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INTRODUCTION TO RESEARCH
Evolution of Nursing Research

THE HISTORICAL DEVELOPMENT OF NURSING RESEARCH

Florence Nightingale in nursing research is said to be: a reformer, reactionary, and researcher
In the 1960s until the 1970s, the significance of nursing research gradually attained prominence although few nurses had the capability and
educational training to conduct studies.
In the 1980s and 1990s, research was considered .as a major force in the development of a scientific base for nursing practice.
In the 21st century, nursing research gives impetus (forward motion) to the promotion of excellence in nursing science. Increased focus on
outcomes research is taking place. Outcomes research has been designed to assess the effectiveness of health care service. (Burns and
Grove, 1997; Polit and Beck, 2004).

HISTORICAL EVOLUTION OF NURSING RESEARCH

Florence Nightingale founder of professional nursing and the first nurse researcher

Researches were focused on:

the importance of a healthy environment
aspects of environment
diet

Result of her research : Decrease in mortality rate within 6 months; used statistics to support her argument for reforms in medical care in military and
civilian hospitals,
NURSING RESEARCH IN 1900 TO 1050

Burns and Grove (1997) reported that following Nightingale's work from 1910, nursing research had minimal attention until the 1950s, which means
that from 1900 to 1950, there were limited research activities.

Incidentally, the first publication of the American Journal of Nursing happened in 1900 and late in the 1920s and 1930s, case studies reported on indepth analysis and systematic evaluation of a patient or a group of similar patients to promote awareness of nursing interventions.
This was the beginning of practice-related research (Burns and Grove, 1997).

In 1940 until 1950, a trend in nursing research started with emphasis on organization and delivery of nursing services.

According to Gortner and Nahm (1977) studies undertaken dealt with:

the number and kinds of nursing personnel
staffing patterns
patient classification system
patient and personnel satisfaction, and
Unit arrangement.
- Studies conducted concerned: nursing education.
Nursing was service oriented in training future nurses rather than education oriented.
Nurse educators had no advanced educational preparation.

Result:
Inadequacies existed in nursing education
Advanced educational preparation was essential.
School of nursing was established at Yale University.

1950's Increase in nurses with advanced degrees.

Journal of Nursing Research was started.
Research was included in curriculum

Studies from 1940-1950

Resulted into the formulation of Evaluative studies focused on types of care such as:

Comprehensive care

Home care, and

Progressive Patient care

Emergence of Research as a high priority

Research was introduced and the steps of research process at baccalaureate level by nursing schools and increased funding for research were
provided.
Five thousand US dollars was awarded for federal research in 1955 (de Tornyay, 1977).
Prior to this, Nursing Research journal was published in 1952 providing nurses the opportunity for ventilating their findings.
Studies conducted during these two decades dealt with:
nursing education; &
standards for nursing practice
nurses' characteristics; (including nursing students characteristics)
staffing patterns, (hospital personnel changes) &
Quality of care.

interaction between a dying patient

NURSING RESEARCH IN 1960

1960's - Introduction of such terms as:

"conceptual framework",
"conceptual model,"
"nursing process,"
"Theoretical base of nursing practice."
NURSING RESEARCH IN 1970

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One significant result of nursing research was observed in 1970s when the groundwork for clinical research was started, and it stays a priority up to
the present (Burns and Grove, 1997).

New research journals published were:

Advances in Nursing Science by Chinn in 1978 which incorporated the works of nursing theorists and research conducted on theories relevant to nursing
Image in 1967 by Sigma Theta Tau, the international Honor Society for Nursing (Barnard, 1980) which included various articles on the research process and
relevant studies.
Research in Nursing & Health, and
Western Journal of Nursing Research (1979)

These journals published in 1978 and 1979 helped in the communication of research findings in the 1970s.

1970's - establishment of National commission by American Nurses Association and The National League for nursing to study nursing and nursing
education.
NURSING RESEARCH IN 1980

The focus of nursing research in the 1980s was the conduct of clinical nursing research.

1987, Scholarly Inquiry for Nursing Practice was published and in

1988, two more journals were published, namely: Applied Nursing Research, and Nursing Science Quarterly.

