3: Nursing Research and Evidence-Based Practice
Research — a systematic way of studying or examining an issue so that the knowledge about that issue is validated.
Common Research Terms
Bias | Any influence that may alter the outcomes of a research study |
Clinical nursing research | Nursing research that has a direct impact on nursing interventions with individuals |
Data | Measurable bits of information collected for the purpose of analysis |
Data collection | Gathering of information necessary to address the research problem |
Deductive reasoning | Logical system of thinking that starts with the whole and breaks it down into its component parts |
Dependent variable | A variable that is affected by the action of the independent variable |
Ethics committee | Committee responsible for review of research proposals to ensure that human subjects are protected from harm |
Hypothesis | Statement of a predicted relationship or difference between two or more variables. A hypothesis contains at least one independent and one dependent variable |
Independent variable | A variable that causes a change in the dependent variable |
Inductive reasoning | Logical system of thinking that begins with the component parts and builds them into a whole |
Informed consent | An agreement by a research subject to participate voluntarily in a study after being fully informed about the study and the risks and benefits of participation |
Instrument | Device or technique used to collect data in a research study (e.g. questionnaires or interviews) |
Literature review | A critical summary of available theoretical and research literature on the selected research topic. It places the research problem for a particular study in the context of what is currently known about the topic |
Nursing research | Research usually conducted by nurses to generate knowledge that informs and develops the discipline and practice of nursing |
Population | All known subjects that possess a common characteristic of interest to a researcher |
Problem statement | A statement that describes the purpose of a research study, identifies key concepts and sets study limits |
Qualitative research | Used to examine subjective human experiences by using non-statistical methods of analysis |
Quantitative research | The systematic process used to gather and statistically analyse information that has been measured by an instrument and converted to numerical data |
Reliability | Characteristic of a good instrument; the assessed degree of consistency and dependability |
Research | A systematic process using both inductive and deductive reasoning to confirm and refine existing knowledge and to build new knowledge |
Research design | The overall plan for collecting data in a research study |
Research process | An orderly series of phrases identifying steps that allow the researcher to move from asking a question to finding an answer |
Research question | Use of an interrogative format to identify the variables to be studied and possible relationships or differences between those variables |
Sample | A subset of a population selected to participate in a research study |
Systematic review | A rigorous review of all the evidence on an aspect of healthcare |
Validity | A characteristic of a good instrument; the extent of an instrument’s ability to measure what it states it will measure |
Variable | A concept, characteristic or trait that varies within an identified population in a research study |
Nursing Research — involves a systematic search for and validation of knowledge about issues important to the nursing profession and links theory, education and practice.
It is important for:
Validating nursing as a profession
Documenting the effectiveness of nursing interventions
Providing a scientific knowledge base for practice
Demonstrating accountability for the profession.
Research-based or evidence-based practice (EBP) is essential if the nursing profession is to deliver safe, effective and efficient care.
Gray and colleagues describe EBP as involving the use of collective research findings in:
Promoting the understanding of individuals’ and families’ experiences with health and illness.
Implementing effective nursing interventions to promote healthcare outcomes.
Providing quality, cost-effective care within the healthcare system.
Evidence-based practice (EBP) — it is built on the belief that decisions about the delivery of care to individuals should be informed by the best available and most current evidence.
EBP is a process of:
Synthesising research evidence
Designing clinical practice guidelines
Implementing practice changes
Evaluating outcomes
Why do we need evidence-based practice?
Rapid increase in amount of information
Rapid increase in healthcare costs
Determination of efficient and effective healthcare practices
Increased emphasis on performance and outcome standards
Where is evidence found?
Published research
Systematic reviews
Special collections of EBP resources
Ask a focused question (PICO Format)
P: Patient/Population—characteristics
I: Intervention/Indicator—what the health professional plans to do for that patient/population
C: Comparison/control—the alternative choice
O: Outcome—what the health professional plans to accomplish, improve or influence.
Assess appropriate evidence.
Finding the best evidence to answer the question; a thorough search of evidence.
Appraise evidence for validity, impact and precision.
Validity: Can you believe the results of the study?
Impact: What is the clinical importance of the evidence?
Precision: Can you apply the results of the study to your situation?
Apply evidence accounting for patient values/preferences, clinical and policy issues.
Nurses should use research evidence to guide their practice, but they must also consider the individual needs and preferences of their patients.
Evaluate/audit your practice/personal skills.
Evaluate the effect on the individual and reflect on the nurse’s own performance—undertake audit or ask yourself self-reflective questions about steps 1 to 4
EBP relies on systematic searching and analyzing research reports
Medline, CINAHL, PsychINFO, and the Cochrane Library are valuable resources.
Cochrane Collaboration —Produces systematic reviews to inform healthcare decisions.
The National Institute of Clinical Studies and the Joanna Briggs Institute (JBI) focus on EBP.
JBI develops best practice information sheets, systematic reviews, and other resources.
Florence Nightingale: Pioneered nursing research with data collection and analysis during the Crimean War.
Slow Development: Nursing research was limited until the late 1940s due to traditional training and limited education.
Advancement in the USA: The shift to advanced degrees and university affiliation led to increased research activity in the 1960s and 1970s.
Focus on Practice: Nursing research began to focus on improving clinical practice and testing nursing theories.
Growth in Australia: Nursing research flourished in Australia in the 1970s and 1980s.
Emphasis on EBP: Nurses prioritize evidence-based practice to inform decision-making.
Technology: Technology facilitates access to research and evidence.
Focus Areas: Research focuses on areas like wound healing, pressure ulcers, patient education, communication, and nutritional support.
Value of Research: Nursing research contributes to understanding clinical phenomena and informing research programs.
Nurse Involvement: Nurse researchers and leaders are active in consulting roles in various institutions.
Magnet Hospitals — These hospitals are recognized for their high-quality nursing care, job satisfaction, and staff retention.
These hospitals demonstrate excellence in nursing, staff development, quality improvement, and sustainable resources.
These hospitals foster an environment conducive to EBP and practice change.
Working in a here can enhance satisfaction and retention for enrolled nurses.
Quantitative research methods — involve the use of numbers and statistical analysis.
It is both logical and systematic in nature and gathers and analyses information that has been measured by an ‘instrument’, such as a questionnaire, and converted to numerical data.
Quantitative nursing research — the investigation of nursing phenomena that lend themselves to a precise measurement, such as pain severity or rate of wound healing.
Variables — concepts or traits that vary; it could be temperature, pulse, respiration, blood pressure, height and weight.
Independent variable — can be controlled or manipulated by the researcher.
Dependent variable — can be measured or observed as a result of independent variable.
Quantitative Research Designs
Type | Description | Example |
Descriptive Research | Describes characteristics of a population or phenomenon without manipulating variables. | Survey research to understand patient satisfaction in a healthcare setting. |
Correlational Research | Examines the relationship between two or more variables without active intervention. | Study investigating the relationship between stress levels and sleep quality in nurses. |
Quasi-Experimental Research | Involves manipulation of an independent variable but lacks random assignment to groups. | Testing the impact of a new teaching method on student performance where groups are pre-assigned. |
Experimental Research | Involves random assignment of participants to control and experimental groups with manipulation of variables. | Randomized Controlled Trials (RCTs) testing a new drug’s effectiveness compared to a placebo. |
Cross-Sectional Research | Collects data at a single point in time to examine current characteristics or behaviours in a population. | Surveying a population’s exercise habits at one specific point in time. |
Longitudinal Research | Follows the same group of individuals over an extended period to observe changes or trends. | Studying the long-term effects of physical therapy on post-surgery recovery over 5 years. |
Retrospective Research | Uses existing data to look back at outcomes or patterns in relation to a specific event or intervention. | Analysing past medical records to assess the link between smoking and lung cancer development. |
Cohort Study | Observes a group of people over time who share a common characteristic, usually prospectively. | Studying a cohort of nurses exposed to long shifts and assessing burnout over time. |
Case-Control Study | Compares individuals with a specific condition to those without it to explore potential causes or risk factors. | Comparing individuals with diabetes to those without to study risk factors associated with the condition. |
Survey Research | Collects data through questionnaires or interviews to gather quantitative insights on attitudes, behaviours, or characteristics. | Conducting a large-scale survey on vaccination attitudes in different communities. |
Qualitative research — a subjective approach used to explore phenomena and describe human experiences.
