Nursing Research

Introduction

  • Research outcome is EBP (Evidenced based practice)

  • Purpose: Basic research (no solution) and applied research (provides solution)

  • Research Ethical Principles

    • Beneficence - Doing good, caring, compassion

    • Non-maleficence - Do no harm (any nursing with a risk of harm is nonmaleficence)

      • Right: to freedom from harm (both beneficence and nonmaleficence)

    • Justice - Fairness, equal distribution of resources (physical or human). Know your prioritization

      • Right: to fair treatment

    • Autonomy - Voluntary decision making

      • Right: to self determination

    • Veracity - Honesty, truth telling, truthfulness, and complete information

      • Right: to full disclosure

    • Confidentiality - Protect medical data

      • Right: to privacy

    • Fidelity - Loyalty and faithfulness

    • Note: Anonimity - Data not linked to any person (Not considered as ethical principle)

  • Nuremberg Code “Eugenics”

    • First code; Informed consent is required

  • Declaration of Helsinki

    • Vulnerable population should receive special protection

    • Pediatric, Elderly, pregnant, PDL

  • BON Resolution No. 220 Series of 2004 "PRESERVE HEALTH AT ALL COST"

  • Criteria for informed consent (VICS)

    • VOLUNTARY: Autonomy

    • INFORMED, Fully understood: Veracity

    • COMPETENT (all of these criteria 3/3) :

      • Of legal age (18 years old and above)

      • Not under the influence of any substance

      • Coherent

    • SIGNATURE (PATIENT; WITNESS)

      • WITNESS: Ensure the validity if signature; Ensure the understanding of the patient

      • It is not our task to explain the surgery, our task is to confirm the understanding.

Basic Concept

Bias (Must be low for accurate results)

  • Something that causes error

  • Higher bias causes less accurate results

Validity

  • You measure what you intend to measure. Identify the relationship between IV and DV. “How confident are you that the IV is the real cause of DV?”

  • Internal Validity - Whether or not there is really a causal relationship between two variables.

  • Threats to Internal Validity (Must be high for accurate results)

    • Selection Bias - to eliminate, use randomization

    • Maturation - caused by physiologic changer over time; to eliminate, use CG (e.g. SSD use on control group)

    • Instrumentation change - inaccurate reading of instruments used; to eliminate, replace equipment (defective pulse ox)

  • External Validity (Generalizability)

    • How generalizable the findings are

Reliability

  • Same setting, same results, consistency of instruments

Blinding

  • Disguising information to prevent bias

    • Single blind - hindi alam ni subject kung ano ang matatanggap na treatment (medication or placebo effect)

    • Double blind - Parehas hindi alam ni subjects and researchers kung anong matatanggap

    • Third Party - Neutral

Research Design (Qualitative Vs. Quantitative)

  • Architectural backbone of the study “Blue Print”

  • Overall plan for obtaining answers

  • Tend to be highly structured and controlled

Qualitative Research Design

  • Use of inductive reasoning and triangulation

  • In depth study. Human experiences

  • Data collected is narrative; no statistics

  • Data collection is interview (semi-structured)

    • Structured - most formal

    • Semi-structured - most preferred (follow up questions are allowed)

    • Unstructured - has the most freedom

Phenomenological

  • Lived experiences of a person

  • Ends with data saturation (no info obtained)

  • Interview semi-structured

Ethnographical

  • Studies culture or tribe

  • Immersion (habitat)

Grounded Theory

  • Social process and psychological stages about a particular event

  • It will start with your own theory if you are not satisfied with existing theories

Case Study

  • Generates in depth understanding

Historical

  • Phenomenon at a particular part of time in the past

Quantitative Research Design

  • Use of deductive reasoning

Experimental

  • There is manipulation or administration of independent variable

  • Beneficial (Medications, Massage, Music therapy)

  • Strongest Design

  • Three elements: Manipulation, Randomization, and Control

  • Three types: True, Quasi-experimental, Pre-experimental

*NON-EQUIVALENT ASSIGN/HANDPICK (no randomization) so Quasi-Experimental

Non-Experimental

  • There is no manipulation

  • Harmful (smoking)

  • Unethical

  • Three types: Descriptive, Descriptive correlational, Descriptive comparative

  • Descriptive (observational research)

    • Weakest

    • Gather characteristics, occurrence, or prevalence

    • Number, gender, age range

  • Descriptive correlational

    • Relationships of variables that co-exist

    • Positive correlation - directly proportional (both increase/decrease)

    • Negative correlation - inversely proportional (one either increase or decrease)

  • Descriptive comparative

    • Cause and effect of variables (without manipulation) by comparing two groups

Research Design According to Timeline

Prospective Approach

  • Longitudinal data collection (months to years)

  • Present to Future - What will happen in the future? (through waiting)

  • Long term

  • Threat: Mortality or Drop out

Retrospective Approach

  • Cross sectional data collection

  • Future to Past - What happened in the past? (through interview)

  • Short term

  • Threat: Recall bias

Types of Sampling Technique

Data Collection Method

Types of Research Instruments

  • Questionnaire - most common

  • Interview - online, face to face, telephone, or email

  • Observation - participant vs non-participant / Covert (covered or hidden) vs Overt (obvious or Hawthorne)

  • Records

  • Delphi Technique - invitation of experts to critic your instrument

  • Biophysiologic measure

    • In vivo (inside) - No extraction involved e.g. BP, temp, and o2

    • In vitro (outside) - Extraction involved e.g. blood chem and urinalysis

Chapter 4

Statistics