Nursing Research

Definitions 1. Descriptive – provides an accurate portrayal or

• Systematic – follows certain steps account of characteristics of a particular
• Controlled – every step of the investigation is individual, situation or group.
planned 2. Correlational – involves the systematic
• Empirical – evidence is on hand, there is investigation of relationships/association between
confidence in the results two
3. Comparative – used to describe the differences
Nursing research is defined as a scientific process in variables in two or more groups in a natural
that validates and refines existing knowledge and setting
generates new knowledge that directly and indirectly 4. Quasi-experimental – causal relationships
influences nursing practice. between two selected variables are examined
Burns and Grove, 2005 through manipulation of the independent variable
but without control or randomization.
Purposes of Research 5. Experimental – it is an objective, systematic,
1. Describe - involves identifying and understanding controlled investigation for the purpose of
the nature of phenomena and sometimes the predicting and controlling phenomena.
relationship among them. Characteristics include manipulation, control, and
randomization.
2. Explain - It clarifies the relationships among 6. Ex post facto – the independent variable is not
phenomena and identifies the reasons why manipulated, either because it is inherently
certain events occur. It could be the basis for unmanipulable or because it occurred in the past
conducting research for prediction and control
Qualitative research is the investigation of
3. Predict - Through prediction, one can estimate phenomena typically in an in-depth and holistic
the probability of a specific outcome in a given fashion, through the collection of rich narrative
situation. However, predicting an outcome does materials using a flexible research design.
not necessarily enable one to modify or control
the outcome. 1. Phenomenological – describes an experience as
they are lived by people
4. Control - If one can predict the outcome of a 2. Grounded theory – discovers what problems
situation, the next step is to control or manipulate exist in a social scene and the process persons
the situation to produce the desired outcome. use to handle them
3. Ethnographic – it is associated with anthropology
Classifications of Research and focuses on the culture of a group of people,
According to level of investigation with an effort to understand the world view of
Exploratory those under study.
Descriptive 4. Historical – a narrative description or analysis of
Experimental events that occurred in the remote or recent past.
5. Philosophical inquiry – involves using
According to approach intellectual analysis to clarify meanings, makes
Experimental values manifest, identify ethics, and study the
Non-experimental nature of knowledge
6. Case study – involves a thorough, in-depth
According to measurement & data analysis analysis of an individual, a group, or an institution
Quantitative or other social units.
Qualitative 7. Critical theory – an approach to viewing the
According to time frame world that involves a critique of society, with the
Longitudinal goal of envisioning new possibilities and effecting
Cross sectional social change
8. Feminist research – seeks to understand,
According to motive or objective typically through qualitative approaches, how
Basic research gender and a gendered social order shape
Applied research women’s lives and their consciousness.

According to time line Mixed Methods Research

Retrospective TRIANGULATION – the use of multiple methods to
Prospective collect and interpret data about a phenomenon, so as
to converge on an accurate representation of reality
According to research environment
Field Steps in the Research Process
Laboratory Identification of problem
Review of related literature
Quantitative research is the investigation of Construction of a framework
phenomena that lend themselves to precise Formulate the hypothesis
measurement and quantification, often involving a Select the research design
rigorous and controlled design. Select the sample
Collect the data
Analyze and interpret the data
Write the research report
Communicate the research report Significance of the study - issues relevant in
considering the significance of the study:
Problem 1. Implications for nursing practice – Is it able to
A problem is a condition requiring a solution. produce evidence for nursing practice?
In research, a problem statement is an expression of 2. Extension of knowledge base – Is it able to produce
a dilemma or a disturbing situation that needs new knowledge that is useful?
investigation. 3. Promotion of theory development – Is it able to test
or develop a new theory?
Sources of research problems 4. Correspondence to research priorities – Is it in line
Personal experiences and observations with research priorities of the country, profession, or
Readings funding institutions?
Conversations with peers, experts, clients
Scope defines where and when the study was
Research Question conducted and who the participants (subjects) were.
The problem is specifically stated in the form of a The scope sets the delimitations and establishes the
research question. boundaries of the study.
The research question should be clear, concise, and
stated in measurable terms specifically in quantitative Limitations – are the weaknesses and shortcomings
research. of the study as acknowledged by the researcher.
Definition of terms
Example
What is the level of creativity among senior student Operational definition – description of how variables
nurses of a center of excellence college in Manila in or concepts will be measured or manipulated in the
terms of originality and flexibility? study