1997, Burns and Grove reported the publication of varied clinical journal namely:
Cancer Nursing,
Cardiovascular Nursing,
Dimensions of Critical Care Nursing,
Heart & Lung,

Activities of nursing research in 1980 includes:

Publication of new research journals
Research conferences
Result of the publication of numerous studies & research conferences:

Improved nursing practice.

improved educational level and

Improved research background of nurses

In 1980s it characterized nursing research a potent force in the development of a solid base for research productivity up to 1990. 1980's establishment of: National Center for Nursing Research in 1986
NURSING RESEARCH IN 1990
1990's to present
More on clinical researches with nursing diagnosis as framework.
The National Center for Nursing Research (NCNR) created in 1985 to fund nursing research activities was renamed the National Institute
for Nursing Research (NINR).

This move under the direction of Dr. Hinshaw

Purpose of the move was: provide for better recognition of nursing as a research discipline and hopes for an increased funding
for nursing research.

NINR research priorities that need funding to the year 2000:

community-based nursing models;
Effectiveness of nursing interventions in HIV/AIDS.
cognitive impairment;
living with chronic illness, and
biobehavioral factors related to immunocompetence (NINR, 1993)

Focus of researches In 1990:

health promotion

illness prevention

Primary care
Since everyone aims to attain an improved quality and quantity of his life. The primary concern of outcomes research in the 1980s was
patient health status and cost related to medical care.
Recommendation of outcome research: that patient outcome researches related to nursing that has received little attention in the early 1990s
should become the major focus for nursing studies in the future (Bowers, 1994; Johnson, 1993; Jones, 1993; Higgins, McCaughan, Griffiths
and Carr-Hill, 1992, and Hegyvary, 1991).

Outcomes research has come out as an important methodology which documents the effectiveness of health care services. The primary concern of
outcomes research in the 1980s was patient health status and cost related to medical care.
Recommendation of outcome research: that patient outcome researches related to nursing that has received little attention in the early 1990s
should become the major focus for nursing studies in the future (Bowers, 1994; Johnson, 1993; Jones, 1993; Higgins, McCaughan, Griffiths
and Carr-Hill, 1992, and Hegyvary, 1991).

DEFINITION OF RESEARCH

Being a major function of the higher education

Is significant in the development of any country, especially in the generation of new ideas and knowledge for productivity. (Palispis 2004)
National Aeronautics and Space Administration (NASA) has begun to appreciate the value of nursing research.
In previous years, most of NASA's health care research has been physician driven
According to Linda Plush, a NASA consultant, the administrators at NASA have started to realize that nurses often have more expertise than
physicians do like:

wound care,

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medication delivery, and

Managing chronic conditions (Domrose, 2005).

The Value of Research

Provide information for:

decision making

Performance of function effectively

The health condition of individuals.

FUNCTIONS OF RESEARCH
It helps us answer questions, solve problems and make decisions.
It enables us to see and understand how and why a situation or a problem exists.
It helps us discover new things and ideas.
It allows us to validate existing theories or generate new ones.
lt helps us identify and understand the causes and effects of a situation or a phenomenon.
To bring out the truth*(Dr. J.S. Esquerra)

The Role of Research in Improving Quality of Life

New knowledge or technology is discovered.
New knowledge can result in development or improvement of skills, behavior or practices, while newly discovered or developed technology
can lead to the development of new tools or devices.
Improved skills, behavior or practices can lead to better conditions and better quality of life.
new or improved tools or strategies can result in improved performance and/or better service delivery, which contribute to the improvement of man's living
conditions and quality of life.
The connection between research and the improvement of man's welfare

Uses of Research as a Scientific Process

As a scientific process, research can be used to:

determine/describe an existing situation (situation analysis),

describe a population (people, objects, institutions, etc.),

compare two conditions or groups of population,

determine existence, degree, or nature of relationship between two or more factors,

evaluate and/or compare effectiveness of an intervention, treatment or exposure, and

predict the value of a certain characteristic

The Role of Research in Development

to improve the welfare of man like:

-development projects in education, health, housing, employment, business, agriculture, etc.

-Which involves planning, implementation, monitoring and evaluation. In each stage of development, research plays an
important role (Mercado,1994).
Research is needed in describing and analyzing existing social or economic problems or conditions.
Research data are important inputs lo planning and in designing a program/project/activity intended lo address an existing problem.

