Research Lecture by Dr. Dereje within WU.pdf

UNIT 1
NURSING RESEARCH AND RESEARCH PROPOSAL
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Research methods
1

At the end of this session the student will be able to:
• Define nursing research, health research, research
design, and research methods
• Understand the different types of research
• Develop research proposal
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Research Methodology
2

DEFINITION OF NURSING RESEARCH
• “systematic inquiry designed to develop trustworthy evidence about issues of importance to the
nursing profession, including nursing practice, education, administration, and informatics” (Polit
and Beck, 2012, p. 3).
• “a scientific process that validates and refines existing knowledge and generates new knowledge
that directly and indirectly influences the delivery of evidence-based nursing practice” (Grove,
Burns, and Gray, 2013, p. 2).
• study results must directly or indirectly affect clinical nursing practice.
• the systematic, objective process of analyzing phenomena of importance to nursing. Using this
definition, nursing research includes all studies concerning nursing practice, nursing education,
and nursing administration.
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DEFINITION OF CLINICAL NURSING RESEARCH
• Nursing research that involves clients or studies that
have the potential to affect the care of clients, such as
studies with patients or with normal participants.
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WHY NURSING RESEARCH?
• To generate new knowledge- basic research
• Using knowledge to solve immediate problems –applied
research
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GOALS OF CONDUCTING NURSING RESEARCH
• To promote evidence-based nursing practice- nurses make
clinical decisions based on the best research evidence, their
clinical expertise, and the healthcare preferences of their
patients/clients.
• To ensure the credibility of the nursing profession
• To provide accountability for nursing practice, and
• To document the cost-effectiveness of nursing care.
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ROLES OF NURSES IN RESEARCH
• Principal investigator
• Member of a research team
• Identifier of researchable problems
• Evaluator of research findings
• User of research findings
• Patient/client advocate during studies
• Subject/participant in studies
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HISTORY OF NURSING RESEARCH
• The growth of nursing research seems to be directly related to
the educational levels of nurses.
• Beginning with a 1923 study, titled the Goldmark Report, non-
nurses became involved in studying nurses and nursing.
• As nurses received advanced educational preparation and became
qualified to conduct research.
• American Journal of Nursing in 1927-launched
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HISTORY OF NURSING RESEARCH
• 1850s - Florence Nightingale studied nursing care during the CrimeanWar. She called for research
that focused on nursing practice. Nightingale admonished nurses to develop the habit of making
and recording observations systematically. She used statistics to clearly illustrate her findings.
• 1902 Lavinia Dock reported a school nurse experiment that was begun by LillianWald. Nurses
gave free care to school children and visited the homes of sick children.
• 1906 Adelaide Nutting conducted a survey of the educational status of nursing.
• 1909The first university-based nursing program was established at the University of Minnesota.
• 1923 A well-known study of nursing and nursing education was conducted by the Committee for the Study of Nursing
Education and funded by the Rockefeller Foundation.The results, known as the recommended advanced educational
preparation for teachers, administrators, Goldmark Report, and public health nurses, and were instrumental in the
establishment of early collegiate nursing schools atYale,Vanderbilt, andWestern Reserve (now CaseWestern Reserve)
universities.
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SOURCES OF NURSING KNOWLEDGE
• Tradition involves the handing down of knowledge from one
generation to another and leads to actions that occur because
“we’ve always done it that way.”
• Great storehouse of knowledge.
• Authority. Experts or authorities in a given field often provide
knowledge for other people.
• Trial and error _ “if it works, we’ll use it.”
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SCIENTIFIC METHOD (SM) AND PROBLEM-SOLVING
• SM- is systematic, orderly, and objective methods of seeking
information.
• The scientific method is based on empirical data, which are data
gathered through the sense organs.
• Scientific research seeks to obtain knowledge that can be
generalized to other people and to other settings.
• Problem solving attempts to seek a solution to a problem that exists
for a person or persons in a given setting.
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WHAT IS RESEARCH?
• Research is defined as multiple, systematic strategies to
generate knowledge about human behavior, human
experience, and human environments in which the
thinking and action processes of the researcher are
clearly specified so that they are logical, understandable,
confirmable, and useful” (Depoy & Gitlin, 2015, p. 3)

OVERVIEW OF HEALTH RESEARCH
• Health research- refers to research that is done to learn
more about human health.
• Health research also aims to find better ways to prevent and
treat disease.
• Health research is an important way to help improve the care
and treatment of people worldwide.
• Scientific approach of searching as far back as the 14th Century,
the era of modern health research started after World War II
with early studies of antibiotics.

OVERVIEW…
• Clinical research is a structured process of investigating
facts and theories and exploring connections.
• It proceeds in a systematic way to examine clinical conditions
and outcomes, to establish relationships among clinical
phenomena, to generate evidence for decision making and to
provide the impetus for improving methods of practice.
• Must be empirical and critical.

PURPOSE OF HEALTH RESEARCH
• To generate knowledge essential to effectively
promote the health of the population.
Without that knowledge, effective action is
impossible because it has no logical or empirical
basis.
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RESEARCH MUST BE:
❖Purposeful: what do you want to contribute?
❖Targeted: Who are the audiences?
❖Credible: consider sources of information, method of data collection,
personnel involved…
❖Timely: Is the information needed?
Research is done to find solutions to health problems.
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PURPOSE OF RESEARCH
▪ Address gap in knowledge
▪ Expand knowledge
▪ Improve practice through new ideas and insight
▪ Create database for policy maker and program manager
▪ Help to build knowledge
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CHARACTERISTICS OF GOOD RESEARCH
➢Originates with a question or problem.
➢Follows a specific plan or procedure.
➢Often divides main problem into sub-problems.
➢Guided by specific problem, question, or hypothesis.
➢Requires collection and interpretation of data.
➢Cyclical in nature.
➢Demands clear statement of the problem
➢Build on existing data using both negative and positive findings
➢The finding should answer the research problem
➢Simple, has good rationale, has clear objectives, and uses appropriate methodology
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Types of research
Basic Vs Applied Research (based on
objective)
1. Basic research (fundamental or pure research)
• Its primary objective is the advancement of knowledge and the theoretical
understanding of the relations among variables
• Basic research provides the foundation for further research.
• Basic research in health is necessary to generate new knowledge and
technologies to deal with major unresolved health problems
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Basic Vs Applied Research cont..
2. Applied research
• Is a research that seeks to solve practical problems
• In health, applied research is necessary to identify priority
problems and to design and evaluate policies and programs that
will deliver the greatest health benefits, making optimal use of
available resources
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BASED ON DATATYPE UTILIZED
1. Quantitative research
• Phenomena that can be expressed in terms of quantity
• Concerned with how much?, how many?, how often?, and to what
extent?
2. Qualitative research
• Qualitative phenomena (those relating to involving quality or kind)
• It is concerned with finding the answers to questions which begin
with how?,Why?, in what way?
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QUANTVS QUAL RESEARCH
QUANTITATIVE RESEARCH
• More objective
• Physical measurement
• Information in numerical values
• Descriptive/exploratory/
experimental
QUALITATIVE RESEARCH
• Describe the nature of people’s
experience
• Understand experience/perception/
impression
• Broad questions
• Use subject’s own words
• Descriptive/exploratory

