HRSGNA Certification Review Class Chapter 7 Research

1. HRSGNA Certification Review ClassChapter 7Research Jan Brooks RN, BSN, CGRN

2. Research • Objectives: • 1. Define basic terms used in the Research Design • 2. Identify a minimum of three steps performed in the Research Process

3. Research • Research has occurred over the past 30-40 years. • Originated with Florence Nightingale in the 1859, publishing her notes on Nursing. • National Center for Nursing Research was established in 1985 within the National Institute of Health. • 1993, renamed National Institute of Nursing Research and had full institute status.

4. Research • We are seeing greater evidence of results from Research as noted with Evidence Based Practice • One area of current practice changes is the verification of NG tube placement: • Previously used withdrawing NG contents, listening for air in the stomach and looking for air bubbles in water • Now—Evaluate NG with documentation of pH of gastric contents

5. Research • Research is a form of rigorous problem solving as Nursing is • Similar practices are applied: • Careful observation • Strict documentation • Systemic assessment

6. Research • Goals of Research • Scientific foundation for knowledge of Nursing Practice • Description • Exploration • Explanation • Prediction and Control

7. Research • Description • Use of controlled, systematic observations to describe the phenomenon under study • Example: 1996 study conducted to describe enema administration by nurses

8. Research • Exploration • This looks at factors that influence, relate to, or cause or affect a phenomenon • Co-existing variables are analyzed Example: Looking at locale (rural, urban or suburban) as part of the effort to link environmental/genetic factors to colon polyp formation

9. Research • Explanation • Related to Theory Building • Represent method of deriving, organizing and integrating ideas and relationships to the phenomena • Example: Evaluating the effects of pre-procedural teaching related to the level of anxiety experienced by patients undergoing GI procedures and the nursing role in stress reduction.

10. Research • Prediction and Control • Studies that attempt to demonstrate a relationship between variables by manipulating one and observing for a predicted outcome. • Variable—Characteristic or attribute that takes on different values within a given population • Independent Variable—The attribute or characteristic that is unaffected by other values in a study. • Dependent Variable—Attribute or characteristic that is affected by other values in a study.

11. Research Classification • Basic Research: Adding to the body of knowledge • Applied Research: Focuses on a solution to a practical problem. • Most Nursing Research has been Applied Research

12. Research • Steps in the Research Process • 1. Identify the Problem • Research begins with a problem detected in practice • Often initial statements are too broad and vague • Must be redefined and limited for a manageable project

13. Research • Steps in the Research Process • 2. Review the Literature • Helps clarify and refine focus of the research • Look at other studies on the same or similar topic • Problem may have been evaluated previously but not sufficiently so it may be replicated • Evaluate research designs which may or may not be appropriate • Important Variables to be considered • Evaluate previously made mistakes

14. Research • Information to look for in Research Reports • Facts, Statistics or findings • Most important category of information • Represents results of other research efforts • Theory or Interpretation • It concerns the relationship between the idea or topic and the existing body of knowledge

15. Research • Information to look for in Research Reports • Methods and Procedures Saves the researcher from redeveloping and revalidating measurement tools that already exist • Opinions, Speculation, anecdotes, clinical impressions or narrations of incidents and situations These are subjective. Broaden researchers understanding Don’t rely too heavily on these

16. Research • Sources of Research Reports • Abstracts—summary of a journal that allows you to determine whether this article will be relevant • Indexes—store of literature on a particular topic • Computer Databases—are usually free and easily accessible • Bibliographies—Complications of references on a particular topic • Personal Contact with other investigators

17. Research • Evaluating Research Reports • Primary Source of Information—Written by the person or persons who conducted the study • Secondary Source of Information—Describes research performed by others. Review is secondary resource • Negative findings are also important—This is an indication that mare research is necessary

18. Research • Steps in the Research Process • 3. State the Purpose of the Study • Formulate Hypotheses or Research Questions • Purpose or Aim: General statements that the researcher hopes to accomplish or learn from a particular research study • Research Questions and Hypotheses • Address relationship between variables to be tested • You may have either or both

19. Research • Research Questions • Written in present tense and ask general questions about the relationship of the variables Research Hypotheses Are more specific, written as declarative sentences Also state the direction of relationship between the variables

20. Research • Steps in Research • 4 Design the Study • How are you going to sample the study population? • Determine setting of the study • Measures used to collect data • Procedures used to collect data • What statistical measurement is to be used?

21. Research • Study Designs Survey—interviews or Self completion questionnaire Quantitative Measurement –Looking at results before and after a treatment or intervention is rendered Qualitative Study –Case Study Data obtained through observation

22. ResearchFactors that influence a Study Interest level of study both by researcher and the professional community Motivation to complete study Time—Can the study be completed in the allotted time? Availability of Subjects—Is there sufficient number of subjects to investigate the problem?

