Intro to Nursing Research – Flashcards
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What is the definition of research?
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a systematic (rules and steps) inquiry using disciplined methods to answer questions and solve problems
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Knowledge is developed, refined, and expanded through what?
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research
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What is the definition of nursing research?
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a systematic inquiry designed to develop knowledge/evidence about nursing issues (important for nurses and clients)
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What does clinical nursing research focus on?
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practice problems
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What is the purpose of nursing research?
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to guide nursing practice and help to improve care of clients
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What is the definition of EBP?
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the use of best evidence in making patient care decisions
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What does EBP lead to?
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clinically appropriate, cost effective care; positive patient outcomes, and practice changes
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Who is expected to understand/undertake research and use EBP?
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nurses
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Where does best evidence come from?
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research studies (conducted by nurses and healthcare professionals)
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What are the roles of the consumer?
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read research reports, develop new skills, keep up-to-date, experience ongoing learning
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What is the nurses role in research?
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participate in a journal club, attend presentations, help in developing ideas, assist with data collection, offer advice to clients, and evaluate it for use in practice
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What is a journal club?
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one person on unit reads study/reports findings to others
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Why is it important for nurses to attend presentations?
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to hear the reports from consumers of research studies
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How can you help in developing ideas?
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staff nurse encounters problem, can suggest and help in research to solve the problem
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What are future roles for MSN or PhD nurses?
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conduct a full EBP project, review proposals for feasibility, serve on institutional ethics committees; producer/active researcher--doctorate level
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What took place in 1860s?
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Florence Nightingale; first nursing researcher, proved effectiveness of her methods
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What took place in 1900s-1940s?
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Nursing education; studies appeared related to nursing education, there was some publication of nursing research (mainly education related)
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What took place in 1950s?
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more nurses with advanced degrees; establishment of Nursing Research--the first journal to focus on research
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What took place in 1960s?
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beginning of practice focus in research, more nursing journals were established
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What took place in 1970s?
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improving patient care, focus on using findings; there was now enough research, which started to be implemented in care; focus in research was not only education related anymore
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What took place in 1980s?
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national development and visibility of nursing research
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What took place in 1986?
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establishment of National Center for Nursing Research (NCNR); at NIH (National Institute of Health) under medicine ; training nurse researchers in research related to nursing care
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What is the purpose of the NCNR?
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promotion of research on patient care (that's the studies the NCNR would finance)
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What took place in 1990s?
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increasing EBP focus and funding (term EBP started to be used)
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What took place in 1993?
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establishment of the National Institute of Nursing Research (NINR), NINR has full institute status, international focus on research and EBP
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What is NINR in control of?
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nursing control, increasing budget, sets priorities (CORPs)
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What are future directions for nursing research?
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continued focus on EBP, involve all nurses in using EBM, improve skills in locating, understanding, critiquing, and using studies, stronger evidence base through confirmatory strategies, stronger designs, confirmation by replication with different client and settings, and developing nurse scientists by testing study results
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What are systematic reviews?
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cornerstone of EBP; integrate research info on a topic, so conclusions about the state of evidence can be reached
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What are characteristics of expanded local research?
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directly done in healthcare settings, solves local problems (high infection rate), related to magnet status
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How is magnet status awarded?
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by the ANA for facilities with high quality nursing care (stamp of excellence)
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How can findings be disseminated?
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internet and on-line access; allows for faster and wider spread of results; easy promotion of research findings
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Why is there increased focus on cultural issues and health disparities?
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to raise awareness for cultural sensitivity of interventions, research must be sensitive to diverse populations, and research addresses beliefs, behaviors, epidemiology and values of culturally/linguistically diverse population
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What are the current NINR priorities?
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health promotion and disease prevention, improve quality of life managing symptoms/self-management of acute and chronic illness, improve caregiving, palliative-and end-of-life care
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What are characteristics of tradition?
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become custom, can undermine problem solving
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What are characteristics of authorities?
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faculty and authors, not infallible or all knowledgeable
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What are characteristics of experience?
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narrow and can be biased
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What are characteristics of trial and error?
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practical but haphazard and solutions may be idiosyncratic (unique to individual)
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What are characteristics of intuition?
