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Nursing research

  2. 2. OBJECTIVES By the end of this lecture Students will be able;  To define research and nursing research  To discuss role of Nurse in research participation  To enlist the process of research.  To Know about the importance of Research.  Discuss the historical trends or history of Nursing Research.  To review the types of research methods “ Qualitative, Quantitative and outcomes ”  To discuss areas of high priorities for nurse researchers 2
  3. 3. NURSING RESEARCH - INTRODUCTION  Nursing cultural change  Nurses expected to understand and conduct research  Base their professional practice on evidence  Evidence Based Practice defined as the use of the best clinical evidence in making patient care decisions, and such evidence typically comes from research conducted by the nurses and other health care professionals. 3
  4. 4. RESEARCH  Research means To Search Again. To examine carefully.  Research seeks answers to questions in an orderly and systematic way.  It is a method of problem solving. 4
  5. 5. DEFINITION OF RESEARCH  It is diligent (careful), systematic inquiry or study that Validates and refines existing knowledge and develops new knowledge.  A scientific process that validates and refines existing knowledge and generates new knowledge that directly and indirectly influences clinical nursing practice. 5
  6. 6. NURSING RESEARCH  Nursing research is systematic inquiry designed to develop knowledge about issues of importance to the nursing profession, including nursing practice, education, administration, and informatics. Example of research question  How do adults with acquired brain injury perceive their social interactions and relationships (Paterson & Stewart, 2002) 6
  7. 7. WHAT DOES RESEARCH DO? Research enables nurses to:  Describe the characteristics of a particular nursing situation about which little is known.  Eg. Nurses work stress  Explain phenomenon that must be considered in planning nursing care.  Eg. Nurses working concept, NPR, Team work, nursing care / concepts of Psychiatric , Pediatric and OBG clients, Water birth. 7
  8. 8. WHAT DOES RESEARCH DO? Research enables nurses to:  Predict the probable outcome of certain nursing decisions made in relation to client care.  Eg. Oral Care – Lemon, Salt, Chlorhexidine  Control the occurrence of undesired client outcomes.  Eg. Muscle dystrophy prevented / controlled by active, passive exercise  Initiate, with a fair degree of confidence, activities that will achieve desired client behavior.  Eg. Good or better IPR makes Good or better client behaviour 8
  9. 9. WHY DO NURSES NEED RESEARCH?  For the continuous growth of nursing profession.  Helps nursing to achieve its own professional identity.  Helps to identify the boundaries of nursing.  To define the parameters of nursing.  For cost containment practices. 9
  10. 10. ROLE OF NURSE IN RESEARCH PARTICIPATION AT VARIOUS LEVELS OF EDUCATION PREPARATION (ANA-1989) BSN Degree 1. Critiquing & synthesizing research findings from nursing profession and other discipline for use in practice. 2. Provide valuable assistance in identifying research problems and collecting data for studies. 10
  11. 11. ROLE OF NURSE IN RESEARCH PARTICIPATION AT VARIOUS LEVELS OF EDUCATION PREPARATION (ANA-1989) Master's degree 1. To lead health care teams  Making essential changes in nursing practice  Health care system based on research 2. Conduct investigations 3. Initial studies in collaboration with other investigators 4. Facilitate research and Provide consultation 11
  12. 12. ROLE OF NURSE IN RESEARCH PARTICIPATION AT VARIOUS LEVELS OF EDUCATION PREPARATION (ANA-1989) Doctoral Degree 1. Assume a major role in the conduct of research. 2. Generation of nursing knowledge in a selected area of interest.  Extend scientific basis  Develop methods to measure nursing phenomena 12
  13. 13. ROLE OF NURSE IN RESEARCH PARTICIPATION AT VARIOUS LEVELS OF EDUCATION PREPARATION (ANA-1989) Post doctoral degree 1. Assumed a full researcher role and has a funded program of research 2. Develop and coordinate funded research programs 13
  14. 14. NURSING RESEARCH PRIORITIES To Improve:  Nursing as a profession  Nursing practice  Patient outcomes 14
  15. 15. IMPORTANCE OF RESEARCH IN NURSING  EBP increases the need or importance for nursing research.  EBP demands high quality / rigorous nursing research  EBP indicates clinically appropriate, cost-effective and result in positive outcomes for clients. 15