It collects data and obtains information from, for example, interviews rather than measurement.
It may wish to examine individuals and their stories and behaviour, organisations and their functioning, or cultures and their interactions and social movement.
Qualitative Research Designs
Type | Description | Example |
Phenomenology | Explores the lived experiences of individuals about a specific phenomenon to understand its essence. | Studying the experiences of patients living with chronic pain. |
Grounded Theory | Aims to develop a theory grounded in data systematically collected and analysed through the research process. | Investigating how nurses develop resilience in high-stress environments to formulate a new theory. |
Ethnography | Studies the culture and social interactions of a particular group or community in their natural setting. | Exploring the working culture of emergency room staff to understand teamwork dynamics. |
Case Study | An in-depth examination of an individual, group, event, or situation to gain detailed insights. | Investigating the care process for a particular patient with a rare disease in a hospital. |
Narrative Research | Focuses on gathering and analysing stories from individuals to understand their experiences and perspectives. | Collecting life stories of elderly patients to explore their experiences of aging in a nursing home. |
Action Research | Involves researchers and participants collaborating to address a specific problem or implement changes in real-time. | Working with nurses to improve patient care practices through iterative cycles of reflection and action. |
Discourse Analysis | Examines language and communication patterns within social and cultural contexts to reveal meaning. | Analysing the language used in healthcare policy documents to understand power relations. |
Content Analysis | Systematically analyses textual or visual content to identify patterns, themes, or meanings. | Analysing patient feedback forms to identify common themes in healthcare service complaints. |
Historical Research | Investigates past events or experiences to provide insights into a phenomenon or process. | Examining historical nursing practices during the early 20th century. |
Focus Groups | Involves group discussions to explore participants' views, experiences, or reactions on a topic. | Using focus groups to gather feedback from nurses about implementing new technology in hospitals. |
Mixed methods approach — a combination of two or more different approaches to data collection and analysis.
It is useful in nursing where complex phenomena may require both quantitative and qualitative data to be fully understood.
Can offer complementary perspectives that can provide a more comprehensive understanding of a research question.
Allows for flexibility in the research design, depending on the specific research question and context.
Mixed Method Research Designs
Mixed Methods Design | Description | Example |
Convergent Parallel Design | Quantitative and qualitative data are collected simultaneously but analysed separately. The results are then compared or combined to understand the research problem from different perspectives. | Investigating patient satisfaction by combining survey data (quantitative) and interviews (qualitative) about hospital services. |
Explanatory Sequential Design | A two-phase design where quantitative data is collected and analysed first, followed by qualitative data to explain or further explore the quantitative findings. | Conducting a survey on nurse burnout levels (quantitative) and then using interviews to explore the reasons behind the results (qualitative). |
Exploratory Sequential Design | A two-phase design where qualitative data is collected and analysed first to explore a phenomenon, followed by quantitative data collection to test or generalize the findings. | Exploring patient experiences with a new treatment (qualitative) and then using a larger survey to validate these findings (quantitative). |
Embedded Design | One form of data (either qualitative or quantitative) is embedded within a larger research design based primarily on the other form of data. This design allows additional insights into the primary data. | Studying the effectiveness of a new medical procedure (quantitative) while gathering patient feedback through interviews (qualitative) within the same study. |
Multiphase Design | Involves multiple phases of data collection, where each phase builds on the previous one, alternating between quantitative and qualitative data collection across several stages. | Using qualitative interviews to understand challenges in healthcare (Phase 1), conducting a survey to measure the extent of the issue (Phase 2), and then refining interventions (Phase 3). |
Transformative Design | Uses a social justice or advocacy lens, integrating quantitative and qualitative data to address a specific social issue, often emphasizing marginalized or vulnerable populations. | Studying health disparities by combining statistical analysis (quantitative) with focus groups of underrepresented communities (qualitative) to inform policy changes. |
Research problem — refined through a process that proceeds from identifying a general idea of interest to defining a specific topic.
Preliminary literature review — reveals related factors that appear critical to the research topic and it should identify a gap in the literature on the specific topic.
Significance of the research problem — it must be identified in terms of its potential contribution to both the individual and the nursing profession.
Choosing the topic of interest may develop from:
Discussing an issue of common interest with a colleague.
Reading about an issue in a journal, text or newspaper.
Identifying an area deficient in information.
An aspect of practice being introduced for the first time.
An aspect of practice that may have been observed but which needs to be validated.
Areas of work that may need to change.
Wanting to repeat a study that has already been conducted, to check the results.
Purpose of the study — states the aims or goals that the investigator hopes to achieve with the research.
It includes what the researcher will do, who the participants will be and where the data will be collected
Literature review — a comprehensive, in-depth, systematic and critical review of scholarly publications and available evidence focused on the research topic.
It is often called ‘secondary research.’
Primary Source — written by an individual(s) who developed the theory or conducted the research.
Secondary Source — descriptions of studies written by someone other than the original researcher who developed the theory or conducted the research.
Purpose of Literature Review
Determines what is known and not known about a subject, concept or problem.
Determines gaps, consistencies and inconsistencies in the literature about a subject, concept or problem.
Discovers unanswered questions about a subject, concept or problem.
Discovers conceptual traditions used to examine problems.
Uncovers a new practice intervention(s) or provides evidence for current practice intervention(s).
Generates useful research questions and hypotheses for the discipline.
Describes the strengths and weaknesses of designs or methods of enquiry and instruments used in earlier works.
Determines an appropriate research design or method (instruments, data collection and analysis methods) for answering the research question(s).
Determines the need for replication of a well-designed study or refinement of a study.
Promotes development of new or revised practice protocols, policies and projects or activities related to nursing practice and to the discipline.
How to search successfully for information
Define Topic: Clearly identify the subject of interest.
Select Resources: Choose appropriate search resources like indexes, abstracts, and catalogs.
Evaluate Materials: Critically review and evaluate the information found.
Search Databases: Utilize electronic indexes like CINAHL, Index Medicus, and MEDLINE.
Search Terms: Use precise search terms to refine results.
Limits: Consider using limits like gender, age, and time factors.
Librarian Assistance: Seek help from librarians for guidance and support.
Online Resources: Explore online databases, patient education resources, and nursing journals.
Critical thinking skills
Read primary research articles from peer-reviewed journals.
Read secondary research (critique/response/commentary) articles from peer-reviewed journals.
Photocopy or print copies and make notations directly on the copy.
While reading articles:
keep a research text and a dictionary by your side
review the chapters in a research text on the various steps of the research process, criteria used to critique, unfamiliar terms and so on
list key variables at the top of the article
highlight or underline new terms, unfamiliar vocabulary and significant sentences
look up the definitions of new terms and write them on the article copy, and review old and new terms before subsequent readings
highlight or underline identified steps of the research process
identify the main idea or theme of the article—state it in your own words in one or two sentences
continue to clarify terms that may be unclear on subsequent readings
make sure you understand the main points of each reported step of the research process you identified before you critique the article.
Determine how well the study meets the critiquing criteria:
ask fellow students to analyse the same study using the same criteria and compare results
consult faculty members about your evaluation of the study.
Type a one-page summary and critical review of each study:
cite bibliographic information of the reference at the top of the summary according to relevant reference style
briefly summarise each reported research step in your own words
briefly describe strengths and weaknesses in your own words
Critical reading skills
Skimming a source . Have a brief look at the source to gain a broad overview of its content.
Comprehending a source . This requires that the source be read carefully, with the focus on understanding major concepts and the flow of ideas within the source.
Analysis of a source . Through careful analysis of the source, the reader can determine the value of the content for a particular study.
Synthesis of a source . This involves clarifying and establishing a meaning obtained from the source.
Theoretical framework — uses a theory or theories to form a foundation or frame of reference for the research study.
It helps the researcher explain or predict study outcomes and link these to the existing body of knowledge.
Conceptual framework — loosely related collection of concepts that has not yet been tested.
Research questions — identify the variables to be studied and possible relationships or differences between those variables.
Hypothesis — tries to predict the relationships between variables and the expected outcomes of the study.