Data on the background and needs of target clients of a proposed program/project are needed in the preparation of the intervention,
Program managers or project implementers should continue collecting, analyzing and using relevant data to determine if, or to make sure
that a project/program is being implemented as planned.
Project implementation should be closely monitored to check progress and quality of implementation. Monitoring requires accurate
information about the status of project implementation, including rate of completion, financial standing, and quality of performance (inputs
and outputs).
Upon completion of a project, its performance or impact needs to be evaluated

.ex:, the effect of a breastfeeding among premature infants:

- new teaching strategy may be evaluated in terms of its effectiveness in improving Clients performance.
- A training intervention can be evaluated in terms of the skills learned and applied by the training participants.
GOALS FOR CONDUCTING NURSING RESEARCH
Aim of EBNP:
to provide the best possible care based on the best available research.
to provide a service to society, and this service should be based on accurate knowledge
To back up the importance of EBNP, Sigma Theta Tau International, Honor Society of Nursing and Blackwell Publishing initiated a new
journal in 2004 titled Worldviews on Evidence-Based Nursing.

It is a quarterly peer-reviewed journal.

Cost effective health care

Ex:
follow-up care by a nurse specialist is safe and cost effective
telephone nursing (TN)
providing home nursing visits
nurse case management program with patients (Bourdeaux et al. (2005)
admission nurse role
Nursing Research
Classification of nursing research:
General Classification It aims to answer or solve perplexities relevant to the nursing profession thereby developing a scientific
knowledge based for nursing practice.

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Cost effective

P
Specific Classification:

Purposes of Nursing Research

Identification naming an unknown phenomenon in relation to nursing practice.

Example: What are the social problems experienced by people with cancer.

Description describing a phenomenon affecting the nursing profession

Example: Changes, experiences of people with cancer.

Exploration investigating a phenomenon.

Example: To what extent is IQ related to passing board exams.

Explanation - clarifying, understanding the "Why

Prediction - estimating the effects of a given situation or prevailing condition

Control - specifying psychological and physiological reactions possible to nursing intervention.

Clinical nursing research

Nursing research involving clients or studies that have the potential for affecting the care of clients, such as animals or so called
normal subjects

Focuses largely on prevention & health prevention as opposed to medical model, which is the treatment /testing research model
(Williams, 2005)

Ex: pt. Symptom management and involves behavior intervention.

SOURCES OF NURSING KNOWLEDGE

Tradition.
Authority.
used trial and error
scientific research - the most objective and reliable source of nursing knowledge.
SCIENTIFIC RESEARCH
Characteristics of Traditional scientific research:

Use of systematic, orderly, and objective methods of seeking information.

The scientific method uses empirical data, which are data gathered through the sense organs.
Information is gained in the form of data or facts that are obtained in an unbiased manner from some aspect of the real world.

Researcher tries to exercise as much control as possible over the research situation, to minimize biased results.

The researcher's of a study opinions and personal biases should not influence the findings.
SCIENTIFIC RESEARCH
Characteristics of Traditional scientific research:
Have many similarities between scientific research and the problem-solving approach that is familiar to all nurses.

Both processes includes:

identifying a problem area,
establishing a plan,
collecting data, and
evaluating the data.

Unit I Chapter 2 B
Research Process vs. problem solving process
Research is a process.

Process includes a purpose or directions, a series of actions, goal.

NURSING RESEARCH AND NURSING PROCESS
Similarities between Nursing Process and Research process

Both involve: abstract, critical thinking and complex reasoning.

They identify new information, discuss relationships and make predictions about phenomena.
- Information is gathered, observations are made, problems are identified, plans are developed and actions taken in both process.

Both are reviewed for effectiveness and efficiency.

Implementing both expands and refines the user's knowledge.

Differences:
1
Knowledge of nursing process will not enable you to conduct the research process.
Research is more complex than nursing process.
Research involves the rigorous application of a variety of research methods and requires the understanding of a unique language.
2
The focus of research-is broader than nursing process.
Example: Nursing process focuses on a specific client and his family:
3
Researcher should be knowledgeable about the world of nursing in order to identify a phenomenon requiring investigation.
Knowledge is obtained from clinical experience and research literature.
4
Theoretical underpinnings of the research process are mush stronger than nursing process.
All steps of the research process are logically linked and are also linked to the theoretical framework of the study.
5
The conduct of research requires greater precision, rigor and control than the implementation of the nursing process.
Problem Solving, Nursing Process &Research Process Compared
Problem Solving
Nursing process
Research
Data
Assessment Data Collection &
Knowledge of nursing; Clinical
collection
interpretation
experience

