Introduction by Saada
Introduction by Saada
Introduction by Saada
LECTURE NOTES
By
Madame SAADA A.
Course Description:
The focus in this course is to explore the types and methods for nursing and midwifery research,
examine the steps in the development of a research, review and evaluates current research findings
in nursing for its applicability to nursing theory and practice and to study the process of scientific
investigation and to assisting the learners to acquire skills in research proposal writing.
INTRODUCTION
Definition
The word research means to search again or to examine carefully. Therefore research is
defined as systematic inquiry, or study to validate and refine existing knowledge and develop
new knowledge. Or it is the systematic collection, analysis and interpretation of data to generate
new knowledge and answer a certain question or solve a problem.
Nursing research is a scientific process that validates and refines existing knowledge and
generates new knowledge that directly and indirectly influences nursing practice. It is essential
for developing and refining knowledge that can be used to improve clinical practice
Diligent and systematic inquiry: which include Planning & organization and Persistence
Discovery: of new knowledge about topics and learning about new areas of study
Research follows the scientific method which is why it can stand the test of time. A scientific
practice base for nursing means that nursing practice is guided by nursing theory or empirical
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clinical research findings. Nursing research involves scientific inquiry and so would require
knowledge of the characteristics of scientific methods.
1. Order and Control: Scientific methods follow a systematic approach to problem solving.
The aspect of control concerns the effort made to reduce interference in the study situation.
For example, in a study to explore the relationship between diet and heart disease, the
researcher must take steps to control other possible causes of heart disease like stress,
cigarette smoking, as well as age and sex.
2. Empiricism: The scientific method searches for evidence (empirical - real) through
observations, verified through our sense organs i.e. sight, taste, touch, smell, and hearing.
E.g. the colour of a patients eye, the presence or absence of skin inflammation. Sometimes,
our senses may not record fully what is real and so, extensions of our senses are used to
collect the empirical evidence in the form of instruments, equipment, tools e.g. weighing
scale, thermometer, questionnaires, or other instruments that aid the senses to gather the
necessary information.
1. The ultimate goal of research is the development of a body of knowledge for a discipline or
profession such as nursing: Research helps the development and generation of knowledge in
each area of specialization. It strengthen the profession by generating knowledge through
scientific studies which guide the nursing practice.
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cost- effective care can be rendered to clients, but also promotes improved outcomes for
Patients and families, Nurses and Health care system
4. Research help in standardization and refining nursing practice: It provides answers to guide
practitioner in the decision-making process. It enables the administrator to take prompt
decisions on health-related problems, and it is essential for moulding attitudes, intellectual
competencies and technical skills.
For many years, nurses have performed lots of weird treatments in the hopes of healing
wounds. They really did:
Pour bleach, iodine, or milk of magnesia into wounds, trying to kill bacteria that
caused infection
Pack wounds with sugar to provide energy to the cells in the wound and promote
healing
Bleach, iodine, milk of magnesia and power washing actually damage cells that work
to heal wounds and form scar tissue
Nurse researchers came up with enough evidence to convince physicians to stop using these
useless treatments.
Therefore the evidence based practice helps to use of research findings to:
Promote the understanding of patients and families experience of health and illness
And now nurse researchers are working on studies in a wide variety of areas, including:
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Nursing shortage and nursing education
Disease management
Health promotion
Caregiver support
Physician-nurse collaboration
Characteristics of research
2. It requires a plan (it is not aimlessly looking for something in the hope that you will come
across a solution)
4. New data should be collected as required and be organized in such a way that they answer
the research question(s)
Types of research
1. Basic or Pure Research: It is investigation or study carried out to satisfy a desire to increase
the knowledge base in an area of interest. Basic or pure research provides the baseline
information in the area of knowledge which could be necessary to undertake further research
in that area. For example, a research to establish factors responsible for poor compliance to
dietary regimen by diabetic patients will result in a list of many factors. Those factors could
form the basis for more research in the future that could lead to certain important decisions in
the care of diabetic patients.
2. Applied Research: It is the research whose findings could have immediate practical utility.
The result of research could be used to solve a problem, make a decision and develop new
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programmes, products or procedures. Applied research could also be used to evaluate a
programme, product or procedure. Example of research to find ways to manage
schizophrenia, finding type anti-smoking campaigns that can reduce smoking among youth.
4. Non Experimental Research: It is one where the study subjects are studied as they are in the
natural environment without any manipulation or active effort to control them. Exploratory
and descriptive studies come under the non experimental research. Exploratory and
descriptive researches seek to explore or identify the kinds of factors responsible for the
variables under investigation. The final result is a list or factors as revealed by the
respondents in the research.
Research in nursing began with Florence Nightingale. Her landmark publication, Notes on
Nursing (1859), described her early interest in environmental factors that promote physical and
emotional well-being.