Functions of a title Conceptual definition – provides a variable with

• It draws in summary form, the content of the connotative meaning. It tells what the concept means.
entire investigation.
• It serves as a frame of reference for the whole An assumption is any fact presumed to be true but
thesis. not actually verified. It pertains to events or situations
• It enables the researcher to claim the title as that seem so true that they are taken for granted.
his own. Unlike the hypothesis it does not need testing or
• It helps the other researchers refer to the confirmation.
work.
Ethics in Research
Titles should be clear and specific. Basic Rights
It should include variables, relationships, target
population, and setting. Ideally, it should have a The right to protection from harm and discomfort.
maximum of 20 substantive words, with function Beneficence – imposes a duty on researchers to
words not included in the counting. minimize harm and to maximize benefits. A related
principle is nonmaleficence (avoid, prevent or
Example minimize harm)
The Effects of Home Visits of Public Health Nurses on
the Dietary Compliance of Adult Diabetic Patients in Right to full disclosure – means that the researcher
Two Barangays in Quezon City has fully described the nature of the study, the
subject’s right to refuse participation, the researcher’s
Variable – an attribute of a person or object that responsibilities, and the likely risks and benefits that
varies, that is, takes on different values. It is anything would be incurred.
that is liable to change or likely to vary.
• Independent variable – cause Basic Rights
• Dependent variable – effect • Debriefing is communication with subjects,
• Extraneous variables – not studied but generally after their participation has been
affects results completed regarding various aspects of the study.
• Intervening – comes between the dependent • Covert data collection or concealment is the
and independent variables. Ex stress, anxiety, collection of data without the subject’s knowledge.
motivation • Deception can involve either withholding
• Organismic – those that can not be changed information about the study or providing subjects
through manipulation. Ex. – age, sex, race with false information.
• Confounding or interfering – interfere with • Placebo is a medically harmless, ineffective
the study design and the data gathering substance that is usually used in testing a new
process by influencing the subjects or the drug when it is given to a control group. It is done
dependent variable. Ex. – social support to rule out any possible biases of subjects and
• Antecedent – occurs earlier than the investigators.
independent variable and bears a relationship
both to it and to the dependent variable. Ex.- There are two variations in the use of placebo
poor health, superstitious beliefs 1. Single blind test design: it is one in which
the evaluations of the results of a treatment
RANDOMIZATION is the best control over unknown are kept from the subjects who have received
variables. it.
 2. Double blind test design: it is one in which
the investigators and the subjects involved in
the study are kept ignorant about the process Literature Review
– that is, they are not suppose to know who It is a collection of materials on a topic. It discusses
are receiving the treatment and who are not published information in a particular subject area
sometimes within a certain time period.
Right to self determination means that the prospective
subjects have the right to voluntarily decide whether A summary is a recap of the important information
or not to participate in a study, without the risk of found in the literature.
imposing any penalties or prejudicial treatment.
It includes the right to decide at any point to terminate A synthesis is a re-organization, or a reshuffling of
their participation, to refuse to give information, or to information to:
ask for clarification about the purpose of the study or 1. Give a new interpretation of old materials
specific study procedures 2. Combine new with old interpretations
3. Trace the intellectual progression of the field
Vulnerable subjects or persons with diminished including major debates.
autonomy are those who are less advantaged
because of legal or mental incompetence, terminal Purpose
illness, or confinement to an institution. It is conducted to generate a picture of what is known
about a particular situation and the knowledge gaps
The right to full disclosure and the right to self that exist in it.
determination are the two major elements on which
informed consent is based Kinds of literature
Research literature: refers to published reports of
Informed consent means that the subjects have actual research studies done previously
adequate information regarding the research; are Conceptual literature consists of articles or books
capable of comprehending the information; and have written by authorities giving their opinions,
the power of free choice, enabling them to voluntarily experiences, theories, or ideas.
consent to participate or decline participation in the
research study. Sources for literature review
A primary source: is the description of an
Informed consent involves the disclosure of the investigation written by the person who conducted it
following information: subject status, study purpose, A secondary source: is a description of a study or
type of information to be obtained, nature of the studies prepared by someone other than the original
commitment, sponsorship, subject selection, researcher
procedures, potential risks, costs, and benefits,
confidentiality pledge, voluntary consent, right to
withdraw, alternatives, and contact information. Framework
A framework is the abstract, logical structure of
Informed consent for children is called assent. The meaning that guides the development of the study
study must be explained within the child’s level of and enables the researcher to link the findings to
comprehension. Most assent are accompanied by nursing's body of knowledge.
parental consent. It is the conceptual underpinnings of a study.