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Problem Definition
Plan-Goal setting; Identifying solutions
Implementation

Nursing diagnosis
Plan-Goal setting; Planned interventions
Implementation

Evaluation & revision

Problem
Solving

Evaluation & modification

Nursing process

Problem & purpose Identification

Methodology-design, sample, statistics
Data collection &
analysis
Outcomes & dissemination of findings
Research

Unit 1 Chapter 2 C
3 General Types of Research

descriptive research,
correlation or association research and
experimental or intervention research (Fraenkel and Wallen, 1996).
Descriptive Research:

answer to the questions who what, when, where and how.

It describes a situation or a given state of affair in terms of specified aspects or factors.

What may be described are characteristics of: individuals or groups (client, health provider, students, administrators, entrepreneurs, patients, etc.) or
physical environments (schools, business establishments, hospitals, cooperatives, etc), or conditions (epidemic, calamities, leadership styles, anxiety
level, sales and profit, productivity, etc.).

Ex:

"The management style of school administrators in Benguet State University College of Nursing"

"Tardiness and absenteeism among college school students

"The medicinal components of the approved DOH medicinal plants"

"Smoking habits of health service providers in government and private hospitals"

"The Medicinal properties of pepper"

Explanatory or Correlation Research

goes beyond description of the problem or situation.

IT attempts to explain the possible factors related to a problem which has been observed in a descriptive study.

This type of study answers the questions why and how?

The factors related to the problem, however, need not be viewed as real "causes" of the problem, but factors which are associated with or may
contribute to the occurrence of the problem.

It investigates Relationships between factors or variables. Certain factors are "assumed" to explain or contribute to the existence of a problem or a
certain condition or the variation in a given situation.

The researcher usually uses a theory or a hypothesis to account for or explain the forces that are "assumed to have caused" the problem.

For example, relationships between the following pairs of variables can be studied:
Local government employees' knowledge about the local government code---------------Work performance
Knowledge about cancer ------------------------- Compliance with medication
Nutritional status -----------------------------------academic performance
Music therapy ---------------------------------------pain experiences

Examples of research explanatory or correlation category topics

Knowledge on Local Government code and work performance of Local government employees
"Knowledge About Cancer and Compliance with Medical Regimen Among Cancer Patients"
Nutritional status and academic performance
Effects of Music therapy and pain management during labor
"Attitudes Towards Health and Smoking Habits of Health Service Providers in Government and Private Hospitals in the Philippines "
Intervention or Experimental Research.

evaluates the effect or outcome of a particular intervention or treatment.

It studies the cause" and effect' relationship between certain factors on a certain
phenomenon under controlled conditions.

The subjects of the study are randomly assigned to the experimental group and to the control group and both groups are exposed lo similar
conditions, except for the intervention/treatment.

For example,
one can assess or compare the effect or outcome of two or more methods of verbal suggestion on the teaching ability of students with
regards to pain management , two or more health management practices on the recovery of patients, or two or more management styles on
employees' productivity.

Ex:
"The Effect of Verbal Suggestion on Overt Pain Reaction of Selected Post- Operative Patients" (Parrenas, 1994)
"The Effect of Oxygen, antacids and diet among decubitus clients

OTHER CLASSIFICATIONS OF RESEARCH (Jackson, 1995, Mercado, 1994)

Pure (Basic and is used mostly by scientists(Original)) or applied (using research items done by others).

To include outcome researches

The distinction between basic and applied research have more to do with financial support for the project than with the purpose of the study. Thus,
basic research may imply that the researcher is provided support to work on a particular project without having to indicate the immediate
practical usefulness of the findings.
Exploratory vs. Explanatory Research

Exploratory Research. Exploratory studies - used to describe an existing problem situation and examine the underlying ' factors that
contribute to the emergence of the problem, the nature of which is not yet well known.