Most studies in the early 1900s concerned nurses' education. During the 1940s, government-
initiated studies of nursing education continued, spurred on by the high demand for nursing
personnel during World War II. An increase in the number of nurses with advanced degrees, the
establishment of a research center at the Walter Reed Army Institution of Research, increased
availability of funding and the inception of the American Nurses' Foundation-which is devoted to
the promotion of nursing research-provided impetus to nursing during this period. In the 1960s,
nursing leaders began to express concern about the dearth of research in nursing practice.
By the 1970s, the growing number of nursing studies and discussions of theoretical and
contextual issues created the need for additional communication outlets. During the 1970s, there
was a change in emphasis in nursing research from areas such as teaching and nurses themselves
to improvements in client care- signifying a growing awareness by nurses of the need for an
evidence base from which to practice..
The 1980s brought nursing research to a new level of development. More attention was paid to
the types of questions being asked, the methods of collecting and analyzing information being
used, the linking of research to theory and the utilization of research findings in practice. Nurses
also began to conduct formal projects specifically designed to increase research utilization.
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Nursing science came into its maturity in the United States during the 1990s. Funding for nursing
research has also grown. Several journals were established in the 1990s.
Subjects or the study participants: are people who are being studied.
Operational Definition is a specification of the operations that the researcher must perform to
collect the required information.
Data (singular, datum) of a research study are the pieces of information obtained in the
course of the investigation it includes:
o Dependent variable refers to the outcome variable of interest or variable that is caused
by another. For example examination marks.
o Independent variable refers to the variable that is believed to cause or influence the
dependent variable. For example; the type of teaching.
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o In a research context, population refers to all members or objects of any defined
group from which measurement might be taken or about which information might be
collected.
o A research population refers to the entire group to which the results of the research
are to apply. For example; all people of a specific age group, all items of equipment
e.g. syringes.
Sample is a sub set of a population selected to participate in a research study, in every aspect
of the population from which it is selected.
Sampling is the process of selecting a portion of the population to represent the entire
population.
Pilot study refers to a small-scale version or trial run, of the research method, in preparation
of the major study to ensure that the design is feasible. May be on a small number of subjects
only, but may help to determine a variety of practical questions.
Generalizability refers to the degree to which the research procedures justify the inference
that the findings can be generalized from the sample to the entire population.
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VARIABLES
Types of variables
There are different ways variables can be described according to the ways they can be studied,
measured, and presented.
Understanding the data types that you are analyzing is important because it determines the most
appropriate way to summarize them. It also dictates the types of statistical tests that should be
used to analyze the data...e.g Chi square, t-test, Pearson correlation etc. Variables can be
qualitative or quantitative.
1. Quantitative Variables:
Numeric variables: have values that describe a measurable quantity as a number, like 'how
many' or 'how much'. Numeric variables may be further described as either continuous or
discrete:
A continuous variable: Observations can take any value between a certain set of real
numbers. Examples of continuous variables include height, time, age, and temperature.(Have
decimal points)
A discrete variable: Data can take only certain fixed numerical values usually whole
numbers (integers). Examples number of patients, number of business locations, and number
of children in a family, all of which measured as whole units (i.e. 1, 2, 3).
2. Qualitative Variables
Categorical variables: have values that describe a 'quality' or 'characteristic' of a data unit, like
'what type' or 'which category'. They tend to be represented by a non-numeric value. Categorical
variables may be further described as ordinal or nominal:
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An ordinal variable: Observations can take a value that can be logically ordered or
ranked. The categories associated with ordinal variables can be ranked higher or lower
than another, but do not necessarily establish a numeric difference between each
category. The response is low, medium and high. Examples of ordinal categorical
variables include academic grades (i.e. A, B, C), clothing size (i.e. small, medium, large,
extra large) and attitudes (i.e. strongly agree, agree, disagree, strongly disagree).
A nominal variable: Observations can take a value that is not able to be organised in a
logical sequence. The response is binary, i.e. Yes/No, Dead/ Alive. Examples of nominal
categorical variables include sex, business type, eye colour, religion and brand.
These are variables that are affected or influenced by the independent variable.
It is also called criterion, effect, response or outcome variable which capture the
interest of a researcher
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ii. Independent variable:
Refers to the variable that is believed to cause or influence the dependent variable.
These are variables or factors that exist between the independent and dependent variable.
Explains why the relationship exists and bears influence on the effect of the independent
variable on the dependent variable.
Objective of the mediator variable is to explain the relationship between IV & DV e.g. IV is
not directly influencing DV but rather IV is indirectly influencing DV through mediator
variable.
Mediator variable
For example, level of education (IV) is positively influencing income (mediator variable)
and then income is positively influencing spending (DV). When the effect of income is
removed, the relationship between level of education and spending disappears.
