Fundamental Concepts and Methodologies in Nursing Research

Definition and Nature of Research

• Root Meaning of Research: The term originates from the concept of searching "again and again" or to examine a subject with extreme care.

• Formal Definition: Research is defined as a systematic inquiry that utilizes disciplined methods to answer specific questions or provide solutions to problems (Polit & Beck, $2008$).

• Primary Goal: The central aim of research is to develop, refine, and expand a fundamental base of knowledge.

Defining Nursing Research

• Comprehensive Definition: Nursing research is a systematic inquiry designed to develop trustworthy evidence concerning issues of vital importance to the nursing profession. This includes areas such as nursing practice, education, administration, and informatics (Polit & Beck, $2008$).

• Clinical Focus: It is concerned with generating knowledge that influences clinical nursing practice both directly and indirectly (Burns & Grove, $2001$).

• Analytical Objective: It is characterized as a systematic and objective process utilized to analyze phenomena that hold importance for the field of nursing (Nieswiadomy, $2002$).

Research Methods and Paradigms

• Scientific Method (Quantitative Research):

  • This refers to a general set of orderly and disciplined procedures used to acquire information.

  • It utilizes deductive reasoning to generate specific predictions that are subsequently tested against real-world data.

• Naturalistic Methods (Qualitative Research):

  • These methods directly explore the issues of human complexity.

  • The goal is to understand human experience as it is lived through the careful collection and analysis of qualitative data, which is narrative and subjective in nature.

  • Inquiry takes place within naturalistic settings.

Characteristics of the Scientific Method

• Order and Discipline: The research follows a series of systematic steps.

• Control: This involves imposing specific conditions on the research situation to ensure that biases and confounding factors are minimized.

• Empiricism: This approach is rooted in objective reality. Knowledge is gathered using the human senses as the basis for generating information.

• Generalization: This characteristic ensures that the findings of a study are applicable to a broader group than just the specific participants involved in the research.

Purposes of Nursing Research: Basic vs. Applied

• Basic or Pure Research: This type of research is primarily concerned with:

  • The generation of new knowledge.

  • The extension of existing knowledge.

  • The refinement of current knowledge.

  • Example: Cadena ($2006$) studied the needs and functioning of persons with schizophrenia living in assisted living facilities in relation to resident characteristics. While the findings had implications for practice, the research itself was not designed to solve a specific, immediate problem.

• Applied Research: This focuses on finding direct solutions for existing problems.

  • It involves the application of generated knowledge to solve practical issues in nursing.

  • Example: Smith ($2006$) conducted a study to determine if any of $3$ alternative methods of peripheral IV catheter securement could extend the average survival time of the catheters.

Levels of Research Explanation: Identification and Description

• Identification: This is the study of a phenomenon about which very little is currently known.

  • Typical Questions: "What is the phenomenon?" and "What is its name?"

  • Qualitative Example: Marcinkowski, Wong, and Dignam ($2005$) studied the experiences of $9$ adults with osteoarthritis who underwent total knee joint arthroplasty. They identified a basic adjustment process they termed "getting back to the future."

• Description: This involves observing, counting, delineating, elucidating, and classifying phenomena.

  • Examples: Patient stress and coping, pain responses, adaptation processes, health beliefs/practices, time patterns of temperature readings, and the experience of waiting in critical care rooms.

  • Quantitative Descriptive Questions: "How prevalent is the phenomenon?", "How often does it occur?", and "What are the characteristics of the phenomenon?"

  • Qualitative Descriptive Questions: "What are the dimensions of the phenomenon?" and "What is important about the phenomenon?"

  • Quantitative Example: Johnson and colleagues ($2006$) described the prevalence and characteristics of childhood sexual abuse among men incarcerated in Texas.

  • Qualitative Example: Rodriguez and Van Cott ($2005$) performed an in-depth study to describe the pain experiences of postoperative head and neck cancer patients with speech impairments and to describe the nurses' methods of pain assessment.

Levels of Research Explanation: Exploration and Explanation

• Exploration: Investigating the full nature of a phenomenon and the factors related to it.

  • Quantitative Exploratory Questions: "What factors are related to the phenomenon?" and "What are the antecedents of the phenomenon?"

  • Qualitative Exploratory Questions: "What is the full nature of the phenomenon?", "What is really going on here?", and "What is the process by which the phenomenon evolves or is experienced?"