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Explanatory Research. The primary goal of an explanatory study is to understand or explain a prevailing situation or explain a relationship
between factors which may have already been identified in exploratory studies, and why the relationship exists.
Explanatory studies seek more specific answers to "why'' and "how" questions. ,;
Examples of Exploratory Research Topics
"Domestic Violence: Ideas, Experiences, and Needs of Married Working Women in the City of Baguio"
"Menopause: Working Women's Perceptions, Experiences and Coping Strategies"
Examples of Explanatory Research Topics *
"Relationship Between Alcohol Intake and Domestic Violence Among Married Men in the Municipality of Alimodian"
"Extent of Exposure to Advertising Materials and Expenditure Patterns of Young Professionals in Northern Luzon"

METHODOLOGIES IN NURSING RESEARCH

Scientific method suits well to nursing research as it intertwines all procedures that scientists use three methodologies
QUANTITATIVE RESEARCH, kinds:
Descriptive Research - explanation or description of phenomena in real life. It describes the characteristics, situations, state of affairs, of
groups ( students, nurses, administrators, etc.); physical environment (schools, hospitals, etc); conditions (performance, anxiety levels,
skills, etc).

Purpose: To examine the relationship among variables where enough information exists.

Examples:
The management styles of deans of colleges of nursing
The effect of tardiness among nursing students
Attitudes and behaviors of senior student nurses in the Operating rooms
Explanatory or Correlation Research It attempts to explain the possible factors related to a problem which has been observed. It
investigates the relationships between factors or variables.

Purpose: to explain the nature of relationship in the real world, not to determine the cause and effect.

Examples:

Relationship between tardiness and socioeconomic factors among nursing students.

Attitude and behaviors of senior student nurses and their performance in the operating room.
Experimental or Intervention Research It evaluates the effect or outcome of a particular intervention or treatment among groups that
are as equal as possible.

Features:
A controlled manipulation an independent variable:
Experimental group and Control group
Subjects are randomly selected

Examples:
The effect of In-house review on the performance of nursing graduates in the local board exams
The effect of verbal suggestion on overt pain reaction of selected post op patients
Quasi - experimental research - Seeks to explain relationship, clarify why certain events happened or both.

It serves as basis for predicting a phenomenon.

Unlike the experimental technique, it manipulates the independent variable but lack randomization of control group o may
not have a control group.

Convenience sampling is done.

QUALITATIVE Researches, Kinds:

Phenomenological Studies - It describes the * lived experiences* of study participants.

The focus is subjective meaning of an experience to an individual

Examples:
Lived Experiences of Breast cancer patients
Lived Experiences of HIV + individuals
Lived Pregnancy Experiences of Women in Prison
Men's views about hysterectomies and women who have them
Grounded Theory - Based on Symbolic Interaction Theory (SIT).

It explores how people define reality and how their beliefs are related to their actions.

Reality is created by attaching meanings to situations.

The researcher compares what is found in real life with that of what is written in books.

Examples:
ARUGA (alaga, ugat galing)
Care core cure (Hall) (see more next slide)
Hendersons 14 fundamental or basic human needs
Pain management by staff nurses.
How do family members manage disclosure to a child who has acquired HIV
Ethnographic Research- originated from anthropological perspective with focus on culture, life-ways in the natural setting.

Ethnography means "Learning from people"

It focuses on the question: "What is the culture of this group of people?

Important criteria for Ethnographic research:

Intensive field work,

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immersion,
live-in activities
techniques to be used.
Interview,
direct participation and
observation.
Historical Research

Examines the events of the past and how these events affect the present, used to determine the growth and development of a
group, organization or institution.

Data are obtained from: documents, relics, artifacts, oral reports, maps, books, diaries, letters, etc.

Sources of data: primary and secondary

Evaluation of historical researches:

External criticism - determine authenticity of collected data
Internal criticism - evaluates the accuracy of data
Case Studies

In depth examination of experiences of a particular patient.

The result is not generalized to other groups of people.

Hypothesis is not tested.

Subject selection is done with care as they may decide to discontinue their participation.

Data evaluation is through content analysis or examining answers and messages.

OUTCOMES RESEARCH or EVIDENCED-BASED NURSING PRACTICE

Focus:
the need to answer the:

growing demand of justifying the quality of interventions,

systems of care as regards improving patient lives, and

spiraling cost of health care.