BASED ON STUDY DESIGN
1. Descriptive
• Case series and case report
• Cross sectional
• Correlational
2. Analytical research (Observational or interventional)
• Case control
• Cohort
• Experimental
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EVIDENCE BASED PRACTICE (EBP)
• EBP is a problem-solving approach to clinical practice that
combines the deliberate and systematic use of best evidence in
combination with a clinician’s expertise, patient preferences and
values, and available health care resources in making decisions
about patient care (Melnyk and Fineout-Overholt, 2019).
• Guides nurses and other health care providers in making
effective, timely, and appropriate clinical decisions.
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EBP
• Addresses a clinical problem by looking for the very best
scientific and clinical evidence available for treating or managing
the problem and implementing changes in practice.
• Research is an input for EBP.
• EBP enhances the patient experience, decreases cost,
empowers clinicians, and improves patient outcomes (Crabtree
et al., 2016; Melnyk and Fineout-Overholt, 2019).
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EBP MODEL
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STEPS OF EVIDENCE-BASED PRACTICE
• 0. Cultivate a spirit of inquiry within an EBP culture and
environment.
• 1.Ask a clinical question in PICOT format. 2. Search for the most
relevant and best evidence.
• 3. Critically appraise the evidence you gather.
• 4. Integrate the best evidence with your clinical expertise and
patient preferences and values to make the best clinical decision.
• 5. Evaluate the outcomes of practice changes based on evidence.
• 6. Communicate the outcomes of EBP decision or changes.
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LITERATURE DATABASES (SOME)
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LEVEL OF EVIDENCE
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CRITICAL APPRAISAL OF THE EVIDENCES
• What is the level of evidence?
• How well was the study (if research) conducted?
• How useful are the findings to practice?
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RESEARCH PROPOSAL
• The plan that describes all the preparatory elements.
• The proposal describes the purpose of the study, the
importance of the research question, the research
protocol and justifies the feasibility of the project.
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DEVELOPING A FULL RESEARCH PROPOSAL
• A full proposal should contain the following :
• Title
• Abstract
• Introduction
• Background
• Statement of the problem/rationale of the study
• Literature review
• Research question/hypothesis/objectives
• Methods
• Timetable of work
• Budget plan
• Summary (significance of proposed work)
• References

DIFFERENT PARTS OF A RESEARCHTHESIS
Acknowledgements
Methodology
References

TITLE SELECTION
• It is choosing appropriate title for our study
• The title summarizes the main idea or ideas of your study.
• A good title contains the fewest possible words that adequately
describe the contents and/or purpose of your research paper.
• The part of a paper that is read the most, and it is usually read first.
• If the title is too long it usually contains too many unnecessary
words
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TITLE
• Project Introduction
• Consider:
• Is it reflecting the content of the proposed work?
• Is it informative but concise?
Example:The effect of a group exercise program on bone health
and physical functioning in individuals with chronic stroke.

Sources of research titles
Research topics are chosen through;
1. Interest of theresearcher
– First andforemost, researchers typicallychoose research topics that are of
interest to them.
2. As a problem solving
– Someresearch‟s ideasmayalsostem from aresearcher‟s motivation to solvea
particular problem.
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TITLESOURCE----
3. Basedon previous research
• –Researchers also choose research topics based on the results of prior research,
whether conducted bythem or bysomeone else.
4.Brainstorming and theory
• –Finally,theories and discussionoften serve asa good source for research ideas.
• (eg.Conceptual framework)
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SOURCECONT…
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5.By Chance
T
opicarea can be found bychance
Eg: case report study
6.Simple observation
–T
opicscan be found bysimple observation
eg.Endode vsSnails death

CRITERIATO SELECT GOOD RESEARCH
TITLE
Objective criteria
1.Relevance: priority, magnitude of problem
2.Avoidance of duplication
3.Feasibility: complexity, manpower, time, equipment, money…
4.Political commitment: interest and support to utilize results
5.Timeliness: urgency of data needed for making decision
6.Ethical acceptability
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In addition,a good research title should be
• It should predict the content of theresearch paper.
• It should be interesting to the reader.
• It should reflect the tone of thewriting.
• It should containimportant keywords that will make
it easier to be located duringa keyword search
• Outcome variable,target population and place of study should be stated well
• Use of measurable action verbs
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Effective titles in academic research papers have several characteristics.
• Indicate accurately the subject and scope of the study.
• Avoid using abbreviations.
• Use words that create a positive impression and stimulate reader interest.
• Use current nomenclature from the field of study.
• Identify key variables, both dependent and independent.
• May reveal how the paper will be organized.
• Suggest a relationship between variables which supports the major hypothesis.
• Is limited to 10 to 15 substantive words.
• Do not include "study of," "analysis of" or similar constructions.
• Titles are usually in the form of a phrase, but can also be in the form of a question.
• Use correct grammar and capitalization with all first words and last words capitalized, including the first word of a subtitle.
• All nouns, pronouns, verbs, adjectives, and adverbs that appear between the first and last words of the title are also capitalized.
• Sometimes it is possible to write the name of study design in title
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TIPSFOR WRITINGANEFFECTIVE
RESEARCH PAPERTITLE
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• Avoid unnecessary words and jargons.
• Keep the title statement as concise as possible.
• Y
ouwant a title that will be comprehensible even to people who are not
experts in your field.
• Most importantly,use critical keywords in the title to increase the
discoverability of your article.

TIPSCONT….
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• Makesure your title isbetween 5 and15 words in length
• Ifyouare writing atitle for auniversityassignmentor for aparticular academicjournal,
verifythat your title conforms to the standards andrequirements for that outlet.
• For example, manyjournals require that titles fallunder acharacter limit, including spaces
• Manyuniversitiesrequire that titles takeaveryspecificform, limiting your creativity.
• Useadescriptive phraseto conveythe purpose ofyour research efficiently.

• Writing good research paper

• How to create quality paper outline?

• Title 1 describes the topic and the method of the study but is not particularly catchy.
• Title 2 partly describes the topic, but does not give any information about the method of
the study it could simply be a theoretical or opinion piece.
• Title 3 is somewhat catchier but gives almost no information at all about the article.
• Title 4 begins with a catchy main title and is followed by a subtitle that gives information
about the content and method of the study.

CHARACTERISTICS OF A GOOD RESEARCHTITLE
• According to rhetoric scholars Hairston and Keene, making a good title for a paper
involves ensuring that the title of the research accomplishes four goals as mentioned
below:
• It should predict the content of the research paper.
• It should be interesting to the reader.
• It should reflect the tone of the writing.
• It should contain important keywords that will make it easier to be located during a
keyword search

TIPS
1. Make sure your research title describes (a) the topic, (b) the method, (c) the sample, and
(d) the results of your study.
• E.g. Meditation makes nurses perform better: a qualitative study of mindfulness meditation among Ethiopian
nursing students
2.Avoid unnecessary words and jargons. Keep the title statement as concise as possible.
You want a title that will be comprehensible even to people who are not experts in your
field. Check our article for a detailed list of things to avoid when writing an effective
research title.
3.Make sure your title is between 5 and 15 words in length.
4.If you are writing a title for a university assignment or for a particular academic journal,
verify that your title conforms to the standards and requirements for that outlet. For
example, many journals require that titles fall under a character limit, including spaces.
Many universities require that titles take a very specific form, limiting your creativity.
5.Use a descriptive phrase to convey the purpose of your research efficiently.