  • Quantitative Example: McCormick, Naimark, and Tate ($2006$) explored whether the length of time patients spent on a coronary artery bypass graft waiting list influenced their psychosomatic condition.

  • Qualitative Example: Bruce and Davies ($2005$) used in-depth conversations and field writings to explore the experience of mindfulness among hospice caregivers practicing at a setting integrating Western palliative care and Zen Buddhist philosophy.

• Explanation: Intends to understand the underpinnings of phenomena and explain systematic relationships.

  • Quantitative Explanatory Questions: "What is the causal pathway through which the phenomenon unfolds?" and "Does the theory explain the phenomenon?"

  • Qualitative Explanatory Questions: "How does the phenomenon work?", "Why does the phenomenon exist?", "What does the phenomenon mean?", and "How did the phenomenon occur?"

  • Quantitative Example: Shaughnessy, Resnick, and Macko ($2006$) tested a theoretical model using concepts like self-efficacy and outcome expectations to explain physical activity among older adults who survived a stroke.

  • Qualitative Example: Weaver, Wuest, and Ciliska ($2005$) interviewed $12$ women to develop an exploratory framework for understanding the journey of recovery from anorexia nervosa in the context of family, community, and society.

Levels of Research Explanation: Prediction and Control

• Prediction: Estimating and anticipating the probability of a specific outcome in a given situation.

  • Typical Questions: "What will happen if we alter a phenomenon or introduce an intervention?" and "If phenomenon $X$ occurs, will phenomenon $Y$ follow?"

  • Example: Epstein and Peerless ($2006$) identified predictors of successful weaning of older adults from mechanical ventilation.

• Control: Manipulating a given situation to produce a desired outcome.

  • Typical Questions: "How can we make the phenomenon happen or alter its prevalence?" and "Can the occurrence of the phenomenon be prevented or controlled?"

  • Example: Calaguas ($2020$) studied factors affecting the intent to use condoms among Filipino Gay and Bisexual Men.

Research Purposes Linked to Evidence-Based Practice (EBP)

• The following purposes are critical for EBP:

  • $1$. Treatment, Therapy, or Intervention.

  • $2$. Diagnosis and Assessment.

  • $3$. Prognosis.

  • $4$. Prevention of Harm.

  • $5$. Etiology or Causation.

  • $6$. Meaning and Processes.

Importance of Research in Nursing Practice, Education, and Administration

• In Nursing Practice:

  • Identifying interventions that foster health maintenance and facilitate wellness.

  • Improving the quality of nursing care.

  • Identifying factors that prevent optimal functioning to help nurses thwart negative influences or provide solutions to counteract them.

• In Nursing Education:

  • Effecting curriculum changes.

  • Refining course content.

  • Designing new teaching methods.

  • Demonstrating the integral role of research to students.

  • Selecting nursing applicants likely to succeed.

  • Understanding factors that facilitate learning processes.

• In Nursing Administration:

  • Solving persistent problems in the organization, delivery, and evaluation of patient care.

  • Organizing nursing personnel efficacy.

  • Planning budgets and justifying requests for increases in nursing positions.

  • Identifying satisfying and dissatisfying elements of the work environment to facilitate job satisfaction.

  • Increasing opportunities for nurses to investigate care effectiveness and patient satisfaction.

Professional Goals and Roles in Nursing Research

• Primary Goals:

  • Establishing Evidence-based Nursing Practice.

  • Ensuring the Credibility of the Nursing Profession.

  • Maintaining Accountability for Nursing Practice.

  • Documentation of the Cost-effectiveness of Nursing Care.

• Core Roles of Nurses in Research:

  • Principal Investigator.

  • Member of a Research Team.

  • Identifier of Researchable Problems.

  • Evaluator of Research Findings.

  • User of Research Findings.

  • Patient/client Advocate during Studies.

  • Subject in Studies.

• Engagement Activities:

  • Participating in journal clubs to discuss and critique research articles.

  • Attending research presentations at professional conferences.

  • Evaluating completed research for use in practice.

  • Developing ideas for clinical studies.

  • Reviewing research plans and offering clinical expertise.

  • Assisting researchers in collecting study information.

  • Providing information and advice to clients participating in studies.

  • Discussing research implications and relevance with clients.