Definition: Translating knowledge into practice
Significance:
Nurses attend to patients most of the time.
They attend personally to interventions given by doctors.
Nurses influence the treatment given due to cart delivery techniques.
The health outcomes depend on many factors where nurses are involved.
Nurses are on the forefront of examining outcomes of programs designed and implemented in the communities.
The professional nurse is in an excellent position to create change that demonstrates quality care that is cost effective
Outcomes research has come to be associated with "how the organization of nursing impacts nursing (e.g., burnout), system (e.g., retention),
and patient (e.g., 30-day mortality) outcomes rather than on the efficacy of an individual nursing intervention" focuses on measurable
outcomes of interventions with certain patient populations.
The increased interest in this type of studies is tied in with the high cost of health care.
Health care policymakers, such as managed care organizations, want to know if the care that is being provided is cost effective.
Consumers also want to know if the services that they purchase will improve their health. Therefore, outcomes become very important been
placed in a separate category because the types of designs, methods, and sampling procedures used in these studies may be somewhat
different from those used in the traditional quantitative or qualitative studies.

TRIANGULATION of METHODS
Refers to the use of two or more research methods in the study of a particular phenomenon.
The combination of qualitative and quantitative methods enhances the technical ability to rule out conflicting explanations. (Hinds, 1989)
The most reliable findings are located when using both methods. (Field and Morse, 1985)
Careful analysis of data from several sources and use of differing methods allows for richer, fuller description of a study than a single approach. (Thurmono,
2001)
IMPORTANCE OF RESEARCH TO NURSING
1. It validates nursing as a profession.
Nursing as a profession must be based on a well defined body of specialized knowledge.
2. It provides a scientific basis for nursing practice.
Topics include the nursing profession as whole, characteristics of nurses, practice of the profession.
3. It demonstrates accountability of the profession.
Accountability implies a duty or obligation to clients to provide quality patient care and predictable instances.
4. It improves the standards of nursing care by providing the basis for sound nursing action as:
Planning, Predicting and Controlling patient care outcomes.
5. Nurses need scientific knowledge to improve their decision-making regarding:
What care to provide patients and How to implement that care.
6. The knowledge generated through research is essential to provide a scientific basis:
For description, Explanation Prediction and Control of nursing practice
They are challenged to question constantly every intervention they perform or see performed.
Questions to ask include:
Am I performing this intervention because someone told me to or maybe even because this is the intervention that has always been used?

What evidence exists that this is the most effective intervention for the problem?
If an intervention is not based on research evidence,

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there is no way to determine that this intervention is the optimum one.

NURSING RESEARCH ONTHEWEB
For additional online resources, research - activities, and exercises, go to www. prenhall.com/nieswiadomy. Select Chapter 1 from the drop-down
menu.
Roles of Nurses in Research

The roles of nurses in research according to level of educational preparation were identified by the American Nurses Association Council of Nurse
Researchers in 1981.
The guidelines were revised in 1993 and 1994. These guidelines, in the form of a position statement, may be found at
http://www.nursingworld.org/readroom/ position/research.
Expectations are presented for nurses prepared at the following educational levels:
associate degree in nursing,
baccalaureate degree in nursing,
should be able to read research critically and determine if research results are ready for use in clinical practice.
should be able to identify clinical problems that need to be investigated.
should assist experienced investigators to gain access to clinical sites.
should help select appropriate data collection methods and collect data.
should implement research findings in their practice.
master's degree in nursing, Be able to make applied experimental studies on experiences
Individual generation of a conceptual/construct theory
doctoral education, and
Generate a theory
postdoctoral education.
Individual generation of a theory.
The American Association of College of Nursing (AACN) published a position statement on nursing research in 1999. which includes:
lists of research expectations and outcomes for graduates of:
baccalaureate,
master's,
doctoral, and
postdoctoral programs.

These expectations are similar to those of the American Nurses Association. This position statement may be found at
http://www.aacn.nche.edu/Publications/ positions/rscposst.htm.
The latest revision of the American Nurses Association guidelines and the AACN guidelines include:
expectations of those with postdoctoral preparation.
Postdoctoral study involves agreements between:
novice researchers,

usually with recent doctorates, and

established investigators.
These seasoned investigators agree to mentor the novices for a period of 2 or 3 years.
Private and federal funding is available for postdoctoral preparation.