  16. 16. WHY IS RESEARCH IMPORTANT IN NURSING?  Knowledge generated through research is essential to provide a scientific basis for:-  Description What exists in Nursing/practice and discover a new knowledge.  Explanation Explains the existing knowledge in relation to the effect and the outcome 16
  17. 17. WHY IS RESEARCH IMPORTANT IN NURSING?  Like bed sore occur in the old people due to lack of mobility  Prediction A nurse could predict the out come on the bases of interventions  Control Ability to write a prescription to produce the desire result. 17
  18. 18. TYPES OF NURSING RESEARCH NURSING RESEARCH Qualitative research Quantitative research Outcome research - Phenomenological - Descriptive - Grounded theory - Correlational - Ethnographic - Quasi-experimental - Historical - Experimental18
  19. 19. QUANTITATIVE RESEARCH  Is a formal, objective, systematic process in which numerical data are used to obtain information about the world.  Is "hard science" it is perceived as rigorous (exact), systematic and objective focusing on numerical data and using statistical analysis and controls in an attempt to eliminate bias. 19
  20. 20. QUANTITATIVE RESEARCH  It is conducted to test theory by;  Describing variables  Examining relationship among variables  Determine cause and effect interaction between variables. Types of Quantitative Research:  Descriptive- explore new areas/describe situations.  Co-relational- examine relationships  Quasi-experimental- effectiveness of intervention.  Experimental- producing positive outcomes. 20
  21. 21. QUALITATIVE RESEARCH  Is a systematic, subjective approach used to describe life experiences and situation and to give them meaning.  "Mode of systematic inquiry concerned with understanding human beings and the nature of their transaction with themselves and with their surrounding" (Benoliel, 1984). 21
  22. 22. QUALITATIVE RESEARCH  Qualitative research is often described as holistic, that is, concerned with humans and their environment in all their complexities. It is lived and as it is defined by the actors themselves 22
  23. 23. QUALITATIVE RESEARCH Types of Qualitative Research:  Phenomenological- describes experience as lived.  Grounded theory- formulate, test and refine a theory about a phenomena.  Ethnographic- investigates cultures in depth.  Historical- description analysis of events that occurred in past. 23
  24. 24. OUTCOME RESEARCH  Is focused on examining the end results of care or determining the changes in health status for the patient. 24
  25. 25. OUTCOME RESEARCH Four essential areas require for this reason:  The patients responses to medical or Nursing Intervention.  Functional maintenance/improvement of physical functioning for the patient.  Financial outcome achieved with the provision of health care services.  Patients satisfaction with the health outcomes care received and the health care provider. 25
  26. 26. QUANTITATIVE & QUALITATIVE RESEARCH CHARACTERISTICS 26 Quantitative Research Qualitative Research 1. Hard science Soft Science 2. Focus: Concise and Narrow Focus: Complex and Broad 3. Reductionistic Holistic 4. Objective Subjective 5. Reasoning: Logistic Deductive Reasoning: Dialectic, Inductive 6. Basis of knowing: cause and effects, relationships Basis of knowing: meaning discovery
  27. 27. QUANTITATIVE AND QUALITATIVE RESEARCH CHARACTERISTICS 27 Quantitative Research Qualitative Research 7. Tests theory Develops theory 8. Control Shared interpretation 9. Instruments Communication and observation 10. Basic elements of analysis: numbers Basic elements of analysis: words 11. Statistical analysis Individual interpretation. 12. Generalization Uniqueness
  28. 28. MAJOR CLASSES OF QUANTITATIVE & QUALITATIVE RESEARCH Quantitative research Qualitative research Experimental Research Non Experimental Research Disciplinary Traditions Experimental Research:- Researchers actively introduce an intervention or treatment. Originated in the disciplines of anthropology, sociology & psychology 28
  29. 29. Non Experimental Research Researchers are bystanders :- The data collected without introducing treatments or making changes. It is based on grounded theory, phenomenology, Ethnography 29
  30. 30. In medical & Epidemiologic research, an Experimental study usually called a controlled trial or clinical trial & Non Experimental inquiry called as an observational study. To describe and understand the key social, psychological and structural processes occurring in a social setting. 30
