of this knowledge? – Own Idea – Own Belief – Own observation – Own experiences – Cultural and Traditional – Books & articles – etc Dr. R S Mehta, MSND, BPKIHS 50
  51. 51. • Not every thing can be quantified.• Some valuable ideas, opinions, perceptions, experiences, behaviours, qualities can be described only in words• These subjective things are shared between people, but the meanings may be distorted in the process of communication and recording. Dr. R S Mehta, MSND, BPKIHS 51
  52. 52. • Although subjective, these aspects often add richness and depth• The art of the doctor and the experience of being human are aspects that need a qualitative approach to investigate/research properly. Dr. R S Mehta, MSND, BPKIHS 52
  53. 53. Definitions• Quantitative Research - investigation in which the researcher attempts to understand some larger reality by isolating and measuring components of that reality without regard to their contextual setting.• Qualitative Research - investigation in which the researcher attempts to understand some larger reality by examining it in a holistic way or by examining components of that reality within their contextual setting. Dr. R S Mehta, MSND, BPKIHS 53
  54. 54. Qualitative Research– Human understanding and interpretation define reality– Complex reality can be understood and not as simply a sum of its parts– Goal of research is to examine complex phenomena to define the reality within– To be meaningful, inquiry must be holistic and contextual
  55. 55. Characteristics of Qualitative Research• Purpose is understanding• Oriented toward discovery• Uses subjective data• Extracts meaning from data• Interprets results in context• Focus is holistic
  56. 56. Disadvantages of Qualitative Research• Subjectivity leads to procedural problems• Replicability is very difficult• Researcher bias is built in and unavoidable• In-depth, comprehensive approach to data gathering limits scope• Labor intensive, expensive• Not understood well by “classical” researchers
  57. 57. Organizational Structures (Types) Historical Analysis Ethnography Phenomenology Life History, Chronology, Historiography Case Study Dr. R S Mehta, MSND, BPKIHS 57
  58. 58. Advantages of Qualitative Research In-depth Examination of Phenomena (Phenomenological Study/Research) Uses subjective information Not limited to rigidly definable variables Examine complex questions that can be impossible with quantitative methods Deal with value-laden questions Explore new areas of research Build new theories Dr. R S Mehta, MSND, BPKIHS 58
  59. 59. Disadvantages of Qualitative ResearchSubjectivity leads to procedural problemsReplicability is very difficultResearcher bias is built in and unavoidableIn-depth, comprehensive approach todata gathering limits scopeLabor intensive, expensiveNot understood well by“classical” researchers Dr. R S Mehta, MSND, BPKIHS 59
  60. 60. Meta Analysis• Statistically combines results of existing research to estimate overall size of relation between variables• Helps in • Developing theory • Identifying research needs, • Establishing validity• Can replace large-scale research studies• Better than literature reviews 60 Dr. R S Mehta, MSND, BPKIHS
  61. 61. Note: CRD-complete random design, RBD-random block design, FD- factorial design 61
  62. 62. Relative strength of various study designs(based on level of evidence for a cause & effect relationship) Strength Design Strong Clinical trial Cohort study Case control study Cross sectional Case series Weak Case report Dr. R S Mehta, MSND, BPKIHS 62
  63. 63. Websites, Search Engine, and address of Journals•••••• (WHO website)•• (TNAI Journal)• (NHRC library site)••• (cancer website)• (HIV/AIDS website)• (HIV/AIDS website)• (HINARI: needs password)• (need passwords)• (free online journal) Dr. R S Mehta, MSND, BPKIHS 63
  64. 64. Some Popular Resource Sites for Nurses•• You can• www.scribd.ocm create your• www.authorstream• own account• and use it.•••• (all study conducted in Nepal)•••
  65. 65. Web 2.0 includes:• Social networking• Blogs• Wikis• Video sharing sites• Hosted services• Web application• Etc. Dr. R S Mehta, MSND, BPKIHS 65
  66. 66. “The beautiful thing aboutlearning is that nobody can take it away from you.” --BB King Thank-You 66 Dr. R S Mehta, MSND, BPKIHS