Nursing Research 63-377 Dr. Wally J. Bartfay

1. Nursing Research 63-377Dr. Wally J. Bartfay “Anyone who has never made a mistake has never tried anything new” (Albert Einstein, 1879-1955)

2. Review Quiz: True of False? • 1. Research questions are qualitative in nature only? • 2. Hypotheses can be both quantitative & qualitative in nature? • 3. Hypotheses are never “proved” through hypothesis testing; rather they are accepted or supported? • 4. A non-directional hypothesis specifies the expected direction or nature of a hypothesized relationship? • 5. A research question guides the type of data to be collected by the investigator?

3. Theory in Research • Is a set of interrelated concepts (building blocks) that structure a systemic view of phenomena for the purpose of explaining or predicting outcomes • Like a “blueprint” which provides a guide for modeling a structure or building, what goes where & how does everything fit together (bricks, pipes, electrical, heating, etc)

4. Theory in Research • Is a set of interrelated concepts that provides a systematic view of phenomenon • Guides practice & research • Practice allows testing of theory & generates ?’s for research • Research contributes to theory-building & establishing practice guidelines • Hence, what is learned through practice, theory & research interweaves to create knowledge fabric of the discipline of nursing

5. Relationships Between Theory, Practice & Research Nursing

6. “Traditional” Types of Theories • (1) “Grand or macro-theories” attempt to describe & explain large segments of phenomenon (e.g., chaos theory, theory of evolution, Roger’s, Orem’s, Newman’s)- • (2) “Middle-range” are more narrow/ restricted in scope (e.g., decision-making, self-care deficits, infant bonding) • (3) “Micro-range” link concrete concepts into a statement that can be examined in practice & research (hypotheses are examples here)

7. Conceptual Models/ Frameworks • Are symbolic representations of a set of concepts (building blocks of theories e.g., health, anxiety, QOL, CGB, adaptation) & their proposed relationships

8. Conceptual Models/ Frameworks: An example Chain of Infection Proposed relationships depicting 3 necessary concepts for chain of infection

9. Conceptual Models/ Frameworks: “Rules of Thumb” • When researchers used quantitative inquiry& deductive reasoning, often appears at beginning of paper before discussion • When researchers use qualitative inquiry & inductive reasoning, often appears at the end of the paper in discussion section

10. Schematic Models • Are common in both qualitative & quantitative research • They represent phenomena “graphically” • Concepts & how they are linked are represented by arrows, symbols, boxes etc • Useful in clarifying associations among concepts

11. Statistical Models • Used in quantitative studies • Use symbols to express quantitatively the nature of relationships between defined variables • Each concept/ term in model is quantifiable • Statistical models where probability is used to describe/ explain & predict outcomes

12. Critiquing Criteria For Theories, Conceptual Models & Frameworks • (1) Is it clearly identified & transparent to the reader? • (2) Is it consistent with a nursing perspective? • (3) Is it appropriate to guide the research question(s) of interest? • (4) Are concepts/ variables clearly defined? • (5) Are the links consistent with concepts being studied and the methods of measurements? • (6) Are the results (data, findings) examined & interpreted employing these theories, conceptual models or frameworks?

13. Design in quantitative research • Word implies “the organization of elements into a masterful work of art” • It describes the basic strategies that will be employed to address research ?(s)

14. Research Design Interrelationships of review of lit., research ?s, hypotheses, research Theoretical framework & research design

15. Element of Control • Defined as measures used to hold conditions of study uniform • Process of holding constant possible influences on the dependent variable or outcome • It is established by ruling-out extraneous or mediating variables that compete with the independent variable as possible explanation for achieved outcome

16. Ways to control for extraneous variables • Are variables that interfere with operation of the phenomena being studied (e.g., age & gender, other chronic disease conditions present) • Use homogeneous sample (e.g., menopausal women aged 55 to 60 years of age, avoid “messy” samples) • Manipulation of independent variable • Randomization helps to eliminate bias & aids in attainment of a representative sample

17. Threats to Internal Validity • Asks whether the independent variable really made difference or change to dependent variable • History: Another specific event that may effect outcomes (e.g., media reports on star with breast CA, so breast-self exams increase) • Maturation: refers to developmental, biological or psychological processes that operate within a subject as a function of time & are external to events of study (e.g., study to examine effects of vit. E on preventing cat. in eyes, where age of subject is a threat)

18. Threats to Internal Validity • Testing: (e.g., effect of taking a pre-test may sensitize subject & improve post-test results) • Instrumentation: (e.g., researcher wants to compare tympanic, digital & electronic thermometers to accuracy of mercury-type- need to check calibration specs pre and post)

19. Threats to Internal Validity • Mortality: loss of study subjects after baseline measures established • Selection bias: (e.g., subjects who want to enter into smoking cessation program, help to avoid by randomization)

20. Threats to External Validity • Deals with possible problems of generalizability of findings/ outcomes to additional populations (e.g., study involved IDDM, can you generalize to NIDDM?) • Selection effects (sample in study was too small to generate statistically significant conclusion- issue of “power”)

21. Threats to External Validity • Reactive effects: defined as subjects’ responses to being studied • Known as “Hawthorne Effect” (Western Electric Corporation study on working conditions) • Here, researchers examined various Rx. Effects (e.g., turning up or down lights, piping in loud/ soft music, changing working hours etc) • No matter what researcher did, workers’ productivity increased • Conclusion, workers productivity increased b/c they were being studied

22. Threats to External Validity • Measurement effects: administration of pre-test in study affects generalizability of findings to other populations (e.g., “attitudes” towards AIDS in general where researcher examines effects of AIDS education program that deals with “risk factors” associated with AIDS)

23. Quantitative Research Designs • (1) Exploratory or Formative: to gain new insights, discover new ideas & increase knowledge about a phenomenon (usually conducted when little is known about a topic) • (2) Descriptive: Structured observations or ?s or both are used to describe a phenomenon, situation, group or characteristic

24. Quantitative Research Designs • (3) Correlational: primary intent is to explain the nature of the proposed relationship(s) • (4) Experimental: Can be used to test cause & effect relationships & serves as basis of prediction: Must have following criteria: • (a) manipulation of treatment variable • (b) control of one or more constants into the experimental situation (e.g., temperature, Dx) • (c) random selection & inclusion of subjects

25. Quantitative Research Designs • (5) Quasi-experimental: lacks one or more criteria for a true experiment • (6) Evaluative: tests how well a program, practice or policy is working

26. Mark down these dates for Dr. Nancy Edwards, Visiting Nursing Research Scholar: November 1st • 10 to 11 am “Need for nursing research: Dissemination & uptake of research evidence” HEC room 104 • 3- 4 pm: Seminar/ workshop: “Developing research teams & programs of research” HEC room 203 • 4 to 5 pm: Major public talk: HEC room 203 Have a great week!!!