  31. 31. GROUNDED THEORY  Was developed in the 1960s by two socilogists Glaser & Strauss  Focus is on a developing social experience, social & psychological stages and phases that characterize a particular event or episode.  Major component is the discovery of a core variable. 31
  32. 32. GROUNDED THEORY Eg. King et al (2006) conducted a series of grounded theory studies with men and women from five ethnocultural groups in Canada who had been diagnosed with Coronary Artery Disease risk. (CAD) The analysis of the process through which patients met the challenge of managing Coronary Artery Disease risk. 32
  33. 33. PHENOMENOLOGY  Rooted in a philosophical tradition  Developed by Husserl and Heidegger  Concerned with lived experiences of humans  It is an approach to thinking about what life experiences of people are like and what they mean. 33
  34. 34. PHENOMENOLOGY  Eg. O’Dell and Jacelon (2005) conducted in depthinterviews to explore the experiences of women who had undergone vaginal closure surgery to correct severe vaginal pralapse. 34
  35. 35. ETHNOGRAPHY  Primary research tradition with in anthropology  Provides framework for studying the patterns, life ways, and experiences of a cultural group ina wholistic fashion.  Aim of ethnographers is to learn from members of a cultural group, to understand their world view as they perceive & live it to describe their customs & norms 35
  36. 36. ETHNOGRAPHY Eg. Schoenfeld and Juarbe (2005) conducted ethnographic fieldwork in two rural Ecuadorian communities and studied the burdens of women’s roles, the women’s perceived health needs, and their health care resources. 36
  37. 37. THE CONSUMER-PRODUCER CONTINUUM IN NURSING RESEARCH  Consumers of nursing research:- Read research reports to develop new skills and to search for relevant findings that may affect their practice.  Producers of nursing research:- Nurses who actively participate in designing and implementing studies. 37
  38. 38. VARIETY OF RESEARCH ACTIVITIES BY CONSUMER- PRODUCER CONTINUUM. 1.Participating in a journal club in a practice setting, which involves meetings among nurses to discuss and critique research articles. 2.Solving clinical problems and making clinical decisions based on rigorous research 3.Collaborating in the development of an idea for a clinical research project. 38
  39. 39. VARIETY OF RESEARCH ACTIVITIES BY CONSUMER- PRODUCER CONTINUUM. 4.Reviewing a proposed research plan with respect to its feasibility in a clinical setting and offering clinical expertise to improve the plan. 5.Recruiting potential study participants 6.Assisting in the collection research information (e.g. distributing questionnaires to patients.) 39
  40. 40. VARIETY OF RESEARCH ACTIVITIES BY CONSUMER- PRODUCER CONTINUUM. 7.Giving clients information and advice about participation in studies 8.Discussing the implications and relevance of research findings with clients. 40
  41. 41. TERMS AND CONCEPTS OF RESEARCH 1. The faces and places of research 2. The building blocks of research a. Phenomena, Concepts and Constructs b. Theories and conceptual models c. Variables d. Conceptual and operational definition e. Data 3. Relationships 41
  42. 42. 1. THE FACES AND PLACES OF RESEARCH Studies with human involves two sets of people I. Those who provide the II. Those who do the information research 42
  43. 43. I. THOSE WHO PROVIDE THE INFORMATION Ina quantitative study In a qualitative study Subjects or Study Participants Informants or key informants or Study participants Respondents Sample 43
  44. 44. II. THOSE WHO DO THE RESEARCH  Researcher or investigator  Collaborative research  Project director or principal Investigator  Co-investigators  Reviewers  Peer reviewers  Funder or sponsor 44
  45. 45. RESEARCH SETTINGS  Naturalistic Settings:-  Laboratory Settings:-  Multisite studies:- 45
  46. 46. KEY TERMS USED IN QUANTITATIVE AND QUALITATIVE RESEARCH CONCEPT QUANTITATIVE TERM QUALITATIVE TERM Person contributing information Subject, study participant, respondent study participant, informant, key informant Person under taking the study Researcher, investigator, scientist Researcher, investigator That which is being investigated Concepts, constructs, variables Phenomena, concepts System of organizing concepts Theory, theoretical framework, conceptual model Theory, conceptual framework, sensitizing framework Information gathered Data(numeric values) Data (narrative descriptions) Connection between concepts Relationships (cause-and- effect, functional) Patterns of association Logical reasoning process Deductive reasoning Inductive reasoning 46