SUMMARY OR ABSTRACT
• Summary of the project or research
• Called mini-proposal or mini research
• Represent full proposal or full research work
• Usually limit to one page
• Consider:
▪ Background (definition of problem, justification, and purpose/objective of study)
▪ Methods (study design, study area, study population, sample size, DC method, method of data analysis)
▪ Work plan and time-line
▪ Result (inline with objective of your study)
▪ Conclusion and recommendation (inline with objective of your study)
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ABSTRACT- IN SUMMARY
• Summary of the project
• Usually limit to one page
• Consider:
• Does it give specific information about:
• Background & purpose
• Methods
• Importance of the proposed work

HOW WOULDYOU DESCRIBE AWELL-WRITTEN
ABSTRACT?
• Dense (with information)
• Informative
• Accurate
• Language
• Content
• Concise
• Coherent
• Readable
• Self-contained
• Standalone
• Succinct
• Welcoming
• Clear
• Impressive

AS FAR ASYOU KNOW,WHAT DOYOU NEED TO
COVER INYOUR ABSTRACT? (HO)

WHAT DOES APA 7TH EDITION SAY
ABOUT ABSTRACT?

PURPOSE OFTHE ABSTRACT IN A
THESIS

ACTIVITY 1
A. To draw the examiners’ or readers’ attention by allowing them to
forecast the results through examining the summary statements of
the experimental methods.
B. To affirm the value of the study by highlighting the significance of
the results and contributions to the field.
C. To help examiners or other readers form expectations of the
contents in the thesis.
D. To add a note about acknowledging the support and contributions
of various parties during the course of the research study.

ACTIVITY 1
E. To provide a summary of the thesis so as to allow a potential reader to
determine if the thesis is relevant to the search and of any interest to
him/her.
F. To demonstrate that the author has the ability to conduct quality
research and write good language in the academic style, meeting the
academia’s expectations.
G. To help examiners or readers understand the structure of the thesis by
inserting references to particular chapters.
H. To provide important references in the form of footnotes to key terms
introduced in the Abstract.

PURPOSES OFTHE ABSTRACT
• summarising the whole thesis;
• highlighting the major contributions of your research and suggesting future
studies;
• convincing the examiners and other readers that the study is valuable; and
• showing to the examiners that you have met the university requirements.

CONTENT OFTHE ABSTRACT IN
ATHESIS

A GOOD ABSTRACT PROVIDES ANSWERS TO ..
(BIRELEY & MORELAND, 2014, P.92)
• What the topic is
• and possibly why the topic is of interest to you
• The basic outlines of the research approach or approach to the topic
• What the main finding(s) are

FIVE ELEMENTS
(WALLWORK, 2016))
• Background/context
• Research problem/aim –
• the gap researchers plan to fill
• Methods
• Results
• Implications and/or conclusions

MOVES IN AN ABSTRACT – A
READINGTASK
ACTIVITY 2

SAMPLE 1
Moves Content
1 Research topic: A call centre...
Rationale of the study: The present study was
motivated by…
2 Research aim: The aim is to find…
3 Theories adopted in the study: The theoretical
framework…
4 Research design: The present study consists
of…
5. Research outcomes: The outcomes of this
study…
6 Significance of the study: The findings from the
present study offer…

SAMPLE 2
Moves Content
1 Research topic and background information: In
view of the serious environmental problems…
2. Research aim: The main aim of this study…
3 Research methods: Questionnaires…
4 Research findings: The findings reveal that…
5. Research methods: Independent t-tests…
6 Research findings: The findings indicated that…
7 Significance of the study: The study also provides
a number of insights…

SAMPLE 3
Moves Content
1 Research topic; Research gap: First paragraph
2. Research aim: Second paragraph
3 Research methods: Third paragraph
4 Research findings: Fourth paragraph
5. Significance and implications of the findings: Fifth
paragraph

STRUCTURE OFTHE ABSTRACT IN ATHESIS
• Overview of the research topic
• Research background
• Aim of the study
• Methodology used in the study
• Findings of the study
• Conclusion
• Implications

LANGUAGE
FEATURES OF
ABSTRACTS IN
THESES

DISSERTATION DESCRIPTION
• Those who see it as a description of the dissertation
document which is in front of the reader are likely to use
the present tense.
• e.g.The major finding of the analysis is that the … contains around
… and only improves by … when … .
• e.g.A qualitative approach is adopted and case study methods are
employed.

RESEARCH SUMMARY
• Those who see it as a summary of the research that was conducted during the
MPhil/PhD programme tend to write in a mixture of past and present tenses.
• e.g.The study explored the effects of … on … .
• e.g. Outcome measures included … and … .

CONCLUSIONS AND RECOMMENDATIONS
• In both cases, the present tense is usually used to state the conclusions and
recommendations, and sometimes the purpose as well.
• e.g.The purpose of this study is to examine the efficacy of … .
• e.g.These results suggest a strong impact of the … on …

VERBTENSES AND
WORD CHOICES IN
AN ABSTRACT
ACTIVITY 4

ACTIVITY 4
• The contamination of water bodies by endocrine disrupting
compounds (EDCs) (1) ________increasing attention in recent
decades because of their potential adverse effects on aquatic lives
and human health.The inefficiency of biological treatment methods in
degrading EDCs (2) ________ the development of various kinds of
advanced oxidation technologies (AOTs). In this study, a chemical-
free AOT by combining high frequency ultrasound and ultraviolet
irradiation (i.e. US/UV) (3) __________ and intensively investigated
to degrade different kinds of EDCs, (4) _______ dimethyl phthalate
(DMP), di-n-butyl phthalate (DBP), diethyl phthalate (DEP),
monomethyl phthalate (MMP), atrazine (ATZ), and nonylphenol (NP).
• [….]
has drawn
(has) promoted
was proposed
including

ACTIVITY 4
• Finally, the degradation mechanisms of the investigated compounds
and mineralization efficiencies in the US, UV, and US/UV processes (5)
____________. Results showed that the ultrasonic process (6)
______ effective in degrading more hydrophobic target compounds,
but less efficient in degrading their more hydrophilic intermediates.
However, the involvement of UV process could promote the
degradation of these less hydrophobic intermediates via direct
photolysis or (7) _________ additional hydroxyl radicals in the bulk
solution by photo-dissociation of hydrogen peroxide.The combined
US/UV process also had the best mineralization performance (8)
_________to individual US or UV process.
were investigated
was
producing
compared

BREVITY
SUPPLEMENTARY EXERCISES
https://www.scribbr.com/academic-
writing/shorten-abstract-summary/

BREVITY
• Since abstracts have prescribed lengths (150-250 words), you need to write
• clearly
• concisely
• succinctly
• Avoid redundancy of content, words and expressions.

1.AVOID USING PASSIVE SENTENCES
The researchers tested the ABC
system.
The SWOT analysis provided a
partial answer.
The recommendations section offers
solutions to the problem.
This study used both qualitative
and quantitative research methods.

MISCONCEPTIONS OFVOICE
• 2 common misconceptions
• The passive voice should be used all the time
• The active voice means the use of “I” or “We” as the subject of the sentence
• In this article, I/we will discuss the pros and cons of legalising abortion in Ethiopia.
• In this article, the pros and cons of legalising abortion in Ethiopia will be discussed.
• This article discusses the pros and cons of legalising abortion in Ethiopia.