23. ResearchFactors that influence a Study Cooperation of others—Relates to resources, obtainin necessary permission individuals as well as institutions Facilities and Equipment—What is needed and will it be available to complete the study? Money—Is funding necessary? How much? Does the cost outweigh the value of the expected findings?

24. ResearchFactors that influence a Study Experience of the Researcher—Has the researcher had experience or knows another researcher who can assist? Ethical Considerations– Does this impose unfair or unethical demands on participants? Includes beneficence (protection from harm or discomfort) justice (equally fair treatment for all participants) and privacy.

25. Research • Steps in the Research Process • 5. Carry out the study Plan • 6. Analyze the Data Statistical methods used

26. Research • Steps of the Research Process • 7. Share the results an essential component • Writing and publishing an article • Giving an oral presentation • Presenting the findings in a poster at local or national meetings • Presenting findings at informal meetings

27. Research Terminology • Null Hypothesis • Is used in statistical testing • Stated in the opposite direction of the research hypothesis • Indicates that there is no relationship between the variables • Most researchers do not write the null hypothesis as it is the opposite and therefore understood.

28. Research Terminology • Sampling—Process of selecting a study group • Random Sampling—Involves selecting study group so each member of a population has an equal probability of participation • Accidental Sampling—Using the most readily available subjects. Also called a non-probability sampling

29. Research Terminology • Experimental Group-Subjects who receive treatment or intervention • Control Group—Subjects who do not receive treatment or intervention • Comparison Group—Subjects used as a basis of evaluating results

30. Research Terminology • Double-Blind Study—Neither the subjects or the investigator is aware of whether they are in the Experimental group or the Control Group • Placebo –Material used whose appearance is identical to the drug under investigation. Allows researchers to separate physiological effects from true effects

31. Research Terminology • Data Measurement Level Terms Nominal—weakest form of measurement Puts data into categories—race, gender, age Ordinal Data—Data arranged by rank Pain scale, strongly disagree to strongly agree Interval level—Rank order data arranged at specific intervals, but has no genuine zero point Ratio—Highest level of measurement—Has the characteristics of Interval and has a zero point

32. Research Terminology • Validity—The degree to which a measure is true and free of bias • Reliability—The ability to reproduce or find results consistent

33. Research Statistical Terminology • Central Tendency—The grouping or score that occurs with the greatest frequency • Mode—The numerical value that occurs most frequently in a set of values • Numbers 14 10 12 14 14 22 16 14 • 14 occurs most often and is therefore the mode

34. Research Statistical Terminology • Median—An index of average position in a set of values 2 8 6 0 5 • Values are placed in numerical order 0 2 5 6 8 (5 is median value) • If there an even number of values, you compute the midpoint of two values 0 2 5 7 8 9 (6 is median value) • If there is an extreme, it is not considered 0 2 5 7 8 99 6 remains the median

35. Research Statistical Terminology • Mean– Also referred to as the Average • In numbers 0 2 5 7 8 • Add all =22, then divide by the number of values (5) Which equals 4.4 Range—The highest score minus the lowest score In the example above range is 8 If the numbers were 110 138 88 122 116 Range is from 88-138 which equals 50

36. Research Statistical Terminology • Standard Deviation– the average size spread among values in a set; how far are those numbers from the average

37. Review Questions • 1. Patients participate in a study on the effects of pre-procedure anxiety related to Endoscopic procedures. Group 1 gets routine pre-procedural care and information pamphlet Group 2 gets the same care and pamphlet plus a visit from an endoscopy nurse. Which best describes Group 1 and 2? A. Group 2 is the experimental group and Group 1 is the control group B. Group 1 is the experimental group and Group 2 is the control group C. Group 2 is the comparison group and Group 1 is the control

38. Review Questions • 1. Patients participate in a study on the effects of pre-procedure anxiety related to Endoscopic procedures. Group 1 gets routine pre-procedural care and information pamphlet Group 2 gets the same care and pamphlet plus a visit from an endoscopy nurse. Which best describes Group 1 and 2? A. Group 2 is the experimental group and Group 1 is the control group B. Group 1 is the experimental group and Group 2 is the control group C. Group 2 is the comparison group and Group 1 is the control

39. Review Questions • During a study of the effects of pre-procedural visits on the anxiety level of patients undergoing endoscopies, the researcher measures the level of anxiety by asking subjects to rate their anxiety on a scale of 1 to 10. What level of measurement is this? A. Interval B. Nominal C. Ordinal D. Ratio

40. Review Questions • During a study of the effects of pre-procedural visits on the anxiety level of patients undergoing endoscopies, the researcher measures the level of anxiety by asking subjects to rate their anxiety on a scale of 1 to 10. What level of measurement is this? A. Interval B. Nominal C. Ordinal D. Ratio

41. Review Questions • 3. When conducting research, a placebo is a: A. Treatment B. Measure of Central Tendency C. Theory D. Standard Deviation

42. Review Questions 3. When conducting research, a placebo is a: A. Treatment B. Measure of Central Tendency C. Theory D. Standard Deviation