  47. 47. 2. THE BUILDING BLOCKS OF RESEARCH A) Phenomena, Concepts and Constructs  Concepts:- Research involves abstractions. For eg. The terms of pain, quality of life, and resilience are all abstractions of particular aspects of human behaviour and characteristics. These abstractions are called concepts. In qualitative study it is known as Phenomena. 47
  48. 48. 2. THE BUILDING BLOCKS OF RESEARCH A) Phenomena, concepts and constructs  Construct:- It refers to an abstraction or mental representation inferred from situations or behaviours. It is a more complex abstraction than concept.  Constructs are abstractions that are deliberately and systematically invented (or constructed) by researchers for a specific purpose. For eg. Self care in Orem's Model of health maintenance is a construct. 48
  49. 49. 2. THE BUILDING BLOCKS OF RESEARCH B) Theories and conceptual Models  Theory :- Is a systematic, abstract explanation of some aspect of reality.  Conceptual Models: interrelated concepts or abstractions assembled together in a rational scheme by virtue of their relevance to a common theme; some times called conceptual framework. 49
  50. 50. 2. THE BUILDING BLOCKS OF RESEARCH C) VARIABLES  In quantitative studies, concepts are usually called as variables i. Continuous, Discrete and categorial variables ii. Dependent & independent variables 50
  51. 51. 2. THE BUILDING BLOCKS OF RESEARCH C) VARIABLES  Variable:- is something varies or differs. Eg. Weight, anxiety levels, body temperature etc. each varies from one person to another.  Heterogeneous:- The degree to which objects are dissimilar on some attribute.  Homogenous:- The degree to which the objects are similar. 51
  52. 52. RESEARCH C) VARIABLES :- I. CONTINUOUS, DISCRETE AND CATEGORIAL VARIABLES  Continuous variables:- have values along a continuous and, in theory, can assume an infinite number of values between two points. Eg. Continuous variable weight between 1 & 2 pounds, the number of values is limitless. 1.05, 1.7, 1.333, and so on. 52
  53. 53. RESEARCH C) VARIABLES :- I. CONTINUOUS, DISCRETE AND CATEGORIAL VARIABLES  Discrete variable:- has a finite number of values between any two points, representing discrete quantities Eg. If people were asked how many children they had, they might answer. 0, 1, 2, 3 or more. The value for number of children discrete, because number such as 1.5 is not meaningful. Between 1 & 3, the only possible value is 2. 53
  54. 54. 2. THE BUILDING BLOCKS OF RESEARCH C) VARIABLES :- I. CONTINUOUS, DISCRETE AND CATEGORIAL VARIABLES Categorial variables:- variable that take on a handful of discrete non-quantitative values are called categorial variables. For eg. Blood type has four values that is A, B, AB and O. Dichotomous variables:- Categorical variables take on only two values. Eg. Gender is dichotomous Male & Female 54
  55. 55. 2. THE BUILDING BLOCKS OF RESEARCH C) VARIABLES :- II. DEPENDENT AND INDEPENDENT VARIABLES  Independent variable :- The presumed cause is the independent variable  Dependent Variable:- The presumed effect is dependent variable 55
  56. 56. 2. THE BUILDING BLOCKS OF RESEARCH C) VARIABLES :- II. DEPENDENT AND INDEPENDENT VARIABLES  Outcome Variable:- The variable capturing the outcome of interest Smoking Lung cancer (cause) (effect) Independent V Dependent V 56
  57. 57. STEPS IN RESEARCH  From beginning point to end point  Sequence of steps  General flow of activities are typical in quantitative studies  5 phases and each phase has certain steps  Conceptual phase  Designing and planning phase  Empirical phase  Analytic phase  Dissemination phase 57
  58. 58. STEPS IN QUANTITATIVE RESEARCH 58 PHASE 1: THE CONCEPTUAL PHASE 1: Formulating and Delimiting (state clearly) the Problem 2: Reviewing the Related Literature 3: Undertaking Clinical Fieldwork 4: Defining Framework & Developing Conceptual Definitions 5: Formulating Hypotheses
  59. 59. PHASE 1: THE CONCEPTUAL PHASE  Strong intellectual and conceptual activity  These activities include  Reading  Conceptualizing  Theorizing  Reconceptualizing  Reviewing ideas  Skills needed are,  Creativity  Deductive reasoning, Insight and firm grounding in previous research on the topic of interest 59
  60. 60. Step1: Formulating and Delimiting (state clearly) the Problem  Researcher identifies an interesting, significant problem and good research questions.  Good research depends to a great degree of good questions.  While developing a research question, researchers must pay close attention to  Substantive issues  Theoretical issues  Clinical issues  Methodologic issues and  Ethical issues 60