A statement of what the researcher thinks will be the outcome of an investigation.
Quantitative research tends to use a research hypothesis whereas qualitative research tends to use research questions.
Research design — the overall plan that guides the way the study is conducted and analysed.
Research question — determines the approach to be used in the design.
Design of the study — must be able to answer the question posed by the researcher.
Key aspects should be considered in a study design.
Intervention:
If there are interventions in the study, they should be part of the design. The study should say what the interventions are (e.g. giving certain medication). What will be the procedure for the intervention? What will be the intensity of the intervention? How long will the duration of the intervention be? Who will perform it?
Comparisons:
In some studies, when making comparisons the design must clearly state what the central issue of the study is.
Extraneous variables:
The researcher must mention in the design what measures will be taken to control the extraneous variables (the factors that influence the issue under study).
Timing of data collection:
The design should indicate when the data will be collected in relation to other steps of the research process.
Research location:
The design must clearly specify the location for data collection.
Communication with the study participants.
In the research design, information given to participants must be clearly identified. When, what and how much information will be provided about the study to the participants?
Population — the subjects of interest for a research study.
They possess certain common characteristics or traits that identify them as a part of the population.
Subjects are selected using a sampling process.
The characteristics of the sample population must closely resemble the characteristics of the population as a whole.
One of the primary concerns in research is to protect the subjects from any harm, discomfort, duress or coercion.
Ethics approval is normally required before any data are collected that involve humans.
National Health and Medical Research Council (NHMRC) — the Australian Government's primary health and medical research funding agency.
It requires that all institutions involved in conducting research on humans or animals establish a relevant institutional ethics committee.
It reviews all studies conducted in the institution to ensure that ethical principles are observed and determines the risk status of all research projects.
Rights needed to be upheld when conducting research
right not to be harmed
right to full disclosure
right of self-determination
right of privacy and confidentiality
right to withdraw from research study
Research participants should have an understanding of the:
Research purpose
Procedures involved
Risks/discomforts of participation
Benefits of participation
Expected duration of involvement
Maintenance of confidentiality and anonymity.
Instrument — tools used to collect data.
Data to be collected are usually physiological, behavioural or psychological in nature.
Physical measurements — sphygmomanometers, electrocardiogram (ECG) machines, glucometers and thermometers.
Behavioural data — collected through observations.
Psychological measurements — used to collect data about knowledge, feelings and attitudes.
Quality instrument — an instrument that is valid and reliable.
Valid instrument — measures what it is supposed to measure.
Reliable instrument — measures the variable consistently and accurately.
Instruments used in research studies should be evaluated for reliability and validity before use in a study.
Treatments are conducted, instruments are administered and data generated and recorded.
Most common methods of data collection in nursing:
Interviews
Questionnaires
Observations
Focus Group
Rating scales
Biophysical measures
Data must be collected in an ideal manner so that they capture the concept that is being researched in a way that is relevant, credible, accurate, unbiased and sensitive.
Any small change to an aspect of data collection can influence the study and interfere with its integrity.
Data analysis — occurs to answer the research questions or to see whether the hypothesis was true.
In the qualitative approach, the analysis will begin almost immediately when data collection begins.
In the quantitative approach, all data has to be collected first before the analysis begins.
In the quantitative approach, statistical analysis enables the researcher to reduce, summarise, organise and give meaning to the data.
Descriptive statistics — used to describe the specific characteristics of the data.
Result section presents the research findings and data in statistical from (quantitative research) or narrative form (qualitative research).
All results from the research should be presented in a clear, logical and concise way that answers each research question and/or hypothesis
In the discussion section, researchers discuss and interpret the research results and give further meaning to the data.
The researcher draws on the research aims, research literature and the theoretical framework used and interprets all the findings/results, whether these are supported by the literature or not, to highlight the outcomes of the study.
Once the findings are stated and discussed, the researcher then makes recommendations for further research.
It provide the reader with suggestions regarding the study’s application to practice, theory and future research.
The researcher also discusses any problems or limitations encountered while conducting the study.
Identifying limitations informs future researchers so they do not repeat them when conducting a similar study.
All references that are cited in the article or research study are included at the end of a paper.
The reference list supports the material presented by identifying sources in a manner that the reader can then follow up to obtain these references for their own use or for any clarification.
Presenting a paper or poster at conferences or seminars at local, national and international levels.
Publication of articles in nursing research or specialty journals and reports.
Research proposal — a written plan identifying the major elements of a study, including the research problem, the purpose of the research, the intended framework to be used and an outline of the proposed research methods and procedures to be used.
It is a formal way to communicate ideas about a proposed study, to apply for approval to conduct the study and, in some instances, to seek funding to support the research.
Content considered to be critical in a proposal are:
The background and significance of the research problem
Purpose
Framework
Research objectives, questions or hypotheses
Methodology or research design
Research production plans (data collection and analysis plan, personnel, schedule and budget).
Essential subcomponents of these critical elements of a research proposal include:
Statement of the problem. This needs to:
be specific enough to be solved be in the form of a question or declaration statement. For example, if the study were about neglect of oral hygiene in nursing homes, the question might be, ‘What is the impact of poor oral hygiene on residents in nursing homes?’
provide the background of the problem, such as how the problem came to be recognised and factors that contributed to the problem.
Significance or importance of the problem:
Includes the implications or possible applications of the knowledge that would be gained through the study.
The research hypothesis (where appropriate), which should be:
reasonable
consistent with known facts or theories
stated in such a way that it can be tested and found to be probably true or false
stated in clear, simple terms.
Assumptions and definitions:
all unusual terms that could be misinterpreted need to be defined
variables considered in the study should be defined.
Review of related literature:
a brief summary of previous research and writings of recognised experts is included to provide evidence that the researchers are familiar with what is known and with what is still unknown and untested.
An outline of the research procedure, which should include:
research design: a brief description of proposed mode of study
sampling protocol: population to be sampled, approximate sample size, characteristics and type of sample
specification of the proposed data gathering techniques (the actual instrument need not be included). Indicate only the data-gathering procedures, conditions for context of data collection and the time frame for data collection
analysis of data and methods to be used
projected timetable for various steps of the research
limitations and weaknesses of the study, as recognised by the researchers.
Proposed budget:
include all necessary items and estimated costs.
Introduction
Background and significance of problem
Statement of the problem and statement of the purpose
Review of relevant literature
Framework
Development of a framework
Formulation of objectives, questions or hypotheses
Methods and procedures
Description of research design
Identification of population and sample
Selection of a setting
Presentation of ethical considerations
Selection of measurement methods
Plan for data collection
Plan for data analysis
Identification of limitations
Discussion of communication of findings
Presentation of a study budget and timetable
References
Appendices
Research utilisation — the translating the knowledge that has been generated by research into clinical practice.
Its goal is to formalise research utilisation to promote research-based policies, procedures and clinical practice guidelines.
Barriers to translating research:
Resistance to change
Insufficient time and resources to implement changes to practice
Lack of supportive infrastructure
Lack of research skills, including an inability to critique
Lack of professional autonomy to effect change
Inability to access and engage with research findings
After research study has been located and surveyed, it must be determined:
Whether it is releval to clinical area
the study a clinical study?
Is the problem being studied one you have seen in your clinical area?
Is the setting used in the study similar to the setting you work in?
Are the sample/participants in the study similar to individuals you work with in clinical settings?
Do the study findings address issues that are within your scope of practice to change?
Do they affect the activities of daily living?
Do they have ramifications for the comfort and wellbeing of individuals under your care?
Do they advocate system or procedural change?
Do the study findings address issues that nursing and midwifery have the power to change?
Are the study findings helpful to your clinical routine?
Do they add to your knowledge base?
Whether the study has rigour and the results have merit and are applicable to the area of work
Are the steps of the research process followed?
When you read the report does it clearly define the clinical problem?
Are ideas concisely and comprehensively identified?
Are participants, tools, methodology and types of analysis clearly defined? In other words, can you follow what was done and why it was done in that way?
Are sampling methods clearly described? Are they appropriate to the study?
Do the results make sense?
Are the conclusions plausible?
Do quantitative studies use reliable and valid instruments?
Do qualitative studies address issues of auditability, transferability and credibility of data?