• It is important to learn this third way of writing because there is an
obvious trend in some journals, such as those in the disciplines of
humanities, design, management, as well as certain streams of
engineering and medical sciences, towards using more active voice
constructions in the writing of academic papers. In some journals
like Social Psychology Quarterly,Administrative Science Quarterly,
Limnology and Oceanography,American Sociological Review, Journal of
Community Health Nursing, and Journal of Human Resources, there are
frequent uses of active constructions as well as the first person
pronoun, such as “we” to represent the authors, (but not in the
methodology section for obvious reasons). These usages naturally
create a more direct feel.

2.AVOID THE NOUN STYLE
The results supported the
hypothesis.
The legislators decided that the
strategy should focus on reducing
waste.
Tourists should consume less
cannabis.
The approach has improved the
depressive symptoms.

3.AVOID LONG SENTENCES
Most participants felt that …
The interview was cancelled due to
time clash.
The research is currently important
because …
The respondents refused to
participate in the study because they
did not agree with ….
This module affects the students’
opinions.
The reason the students failed the
viva voce was unknown.
The goal of the study was to
determine whether the variable
played a role in the process.

4.AVOID REPETITION
The research gave rise to a strategy
to achieve the desired outcome.
The research results from the
survey were analysed using SPSS.
The problem is that the Dutch
companies lack insight into the
demand of sweet fillings in the
Netherlands

• This is a sample abstract of a journal article that examines people with asthma who
cannot tolerate taking aspirin.The research aims to identify the genes
connected to this intolerance.The researchers looked for a different genetic
cause that others have not considered.
INTRODUCTION

METHODS

RESULTS

CONCLUSION

WHAT ABOUTYOUR THESIS??
1. What is your research about? What were you
investigating? What is your research
question or problem?
1. Why did you conduct this research? Why is
this research important, relevant, or
significant?
1. What methods did you adopt in your
research?
1. What are the major findings in your
research?
2. What are the implications of your results?

STRUCTURE AND
FLOW OF A
RESEARCHTHESIS

A COMMON STRUCTURE OF A RESEARCH
THESIS
• Introduction
• outlines objective and scope of study
• gives operational definitions of terms and technical words
used
• describes the methods and process of data collection and analysis
• presents major findings briefly
• states the main conclusion
• outlines the chapters in the thesis

THESIS
• Literature review
• reviews the work that has been done in the field and situates your own work in
context
• covers views from different, even contrasting, perspectives
• shows gap in existing literature and how your study can begin to fill that gap
• asks research questions
• Methodology
• explains research approach, design, methods of data collection and data analysis
• describes procedures, sampling method, equipment, variables, controls, pilot test,
reliability and validity measure

THESIS
• Findings/results
• presents the main findings objectively with the support of tables and
diagrams
• Discussion of results
• interprets the findings, building an unbiased, logical argument
• Conclusion
• summarises the main findings of the research; shows how research has
answered the research questions
• explains the limitations of the research
• states the main contributions of the research
• gives recommendations for future research

THESIS
• References
• list all the sources cited in the thesis
• Appendices
• include specific areas related to the thesis but not included in the
main text
• consent form,
• questionnaire sample,
• interview transcript,
• more figures and charts

WRITING INTRODUCTION CHAPTER
• It is an extremely important part of the
proposal/thesis/project.
• Address three areas:
i) define what is to be studied;
ii) explain why it is worth studying; and
iii) provide an outline of your research.

INTRODUCTION
1.1 Background
1.2 Statement of the problem
1.3 Significance of the study
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THE PURPOSE OF THE INTRODUCTION WRITING
• To set the context of the study by providing readers the
background of your research topic;
• To situate your research in the field by showing the
relationship between your work and previous studies;
• To review previous studies and identify the research gap
that your study aims to address;

PURPOSE …
• To establish the significance of your research by showing how
your research can address the research gap under study;
• To indicate how the study addresses the research gap being
investigated;
• To indicate the questions that your research aims to answer or
the research hypothesis that your study aims to test; and
• To show the outline of the proposal.

MOVES INTHE INTRODUCTION CHAPTER
• In his ‘Create a Research Space’ (CARS) model, Swales
(1990, 2004) states that an introduction generally
consists of three main moves:
• Move 1: Establishing a territory
• Move 2: Establishing a niche
• Move 3: Occupying a niche

BACKGROUND
▪ It is introducing the problem
▪ Consists of any information related with problem with coherently related information
▪ Derived from literature review
▪ Consider:
▪ Does the author use primary sources?
▪ How recent are the studies that are cited?
▪ How relevant are these cited studies?
▪ Has the researcher thoroughly and thoughtfully reviewed the relevant literature?
▪ Does it provide a nice synthesis of literature, rather than simply quoting individual studies?
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LANGUAGE USE
• Move 1- present or present perfect tense to signal the importance of the research area.
Adjectives are also often used to highlight the significance or interest of the topic.
• E.g. 1 “The growing importance and popularity of the Internet market in the hotel
industry today have triggered widespread interests among hoteliers, customers and
hospitality researchers to seek an understanding of room pricing behaviour on the
Internet so that they can use the knowledge for strategic decision-making” (Mohammed,
2016).
• E.g. 2 “Digital composition presents the possibility for digital writers to be both
interactive producers and consumers of digital media…. How these digital authors
compose in the assorted digital spaces they visit is an area of interest…” (Cooperman,
2017).

LANGUAGE USE…
• The move tends to employ present tense to give your research current relevance.
• E.g. 7 “The purpose of this study is to understand how social class background plays a
role in student experiences on selective campuses” (Goward, 2018).
• E.g. 8 “This research aims at developing a content blueprint of a certification
programme for infection control nurses in Hong Kong” (Chan, 2012).
• E.g. 9 “This study investigates the performance of DCSs and conducts design optimization
for DCSs and ICSs considering uncertainty of cooling loads and system reliability” (Gang,
2016). (DCS – District cooling system; ICS – Individual cooling system)

LANGUAGE USE
• Move 2- the language of “gap statements” is usually negative in meaning.
• E.g. 5 “As far as the existing literature in hospitality is concerned, limited attempts have
been made to quantify these pricing behaviours” (Mohammed, 2016).
• E.g. 6 “There is little knowledge regarding how parents can contribute to children’s
literacy growth with the use of books…more research is needed to see what teen
mother’s perceptions are regarding their influence in their child’s language ability to help
break this recursive cycle” (Duncan, 2016).

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ADVISE ON INTRODUCTION WRITING
• Do not simply quote or refer to what different
previous reports found.
• You need to assimilate and integrate the information
from previous studies.
• Requires analysis and interpretation from your part.