  61. 61. Step 2: Reviewing the Related Literature  Quantitative research conducted within the context of previous knowledge.  What is already known about a research problem?  Through literature review  For clinical problems learn about “status quo” of current procedures relating to topic  Review existing practice guidelines or protocols. 61
  62. 62. Step 3: Undertaking Clinical Fieldwork  To refresh or updating clinical knowledge.  Spend time in clinical settings  Discussing the topic with clinicians, health care administrators and observing current practices.  Clinical field work provides perspectives.  Recent clinical trends  Current diagnostic procedures and Relevant health care delivery models  Better understand affected client and setting in which the care is provided  Field work strengthen the study. 62
  63. 63. Step 4: Defining Framework & Developing Conceptual Definitions  Quantitative research performed within the context of a theoretical framework  Findings may have broader significance and utility.  If research question not embedded in a theory  Have a conceptual rationale  Clear sense of concepts under study  Development of conceptual framework is an important task 63
  64. 64. Step 5: Formulating Hypotheses  Hypothesis is a statement of researcher’s expectations about relationship between study variables.  It is predictions of expected outcomes.  The research question ask how the concepts under investigation might be related.  But the hypothesis predicts the answer. 64
  65. 65. STEP 5: FORMULATING HYPOTHESES  Eg. Research Question Is preeclamptic toxemia related to stress factors during pregnancy? Hypothesis Women with a higher incidence of stress during pregnancy will be more likely than women with a lower incidence of stress to experience preeclamptic taxemia. 65
  66. 66. STEPS IN QUANTITATIVE RESEARCH 66 PHASE 2: THE DESIGN AND PLANNING PHASE 6: Selecting a Research Design 7: Developing Protocols for the Intervention 8: Identifying the Population to be Studied 9: Designing the Sampling Plan 10: Specifying Methods to Measure the Research Variables 11: Developing Methods for Safeguarding human/ Animal Rights 12: Finalizing and Reviewing the Research Plan
  67. 67. PHASE 2: THE DESIGN AND PLANNING PHASE  Second major phase of quantitative study  Decision about methods and procedures to address the research question  Plan for actual collection of data  Nature if research question dictates the methods to be used  Considerable flexibility and makes many decisions  Methodologic decisions have important implications for the integrity of study findings 67
  68. 68. STEP-6 SELECTING A RESEARCH DESIGNS  It is the overall plan for obtaining answers  Helps in handling some difficulties encountered during research process  Research designs in quantitative study- non- experimental, experimental  Researcher specify the design will be adopted, procedure to minimize the bias and enhance the interpretability of results  In quantitative study research designs are highly structured and controlled  Research design indicates other aspects of study  Eg. How often data will be collected, what type of comparisons will be made, where the study will take place 68
  69. 69. STEP 7- DEVELOPING PROTOCOLS FOR THE INTERVENTION  In experimental research the researcher creates the independent variable – means participants exposed to different treatments  Eg. Relaxation therapy  Development of intervention protocol – who would administer it, how frequently, over how long a period the treatment would lost, and so on and what alternative condition would be  The goal of well articulated protocol is treating the subjects in each group same way  In non-experimental research this step is unnecessary 69
  70. 70. STEP 8- IDENTIFYING THE POPULATION  Quantitative researchers need to know  Characteristics of study participants  To which group the study results can be generalized ie identification of the population to be studied  Population is all the individuals or objects with common, defining characteristics Eg.  Population undergoing chemotherapy in belgaum  Menopausal women in belgaum  Neonates in belgaum 70