In qualitative studies, does the final picture of the phenomena under study flow logically from the data?
In quantitative studies, does the discussion section clearly identify who the results could be applied to? Are the findings clearly tied to existing knowledge?
Have other studies been done that address the identified problem (that is, are there replications, meta-analysis or evidence in the literature of similar findings)?
How to implement any relevant or applicable results
Who will be affected and in what numbers?
What are the advantages of implementation?
What are the risks of implementation?
What are the risks of no implementation?
Do the advantages outweigh the risks?
How complex is the change (e.g. a simple intervention or a lengthy protocol that requires extensive retraining of personnel)?
How much will it cost (e.g. need for staff training, equipment, supplies)?
How many people need to be treated to observe a benefit?
Who will be affected by the change besides nursing or midwifery (e.g. medical officers, pharmacy, housekeeping, billing, care services)?
What are the tangible observable outcomes of the utilisation (e.g. will it decrease complications? Save money? Make the staff function better?)
Aspect | Systematic Review | Literature Review |
Definition | A comprehensive, rigorous summary of all relevant studies on a specific research question using systematic and predefined methods. | A general review and summary of literature on a topic without a standard methodology. |
Purpose | To answer a specific research question by synthesizing evidence from multiple studies. | To provide an overview of the topic, summarize findings, and identify gaps in research. |
Scope | Focused on a specific, narrow question or hypothesis. | Broad overview of a topic or field. |
Methodology | Follows a structured and predefined process (e.g., PRISMA) with inclusion/exclusion criteria. | May not follow a specific methodology and is often narrative in nature. |
Search Strategy | Exhaustive and systematic search across multiple databases with documented strategies. | Often selective, searching only a few sources, and may not document the search process. |
Bias and Objectivity | Designed to minimize bias with strict criteria for study inclusion. | Potential for bias, as the selection of literature may not follow a predefined process. |
Quality Appraisal | Includes a formal appraisal of study quality and relevance (e.g., risk of bias assessment). | Typically lacks formal evaluation of study quality or methodological rigor. |
Data Synthesis | Often uses meta-analysis to statistically combine data from multiple studies, if appropriate. | Narrative synthesis of findings without statistical combination. |
Reproducibility | Highly reproducible due to the transparency of methods and documentation. | Less reproducible as the process is less formal and methods are not always clear. |
Outcome | Provides high-level evidence that can be used to inform clinical guidelines and EBP decisions. | Provides background information or an overview but may not offer definitive guidance for practice. |
Time and Resources | Time-intensive and requires significant resources to conduct. | Quicker and easier to complete, typically requiring fewer resources. |
Number of Authors | Three or more | One or more |
Quantitative Research | Qualitative Research |
Focuses on a small number of specific concepts and their relationships and differences | Attempts to understand the entirety or whole of some phenomenon within a prescribed context |
Set on a predefined theoretical foundation. ‘Educated guesses’ made about relationship of concepts and study outcomes | No preconceived theoretical boundaries or preconceived notions about study outcomes |
Researcher controls and interprets data | Focuses on people’s interpretations of events and circumstances rather than researcher’s |
Tends to use larger samples | Uses smaller samples |
Describes people in the study as ‘subjects’ | Describes people in the study as ‘participants’, ‘informants’ or sometimes ‘co-investigators’ |
Uses language in a way that implies neutrality, such as writing in the third person | Can be written up using the first person |
Uses structured procedures and formal instruments to collect information | Collects information without formal structured instruments |
Collects information under conditions of control and manipulation | Doesn’t attempt to control the context of research, but attempts to capture it in its entirety |
Emphasises objectivity in collection and analysis of information. Attempts to exclude all forms of subjective ‘bias’ | Attempts to capitalise on the subjective as a means of understanding and interpreting human experiences. ls comfortable with the notion of ‘bias’ |
Uses ‘objective’ tools to collect data | Researcher is the instrument of data collection |
Applied Nursing Research — Focuses on applied clinical research to improve patient care across different settings.
Australian Journal of Advanced Nursing — Publishes research on nursing practices and policies relevant to the Australian context and beyond.
Clinical Nursing Research — A peer-reviewed journal emphasizing clinical research to inform evidence-based nursing practice.
International Journal of Nursing Studies — Provides high-quality international research on nursing and healthcare.
Journal of Advanced Nursing — Covers a wide range of topics in nursing including clinical, education, and management research.
Journal of Nursing Education — Specializes in studies related to nursing education, curriculum development, and educational methodologies.
Journal of Nursing Research — Focuses on the publication of original research that advances the science of nursing.
Journal of Nursing Scholarship — Publishes research that addresses global healthcare challenges and contributes to nursing knowledge.
Nursing Outlook — Covers issues related to healthcare policy, management, and nursing’s role in addressing public health.
Nursing Research — One of the oldest nursing journals, focusing on research that advances nursing science and practice.
Nursing Science Quarterly — Emphasizes theoretical and philosophical aspects of nursing science.
Qualitative Health Research — A multidisciplinary journal featuring qualitative studies in health and healthcare.
Research in Nursing and Health — Publishes a wide range of research aimed at enhancing patient care and nursing practice through rigorous investigation.
Is it easy to read and understand; that is, no jargon or obscure phraseology?
Is the topic important and relevant?
Have the definitions, key terms and concepts been explained clearly?
In the background to the study, is there enough information in the introduction to set the scene? Has the purpose of the study been identified?
How did they conduct the study; that is, what is the methodology?
Is there evidence of reliability and validity?
How were the subjects selected?
Are they a large or small group?
What did the researchers find, and are the methods of analysis appropriate?
Do the discussions and recommendations relate to study? Are the author’s claims justified by the data? Were the suggestions made based on personal views and not on data? Are the recommendations based on reported findings?
Is the language used understandable?
Is the visual material (e.g. graphs, tables, charts) easy to follow and clearly marked?
Comment on the study’s strengths as well as its weaknesses.
Justify criticisms; offer a rationale for how a different approach could have solved a problem.
Try to be objective; try to avoid being overly critical of a study because of a personal lack of interest in the topic.
Is the report or study written in an objective style or are the author’s biases and viewpoints apparent?
Does the author include a reference for every citation made in the text, so that readers can refer to earlier work on the topic?
Check the credibility of the author.
Check the year of publication—whether it is recent or old.
Risks to participants are minimised.
Risks to participants are reasonable in relation to anticipated benefits, if any, and the importance of the knowledge that may reasonably be expected to result.
Selection of participants is equitable.
Informed consent will be sought.
Informed consent will be appropriately documented.
Adequate provision is made for monitoring the research to ensure the safety of participants.
Appropriate provisions are made to protect the privacy of participants and the confidentiality of data.
When vulnerable subjects are involved, appropriate additional safeguards are included to protect their rights and welfare.
Introduction
Identification of the phenomenon to be studied
The study purpose and type of qualitative study
Study question or aims
Discussion of the significance of the study
Research paradigm
Identification of the research paradigm for the type of qualitative study to be conducted
Description of the philosophical correlates of the research paradigm
Explanation of research assumptions
Research methods
Researchers’ credentials for conducting a particular type of qualitative study
Identification of the research method for the study
Selection of site and population
The researchers’ role
Ethical considerations
The data collection process
Data analysis techniques
Plan to document the research process during the study
Preliminary findings, limitations and plans for communicating the study results
Summary and relevant reference literature
Identification of biases and previous experiences with research problem
Disclosure of anticipated findings, hypotheses and hunches
Discussion of how procedures will remain open to unexpected information
Discussion of limitations of study
Identification of a plan for communicating findings
References
Appendices
The research itself
Resistance to change
Insufficient time and resources to implement changes to practice
Lack of supportive infrastructure
Lack of research skills, including an inability to critique
Lack of professional autonomy to effect change
Inability to access and engage with research findings
Practicing nurses
Isolation from knowledgeable colleagues
Nurses too new on the job to implement new ideas
Lack of authority to implement changes.
Organisational settings
No support of nursing findings
Changes in the healthcare environment
Acuity rate
Degree of nursing shortage
Financial constraints to implement change
The nursing profession
Limited research-based journals
Limited federal funding for nursing research
Poor communication between practitioners and researchers
Shortage of appropriate role models
Research — a systematic way of studying or examining an issue so that the knowledge about that issue is validated.