ROLES OF NURSES IN RESEARCH

Principal Investigator
Nurses can and should serve as principal investigators in scientific investigations.
To be a principal investigator, special research preparation is necessary.
It might be possible for a beginning researcher to conduct a small-scale survey study,
but preparation beyond the baccalaureate level is necessary for independent investigator status in most nursing research studies.
Member of a Research Team
Nurses can serve as members of a research team.
They may act as data collectors or administer the experimental intervention of the study.
As nurses increasingly participate in research, it is possible that interest and enthusiasm to conduct their own investigations may grow.
Identifier of Researchable Problems
All nurses, from associate degree to doctoral-level preparation, have the responsibility of trying to identify areas of needed research.
Nurses at the bedside are particularly well situated to identify patient-related researchable problems.
Evaluator of Research Findings
Every nurse should be involved in the evaluation of research findings.
As research consumers, nurses have the obligation to become familiar with research findings and determine the usefulness of these
findings in the practice area.
Beginning researchers should critique research articles,
first with the help of an experienced researcher and
eventually on their own, through the use of knowledge gained in a structured research course
(either in their basic nursing education program or in a continuing education course).
User of Research Findings

Through the years, nurses have tended to carry out nursing procedures and provide nursing care "the way we've always done it.

After evaluating research findings, nurses should use relevant findings in their practice.

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The primary goal of nursing research,
is the improved care of clients.

Research utilization and evidence-based nursing practice

are related because both processes place emphasis on research findings.

However, nurses must be judicious in their use of research findings.

The results of one small study conducted with a sample of 15 volunteers would not provide sufficient evidence for a change in nursing practice
Patient/client advocate during studies
Subject/participant in studies
RESEARCH PRIORITIES FORTHE FUTURE

Research priorities of the BSU CON (Tentative)

Qualitative study

Replication

Preventive & Promotive

Research priorities were developed by Professional nursing organizations and individual nurse leaders
They were united in identifying the need for research that will help build a scientific knowledge base for nursing practice.
In 1980 the ANA Commission on Nursing Research identified priorities for nursing research. Which were:
health promotion and preventive health practices for all age groups,
health care needs of high-risk groups,
life satisfaction of individuals and families, and
the development of cost-effective health care systems.
In 1985 the ANA Cabinet on Nursing Research identified 10 priority areas. Which were:

promote health, well-being, and the ability to care for oneself among all age, social, and cultural groups;

minimize or prevent behaviorally and environmentally induced health problems that compromise the quality of life and reduce
productivity; and

minimize the negative effects of new health technologies on the adaptive abilities of individuals and families experiencing acute
or chronic health problems.
In November 1987 Dr. Ada Sue Hinshaw, director of the National Center for Nursing Research (NCNR), invited nursing organizations to
identify their research priorities.
Research priorities for people with Alzheimer's disease were identified at a research conference held in 1988 (Duffey, Hepburn,
Christensen, & Brugge-Wiger, 1989).
The top priority was given to research on:
the management of physical problems (i.e., incontinence of bowel and bladder, falls, sleep disturbance, gait
disturbance, maintenance of adequate nutrition).

Management of disruptive behaviors (i.e., agitation, wandering) was listed as the second priority.
The National Association of Orthopedic Nurses identified a list of priorities in 1990 (Salmond, 1994).
They used a Delphi technique to survey experts in the field.
"Some of the highest ratings were given: to preventing confusion in elderly patients post-hip fracture, determining the most effective
safety measures to use with the patient with acute confusional state, and differentiating pain responses according to diagnoses, ages,
and pain management interventions. In 1997 Sedlak et al. (1998)
Replicated the 1990 study.
need for more research on pain and patient complications, such as deep vein thrombosis (DVT).
The authors expressed some concern about this particular priority because of the large amount of published research on DVT.
Sedlak et al. called for an ongoing and wider dissemination of research results.
In 1999 Pullen, Tuck, and Wallace published a list of priorities in mental health nursing.
These priorities were obtained by examining the published literature from 1990 to 1996.

No specific mental health nursing agenda was found.

Six broad categories were identified:

support,

holism,

mental health nursing practice,

quality care outcomes,

mental health etiology, and

mental health delivery systems.

These authors cautioned that as nursing promotes evidence-based practice, there is a need for clear research priorities.

They called for mental health nursing experts and organizations to propose a national/international mental health research
agenda.
The Emergency Nursing Association conducted a Delphi study on national research priorities for emergency nurses in the United States
(Bayley, MacLean, Desy, & McMahon, 2004).
Three rounds of mailed surveys were used to gather data.
Responses were received from 101 emergency nursing leaders.
The study was completed in summer 2001.