Right to fair treatment means that the subjects receive Theoretical framework is based on theories.
equitable treatment before, during, and after their
participation in the study. Conceptual framework is rooted on specific
concepts or conceptual model
Right to privacy means that researchers need to Both provides the structure for examining a problem
ensure that their research is not more intrusive than it and serves as a guide to examine relationships
needs to be and that the subject’s privacy is between variables.
maintained throughout the study The use of a framework
In quantitative research, the framework is a testable
Anonymity occurs when even the researcher can not theory that may emerge from a conceptual model or
link a subject with the information for that subject. The may be developed inductively from published
subjects remain unknown. research or clinical observations
In qualitative research, the initial framework is a
Confidentiality to the subjects is a guarantee that philosophy or a worldview. A theory consistent with
any information that the subjects provide will not be the philosophy is developed as the outcome of the
publicly reported or made accessible to parties other study.
than those involved in the research.
Hypothesis
Nuremberg Code The hypothesis is a tentative, declarative statement
This ethical code of conduct contains rules that were about the relationship between two or more variables.
developed to guide investigators in conducting
research ethically w/c are: It is a tentative explanation for certain behaviors,
1. voluntary consent phenomena or events that have occurred or will
2. withdrawal of subjects from studies occur.
3. protection of subjects from physical and mental
suffering, injury, disability, death It is an educated guess, which needs to be tested.
4. balance of benefits and risk
Characteristics Quantitative Designs
• It should be reasonable.
• It should state in definite terms, the • Descriptive design is used to identify a
relationship between variables. phenomenon of interest, identify variables within
• It should be testable. the phenomenon, event or group in real life
Types situations for the purpose of discovering new
Null hypothesis (Ho) is a statement of a no meaning, describing what exists, determining the
relationship, no difference, no effect or no interaction. frequency with which something occurs, and
It is tested with statistics. categorizing information.
Example: There is no relationship between nursing
admission test results and board examination ratings • Survey designs are employed to measure the
among the graduates of nursing schools in Manila. existing phenomenon without inquiring into why it
exists. The main intention is to use the data for
Alternative or research hypothesis (H1) is the problem solving rather than for hypothesis testing.
expectation based on theory. This could either be:
• Correlational designs help one determine the
Directional – specifies the direction of the extent to which different variables are related to
relationship. each other in the population of interest. The
critical distinguishing characteristic is the effort to
Non-directional – only specifies that there is a estimate a relationship as distinguished from
relationship. simple description.

Example: • Comparative designs examine and describe

Directional - The higher the nursing admission test differences in variables in two or more groups that
results, the higher is the board examination ratings. occur naturally in the setting. Descriptive and
inferential statistical analyses are used to
Non-directional - There is a relationship between examine differences between or among groups.
nursing admission test results and board examination
ratings among the graduates of nursing schools in • Time dimensional designs were developed
Manila. within the discipline of epidemiology where the
occurrence and distribution of disease among
Types populations are studied. These designs examine
Simple hypothesis has one independent and one sequences and patterns of change, growth or
dependent variable. change over time. The dimension of time
Example: There is no relationship between nursing becomes an important factor.
admission test results and board examination ratings
among the graduates of nursing schools in Manila. • Longitudinal designs examine changes in the
same subjects over an extended period.
Complex hypothesis has two or more independent
and dependent variables • Cross sectional designs are used to examine
Example: There is no relationship between nursing groups of subjects in various stages of
admission test results and grade point average to development simultaneously with the intent to
board examination ratings and CGFNS results describe changes in the phenomenon across
among the graduates of nursing schools in Manila. stages.

Wording the hypothesis Primary longitudinal designs

1. Hypothesis should specify the independent and
dependent variables and the relationship between • Trend studies: the general population is studied at
them. different points over a long period of time.
2. Hypothesis should be worded in the present Participants are not the same at each period but
tense they are representative of the population at that
3. Hypothesis should be stated declaratively. time.
2. Cohort studies: focus on the same specific
Remember population each time data are collected, samples may
Hypotheses are never proved through hypothesis be composed of different subjects but with similar
testing rather they are accepted or supported or characteristics.
rejected. Findings are always tentative. If results are
replicated in numerous investigations, greater 3. Panel studies: use the same respondents for each
confidence can be placed in the conclusions. progressive time period that the data are collected.
Hypotheses come to be supported with mounting Characteristics of a True Experiment
evidences.
Manipulation: the researcher manipulates i.e.
Research design is the plan, structure, and strategy provides intervention or treatment in the experimental
of an investigation. group. The independent variable is manipulated to
assess its effect on the dependent variable.
Research method is the totality of how the study is
carried out. It includes the design, sample, setting, Control: imposing of rules by the researcher to
instruments, interventions, procedures, and data decrease the possibility of error and increase the
analysis. probability that the study’s findings are an accurate
reflection of reality.
Ways of control: Solomon Four Group Design
• Homogenecity: the researcher limits the Notation:
subjects to only one level of extraneous RS O1 X O2
variable to reduce the impact on study RC O3 O4
findings RS X O5
• Blocking: including the extraneous variable RC O6
as part of the design
• Matching: it is used when a subject in the Quasi-experimental designs are studies involving
experimental group is randomly selected and an intervention in which subjects are not randomly
then a subject similar in relation to important assigned to treatment conditions but the researcher
extraneous variables is randomly selected for exercises controls to enhance the study’s internal
the control group. validity.