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hunches based on reasoning and instruction
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What is an issue regarding using textbooks?
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information may be out of date
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Benchmarking data
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rates of procedures or incidence of disorders/conditions (infections, STDs)
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Quality improvement and risk management data
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incident reports on falls or med errors; may be used to assess practice and determine need for practice change; no way to know if patient outcome improved
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What is the best method for acquiring reliable knowledge?
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disciplined research: rigorous, systematic process, leads to cumulative evidence, provides best evidence for practice
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What is local reasoning?
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combines experience, intellectual ability and formal systems of thought
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Inductive
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develops generalizations from specific observations: lead to theory development
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Deductive
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develops specific predictions from general principles
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What is a paradigm?
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world view of individual; way of seeing or examining the world; general philosophical perspectives
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What are the two types of paradigm?
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Positivist and Constructivist/Naturalistic
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What are characteristics of Positivist paradigm?
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based on work of Newton, Locke, & Comte (1800s), reality exist--real world, objective, determinism, scientific, rational method; much research is aimed at understanding the underlying causes of natural phenomena
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Determinism
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events have antecedent causes, are not haphazard
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Assumption
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is a principle believed to be true, without any verification
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What are characteristics of Post Positivism?
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still believe in reality but question the ability of persons being able to be truly objective, impossible to be completely objective, strives for objectivity and neutrality, there are impediments in certainty of reality; learning what is probably true, not absolutely true
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What are characteristics of Constructivist/Naturalistic?
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based on work of Kant & Weber, relativism, be aware of each clients individual situation, subjective reality, multiple interpretations of reality, naturalistic, interactive, understand others view/experience is important
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Relativism
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individual and multiple realities, depends on context (situation/environment)
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How is Positivist paradigm linked with quantitative research?
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systematic process, deductive reasoning, explores discrete, specific concepts, gathers empirical evidence, uses a fixed design or plan, involves control to decrease bias, uses formal instruments to collect info, numerical info, seeks generalizations beyond subjects, focus on product
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Empirical evidence
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evidence rooted in objective reality, gathered through the senses
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Generalizability
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evidence can be generalized to individuals other than study participants
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What are issues with the quantitative approach?
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it is preplanned, considered the "best" by many, problem with measuring certain concepts, focus is on a discrete (single) aspect when human beings are complex individuals, obscures insights, reductionism, narrow, inflexible view, numbers will be subjective (for psychological phenomena, e.g. pain rating)
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How is Constructivist/Naturalistic paradigm linked with qualitative research?
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holistic, dynamic, individual aspects, emerging insight based on others experiences: start with a broad question then it becomes more specific, flexible, evolving design, context-bound, inductive reasoning, naturalistic settings, narrative, subjective data, narrative analysis, end result is rich in-depth understanding of subject, focus on process as well as product
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What are issues with qualitative approach?
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human beings are the research tool (fallible: analysis made by interpretation--subjective), results can be trivial, idiosyncratic, small number of participants in the study, cannot generalize the results to non-participants of the study
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Which paradigm? Reality exists (regardless of human observation)
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Positivist
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Which paradigm? Reality is multiple and subjective (mentally constructed by individuals)
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Constructivist
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Which paradigm? The researcher is independent from those being researched
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Positivist
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Which paradigm? The researcher interacts with those being researched. Findings are the creation of the interactive process.
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Constructivist
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Which paradigm? Values and biases are to be held in check; objectivity is sought
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Positivist
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Which paradigm? Subjectivity and values are inevitable and desirable
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Constructivist
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Which paradigm? Deductive process--hypothesis testing. Emphasis on discrete, specific concepts (product). Focus on the objective and quantifiable
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Positivist
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Which paradigm? Inductive process--hypothesis generation. Emphasis on the whole (process and product). Focus on the subjective/non-quantifiable
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Constructivist
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Which paradigm? Corroboration of researchers' predictions. Fixed, pre-specified design. Controls over context. Measured, quantitative information. Statistical analysis. Seeks generalizations
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Positivist
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Which paradigm? Emerging insight grounded in participants' experiences. Flexible, emergent design. Context-bound, contextualized. Narrative information. Qualitative analysis. Seeks in-depth understanding.
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Constructivist
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What is the ultimate goal of both types of research?