Common Research Terms
Bias | Any influence that may alter the outcomes of a research study |
Clinical nursing research | Nursing research that has a direct impact on nursing interventions with individuals |
Data | Measurable bits of information collected for the purpose of analysis |
Data collection | Gathering of information necessary to address the research problem |
Deductive reasoning | Logical system of thinking that starts with the whole and breaks it down into its component parts |
Dependent variable | A variable that is affected by the action of the independent variable |
Ethics committee | Committee responsible for review of research proposals to ensure that human subjects are protected from harm |
Hypothesis | Statement of a predicted relationship or difference between two or more variables. A hypothesis contains at least one independent and one dependent variable |
Independent variable | A variable that causes a change in the dependent variable |
Inductive reasoning | Logical system of thinking that begins with the component parts and builds them into a whole |
Informed consent | An agreement by a research subject to participate voluntarily in a study after being fully informed about the study and the risks and benefits of participation |
Instrument | Device or technique used to collect data in a research study (e.g. questionnaires or interviews) |
Literature review | A critical summary of available theoretical and research literature on the selected research topic. It places the research problem for a particular study in the context of what is currently known about the topic |
Nursing research | Research usually conducted by nurses to generate knowledge that informs and develops the discipline and practice of nursing |
Population | All known subjects that possess a common characteristic of interest to a researcher |
Problem statement | A statement that describes the purpose of a research study, identifies key concepts and sets study limits |
Qualitative research | Used to examine subjective human experiences by using non-statistical methods of analysis |
Quantitative research | The systematic process used to gather and statistically analyse information that has been measured by an instrument and converted to numerical data |
Reliability | Characteristic of a good instrument; the assessed degree of consistency and dependability |
Research | A systematic process using both inductive and deductive reasoning to confirm and refine existing knowledge and to build new knowledge |
Research design | The overall plan for collecting data in a research study |
Research process | An orderly series of phrases identifying steps that allow the researcher to move from asking a question to finding an answer |
Research question | Use of an interrogative format to identify the variables to be studied and possible relationships or differences between those variables |
Sample | A subset of a population selected to participate in a research study |
Systematic review | A rigorous review of all the evidence on an aspect of healthcare |
Validity | A characteristic of a good instrument; the extent of an instrument’s ability to measure what it states it will measure |
Variable | A concept, characteristic or trait that varies within an identified population in a research study |
Nursing Research — involves a systematic search for and validation of knowledge about issues important to the nursing profession and links theory, education and practice.
It is important for:
Validating nursing as a profession
Documenting the effectiveness of nursing interventions
Providing a scientific knowledge base for practice
Demonstrating accountability for the profession.
Research-based or evidence-based practice (EBP) is essential if the nursing profession is to deliver safe, effective and efficient care.
Gray and colleagues describe EBP as involving the use of collective research findings in:
Promoting the understanding of individuals’ and families’ experiences with health and illness.
Implementing effective nursing interventions to promote healthcare outcomes.
Providing quality, cost-effective care within the healthcare system.
Evidence-based practice (EBP) — it is built on the belief that decisions about the delivery of care to individuals should be informed by the best available and most current evidence.
EBP is a process of:
Synthesising research evidence
Designing clinical practice guidelines
Implementing practice changes
Evaluating outcomes
Why do we need evidence-based practice?
Rapid increase in amount of information
Rapid increase in healthcare costs
Determination of efficient and effective healthcare practices
Increased emphasis on performance and outcome standards
Where is evidence found?
Published research
Systematic reviews
Special collections of EBP resources
Ask a focused question (PICO Format)
P: Patient/Population—characteristics
I: Intervention/Indicator—what the health professional plans to do for that patient/population
C: Comparison/control—the alternative choice
O: Outcome—what the health professional plans to accomplish, improve or influence.
Assess appropriate evidence.
Finding the best evidence to answer the question; a thorough search of evidence.
Appraise evidence for validity, impact and precision.
Validity: Can you believe the results of the study?
Impact: What is the clinical importance of the evidence?
Precision: Can you apply the results of the study to your situation?
Apply evidence accounting for patient values/preferences, clinical and policy issues.
Nurses should use research evidence to guide their practice, but they must also consider the individual needs and preferences of their patients.
Evaluate/audit your practice/personal skills.
Evaluate the effect on the individual and reflect on the nurse’s own performance—undertake audit or ask yourself self-reflective questions about steps 1 to 4
EBP relies on systematic searching and analyzing research reports
Medline, CINAHL, PsychINFO, and the Cochrane Library are valuable resources.
Cochrane Collaboration —Produces systematic reviews to inform healthcare decisions.
The National Institute of Clinical Studies and the Joanna Briggs Institute (JBI) focus on EBP.
JBI develops best practice information sheets, systematic reviews, and other resources.
Florence Nightingale: Pioneered nursing research with data collection and analysis during the Crimean War.
Slow Development: Nursing research was limited until the late 1940s due to traditional training and limited education.
Advancement in the USA: The shift to advanced degrees and university affiliation led to increased research activity in the 1960s and 1970s.
Focus on Practice: Nursing research began to focus on improving clinical practice and testing nursing theories.
Growth in Australia: Nursing research flourished in Australia in the 1970s and 1980s.
Emphasis on EBP: Nurses prioritize evidence-based practice to inform decision-making.
Technology: Technology facilitates access to research and evidence.
Focus Areas: Research focuses on areas like wound healing, pressure ulcers, patient education, communication, and nutritional support.
Value of Research: Nursing research contributes to understanding clinical phenomena and informing research programs.
Nurse Involvement: Nurse researchers and leaders are active in consulting roles in various institutions.
Magnet Hospitals — These hospitals are recognized for their high-quality nursing care, job satisfaction, and staff retention.
These hospitals demonstrate excellence in nursing, staff development, quality improvement, and sustainable resources.
These hospitals foster an environment conducive to EBP and practice change.
Working in a here can enhance satisfaction and retention for enrolled nurses.
Quantitative research methods — involve the use of numbers and statistical analysis.
It is both logical and systematic in nature and gathers and analyses information that has been measured by an ‘instrument’, such as a questionnaire, and converted to numerical data.
Quantitative nursing research — the investigation of nursing phenomena that lend themselves to a precise measurement, such as pain severity or rate of wound healing.
Variables — concepts or traits that vary; it could be temperature, pulse, respiration, blood pressure, height and weight.
Independent variable — can be controlled or manipulated by the researcher.
Dependent variable — can be measured or observed as a result of independent variable.
Quantitative Research Designs
Type | Description | Example |
Descriptive Research | Describes characteristics of a population or phenomenon without manipulating variables. | Survey research to understand patient satisfaction in a healthcare setting. |
Correlational Research | Examines the relationship between two or more variables without active intervention. | Study investigating the relationship between stress levels and sleep quality in nurses. |
Quasi-Experimental Research | Involves manipulation of an independent variable but lacks random assignment to groups. | Testing the impact of a new teaching method on student performance where groups are pre-assigned. |
Experimental Research | Involves random assignment of participants to control and experimental groups with manipulation of variables. | Randomized Controlled Trials (RCTs) testing a new drug’s effectiveness compared to a placebo. |
Cross-Sectional Research | Collects data at a single point in time to examine current characteristics or behaviours in a population. | Surveying a population’s exercise habits at one specific point in time. |
Longitudinal Research | Follows the same group of individuals over an extended period to observe changes or trends. | Studying the long-term effects of physical therapy on post-surgery recovery over 5 years. |
Retrospective Research | Uses existing data to look back at outcomes or patterns in relation to a specific event or intervention. | Analysing past medical records to assess the link between smoking and lung cancer development. |
Cohort Study | Observes a group of people over time who share a common characteristic, usually prospectively. | Studying a cohort of nurses exposed to long shifts and assessing burnout over time. |
Case-Control Study | Compares individuals with a specific condition to those without it to explore potential causes or risk factors. | Comparing individuals with diabetes to those without to study risk factors associated with the condition. |
Survey Research | Collects data through questionnaires or interviews to gather quantitative insights on attitudes, behaviours, or characteristics. | Conducting a large-scale survey on vaccination attitudes in different communities. |
Qualitative research — a subjective approach used to explore phenomena and describe human experiences.