Randomization: each individual in the population Time series experiment

should have a greater than zero opportunity to be O1 O2 O3 O4 X O5 O6 O7 O8
selected for the sample. Random assignment is the
assignment of subjects to treatment conditions in a Non-equivalent control group design
manner determined by chance. O1 X O2
---------------------
Quantitative Experimental O3 O4
Pre-experimental design is a research design that
does not include mechanisms to compensate for the Threats to Experimental Validity
absence of either randomization or a control group. Internal validity: refers to the condition that the
Done as a preliminary study. observed differences on the dependent variable are a
direct result of the manipulation of the independent
One shot case study variable, not some other variable

Notation Selection threat is more likely to occur in studies in

X O which randomization is not possible
Where:
X – Treatment/intervention Maturation is defined as growing older, wiser,
O - Posttest stronger, hungrier, more tired, or more experienced
during the study. Unplanned and unrecognized
changes can influence the findings of the study.
Posttest only design with comparison group
Mortality is due to subjects who drop out of a study
Notation before completion
Experimental group X O1
Control group O2 External validity refers to the condition wherein the
results are generalizable or applicable to groups and
environments outside of the experimental setting
One-Group Pretest Posttest Design
Notation: Epidemiological Designs
O1 X O2 Two broad classifications
Where: 1. Observational studies – examine associations
O1 – Pretest between risk factors and outcomes
X - Treatment/Intervention 2. Intervention studies – explore the association
O2 - Posttest between interventions and outcomes

True experimental designs possess the Observational studies

characteristics of a true experiment. 1. Analytical – determinants and risk of disease
2. Descriptive – patterns and frequency of disease
True Experimental Designs

Pretest Posttest Control Group Design or Sampling involves selecting a group of people,
Classical Experimental Design events, behaviors, or other elements with which to
Notation: conduct a study.
RS O1 X O2
____________________ Sampling plan defines the process of making the
selection.
RC O3 O4
Where: Sample defines the selected group of people or
R – Random assignment elements.
O1 – Experimental pretest
O2 - Experimental posttest Population or target population is the entire set of
O3 – Control pretest individuals or elements who meet the sampling
O4 – Control posttest criteria.
X - Treatment/Intervention
S – Study group Sampling criteria list the characteristics essential for
C – Control group membership in the target population.
Accessible population is the portion of the target Accidental, convenience, incidental: utilizes readily
population to which the researcher has reasonable available subjects
access.
Snowball or network: subjects act as informants
Elements are the entities that make up the sample or who identify others for inclusion in the sample who in
the population turn leads to more samples

