Nursing Research 63 377 Dr Wally J Bartfay

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

Review Quiz: True of False? l l l 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?

Theory in Research l l 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)

Theory in Research l l l 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

Relationships Between Theory, Practice & Research Theory Nursing Research Practice

“Traditional” Types of Theories l l l (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)

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

Conceptual Models/ Frameworks: An example Agent Host Chain of Infection Environment Proposed relationships depicting 3 necessary concepts for chain of infection

Conceptual Models/ Frameworks: “Rules of Thumb” l l 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

Schematic Models l l 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

Statistical Models l l 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

Critiquing Criteria For Theories, Conceptual Models & Frameworks l l l (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?

Design in quantitative research l l 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)

Research Design Hypotheses Research ? s Review of Literature Theoretical Framework Research Design Interrelationships of review of lit. , research ? s, hypotheses, research Theoretical framework & research design

Element of Control l 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

Ways to control for extraneous variables l l 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

Threats to Internal Validity l l l 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)

Threats to Internal Validity l l 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-typeneed to check calibration specs pre and post)

Threats to Internal Validity l l 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)

Threats to External Validity l l 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”)

Threats to External Validity l l l 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

Threats to External Validity l Measurement effects: administration of pretest 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)

Quantitative Research Designs l l (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

Quantitative Research Designs l l l (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

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

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