INTRODUCTION …
Consider:
• Does the literature review provide a sound rationale for the study?
• How will the proposed work fill the gap in the literature?
• Something new (it has never been done before).
• It has been done before, but previous studies have major limitations, or you have something to
add.
• It has been done before in other contexts, now you would like to apply the intervention in
other contexts (different populations, settings)

INTRODUCTION …
• You must slowly, logically, and convincingly build your case.
• You must do so without overly criticizing previous work by others.
• The fact that the same study has not been done in Ethiopia alone does
not provide a strong rationale, except:
• Translation and validation of assessment tools.
• Epidemiology studies (normative studies, disease patterns, risk factors, etc.)
• If the variables of interest are clearly influenced by geographical, cultural or racial
factors (e.g. bone density,

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STATEMENT OF THE PROBLEM
▪ The first and most important step in any research is to identify and delineate the
research problem (that is, what the researcher wants to solve and what questions
he/she wishes to answer).
▪ A research problem may be defined as an area of concern, a gap in the existing
knowledge, or a deviation in the norm or standard that points to the need for
further understanding and investigation.
▪ The statement of the problem briefly addresses the question: What is the
problem that the research will address

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1. Definition of the problem
2. Burden of the problem
3. Consequence of the problem
4. Potential factors associated with the problem
5. Intervention done
6. Existing gap
7. Conclusion of the study

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STEPS OFWRITING STATEMENT OF THE
PROBLEM
1. Defining the problem (not dictionary definition) from the global to local
• Is the first paragraph of the statement of the problem
• Define the problem contextually, not direct definition of terms
• Go from global to local (Globally- regionally-nationally-----)
• Why is the research important/ urgent? Or define according to the urgency of the problem
• Avoid dictionary definition of terms and phrases
Eg: The title of the study is: Prevalence and associated factors of SAM among under
five children in Nekemte town,Western Ethiopia.
Malnutrition or SAM is the leading cause of mortality among under-five
children…Globally, 50% of children died due to malnutrition in 2017. The
magnitude is mortality due to malnutrition is high in SSA…..

2. Burden of the problem from global to local
▪ Describe the magnitude of the problem from global to local
▪ This shows the severity of the problem
▪ Describe the problem at Global, regional, national and study area's local levels in terms
of Magnitude and Severity of the problem
Eg. The title of the study is: Prevalence and associated factors of SAM among
under five children in Nekemte town,Western Ethiopia.
Globally, the prevalence of SAM among under-five is around 47%. The magnitude is
around 57% in SSA. ….
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3. Consequences of the problem
▪ Clearly describe the consequence happened duo to the presence of the problem with
one or two paragraphs
▪ Focus on outcome variable
4. Potential factors that contributes for of the problem
▪ Describe factors that contributed for the problem
▪ Focus on outcome variable
▪ Existing theories/controversies explaining it
▪ Give reference for each variables
Eg
▪ Unavailability of latrine, poor exclusive breast feeding, and presence of diarrhea [13-20] were
factors that contributed for malnutrition.
▪ Unavailability of latrine [13, 14], poor exclusive breast feeding [15, 16], and presence of diarrhea
[17-20] were factors that contributed for malnutrition.
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5. Intervention done to overcome the problem
▪ Any policy developed to solve the problem
▪ Any guideline
▪ Any program
▪ Generally it is efforts that were made to solve the problem
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ASSOCIATED LANGUAGE USE
i. Identifying the research gap
• Evaluative language (hedging)
ii. Reviewing and evaluating relevant research
• Summarizing skills
• Evaluative language (hedging)
iii. Presenting theoretical viewpoints, product or system designs, models and algorithms, to establish
their relevance to the research topic
• Language of comparison and contrast (connection among studies)
iv. Stating the contribution of the study
• ▫ Hedging devices
v. Identifying the research topic and areas of focus related to it
• Summarizing skills

ARGUE
• support;
• oppose;
• amend;
• complicate; and
• qualify.

LANGUAGE USE
• i) the use of language of comparison and contrast to show
the relationship among previous studies;
• ii) the use of evaluative language to present a writer’s
critical evaluation of the previous studies; and
• iii) the use of hedging devices to enhance the tentativeness
of writers’ criticism of other researchers’ works.

EXAMPLE OF LANGUAGE OF COMPARE AND
CONSTRAST
• This technique is analogous to the stepwise method of identifying
independent variables in MLR.Alternatively , sensitivity analysis works
by varying each input variable over either the entire or a partial range
of possible values while holding all other input variables constant at a
specified percentile […]. Sung [170] compared COE and sensitivity
analysis in a real engineering problem, and found that both methods
generated comparable results.Thus far, consensus has not been
reached on which group of methods outperforms the other [82, 141].

A FINAL CHECKLIST
1. Have you shaped your literature review to fit your research questions or hypotheses?
2. Have you appropriately grouped your various sources?
3. Have you struck an appropriate balance between description and evaluation?
4. If your literature review is lengthy or complex, have you used a sufficient amount of
metadiscourse to guide your readers and ensure they can see the research story that is
unfolding?
5. Have you sufficiently explained why certain sources were included and excluded?

A FINAL CHECKLIST
6. If appropriate for your field, have you included both author prominent (integral) and
research prominent (non-integral) citations?
7. Have you used a variety of reporting verbs and structures?
8. Have you chosen the right verb tenses for your citations?
9.Are there possibly any “missing inputs” that your readers or reviewers are likely to pick
up on? In other words have you adequately covered the research territory?
10. Have you described the literature in an original manner so that questions of plagiarism
will not arise?

SUMMARY
• Follow the three moves in writing introduction.
• Use best structure and language use in writing introduction
and literature.
• Search for references thoroughly.
• The work is not easy, but you should practice it well.
• As you read more, you understand about the study.

6. Any gap that exist between the intervention done and what is not done
The gap may be
✓Gap in knowledge/literature
If there is no research finding on the area
✓Gap in evidence
If there is an evidence but their finding is contradictory
In systematic review and meta analysis
✓Gap in population
If the title is not conducted on specific population/neglected population or some
populations are under-researched
✓Gap in methodology
Research design gap
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✓Empirical gap
o It is to test and verify previously conducted research
o It is more of replication of previous research for verification purpose
o The problem is that, is replicating research is acceptable?
Yes!
1. Verification may leads to new result
2. Verifiability and falsification of theory or generating theory or hypothesis
3. Replication is not to copy the previous research directly
4. New data or new context are explored
5. You have to justify the needs to replicate research
✓Gap in setting/area
o If there is no study in the area
✓Gap in outcome measurement
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• When you go from intervention to gap, use the following words!
• However
• Despite
• Even though
• Though
• But
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7. Finally, put conclusion based on the gap identified
▪ Now you'll move onto your conclusion.This should consist of the
problem, why it needs to be fixed and a summarized argument of why
your solution is the best answer to the problem
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What are the key characteristics of a statement of the problem?
▪ It should clearly address a gap exist.
▪ Should be coherent and well organized
▪ Should be consistent with the title of the study
▪ It should be significant enough to contribute to the existing body of research
▪ It should be of interest to the researcher and suit his/her skills, time, and resources
▪ The approach towards solving the problem should be ethical
▪ A statement of problem need not be long and elaborate: one page to 1/half page is
more than enough for a good statement of problem.
▪ Do not include positive sentences when you write statement of the problem

SIGNIFICANCE OF THE STUDY/RESEARCH
▪ Who will be benefited from the study and how they will be benefited
• Participants of the study
• Other researchers
• Practitioners
• Policy makers
Two main things to be considered when writing significance of the study
1. What is the general contribution of your research on your field of study
▪ Indicate how your research will strengthen, revise, or extend existing
knowledge in the area under investigation (Knowledge, evidence, or
methodological significance)
2. Implication of the research-how the finding of the research used by policy
makers, program managers or any intervention or researchers
what specific contribution of the research and who does this benefit the most
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▪ When you write significance of the study, do not directly start from the
beneficiary, rather put introduction section/problem within the significance
of the study and explaining to the reader where the gap in literature is.
▪ Significance of the study should be no more than 500 words
▪ Last sentence of significance of the study should be the contribution of the
finding for the researcher and students.
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Eg:
• In 2015, the government of Ethiopia announced a multi-year Seqota declaration program
to end under two years malnutrition in 2030 through multi-sectorial response, maximizing
the budget, monthly growth monitoring for children under two years, improving diets,
water and sanitation at the household level; and ensuring sustainable agricultural
production and practices (2). Generating local evidences about the incidence of SAM among
children diagnosed with MAM with a follow-up study and factors that contributed for SAM could
help to reach the national Seqota declaration of ending all forms malnutrition, and improves the
treatment outcome of children diagnosed with MAM.
• Furthermore, most of the studies conducted in Ethiopia were based on retrospective
review of patient cards which may be affected by incompleteness and limited sample sizes
thereby restricted their power to detect associations and inferences that causes SAM.
Therefore, this study will be conducted with prospective cohort study to generate comprehensive
information on the treatment outcome of children diagnosed with MAM in western Ethiopia
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LITERATURE REVIEW
•Defined as “a written summary of articles,
books, and other documents that describes
the past and current state of knowledge
about a topic” (Creswell, 2002, p.86).