Sampling frame is a list of all cases, objects, or Steps in Sampling

groups of cases in the populations. General outline of procedures
1. Identify the target population
Generalizing means that the findings can be applied 2. Identify the accessible population
to the population. 3. Decide the sample size and how the sample will
be taken.
Representativeness means that the sample must be 4. Recruit subjects according to the designated
like the population in as many ways as possible. plan.
5. Obtain the subject’s cooperation.
Categories of Sampling Plans
Probability sampling: a process in which each
element of the population has an equal chance of Qualitative sampling
being chosen for the sample. There is randomization. 1. Sample size is not predetermined in qualitative
research
Non-probability sampling: elements are selected by 2. Saturation: is the point in data gathering where
non-random methods no new data emerge therefore sampling is
Sample Size stopped. There is data repetition.
RULE: The larger the sample, the more
representative of the population. Data Collection
Goal and Purpose
Minimum acceptable sample size • Goal – to collect data that are meaningful for
1. Descriptive: 10 – 20% of the population the purpose of the study
2. Correlational: 30 subjects • Meaningful data depend on the quality of the
3. Ex post facto: 15 subjects instrument employed in the process
4. Experimental: 15 – 30 subjects per group • No amount of sophisticated statistics can
Gay and Diehl,1992 salvage a poor set of data gathered through
Sample Size defective instruments.
•Slovin’s Formula Questionnaire
n = N
• Questionnaire: a paper and pencil instrument
1 + Ne2
completed by the study subjects
Where: n = sample size
N = population • Formats
e = desired margin of error 1. Checklist
2. Multiple Choice
( 0.05 or 0.01 )
3. Rating Scales: list an ordered series of categories
Probability Techniques
Simple random: sampling by chance either by lottery of a variable assumed to be based on an underlying
continuum.
or by the use of table of random numbers
A numerical value is assigned to each category.
Probability Techniques
Questionnaire Formats
Stratified random: involves taking certain areas of
the population, dividing the areas into sections, and • Checklist
• Multiple Choice
then taking a random sample from each section.
• Rating Scale and Ranking Type
Probability Techniques
Interview
Systematic sampling: every nth name from a roster
of names can be taken as • Interview involves verbal communication
between the researcher and the subject
sample.
• Interview structure is the amount of direction
K = N/n
Where: K = sampling interval and restriction imposed by the interview
situation
N = population
n = sample size
Interview Types
Cluster sampling: sampling in groups • Structured: the interviewer has a list of
prepared questions in the form of an interview
Purposive or judgmental: subjects are hand picked schedule
to be included in the sample, based upon the • Unstructured interview: more like a
researcher’s knowledge of the population. conversation. The interviewer uses an
interview guide
Non-probability Techniques
Quota sampling: researchers identify strata of the Interview Tools
population and then determine how many participants Observation
are needed from each stratum to meet a quota. 1. Observation: involves looking at the
Non-probability Techniques phenomenon
 2. Used to study human behavior
3. Hawthorne effect: is the effect on the Purposes of statistics
dependent variable caused by the subject’s Summarize
awareness that they are participants in a Organize
study Evaluate Numeric
Interpret Information
Types of Observation Communicate
1. Structured observation is one in which aspects
of the phenomenon to be observed are decided in Factors to consider in choosing the appropriate
advance statistical test
2. Unstructured observation is a nonselective 1. Purpose of the study
description of the phenomenon to be observed 2. Research questions
3. Participant observation is done when the 3. Number and measure of variables
researcher is involved in the setting with the 4. Sampling technique and sample size
subject 5.Availability of statistical software
4. Non-participant observation is when the 6. Ability of the researcher
researcher is merely viewing the situation
Records 1. Comprehending – making sense of the data
1. Records are prepared and preexisting data and learning “what is going on” and preparing
2. Selective deposit and selective survival are a thorough description of the phenomenon.
the two major sources of bias. 2. Synthesizing – involves sifting of the data
3. Records available for use may not constitute and putting pieces together. Researchers get
the entire set of all possible data. a sense of what is typical with regard to the
phenomenon and what variation is like.
Physiologic measurements are techniques used to 3. Theorizing – involves a systematic sorting of
measure physiologic variables either directly or the data. Researchers develop alternative
indirectly. This is also called biophysiologic measures explanations of the phenomenon and then
1. Used in clinical nursing studies hold these explanations up to determine their
2. The choice of the physiologic measure is fit with the data.
dependent upon its ability to yield good 4. Recontextualizing – involves the further
information. development of the theory such that its
applicability to other settings or groups is
Criteria for effective question explored. After analysis you deserve a…
1. Clarity of language
2. Specificity of content and time period
3. Singleness of purpose
4. Freedom from assumption
5. Freedom from suggestion
6. Linguistic completeness
7. Grammatical consistency

Types of questions
Closed ended: respondents answer a number of
alternative responses
1. Dichotomous: two-response alternative
2. Multichotomous: multiple responses
Open ended: respondents are given enough
flexibility to answer questions or specify
answers other than those found in the
questionnaire
Characteristics of tools
Validity refers to the ability of a data-gathering
instrument to measure what it is supposed to
measure and to obtain data relevant to what is
being measured.
Reliability refers to the ability to obtain consistent
results when reused.

It is time to sip a good cup of coffee!

Data Analysis and Interpretation

Data Analysis - is the systematic organization and
synthesis of research data and, in most quantitative
studies, the testing of the hypotheses using those
data.

Quantitative Analysis
The manipulation of numerical data through statistical
procedures for the purpose of describing
phenomenon or assessing the magnitude and
reliability of relationships among them.