Chapter 1: Research & Evidence in Nursing

Chapter 1: Introduction to Nursing Research in an Evidence-Based Practice Environment
Without evidence, clinical practice cannot advance scientifically.

What Is Nursing Research?
Research: Systematic inquiry using disciplined methods to solve problems or answer questions
Nursing research: Systematic inquiry to develop trustworthy evidence and knowledge about issues of
importance to the nursing profession
Clinical Nursing Research: Research designed to generate knowledge to guide nursing practice and
improve the care and quality of life of clients.
Goal of Research: to discover new knowledge and relationships and find solutions to problems or
questions
The Importance of Research to EvidenceBased Nursing
Evidencebased practice (EBP)the use of the best clinical evidence in making patient care decisions
Nursing decisions need to be based on evidence.
Many recent clinical practice changes reflect the impact of research.
Roles of Nurses in Research
Continuum of participation, from producers of research to skilled consumers of research findings who
use research evidence in their practice
Nursing Research: Past
Pioneered by Florence Nightingale, 1850s
First journal on research (Nursing Research) emerged, 1950s.
*Clinical research increasingly important, 1980s
National Center for Nursing Research established at NIH, 1986
National Institutes of Nursing Research (NINR) established, 1993
NINR budget exceeds $100 million, 2000s.
Future Directions for Nursing Research
Heightened focus on evidencebased practice
Use of multiple confirmatory strategies (e.g., replication and multisite studies
Greater stress on systematic reviews
Expanded local research in health care settings (e.g., as part of Magnet process)
More multidisciplinary collaboration
Expanded dissemination of research findings
Greater focus on cultural issues and health disparities
Sources of Evidence for Nursing Practice
Tradition Weve always done it that way!
Authority Because I said so!
Clinical experience; trial and error; intuition
Logical reasoning Assembled information (e.g., quality improvement data)
Disciplined research
Paradigms and Methods for Nursing Research
Paradigm: a world view; a general perspective on the complexities of the real world, with certain
assumptions about reality
Key paradigms for nursing research:
o Positivist paradigm
Positivist assumptionreality exists and there is a real world driven by natural causes
involves viewing reality as being driven by natural causes
o Constructivist paradigm (naturalistic)multiple realities; associated with qualitative research
Paradigms and Methods
Research methods: the techniques used to structure a study and to gather, analyze, and interpret
information
Quantitative researchmost often allied with the positivist tradition
o Orderly procedures
o Pre-specified plan
o Control over context
o Formal measurement
o Quantitative information
o Seeks generalization
Qualitative researchmost often allied with the constructivist tradition
o Dynamic design
o Holistic
o Context-bound
o Humans as instruments
o Seeks patterns
Purposes of Nursing Research
Examples of classification systems:
o Utility of Findings
o Levels of Explanation
o Purposes linked to EBP
Utility of Findings
Basic Research
o accumulate information
o extend the base of knowledge
o formulate or refine a theory
Applied Research
o Solve immediate problems
o Ultimate goal is the systematic planning of change in a problematic situation.
o Most nursing research is applied research!
What type of research is indicated by the example?
Cadena (2006) studied the needs and functioning of persons with schizophrenia living in an assisted
living facility in relation to the residents characteristics. Basic Research
Smith (2006) conducted a study to determine whether any of three alternative methods of peripheral IV
catheter securement could extend the average survival time of such catheters. Applied Research
A study by Cuellar, Hanlon, and Ratcliff (2011) explored the relationship between serum iron levels in
the body and symptom severity, sleep quality, daytime sleepiness, depression, fatigue, and quality of life
for participants. Exploratory Research
Cohen (1999) undertook a study aimed at developing a comprehensive explanation of the process of
transitioning technologydependent children from hospital to home and community based care.
Explanatory Research, Qualitative
Robinson (2000) undertook an indepth study to describe the psychosocial and behavioral aspects of
living with urinary incontinence in a nursing home. Descriptive Research, Qualitative
Shaughnessy, Resnick, and Macko (2006) tested a theoretical model to explain physical activity among
older adults who survived a stroke. The model purported to explain exercise behavior on the basis of
theoretically relevant concepts such as selfefficacy and outcome expectations. Explanatory Research
Im et al. (2007) explored the differences in males and females in four ethnic groups on cancer pain
experiences. Exploratory Research
Epstein and Peerless (2006) conducted a study to identify predictors of successful weaning of older
adults from mechanical ventilation. Prediction Research
Johnson and colleagues (2006) described the prevalence and characteristics of childhood sexual abuse
among men incarcerated in Texas. Descriptive Research
Research to Achieve Varying Levels of Explanationpg. 11
Identification and descriptiondescribes phenomenon
Explorationuncovers manifestations of phenomenon
Explanationbroadest and least theoretically grounded; identify relationships among phenomenon; goal
is to understand underpendings and explain systematic relationships of phenomenon
Prediction and controlmake predictions about phenomenon; attempts to forecast relationships between
phenomenon
Research Purposes Linked to EBP
Therapy, treatment or intervention
Diagnosis and assessmentdevelopment and eval. of instruments
Prognosislook at probability of outcomes to occur
Etiology and harmhelps to ID factors that cause illness, morbidity, and mortality
Meaning and processesqaulitative research
Practice Questions (choose quantitative or qualitative)
What is the effect of interuptions while nurses are giving medications on the number of medication
errors they make? Quantitative
What is it like for women to be the victims of physical abuse? Qualitative
What does it mean to a patient to receive a diagnosis that he or she has colon cancer? Qualitative
What is the effect of a nursing smoking cessation intervention on the number of cigarettes that patients
smoke? Quantitative
Do the babies of women who do not get prenatal care have lower birth weights than other babies?
Quantitative

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Chapter 1: Introduction to Nursing Research in an Evidence-Based Practice Environment

Without evidence, clinical practice cannot advance scientifically.

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