This is a variable that affect the strength or direction of the relationship between the
dependent and independent variable.
The independent variable interact with the moderator variable which makes the relationship
between independent and dependent variable be stronger or weaker.
Objective of the moderator variable is to measure the strength of the relationship between the
IV & DV.
That is: moderator variable's arrow line is pointing to the mid point of the arrow-lined
relationship between independent and dependent variable
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(stress)Independent variable (depression) Dependent variable.
For example: if social support is a moderator variable between stress (IV) and depression
(DV), then relationship between stress & depression can be stronger for people with no social
support and less strong for people with social support.
(i)Nominal Measurement
The nominal scale measures nominal variables. It classifies persons or things based on a
qualitative assessment of the characteristic being assessed. It is the lowest level of measurement
and it neither includes information on quantity or amount nor does it indicate more than or less
than.
(ii)Ordinal Measurement
The ordinal scale measures ordinal variables. It also classifies persons or things based on the
characteristic being assessed but does indicate more than or less than. In this sense, it provides
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more information than the nominal scale. However, the ordinal scale does not indicate how
much more than or less than. This is the medium level of measurement.
(iii)Interval Measurement
The interval scale measures numerical variables. It has the same characteristics of the ordinal
scale classifying persons or things based on the characteristic assessed and indicating more
than or less than but the interval scale indicates how much more than or less than.
The interval scale does not indicate a true zero point, meaning that there cannot be an absence of
a characteristic being measured. Additionally, ratios made with two numbers in the interval
scale do not have meaning.
o Example: Temperature is an interval in that different values can tell you how much more
or less. However, there is no true zero point. The value of zero in temperature does not
indicate absence of temperature. Also, when comparing two temperatures, their ratio is
not meaningful. We would not say that a 90 degree temperature is twice as hot as a 45
degree temperature.
(iv)Ratio Measurement
The ratio scale measures numerical variables and it includes all the characteristics of the interval
scale but does indicate a true zero point.
o Example: Height and weight measurements indicate how much more or less, but also
have a true zero point. A weight of zero indicates an absence of weight.
Note:
Data gathered at a higher level can always be converted to data at a lower level. However, the
reverse is not true.
For example, if you collect data on the number of cigarettes smoked per day, discrete data, you
can convert these data to ordinal data: < ½ a pack; ½ a pack to 1 pack; >1 pack. While this may
have made it easier to summarize the data, information has been lost in the conversion.
Had you collected these data by category, it would have been impossible to express them as
discrete data as the actual number of cigarettes smoked per day would not be known.
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An easy way to keep these terms straight is to think of these data types as comprising a hierarchy
from nominal at the lowest and least informative level to continuous data at the highest and most
informative level.
Qualitative Data
vii. Chi Square test
viii. McNemar Test
ix. Kappa estimate
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v.
RESEARCH APPROACHES
Quantitative research relies primarily on the collection of quantitative data. It deals with numbers
and anything that is measurable in a systematic way. It is used to answer questions on
relationships within measurable variables with an intention to explain, predict and control the
environment in which the data is collected to avoid the risk of variables, other than the one being
studied, accounting for the relationships identified.
Quantitative research is perhaps the simpler to define and identify. The data produced are always
numerical, and they are analysed using mathematical and statistical methods. If there are no
numbers involved, then its not quantitative research.
3. Applying well established standards means that the research can be replicated, and then
analyzed and compared with similar studies;
4. You can summarize vast sources of information and make comparisons across categories and
over time; and,
5. Personal bias can be avoided by keeping a 'distance' from participating subjects and using
accepted computational techniques.
Quantitative data is more efficient and able to test hypotheses, but may miss contextual detail
Uses a static and rigid approach and so employs an inflexible process of discovery;
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Results provide less detail on behavior, attitudes, and motivation;
Researcher may collect a much narrower and sometimes superficial dataset;
Results are limited as they provide numerical descriptions rather than detailed narrative and
generally provide less elaborate accounts of human perception;
Preset answers will not necessarily reflect how people really feel about a subject and, in some
cases, might just be the closest match to the preconceived hypothesis.
Qualitative research relies on the collection of qualitative data. Qualitative research is any which
does not involve numbers or numerical data. It often involves words or language, but may also
use pictures or photographs and observations. Qualitative analysis results in rich data that gives
an in-depth picture and it is particularly useful for exploring how and why things have happened.
The word qualitative implies an emphasis on the qualities of entities and on processes and
meanings that are not experimentally examined or measured [if measured at all] in terms of
quantity, amount, intensity, or frequency. Qualitative researchers seek to answers questions that
stress how social experience is created and given meaning. In contrast, quantitative studies
emphasize the measurement and analysis of causal relationships between variables, not
processes. The advantage of using qualitative methods is that they generate rich, detailed data
that leave the participants' perspectives intact and provide multiple contexts for understanding
the phenomenon under study. In this way, qualitative research can be used to vividly demonstrate
phenomena or to conduct cross-case comparisons and analysis of individuals or groups.