COMPONENTS OF LITERATURE REVIEW
• Competing perspectives (individual, group, societal and organizational)
• Synthesis of previous research (patterns, themes, common findings,
gaps)
• Critical analysis (evaluation, strengths and weaknesses, gap fill)
(Calabrese, 2006,
p. 23-28)

SEARCHING LITERATURE
• Through searching of the available evidences.
• Use databases. E.g. PubMed
• Select searching method
• Define keywords

STARTING TO WRITE
• Before you start writing,you may want to ask yourself these questions:
• What is the length and format of the literature review?
• How should I organize the review?
• What is the scope of the review?
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STARTING WRITING
You should also consider questions which your literature review should answer (Murray, 2011, p. 128):
• Why is this subject important?
• Who else thinks it is important?
• Who has worked on this subject before?
• Who has done something similar to what I will be doing?
• What can be adapted to my own study?
• What are the gaps in the research?
• Who is going to use my material?
• What use will my project be?
• What will my contribution be?
• What specific questions will I answer?
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STRUCTURE OF A LITERATURE REVIEW

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ORGANIZING A LITERATURE REVIEW

LITERATURE
REVIEW
LANGUAGE USE (SEE SEPARATE
PDF)
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RESEARCH OBJECTIVE
• A research objective summarize what is to be achieved by the study.
• Research objectives are usually classified into general objectives and
specific objectives.
General objective
▪ Summarizes what is to be achieved by the study
▪ Should be clearly related to the title of the study and statement of the
problem
▪ Be at parallel with the topic of the study
▪ Should include all the specific objectives
▪ Stated with action verb which is more wider than action verbs used for
specific objectives
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Specific objectives:
▪ Are logically connected parts of the general objective
▪ Use MEASURABLE action verbs such as:
-determine -verify -identify
-describe -assess -compare
–calculate -establish -explore
▪ Be SMART
▪ Maximum 4 specific objective as far as possible
▪ Should emanate from the general objective
▪ Do not use fuzzy words/vague words
▪ Action words used for specific objectives should be narrower than action
words used for general objective
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CRITERIA FOR SETTING OBJECTIVES
▪ Focused, covering a single point
▪ Include all components of research topic (variable to be studied, population,time)
Eg
1.To assess prevalence of malnutrition
2.To assess prevalence of malnutrition among under 5 children in Nekemte public health facilities, 2021
▪ Ordered in logical sequence
▪ Realistic and feasible to achieve
▪ Meet the purpose the study
▪ Use action verbs that are specific enough to be measured
▪ Measurable outcomes at the end of the research
▪ Avoid the use of vague non action verbs such as
✓ To appreciate
✓ To understand
✓ To study
✓ To believe
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FORMAT OF WRITING RESEARCH OBJECTIVE
Research objective can be stated as:
A. Questions:“The objectives of this study are to answer the following questions…”
Ex: What is the prevalence of SAM among under 5 children in Nekemte town, Western Ethiopia,
2021?
What are the factors that contributes for SAM among under 5 children in Nekemte town, Western
Ethiopia, 2021?
B. Positive statements:“The objectives of this study are to determine…”
Ex- To determine the prevalence of severe acute malnutrition among under five children in
Nekemte town,Western Ethiopia, 2021.
C. Hypothesis:“The objective of this study is to verify the following hypothesis….”
Ex- Living in rural area increase the prevalence of SAM among under five children in Nekemte
town,Western Ethiopia, 2021.
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METHODS AND MATERIALS
➢Components
✓ Study area
✓ Study period
✓ Study design
✓ Population
✓ Eligibility criteria
✓ Sample size
✓ Sampling procedure
✓ Variables
✓ Data collection tool and data collection procedure
✓ Data quality management
✓ Data management and analysis
✓ Ethical consideration
✓ Result dissemination
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STUDY AREA AND STUDY PERIOD
Study area
▪ Description of the background information including: Population, geography,
institution as relevant, use map if possible.
▪ The research setting can be seen as the physical, social, and cultural site in which
the researcher conducts the study
▪ Study area defines your target segment.
▪ For an ideal research work the target segment should be very well defined, other
wise the net outcome would not suit your research objective.
▪ Should describe perspectives which have relation with your outcome of interest
▪ e.g. outcome= podoconiosis, describe the soil nature, shoe wearing habit etc.
Mapping is good if necessary
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Study period
▪ Data collection period
▪ Should indicate the time interval when the data primarily were obtained
▪ Not time of analysis, not time of secondary data retrieval
▪ For secondary data study period is when the primary data is collected
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• Study design
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INTRODUCTION
• Epidemiology: Is concerned with the distributions and determinants of disease
frequency in human populations & its application
✓Epidemiological study design can be classified based on:
✓ Describing of distribution and frequency
✓ Elucidating determinants of disease
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▪ Scientific research is systematic (methodical), controlled (measured), empirical (experiment), and critical
investigation of natural phenomena guided by theory and hypotheses about the presumed relations
among such phenomena.”
▪ Research is an organized and systematic way of finding answers to questions
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DESIGNS OVERVIEW
• What is study design?
Definition: A study design is a specific plan or protocol for conducting the study, which
allows the investigator to translate the conceptual hypothesis into an operational one.
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SCHEMATIC PRESENTATION OF THE CLASSIFICATION OF EPIDEMIOLOGICAL STUDY DESIGNS.
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QUANTITATIVE DESIGNS
• Observational: studies that do not involve any intervention or experiment (simple observation).
• Experimental: studies that entail manipulation of the study factor (exposure) and
randomization of subjects to treatment (exposure) groups
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• Descriptive: used to formulate a certain hypothesis: small / large scale.
Examples: case-studies; cross-sectional studies
• Analytical: used to test hypotheses: small / large scale. Examples: case-control,
cross-sectional, cohort etc.
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CHOICE OF DESIGN
DEPENDS ON:
• Research Questions and goals
• Researcher Skills
• Time and Funds
It is also related to:
• Status of existent knowledge
• Occurrence of disease
• Duration of latent period
• Nature and availability of information
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DESCRIPTIVE STUDIES
• Are mainly concerned with the distribution of diseases with respect to time, place
and person.
• Provide useful information for health managers
• to allocate resource and to plan effective prevention programs.
• Generate epidemiological hypothesis.
• Can use information collected routinely which are readily available in many
places.
• are less expensive and less time-consuming than analytic studies.
• Are the most common type of epidemiological design strategies in medical
literature.
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PURPOSE OF DESCRIPTIVE STUDIES
• To evaluate trends in health and disease and allow comparisons among countries and
subgroups among countries;
• To provide basis for planning, provision and evaluation of services;
• To identify problems to be studied by analytic methods and to test hypotheses related to these
problems.
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• There are three main types of descriptive studies:
• Correlational/ecological
• Case report or case series
• Cross-sectional
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CORRELATIONAL OR ECOLOGICAL
• Uses data from entire population to compare disease frequencies.
• Does not provide individual data, rather presents average exposure level in the community.
• Cause could not be ascertained.
• E.g
• Gross national product,
• Air quality measures,
• lead in water,
• the weather,
• Type of political structure
• Density of population
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STRENGTH AND LIMITATION
• Strength: can be done quickly and inexpensively, often using available data.
• Limitation
• Inability to link exposure with disease. association found with aggregate data may not apply to
individuals (ecological fallacy)
• Lack of ability to control for effects of potential confounding factors.
• It may mask a non-linear relationship between exposure and disease.
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CASE REPORT AND CASE SERIES
• Describes the experience of a single or a group of patients with similar diagnosis or health
problem.
• derived from the practice of one or more health care professionals or a defined health care
setting.
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IMPORTANT INPUTS IN MAKING BETTER USE OF THE
CASE SERIES STUDY
• Defining the disease or health problem clearly
• Recording the date when the disease/death occurred (Time)
• Recording where the person lived, worked… (Place).
• Recording personal characteristics of the person such as age and
sex (Person)
• Explore the opportunities for collecting additional data from
records or the person directly.
• Estimating the size and the characteristics of the population at
risk.
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• E.g. The 5 young homosexual men with PCP seen between Oct.
1980 and May 1981 in Los Angeles created a serious concern among
physicians since PCP among young adults is not common.
• One case of pulmonary embolism observed 5 weeks after a woman
started using oral contraceptive was the first clue to the association
between oral contraception and increased risk of venous
thromboembolism.
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STRENGTH AND LIMITATIONS
Strength:
• useful for studying signs and symptoms and creating case definitions for epidemiological studies
• case-series that include cases at various stages of an illness from mild cases to dead
supplemented by investigation build a picture of the natural history of a disease.
• Very useful in providing critical information, for hypothesis generation
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LIMITATIONS:
• Report is based on single or few patients, which could happen just by coincidence.
• Lack of an appropriate comparison group.
• Detailed and complete risk factor information is difficult to obtain for all cases from records.
• Studies are prone to atomistic fallacy.
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• Overall
There is no clear identified method for
❑ Types of population
❑ Sample size calculation
❑ Sampling techniques
❑ Data collection method
❑ Data collection tool
❑ Data analysis
For correlational, case reports and case series studies