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knowledge: answer questions and solve problems
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What are the major similarities of quantitative and qualitative research?
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external evidence is gathered on/from others using senses, depend on reliance of human cooperation, ethical constraints limits the ability to explore certain areas, fallibility of disciplined research (no one study every completely answers a question--all have limitations)
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What are the main purposes of research?
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indicate broad range of questions that can be asked and indicate differences in qualitative and quantitative
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What are the two different ways to classify goals of studies?
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explanation/cause-based or EBP-related
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What are the five levels of explanation/cause probing research?
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identification, description, exploration, prediction and control, explanation
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What is identification?
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naming, identifying; QUALITATIVE only; What is it? What is the phenomenon?
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What is description?
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observe, count, delineate, elucidate, or classify Quantitative: prevalence, incidence, frequency, size, measurable attributes or characteristics of the phenomenon Qualitative: nature, dimensions, importance of the phenomenon
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What is exploration?
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examine nature of a phenomenon; how does it manifest itself Quantitative: related factors, antecedents of the phenomenon Qualitative: process or evolution of experience, what is really happening with the phenomenon, full nature of the phenomenon
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What is explanation?
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explain the cause or full nature of the phenomenon; to explain a phenomenon, it has to be linked to theories Quantitative: what factors causing the phenomenon? Does the theory explain phenomenon? Test specific aspects of theory. Deductive reasoning Qualitative: Why does it exist? What is the meaning? How did it occur? Develops a theory (constructivist)--which is then tested by quantitative stories. Inductive reasoning. In-depth, experiential evidence
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What is predict and control?
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cause and effect, QUANTITATIVE only. If phenomenon X occurs will phenomenon Y follow? Can the occurrence of the phenomenon be controlled or prevented? Must introduce an intervention or a treatment.
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Identification
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Qualitative: What is this phenomenon? What is its name?
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Description
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Quantitative: How prevalent is the phenomenon? How often does the phenomenon occur? Qualitative: What are the dimensions/characteristics of the phenomenon? What is important about the phenomenon?
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Exploration
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Quantitative: What factors are related to the phenomenon? What are the antecedents of the phenomenon? Qualitative: What is the full nature of the phenomenon? What is really going on here? What is the process by which the phenomenon evolves?
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Predict and Control
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Quantitative: If phenomenon X occurs, will phenomenon Y follow? Can the phenomenon be prevented or controlled?
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Explanation
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Quantitative: What is the underlying cause of the phenomenon? Does the theory explain the phenomenon? Qualitative: Why does the phenomenon exist? What does the phenomenon mean? How did the phenomenon occur?
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What are the research purposed linked to EBP?
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Treatment, therapy or intervention research; quantitative only; diagnosis and assessment studies, prognosis studies, harm and etiology studies, meaning and process studies; qualitative only
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What is treatment, therapy or intervention research?
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Quantitative only: intervention research, study very specific interventions, treat or prevent health problems and adverse outcomes, leads to EBP
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What is diagnosis and assessment research?
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development of formal screening/assessment tools; tools for use in screening, diagnosing and assessing patients, tools needed for clinical practice and research
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What is prognosis research?
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which group of people is more likely to develop something, examines consequences of a disease or health problems, explore factors that can modify outcomes (prognosis), determine when these outcomes are most likely, used to guide lifestyle changes
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What is etiology and harm?
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factors and exposures that will lead to illness, morbidity, and mortality
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What is meaning and process?
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Qualitative only: study the meaning of health and illness to clients, barriers to positive health practices, and processes during transitions through a health care crisis
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Therapy/Intervention
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What therapy or intervention will result in better health?
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Diagnosis/Assessment
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What test or assessment procedure will yield accurate diagnoses or assessments of critical patient conditions and outcomes?
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Prognosis
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Does exposure to a disease or health problem increase the risk of subsequent adverse consequences?
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Etiology/Cause/Harm
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What factors/exposures cause or contribute to the risk of a health problem or disease?
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Meaning/Process
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What is the meaning of life experiences, and what is the process by which they unfold?
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How do you conduct a preliminary overview of a research report?
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relevance to the practice of nursing and priority area, paradigm or approach, underlying purpose of the study, clinical implications, and application--who and how