Interventions for pain management received the highest ranking.

Emergency nurses were also concerned with:

Staff shortages and overcrowding of emergency departments and the effects of these two conditions on patients.
A survey was conducted among members of the Oncology Nursing Society (ONS)
To determine research priorities for 2005 to 2008 (Berger et al, 2005).

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Responses were received from 431 members.
The top 20 research priorities were identified:
quality of life,
participation in decision making about treatment in advanced disease,
patient/family education,
participation in decision making about treatment, and
pain management.
Clinical nursing research is essential for the profession, However, other types of research are also needed.
Grier (1982)

patient care research had become the "sacred cow" for nursing research.
Brown, Tanner, and Padrick (1984) wrote that research regarding:

nurse characteristics,

nursing education, and

nursing administration should not be abandoned because these factors affect the care that nurses provide.
Abdellah and Levine (1994) also called for studies other than clinical studies.

They wrote that we need reliable tests to predict clinical performance by students and research on occupational
choice.
Clinical nursing research is essential for the profession, However, other types of research are also needed.
Fitzpatrick (1999)

contended that nursing education research should receive the same recognition as clinical research.

She mentioned the pressure in recent years to transform nursing educational programs to meet changing health care needs
and contended that any changes should be based on research.
Tucker-Alien (2003) wrote an editorial on nursing education research is not always respected.

She called for nurse educators to conduct research:

on both clinical issues and educational issues.
Replication studies should be a high priority for nursing research. Which involve:
Repeating a study with all the essential elements of the original study held intact.
Different samples and settings may be used.
Replication studies in nursing have not been numerous,
The lack of these studies has hindered the development of a cumulative body of nursing knowledge.
This type of study is of particular importance in clinical nursing research.
Because of the small nonrandom samples

SUMMARY of Unit 1
Nursing research is defined as the systematic, objective process of analyzing phenomena of importance to nursing. It includes studies concerning nursing
practice, nursing education, nursing administration, and nurses themselves. Clinical nursing research is research that has the potential for affecting the care of
clients.
Nursing knowledge has come from tradition, authority, trial and error, and scientific research. Scientific research uses empirical data (data gathered through the
senses) and is a systematic, orderly, and objective method of seeking information.
Basic research, also called pure research, is concerned with generating new knowledge; applied research seeks solutions to immediate problems. Most nursing
studies have been applied research. Many studies, however, contain elements of both basic and applied research.
The most important goal for conducting nursing research is the promotion of evidence-based nursing practice. Evidence-based nursing practice (EBNP) means
that nurses make clinical decisions based on the best research evidence, their clinical expertise, and the health care preferences of their patients/clients. Other
goals for conducting nursing research are to ensure credibility of the nursing profession, provide accountability for nursing practice, and document the cost
effectiveness of nursing care.
Quantitative research is concerned with objectivity, tight controls over the research situation, and the ability to generalize findings. Qualitative research is con cerned with the subjective meaning of an experience to an individual. Outcomes research focuses on measurable outcomes of interventions with certain patient
populations.
Nurses act as principal investigators, members of research teams/identifiers of researchable problems, evaluators of research findings, users of research
findings, client advocates during studies, and subjects/participants in research. Research utilization focuses on the implementation of findings from specific
research studies.
Because nurses were not prepared to conduct research, many of the early nursing studies were conducted by members of other disciplines. Some of these studies,
such as the Goldmark Report in 1923 and the Brown Report in 1948, contributed important information about nursing and nursing education. As nurses began to
receive advanced degrees, these degrees were generally in the field of education. Many of the studies conducted by the first nurse researchers in this country,
therefore, were in the area of nursing education. Although Florence Nightingale recommended clinical nursing research in the mid-1800s, this type of research was
scarce until the 1970s. Many nursing organizations have identified clinical nursing research priorities for the future. Also, replication studies are needed in
nursing. Replication studies involve repeating a study with all the essential elements of the original study held intact. The National Institute of Nursing Research
(NINR) was established in 1993. Funding by Congress has increased from $16 million in 1986 to the National Center for Nursing Research, the precursor to the
NINR, to over $138 million to NINR in 2005.

Audray Kyle
Saydoven