  71. 71. STEP 9-DESIGNING AND SAMPLING PHASE  Data collected from the sample which is a subset of the population  Using samples is more practical and less costly than collecting a data from an entire population  But the risk is the sample might not adequately reflect the population traits  In quantitative study the sample’s adequacy is assessed by the criterion of “REPRESENTATIVENESS”  The quality of the sample depends on how typical or representative, the sample is of the population  Sophisticated sampling procedures  Sampling plan specifies in advance hoe the sample will be selected, recruited and how many subjects 71
  72. 72. STEP 10- SPECIFYING METHODS TO MEASURE RESEARCH VARIABLE  It must be developed or it can be barrowed  Quantitative data collection approaches are  self reports – interviews  Observations – sleep and wake status of infants  Bio physiologic measurements  Data collection plan – task of developing measuring variables  Complex and challenging process 72
  73. 73. 11. DEVELOPING METHODS TO SAFE GUARD THE HUMAN OR ANIMAL RIGHTS  Nursing research involves human subjects and some times animals  Ensure that study adheres to ethical principals  Protection of rights of study subjects  Review committee acceptance 73
  74. 74. 12. REVIVING AND FINALIZING THE RESEARCH PLAN  Performing number of tests to ensure smooth work  Eg  Readability – ability to understand  Pretest – measuring instrument  Pilot study  Submission of proposal to funding source 74
  75. 75. STEPS IN QUANTITATIVE RESEARCH 75 PHASE 3: THE EMPIRICAL (PRACTICAL) PHASE 13: Collecting the Data 14: Preparing the Data for Analysis PHASE 4: THE ANALYTIC PHASE 15: Analyzing the Data 16: Interpreting the Results
  76. 76. PHASE 3: EMPIRICAL PHASE  Collecting research data  Preparing those data for analysis  Time consuming part  Requires several weeks, months of work
  77. 77. STEP 13: COLLECTING DATA  Proceeds according to the pre established plan  Plan typically specifies procedures for the actual data collection – where, when  Describing the study to the participants  Recording the information  Technological advance helps
  78. 78. STEP 14: PREPARING FOR DATA ANALYSIS  Coding: translation of verbal data into numeric form  Eg: Gender might be coded M1 and F2  Transferring data from written documents on to computer files for subsequent analysis
  79. 79. PHASE 4: ANALYTIC PHASE  Data collected in empirical phase are subjected to analysis and interpretation
  80. 80. STEP 15: ANALYZING THE DATA  Orderly and coherent fashion  Quantitative information analyzed through statistical procedures  Statistical analysis
  81. 81. STEP 16: INTERPRETING THE RESULTS  Interpretation: process of making sense of study results and of examining their implications  Explaining the findings with prior evidence, theory and their own clinical experience  Interpretation also involves, how findings can best be used in clinical practice, or what further research is needed
  82. 82. STEPS IN QUANTITATIVE RESEARCH 82 PHASE 5: THE DISSEMINATION PHASE 17: Communicating the Findings 18: Utilizing the Findings in Practice
  83. 83. PHASE 5: DISSEMINATION PHASE  In analytic phase the research question posed are answered  Responsibility is not completed it ends with the study results dissemination
  84. 84. STEP 17: COMMUNICATING THE FINDINGS  Final task – preparation of a research report to share with others  Various forms of research reports are – term papers, dissertations, journal articles, presentation at conferences  journal articles – reports appearing in professional journals as nursing research
  85. 85. STEP 18: UTILIZING THE FINDING IN PRACTICE  High quality study is to plan for its use in practice settings  Recommending the evidence of the study to be incorporated into practice of nursing
  87. 87. RESEARCH PROCESS OR FLOW OF STEPS IN QUALITATIVE RESEARCH 87 Planning the study •Identifying the research problem •Doing a literature review •Developing a overall approach •Selecting and gaining entrée into research sites •Developing methods to safeguard participants Developing data collection strategies •Deciding what type of data to gather and how to gather •Deciding from whom to collect the data •Deciding how to enhance the trustworthiness Gathering and analyzing data •Collecting data •Organizing and analyzing data •Evaluating data: making modifications to data collection strategies, if necessary •Evaluating data: determining if saturation has been achieved Disseminating findings •Communicating findings •Utilizing or making recommendations for utilizing findings in practice and future research