Obtain a more realistic view of the lived world that cannot be understood or experienced
in numerical data and statistical analysis;
Provide the researcher with the perspective of the participants of the study through
immersion in a culture or situation and as a result of direct interaction with them;
Allow the researcher to describe existing phenomena and current situations;
Develop flexible ways to perform data collection, subsequent analysis, and interpretation
of collected information;
Yield results that can be helpful in pioneering new ways of understanding;
Respond to changes that occur while conducting the study e.g., extended fieldwork or
observation and offer the flexibility to shift the focus of the research.
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It is very much true that most of the limitations you find in using qualitative research
techniques also reflect their inherent strengths. For example, small sample sizes help you
investigate research problems in a comprehensive and in-depth manner. However, small
sample sizes undermine opportunities to draw useful generalizations from, or to make broad
policy recommendations based upon, the findings. Additionally, as the primary instrument of
investigation, qualitative researchers are often imbedded in the cultures and experiences of
others. However, cultural embeddedness increases the opportunity for bias to enter into the
way data is gathered, interpreted, and reported.
Drifting away from the original objectives of the study in response to the changing nature of
the context under which the research is conducted;
Arriving at different conclusions based on the same information depending on the personal
characteristics of the researcher;
Replication of a study is very difficult;
An inability to investigate causality between different research phenomena;
Difficulty in explaining differences in the quality and quantity of information obtained from
different respondents and arriving at different, non-consistent conclusions.
Data gathering and analysis is often time consuming and/or expensive;
Requires a high level of experience from the researcher to obtain the targeted information
from the respondent.
Group Studied Larger & randomly selected. Smaller & not randomly selected.
Form of Data Quantitative data based on precise Qualitative data such as open- ended
Collected measurements using structured & responses, interviews, participant
validated data-collection instruments. observations, field notes, & reflections.
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Subjectivity
Most Common Research Describe, explain, & predict Explore, discover, understand &
Objectives construct.
.
Final Report Statistical report with Narrative report with contextual
correlations, comparisons of description & direct quotations
means, & statistical significance from research participants.
of findings.
Which approach to choose will depend on your research questions and your preferences and
skills. Finally, it is important to say that there is no right and wrong answer to which methods
you choose. Sometimes you may wish to use one single method, whether quantitative or
qualitative, and sometimes you may want to a mixture. It is your research and only you can
decide which methods will suit both your research questions and your skills.
By looking at your research question(s), you should be able to determine whether you are
looking at causal relationships (quantitative study) or exploring a phenomenon (qualitative
study). The wording and structure of quantitative and qualitative research questions differ
significantly.
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How often do people aged 30 to 40 visit their parents?
How do lean participants compare to obese participants in their frequency and intensity
of food cravings?
Does stress at work relate to quality of life in people working night shifts?
Does a stressful work environment lead to higher turnover rates?
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RESEARCH PROCESS
This is a concise and coherent summary of your proposed research. It sets out the central issues
or questions that you intend to address. It outlines the general area of study within which your
research falls, referring to the current state of knowledge and any recent debates on the topic. It
is written using future tense.
Be prepared for:
To make mistakes and to learn.
To write and rewrite many times.
To spend many hours looking for information.
To have your writing criticized.
To feel confuse and hopeless some times.
CHAPTER ONE
1.0 INTRODUCTION
1.1..........................................................................................................Background
1.2...............................................................................................Problem statement
1.3...........................................................................................................Objectives
Broad objective
Specific objectives
1.4............................................................................Research questions/hypothesis
1.5.....................................................................................Significance of the study
CHAPTER TWO
2.0 LITERATURE REVIEW
CHAPTER THREE
3.0 RESEARCH METHODOLOGY
3.1 Study design
3.2 Study area
3.3 Study population
3.4 Sample size estimation
3.5 Sampling technique
3.6 Data collection method
3.7. Data collection tool
3.8. Validity and reliability
3.9.Variable measurement
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3.10. Data analysis
3.11 Ethical consideration
3.12.Limitation
4.0 REFERENCES
APPENDIX
Appendix 1. Data collection tool
Appendix 2. Consent form (English and Swahili version)
Appendix 3.Work plan
Appendix 4. Budget
Appendix 5. Map (optional)
Research as a multi-stage process that you must follow in order to undertake and complete your
research project.
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Phase 3: The Empirical Phase
This involves the actual collection of research data and preparation of those data for
analysis. This is the most time consuming part of the investigation. It may require several
weeks or months of work depending on the method used.
o Collecting the data.
o Preparing the data for analysis.
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