.
Cross-sectional (overview)
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Why cross sectional?
❖ We need information to guide decisions.
❖ Conducting a census is either too hard or
impossible.
The Purpose of cross-sectional
Parameters are often impossible to know, so we
conduct good surveys to find statistics.
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Observational Studies: Sample Size < Population
Size
1. Prohibitively difficult to conduct
2. Powerful because they report parameters
μ (mu):“true mean” or population mean and σ (sigma):
“true standard deviation” or population standard deviation
Types of cross-sectional
Census: Sample Size = Population Size
◼ Easier to conduct
◼ Weaker because they report statistics ( sampling error)
◼ (x-bar):“estimated mean” or sample mean
◼ s:“estimated standard deviation” or sample standard
deviation
ҧ
𝑥
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CENSUS
• Investigation of all individual elements that make up a population

CROSS-SECTIONAL
• Based on representative sample of a population of interest who are studied
/interviewed at one point in time
• The unit of the study are the individual & it can be also an organization if
organizations are the sampling units (eg. medical clinics)
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.
Objectives of survey study
• To estimate certain population parameters (eg. prevalence )
• Assess association of factors
• To generate and/or test hypothesis
Advantages of survey
• It is carried out in natural settings
• Random probability sampling is often easier to conduct than for experimental studies
• This allows statistical inferences
• Thus allows generalizations
• Increases the external validity of the study
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…. SURVEYS …..
• Characteristics: detects point prevalence
• Merits: feasible; quick; economic; allows study of several diseases / exposures; useful for
estimation of the population burden, health planning & priority setting of health problems
• Limitations: temporal ambiguity, possible measurement error; not suitable for rare
conditions; liable to survivor bias
• Effect measure: Odds Ratio
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SURVEY …..
▪ Both exposure and disease outcome are determined simultaneously for
each study subjects
▪ Populations are commonly selected without regard to exposure or disease
status
▪ One of its major advantages is it is based on sample of general population
▪ Thus it is generalizable to the population
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….SURVEY…
• current disease status is usually examined in relation to current exposure level
• It is also possible to examine disease prevalence in relation to past exposure if
the dates of exposure are ascertained
• Prevalence rates of disease among those with varying levels of exposure are
measured
Cross sectional studies are carried out for:
• Magnitude of certain health conditions
• Clue for etiologic research
• It is less useful in studying disease causation
• It is more important in public health planning & evaluation
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…..CROSS SECTIONAL... 11/9/2023
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STRENGTH AND LIMITATIONS
Strength
• Easy to conduct
• Not time consuming
• Can be used to compare population with different Cxs as in comparative cross sectional
Limitation:
• "chicken or egg" dilemma.
• Healthy worker Survivor bias
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CASE CONTROL STUDY
✓It analytical study
✓Test hypothesis or not generate hypothesis
✓Only one objective (determinants)
✓Subjects are classified into case and control and their exposure status will be compared among
cases and control
✓There is a control group
✓Selection bias and recall bias
✓Always the nature of outcome variable is categorical data
✓Uses odds ratio as a measure of association
✓Model of study is binary logistic regression
✓During analysis it compares the exposure variable among cases and control
✓For sample size estimation it uses double proportion population formula or power approach

COHORT STUDY DESIGN
• Observational analytical study design
• Tests hypothesis
• Three objectives
• Starts from exposed and non-exposed group and will compare outcome at the end of study
• There is control group
• Measures incidence/risk not a prevalence
• Retrospective and prospective cohort study
• Single and double cohort
• Has two types of population (open and closed population)
• Use cumulative incidence and incidence density as a measure of disease frequency

• Model of study is logistic regression and cox regression based on types of population
• Measure of association is OR and HR based on types of model
• Lost follow up and incomplete information is limitation of the study
• Finally interpret by using risk or hazard
• Eg: The risk/hazard of developing hypertension was 3.2 times higher among urban than
rural population