It collects data and obtains information from, for example, interviews rather than measurement.
It may wish to examine individuals and their stories and behaviour, organisations and their functioning, or cultures and their interactions and social movement.
Qualitative Research Designs
Type | Description | Example |
Phenomenology | Explores the lived experiences of individuals about a specific phenomenon to understand its essence. | Studying the experiences of patients living with chronic pain. |
Grounded Theory | Aims to develop a theory grounded in data systematically collected and analysed through the research process. | Investigating how nurses develop resilience in high-stress environments to formulate a new theory. |
Ethnography | Studies the culture and social interactions of a particular group or community in their natural setting. | Exploring the working culture of emergency room staff to understand teamwork dynamics. |
Case Study | An in-depth examination of an individual, group, event, or situation to gain detailed insights. | Investigating the care process for a particular patient with a rare disease in a hospital. |
Narrative Research | Focuses on gathering and analysing stories from individuals to understand their experiences and perspectives. | Collecting life stories of elderly patients to explore their experiences of aging in a nursing home. |
Action Research | Involves researchers and participants collaborating to address a specific problem or implement changes in real-time. | Working with nurses to improve patient care practices through iterative cycles of reflection and action. |
Discourse Analysis | Examines language and communication patterns within social and cultural contexts to reveal meaning. | Analysing the language used in healthcare policy documents to understand power relations. |
Content Analysis | Systematically analyses textual or visual content to identify patterns, themes, or meanings. | Analysing patient feedback forms to identify common themes in healthcare service complaints. |
Historical Research | Investigates past events or experiences to provide insights into a phenomenon or process. | Examining historical nursing practices during the early 20th century. |
Focus Groups | Involves group discussions to explore participants' views, experiences, or reactions on a topic. | Using focus groups to gather feedback from nurses about implementing new technology in hospitals. |
Mixed methods approach — a combination of two or more different approaches to data collection and analysis.
It is useful in nursing where complex phenomena may require both quantitative and qualitative data to be fully understood.
Can offer complementary perspectives that can provide a more comprehensive understanding of a research question.
Allows for flexibility in the research design, depending on the specific research question and context.
Mixed Method Research Designs
Mixed Methods Design | Description | Example |
Convergent Parallel Design | Quantitative and qualitative data are collected simultaneously but analysed separately. The results are then compared or combined to understand the research problem from different perspectives. | Investigating patient satisfaction by combining survey data (quantitative) and interviews (qualitative) about hospital services. |
Explanatory Sequential Design | A two-phase design where quantitative data is collected and analysed first, followed by qualitative data to explain or further explore the quantitative findings. | Conducting a survey on nurse burnout levels (quantitative) and then using interviews to explore the reasons behind the results (qualitative). |
Exploratory Sequential Design | A two-phase design where qualitative data is collected and analysed first to explore a phenomenon, followed by quantitative data collection to test or generalize the findings. | Exploring patient experiences with a new treatment (qualitative) and then using a larger survey to validate these findings (quantitative). |
Embedded Design | One form of data (either qualitative or quantitative) is embedded within a larger research design based primarily on the other form of data. This design allows additional insights into the primary data. | Studying the effectiveness of a new medical procedure (quantitative) while gathering patient feedback through interviews (qualitative) within the same study. |
Multiphase Design | Involves multiple phases of data collection, where each phase builds on the previous one, alternating between quantitative and qualitative data collection across several stages. | Using qualitative interviews to understand challenges in healthcare (Phase 1), conducting a survey to measure the extent of the issue (Phase 2), and then refining interventions (Phase 3). |
Transformative Design | Uses a social justice or advocacy lens, integrating quantitative and qualitative data to address a specific social issue, often emphasizing marginalized or vulnerable populations. | Studying health disparities by combining statistical analysis (quantitative) with focus groups of underrepresented communities (qualitative) to inform policy changes. |
Research problem — refined through a process that proceeds from identifying a general idea of interest to defining a specific topic.
Preliminary literature review — reveals related factors that appear critical to the research topic and it should identify a gap in the literature on the specific topic.
Significance of the research problem — it must be identified in terms of its potential contribution to both the individual and the nursing profession.
Choosing the topic of interest may develop from:
Discussing an issue of common interest with a colleague.
Reading about an issue in a journal, text or newspaper.
Identifying an area deficient in information.
An aspect of practice being introduced for the first time.
An aspect of practice that may have been observed but which needs to be validated.
Areas of work that may need to change.
Wanting to repeat a study that has already been conducted, to check the results.
Purpose of the study — states the aims or goals that the investigator hopes to achieve with the research.
It includes what the researcher will do, who the participants will be and where the data will be collected
Literature review — a comprehensive, in-depth, systematic and critical review of scholarly publications and available evidence focused on the research topic.
It is often called ‘secondary research.’
Primary Source — written by an individual(s) who developed the theory or conducted the research.
Secondary Source — descriptions of studies written by someone other than the original researcher who developed the theory or conducted the research.
Purpose of Literature Review
Determines what is known and not known about a subject, concept or problem.
Determines gaps, consistencies and inconsistencies in the literature about a subject, concept or problem.
Discovers unanswered questions about a subject, concept or problem.
Discovers conceptual traditions used to examine problems.
Uncovers a new practice intervention(s) or provides evidence for current practice intervention(s).
Generates useful research questions and hypotheses for the discipline.
Describes the strengths and weaknesses of designs or methods of enquiry and instruments used in earlier works.
Determines an appropriate research design or method (instruments, data collection and analysis methods) for answering the research question(s).
Determines the need for replication of a well-designed study or refinement of a study.
Promotes development of new or revised practice protocols, policies and projects or activities related to nursing practice and to the discipline.
How to search successfully for information
Define Topic: Clearly identify the subject of interest.
Select Resources: Choose appropriate search resources like indexes, abstracts, and catalogs.
Evaluate Materials: Critically review and evaluate the information found.
Search Databases: Utilize electronic indexes like CINAHL, Index Medicus, and MEDLINE.
Search Terms: Use precise search terms to refine results.
Limits: Consider using limits like gender, age, and time factors.
Librarian Assistance: Seek help from librarians for guidance and support.
Online Resources: Explore online databases, patient education resources, and nursing journals.
Critical thinking skills
Read primary research articles from peer-reviewed journals.
Read secondary research (critique/response/commentary) articles from peer-reviewed journals.
Photocopy or print copies and make notations directly on the copy.
While reading articles:
keep a research text and a dictionary by your side
review the chapters in a research text on the various steps of the research process, criteria used to critique, unfamiliar terms and so on
list key variables at the top of the article
highlight or underline new terms, unfamiliar vocabulary and significant sentences
look up the definitions of new terms and write them on the article copy, and review old and new terms before subsequent readings
highlight or underline identified steps of the research process
identify the main idea or theme of the article—state it in your own words in one or two sentences
continue to clarify terms that may be unclear on subsequent readings
make sure you understand the main points of each reported step of the research process you identified before you critique the article.
Determine how well the study meets the critiquing criteria:
ask fellow students to analyse the same study using the same criteria and compare results
consult faculty members about your evaluation of the study.
Type a one-page summary and critical review of each study:
cite bibliographic information of the reference at the top of the summary according to relevant reference style
briefly summarise each reported research step in your own words
briefly describe strengths and weaknesses in your own words
Critical reading skills
Skimming a source . Have a brief look at the source to gain a broad overview of its content.
Comprehending a source . This requires that the source be read carefully, with the focus on understanding major concepts and the flow of ideas within the source.
Analysis of a source . Through careful analysis of the source, the reader can determine the value of the content for a particular study.
Synthesis of a source . This involves clarifying and establishing a meaning obtained from the source.
Theoretical framework — uses a theory or theories to form a foundation or frame of reference for the research study.
It helps the researcher explain or predict study outcomes and link these to the existing body of knowledge.
Conceptual framework — loosely related collection of concepts that has not yet been tested.
Research questions — identify the variables to be studied and possible relationships or differences between those variables.
Hypothesis — tries to predict the relationships between variables and the expected outcomes of the study.