  88. 88. HISTORY IN NURSING RESEARCH  Began with Florence Nightingale over 150 years ago (1850).  In (1859) describes her initial research activities which looked at the importance of leading environment in promoting physical and mental well being  Ventilation  Cleanliness  Purity of water  Diet 88
  89. 89. HISTORY IN NURSING RESEARCH  In addition collected the data of morbidity from Crimean War this made the military provide:  Enough food.  Clear quarters for the sick.  Appropriate medical treatment.  These interventions made impact on public health (military help)  drastically reduces mortality from 43% up-to 2% in the Crimean War.  Testing public water  Improve sanitation  preventing starvation. 89
  90. 90. HISTORY IN NURSING RESEARCH  1900- 20’s First Journal Published “ American Journal of nursing (1900) Case study appeared ( 1920 - 1930) In-depth analysis and systematic description of one patient or group to promote understanding of nursing Research. 90
  91. 91. HISTORY IN NURSING RESEARCH Little research done except for a few important educational studies recommending establishing School of nursing in a university. (Gold mark report, 1923) First doctoral program for nurses was at Teachers college in Colombia. (NYC) in 1924. 91
  92. 92. HISTORY IN NURSING RESEARCH  1950 American Nurse Association (ANA) initiated a five year study on nursing functions and activities. Clinical Research began Research took on new importance due to vision of Virginian Henderson & Faye Abdullah; One could see more nurses with Master's degree and School of Nursing began introducing research as a separate course 92
  93. 93.  1952 First Journal Of Nursing Research published. Researches conducted at Baccalaureate and masters level.  1953 The institute of Research and services in Nursing education established at teachers collage Columbia University, New York. Provided learning experience in research for Doctoral studies.  late 60's saw more research being done that imported clinical and quality of care 93
  94. 94.  1970's  Saw nursing process as focus for many studies.  Saw increase in number of nursing theories and models.  Image: Journal of nursing scholarly, first published in 1967 and Advance in nursing science in 1978 ( Including Nursing Theories) by STTI. • To tackle the issue of communication / dissemination of information  Council of Nurse research establish 94
  95. 95.  1980's  Clinical research became the important design in research  Saw many new journals being published e.g. Cancer nursing; Pediatric nursing, Dimension of critical care nursing etc.., Applied nursing research.  Clinical research written priority of the 80's increase funding for nursing research.  The ANA achieved a victory by establishing the National Center for Nursing Research in 1985. 95
  96. 96.  Priorities of National Center for Nursing Research 1999 includes: Community based nursing models. Effectiveness of nursing interventions in HIV/AIDS. Cognitive impairment. Living with chronic illness. 96
  97. 97. QUANTITATIVE & QUALITATIVE RESEARCH CHARACTERISTICS 97 Quantitative Research Qualitative Research 1. Hard science Soft Science 2. Focus: Concise and Narrow Focus: Complex and Broad 3. Reductionistic Holistic 4. Objective Subjective 5. Reasoning: Logistic Deductive Reasoning: Dialectic, Inductive 6. Basis of knowing: cause and effects, relationships Basis of knowing: meaning discovery
  98. 98. QUALITATIVE RESEARCH CHARACTERISTICS 98 Quantitative Research Qualitative Research 7. Tests theory Develops theory 8. Control Shared interpretation 9. Instruments Communication and observation 10 . Basic elements of analysis: numbers Basic elements of analysis: words 11 . Statistical analysis Individual interpretation. 12 . Generalization Uniqueness
  99. 99. AREAS OF HIGH PRIORITY FOR NURSE RESEARCHER  Patient focused research  The management processes within health care services  Cultural issues for nurses and patients  The history of nursing  Ethical decision making  Nursing and professional regulation  Education of nurses  Nursing workforce skills mix 99
  100. 100. REFERENCES  Polit, D.F., and Bech, C.T. “Nursing Research; principles and Methods” 7th edition, LWW.  Burns, N., and Grove, S.K. (2007). “Understanding Nursing Research; building an evidence based practice” 4th edition, New Delhi, Elsevier. 100
  101. 101. REFERENCES  Anonymous, (n.d). Promoting Research in Clinical Practice: Strategies for Implementing Research Initiatives. Journal of Trauma Nursing, April/June 2009 Acknowledgements  Dr. Fauziya Ali Ph.D  Tazeen Saeed Ali RN, RM, BScN, MSc (Epidemiology) 101