SAMPLE
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SAMPLE
• Who will be the subjects?
• Any specific information on inclusion and exclusion criteria?
• Where will these subjects be recruited from?
• How will the subjects be selected (sampling technique)?
• Is the sample representative of the group being studied?
• How many subjects will be studied? Need to include sample size
calculation
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SAMPLE
•Sample size calculation
•Different study types have different methods of
calculation.
•Be conservative in calculation.
•Expect attrition.
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INCLUSION CRITERIA
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EXCLUSION CRITERIA
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SAMPLE SIZ CALCULATION
• Based on hip BMD changes reported in an exercise
study in post-menopausal women with similar protocol:
• Exercise group: +0.93%, SD=1.99%
• Control group: -0.51%, SD= 1.48%
• Standardized effect size of exercise =0.8 (large)
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SSC
• Based on Multivariate regression analysis
• Medium to large effect size expected (f2=0.25)
• Number of predictors based on the conceptual model= 9
• Alpha=0.05
• Power=0.80
• Attrition rate=20%
• Minimum sample size 84 (42 per group).
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SSC FOR CROSS SECTIONAL DESIGN
• when outcome variable is categorical data
• Sample size calculation depends on the number of specific objectives of your
study. If the number of specific objectives are two (prevalence and associated
factors) calculate sample size for both objectives and select the largest
sample size.
• There are two approach
• a. Single proportion formula (precision approach) For the first objective
(prevalence estimation)
• b. Double proportion formula (power approach) For second objective
(factors associated with the prevalence) Calculated by using different
software (epi-info, stata, GPower*)
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A. SINGLE POPULATION PROPORTION FORMULA
• used for cross-sectional study design with categorical data outcome
• For proportion estimation
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SINGLE POPULATION PROPORTION
• We use single population formula if the aim is only to conduct a descriptive
study like proportion.
• ✓If we have two specific objectives, the first as prevalence objective and the
second as associated factors, then the prevalence objective requires single
population formula
• ✓In proportion estimation, p can be obtained from: ➢previous studies ➢take
50% if there is no previous studies conduct pilot study, or Use expert idea
to estimate sample size if not feasible to use 50% When you take a previous
study to estimate sample size,
• The study conducted with the same geographical and economic characteristics
• Current published study or the year when the previous studies conducted
should not faced out.
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• It is optimal to use 5-15% non response rate based on the nature of the study.
• If we plan to use multi-stage sampling and cluster sampling techniques we can add a
design effect to the calculated sample size.
• For multistage sampling we will use the design effect of 2 and
• For cluster sampling technique we will use design effect of 1.5
• If multistage sampling technique is planned, then the final sample size would be n= 10% +
(384*2) = 806
• If cluster sampling technique is planned, with 10% non response rate, then the final
sample size would be n= 10% + (384*1.5) = 614
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RULES OF THUMB
• If the population size is small (N ‹ 100), there is little point in
sampling.
• Survey the entire population.
• If the population size is around 500, 50% should be sampled.
• If the population size is around 1500, 20% should be sampled.
• If population size is around 5000, the population size is almost
irrelevant and a sample size of 400 may be adequate.
• Statistician – maximalist – at least 500
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SAMPLING
• Sampling:- Is a process of selecting a small representative group
can be used with confidence to make predictions about the
larger world.
• Population:The larger group to which research results are
generalized.
• An aggregate of persons, objects or events that meet a
specified set of criteria
• Sample - a subgroup of the population.
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208
• Target population: the overall group
of people to which the researcher
intends to generalize findings.
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SAMPLING TECHNIQUES
• Methods of sampling
• Two broad categories: Probability and non-probability
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PROBABILITY SAMPLING
• It is a random selection, giving every member of a
population an equal opportunity, or probability, of being
selected; however, this technique is rarely used in
practice because of practical difficulties in accessing
total populations.
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SIMPLE RANDOM SAMPLING
• drawn from the accessible population, often taken from a listing
of persons, such as membership directories, or institutions, such
as lists of accredited hospitals.
• Need listing
• A more convenient method involves the use of a table of
random numbers
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SYSTEMATIC SAMPLING
• the researcher divides the total number of elements in
the accessible population by the number of elements to
be selected.
• Need sampling interval and random start
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STRATIFIED RANDOM SAMPLING
• involves identifying relevant population characteristics,
and partitioning members of a population into
homogeneous, nonoverlapping subsets, or strata,
based on these characteristics.
• May need proportional stratified sampling
• Disproportional sampling design???
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PROPORTIONAL
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CLUSTER SAMPLING
• Cluster sampling involves successive random sampling of a series of units in the
population.
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CLUSTER SAMPLING
• random-digit dialing, involves the random selection of
phone numbers based on multistage sampling of area
codes and telephone exchanges.
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NONPROBABILITY SAMPLING
• created when samples are chosen on some basis other
than random selection.
• the population do not have an equal chance of being
selected under these circumstances, we cannot readily
assume that the sample represents the target
population.
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CONVENIENCE SAMPLING OR ACCIDENTAL
SAMPLING
• subjects are chosen on the basis of availability.
• the most used and practical approach to convenience
sampling is consecutive sampling, which involves recruiting
all patients who meet the inclusion and exclusion criteria
as they become available.
• Self-selection??
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QUOTA SAMPLING
• a researcher can control for the potential confounding
effect of known characteristics of a population by
guiding the sampling process so that an adequate
number of subjects are obtained for each stratum.
• requires that each stratum is represented in the same
proportion as in the population.
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PURPOSIVE SAMPLING
• The researcher handpicks subjects on the basis of specific criteria.
• The researcher may locate subjects by chart review or interview patients
to determine if they fit the study.
• A researcher must exercise fair judgment to make this process
meaningful.
• Are commonly used in qualitative research to assure that subjects have
the appropriate knowledge and will be a good informant for the study
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SNOWBAL L SAMPLING
• a method that is often used to study sensitive topics, rare traits, personal
networks, and social relationships.
• This approach is carried out in stages.
• In the first stage, a few subjects who meet selection criteria are identified
and tested or interviewed. In the second stage, these subjects are asked to
identify others who have the requisite characteristics.
• This process of "chain referral" or "snowballing" is continued until an
adequate sample is obtained.The researcher must be able to verify the
eligibility of each respondent to ensure a representative group.
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• Snowball sampling is most useful when the population
of interest is rare, unevenly distributed, hidden, or hard
to reach.
• E.g. Postpartum depression
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TOOL DEVELOPMENT
• Before designing the questionnaire, the initial driver for its design has to
be the research question.
• An early decision will be to choose the method that your survey will be
administered.
• self-administered and interviewer administered
• Deciding on which is the best for you will depend upon your question
and the target population.
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• The format of your questions will affect the answers:
• Keep your questions short, less than twenty five words if possible.
• Don't use “double negatives, ” they can be confusing.
• Choose appropriate question formats so they are understandable to the person
answering and that enable you to analyses the resultant data
• A research proposal should address analysis, "data will be analyzed using SPSS…….” •
You might include open ended questions in the questionnaire…
• The pilot is a good time to use more open questions to check there are sufficient
options on multichoice answers and that there is sufficient discrimination in the question.
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• Ambiguous questions.
• Ambiguous questions yields no useful data
• can frustrate the respondent
• encourage them to give up!
• Avoid asking two questions at once.
• Example :‘Are you happy with the amount and timeliness of
feedback you receive from your tutors?”
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• Leading Questions.
• Leading questions will bias the results, this will reduce
objectivity and hence the value of the research.
• Layout and question types.
• Be absolutely unambiguous about how the subject should fill
in the question.
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• Try it out! Run a Pilot
• When you have created the ultimate questionnaire try it out o It is
very unlikely to be right first time!
• Don't just pilot the survey but carry that data through to analysis to.
• Solicit comments from your pilot group
• Friends might be shy of being critical
• Make sure they feel it is OK to note the shortcomings.
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• How long should a questionnaire be?
• How long is a piece of string? …. there is no definite rule
• twenty Likert type questions is probably OK but forty is probably too many!
• It does depend partly on the target group
• the amount of time people will happily take in filling it in will depend on their
interest.
• Another good reason to properly pilot it!
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• What kind of questions should I use?
• They should fit two criteria
• they should furnish the data required
• can be analyzed.
• the Likert scale question and the yes/no question= relatively easy to
handle
• Dichotomous like : Male & Female (yields nominal data),Y/N
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