A statement of what the researcher thinks will be the outcome of an investigation.
Quantitative research tends to use a research hypothesis whereas qualitative research tends to use research questions.
Research design — the overall plan that guides the way the study is conducted and analysed.
Research question — determines the approach to be used in the design.
Design of the study — must be able to answer the question posed by the researcher.
Key aspects should be considered in a study design.
Intervention:
If there are interventions in the study, they should be part of the design. The study should say what the interventions are (e.g. giving certain medication). What will be the procedure for the intervention? What will be the intensity of the intervention? How long will the duration of the intervention be? Who will perform it?
Comparisons:
In some studies, when making comparisons the design must clearly state what the central issue of the study is.
Extraneous variables:
The researcher must mention in the design what measures will be taken to control the extraneous variables (the factors that influence the issue under study).
Timing of data collection:
The design should indicate when the data will be collected in relation to other steps of the research process.
Research location:
The design must clearly specify the location for data collection.
Communication with the study participants.
In the research design, information given to participants must be clearly identified. When, what and how much information will be provided about the study to the participants?
Population — the subjects of interest for a research study.
They possess certain common characteristics or traits that identify them as a part of the population.
Subjects are selected using a sampling process.
The characteristics of the sample population must closely resemble the characteristics of the population as a whole.
One of the primary concerns in research is to protect the subjects from any harm, discomfort, duress or coercion.
Ethics approval is normally required before any data are collected that involve humans.
National Health and Medical Research Council (NHMRC) — the Australian Government's primary health and medical research funding agency.
It requires that all institutions involved in conducting research on humans or animals establish a relevant institutional ethics committee.
It reviews all studies conducted in the institution to ensure that ethical principles are observed and determines the risk status of all research projects.
Rights needed to be upheld when conducting research
right not to be harmed
right to full disclosure
right of self-determination
right of privacy and confidentiality
right to withdraw from research study
Research participants should have an understanding of the:
Research purpose
Procedures involved
Risks/discomforts of participation
Benefits of participation
Expected duration of involvement
Maintenance of confidentiality and anonymity.
Instrument — tools used to collect data.
Data to be collected are usually physiological, behavioural or psychological in nature.
Physical measurements — sphygmomanometers, electrocardiogram (ECG) machines, glucometers and thermometers.
Behavioural data — collected through observations.
Psychological measurements — used to collect data about knowledge, feelings and attitudes.
Quality instrument — an instrument that is valid and reliable.
Valid instrument — measures what it is supposed to measure.
Reliable instrument — measures the variable consistently and accurately.
Instruments used in research studies should be evaluated for reliability and validity before use in a study.
Treatments are conducted, instruments are administered and data generated and recorded.
Most common methods of data collection in nursing:
Interviews
Questionnaires
Observations
Focus Group
Rating scales
Biophysical measures
Data must be collected in an ideal manner so that they capture the concept that is being researched in a way that is relevant, credible, accurate, unbiased and sensitive.
Any small change to an aspect of data collection can influence the study and interfere with its integrity.
Data analysis — occurs to answer the research questions or to see whether the hypothesis was true.
In the qualitative approach, the analysis will begin almost immediately when data collection begins.
In the quantitative approach, all data has to be collected first before the analysis begins.
In the quantitative approach, statistical analysis enables the researcher to reduce, summarise, organise and give meaning to the data.
Descriptive statistics — used to describe the specific characteristics of the data.
Result section presents the research findings and data in statistical from (quantitative research) or narrative form (qualitative research).
All results from the research should be presented in a clear, logical and concise way that answers each research question and/or hypothesis
In the discussion section, researchers discuss and interpret the research results and give further meaning to the data.
The researcher draws on the research aims, research literature and the theoretical framework used and interprets all the findings/results, whether these are supported by the literature or not, to highlight the outcomes of the study.
Once the findings are stated and discussed, the researcher then makes recommendations for further research.
It provide the reader with suggestions regarding the study’s application to practice, theory and future research.
The researcher also discusses any problems or limitations encountered while conducting the study.
Identifying limitations informs future researchers so they do not repeat them when conducting a similar study.
All references that are cited in the article or research study are included at the end of a paper.
The reference list supports the material presented by identifying sources in a manner that the reader can then follow up to obtain these references for their own use or for any clarification.
Presenting a paper or poster at conferences or seminars at local, national and international levels.
Publication of articles in nursing research or specialty journals and reports.
Research proposal — a written plan identifying the major elements of a study, including the research problem, the purpose of the research, the intended framework to be used and an outline of the proposed research methods and procedures to be used.
It is a formal way to communicate ideas about a proposed study, to apply for approval to conduct the study and, in some instances, to seek funding to support the research.
Content considered to be critical in a proposal are:
The background and significance of the research problem
Purpose
Framework
Research objectives, questions or hypotheses
Methodology or research design
Research production plans (data collection and analysis plan, personnel, schedule and budget).
Essential subcomponents of these critical elements of a research proposal include:
Statement of the problem. This needs to:
be specific enough to be solved be in the form of a question or declaration statement. For example, if the study were about neglect of oral hygiene in nursing homes, the question might be, ‘What is the impact of poor oral hygiene on residents in nursing homes?’
provide the background of the problem, such as how the problem came to be recognised and factors that contributed to the problem.
Significance or importance of the problem:
Includes the implications or possible applications of the knowledge that would be gained through the study.
The research hypothesis (where appropriate), which should be:
reasonable
consistent with known facts or theories
stated in such a way that it can be tested and found to be probably true or false
stated in clear, simple terms.
Assumptions and definitions:
all unusual terms that could be misinterpreted need to be defined
variables considered in the study should be defined.
Review of related literature:
a brief summary of previous research and writings of recognised experts is included to provide evidence that the researchers are familiar with what is known and with what is still unknown and untested.
An outline of the research procedure, which should include:
research design: a brief description of proposed mode of study
sampling protocol: population to be sampled, approximate sample size, characteristics and type of sample
specification of the proposed data gathering techniques (the actual instrument need not be included). Indicate only the data-gathering procedures, conditions for context of data collection and the time frame for data collection
analysis of data and methods to be used
projected timetable for various steps of the research
limitations and weaknesses of the study, as recognised by the researchers.
Proposed budget:
include all necessary items and estimated costs.
Introduction
Background and significance of problem
Statement of the problem and statement of the purpose
Review of relevant literature
Framework
Development of a framework
Formulation of objectives, questions or hypotheses
Methods and procedures
Description of research design
Identification of population and sample
Selection of a setting
Presentation of ethical considerations
Selection of measurement methods
Plan for data collection
Plan for data analysis
Identification of limitations
Discussion of communication of findings
Presentation of a study budget and timetable
References
Appendices
Research utilisation — the translating the knowledge that has been generated by research into clinical practice.
Its goal is to formalise research utilisation to promote research-based policies, procedures and clinical practice guidelines.
Barriers to translating research:
Resistance to change
Insufficient time and resources to implement changes to practice
Lack of supportive infrastructure
Lack of research skills, including an inability to critique
Lack of professional autonomy to effect change
Inability to access and engage with research findings
After research study has been located and surveyed, it must be determined:
Whether it is releval to clinical area
the study a clinical study?
Is the problem being studied one you have seen in your clinical area?
Is the setting used in the study similar to the setting you work in?
Are the sample/participants in the study similar to individuals you work with in clinical settings?
Do the study findings address issues that are within your scope of practice to change?
Do they affect the activities of daily living?
Do they have ramifications for the comfort and wellbeing of individuals under your care?
Do they advocate system or procedural change?
Do the study findings address issues that nursing and midwifery have the power to change?
Are the study findings helpful to your clinical routine?
Do they add to your knowledge base?
Whether the study has rigour and the results have merit and are applicable to the area of work
Are the steps of the research process followed?
When you read the report does it clearly define the clinical problem?
Are ideas concisely and comprehensively identified?
Are participants, tools, methodology and types of analysis clearly defined? In other words, can you follow what was done and why it was done in that way?
Are sampling methods clearly described? Are they appropriate to the study?
Do the results make sense?
Are the conclusions plausible?
Do quantitative studies use reliable and valid instruments?
Do qualitative studies address issues of auditability, transferability and credibility of data?
In qualitative studies, does the final picture of the phenomena under study flow logically from the data?
In quantitative studies, does the discussion section clearly identify who the results could be applied to? Are the findings clearly tied to existing knowledge?
Have other studies been done that address the identified problem (that is, are there replications, meta-analysis or evidence in the literature of similar findings)?
How to implement any relevant or applicable results
Who will be affected and in what numbers?
What are the advantages of implementation?
What are the risks of implementation?
What are the risks of no implementation?
Do the advantages outweigh the risks?
How complex is the change (e.g. a simple intervention or a lengthy protocol that requires extensive retraining of personnel)?
How much will it cost (e.g. need for staff training, equipment, supplies)?
How many people need to be treated to observe a benefit?
Who will be affected by the change besides nursing or midwifery (e.g. medical officers, pharmacy, housekeeping, billing, care services)?
What are the tangible observable outcomes of the utilisation (e.g. will it decrease complications? Save money? Make the staff function better?)
Aspect | Systematic Review | Literature Review |
Definition | A comprehensive, rigorous summary of all relevant studies on a specific research question using systematic and predefined methods. | A general review and summary of literature on a topic without a standard methodology. |
Purpose | To answer a specific research question by synthesizing evidence from multiple studies. | To provide an overview of the topic, summarize findings, and identify gaps in research. |
Scope | Focused on a specific, narrow question or hypothesis. | Broad overview of a topic or field. |
Methodology | Follows a structured and predefined process (e.g., PRISMA) with inclusion/exclusion criteria. | May not follow a specific methodology and is often narrative in nature. |
Search Strategy | Exhaustive and systematic search across multiple databases with documented strategies. | Often selective, searching only a few sources, and may not document the search process. |
Bias and Objectivity | Designed to minimize bias with strict criteria for study inclusion. | Potential for bias, as the selection of literature may not follow a predefined process. |
Quality Appraisal | Includes a formal appraisal of study quality and relevance (e.g., risk of bias assessment). | Typically lacks formal evaluation of study quality or methodological rigor. |
Data Synthesis | Often uses meta-analysis to statistically combine data from multiple studies, if appropriate. | Narrative synthesis of findings without statistical combination. |
Reproducibility | Highly reproducible due to the transparency of methods and documentation. | Less reproducible as the process is less formal and methods are not always clear. |
Outcome | Provides high-level evidence that can be used to inform clinical guidelines and EBP decisions. | Provides background information or an overview but may not offer definitive guidance for practice. |
Time and Resources | Time-intensive and requires significant resources to conduct. | Quicker and easier to complete, typically requiring fewer resources. |
Number of Authors | Three or more | One or more |
Quantitative Research | Qualitative Research |
Focuses on a small number of specific concepts and their relationships and differences | Attempts to understand the entirety or whole of some phenomenon within a prescribed context |
Set on a predefined theoretical foundation. ‘Educated guesses’ made about relationship of concepts and study outcomes | No preconceived theoretical boundaries or preconceived notions about study outcomes |
Researcher controls and interprets data | Focuses on people’s interpretations of events and circumstances rather than researcher’s |
Tends to use larger samples | Uses smaller samples |
Describes people in the study as ‘subjects’ | Describes people in the study as ‘participants’, ‘informants’ or sometimes ‘co-investigators’ |
Uses language in a way that implies neutrality, such as writing in the third person | Can be written up using the first person |
Uses structured procedures and formal instruments to collect information | Collects information without formal structured instruments |
Collects information under conditions of control and manipulation | Doesn’t attempt to control the context of research, but attempts to capture it in its entirety |
Emphasises objectivity in collection and analysis of information. Attempts to exclude all forms of subjective ‘bias’ | Attempts to capitalise on the subjective as a means of understanding and interpreting human experiences. ls comfortable with the notion of ‘bias’ |
Uses ‘objective’ tools to collect data | Researcher is the instrument of data collection |
Applied Nursing Research — Focuses on applied clinical research to improve patient care across different settings.
Australian Journal of Advanced Nursing — Publishes research on nursing practices and policies relevant to the Australian context and beyond.
Clinical Nursing Research — A peer-reviewed journal emphasizing clinical research to inform evidence-based nursing practice.
International Journal of Nursing Studies — Provides high-quality international research on nursing and healthcare.
Journal of Advanced Nursing — Covers a wide range of topics in nursing including clinical, education, and management research.
Journal of Nursing Education — Specializes in studies related to nursing education, curriculum development, and educational methodologies.
Journal of Nursing Research — Focuses on the publication of original research that advances the science of nursing.
Journal of Nursing Scholarship — Publishes research that addresses global healthcare challenges and contributes to nursing knowledge.
Nursing Outlook — Covers issues related to healthcare policy, management, and nursing’s role in addressing public health.
Nursing Research — One of the oldest nursing journals, focusing on research that advances nursing science and practice.
Nursing Science Quarterly — Emphasizes theoretical and philosophical aspects of nursing science.
Qualitative Health Research — A multidisciplinary journal featuring qualitative studies in health and healthcare.
Research in Nursing and Health — Publishes a wide range of research aimed at enhancing patient care and nursing practice through rigorous investigation.
Is it easy to read and understand; that is, no jargon or obscure phraseology?
Is the topic important and relevant?
Have the definitions, key terms and concepts been explained clearly?
In the background to the study, is there enough information in the introduction to set the scene? Has the purpose of the study been identified?
How did they conduct the study; that is, what is the methodology?
Is there evidence of reliability and validity?
How were the subjects selected?
Are they a large or small group?
What did the researchers find, and are the methods of analysis appropriate?
Do the discussions and recommendations relate to study? Are the author’s claims justified by the data? Were the suggestions made based on personal views and not on data? Are the recommendations based on reported findings?
Is the language used understandable?
Is the visual material (e.g. graphs, tables, charts) easy to follow and clearly marked?
Comment on the study’s strengths as well as its weaknesses.
Justify criticisms; offer a rationale for how a different approach could have solved a problem.
Try to be objective; try to avoid being overly critical of a study because of a personal lack of interest in the topic.
Is the report or study written in an objective style or are the author’s biases and viewpoints apparent?
Does the author include a reference for every citation made in the text, so that readers can refer to earlier work on the topic?
Check the credibility of the author.
Check the year of publication—whether it is recent or old.
Risks to participants are minimised.
Risks to participants are reasonable in relation to anticipated benefits, if any, and the importance of the knowledge that may reasonably be expected to result.
Selection of participants is equitable.
Informed consent will be sought.
Informed consent will be appropriately documented.
Adequate provision is made for monitoring the research to ensure the safety of participants.
Appropriate provisions are made to protect the privacy of participants and the confidentiality of data.
When vulnerable subjects are involved, appropriate additional safeguards are included to protect their rights and welfare.
Introduction
Identification of the phenomenon to be studied
The study purpose and type of qualitative study
Study question or aims
Discussion of the significance of the study
Research paradigm
Identification of the research paradigm for the type of qualitative study to be conducted
Description of the philosophical correlates of the research paradigm
Explanation of research assumptions
Research methods
Researchers’ credentials for conducting a particular type of qualitative study
Identification of the research method for the study
Selection of site and population
The researchers’ role
Ethical considerations
The data collection process
Data analysis techniques
Plan to document the research process during the study
Preliminary findings, limitations and plans for communicating the study results
Summary and relevant reference literature
Identification of biases and previous experiences with research problem
Disclosure of anticipated findings, hypotheses and hunches
Discussion of how procedures will remain open to unexpected information
Discussion of limitations of study
Identification of a plan for communicating findings
References
Appendices
The research itself
Resistance to change
Insufficient time and resources to implement changes to practice
Lack of supportive infrastructure
Lack of research skills, including an inability to critique
Lack of professional autonomy to effect change
Inability to access and engage with research findings
Practicing nurses
Isolation from knowledgeable colleagues
Nurses too new on the job to implement new ideas
Lack of authority to implement changes.
Organisational settings
No support of nursing findings
Changes in the healthcare environment
Acuity rate
Degree of nursing shortage
Financial constraints to implement change
The nursing profession
Limited research-based journals
Limited federal funding for nursing research
Poor communication between practitioners and researchers
Shortage of appropriate role models
