Nursing Research Essay Assignment Papers
Nursing Research
Hill, W., Weinert, C., Cudney, S.(2006). Influence of a computer intervention on the psychological status of chronically ill rural women.
Nursing Research
, 55(1), 34-42.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1484522/
Assignment # 1
Read the abstract and background (pp.34-38 up to results) of the report by Hill and Colleagues (2006) PROVIDED ABOVE and answer the following questions: Nursing Research Essay Assignment Papers
Is this a qualitative or quantitative study?
What is the purpose of this study?
Does the report specify hypotheses? If there are hypotheses, were they appropriately worded?
If no hypotheses were stated, what would one be?
Did the report present conceptual definitions of key concepts? What are they?
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QUESTION 1: IS THIS A QUALITATIVE OR QUANTITATIVE STUDY
Qualitative research design is used for exploratory purposes to gain an understanding into a particular issue, problem or topic. It deals primarily the personal opinions and underlying reasons behind a problem. Data collection for qualitative research is done through the use of largely open ended and unstructured collection instruments to provide the respondents with an unconstrained platform to air the views and opinions (Cresswell, 2013). Data collection instruments utilized in qualitative research include: focus groups, interviews and observation. The sample size required for qualitative research is also relatively small. Results gathered from qualitative research can be used to form hypotheses for further quantitative research in the topic. Nursing Research Essay Assignment Papers.
Quantitative research differs from qualitative in that it deals with numerical data. Quantitative research relies on measurable data that is then subjected to mathematical statistical analysis to uncover fact based patterns and/or trends that offer insight into the research topic. Quantitative research utilizes more structured data collection tools that ensure the respondents’ feedback is standard (Neuman and Robson, 2012). Data collection instruments utilized in quantitative research includes questionnaires, structured interviews surveys, polls and structured observation.
This study utilizes a quantitative research design due to two main reasons. Firstly, the data collection utilized is a structured questionnaire that is designed to collect standardized responses from the responses. Secondly, the study utilizes mathematical statistical analysis to identify patterns for the discussion. Nursing Research Essay Assignment Papers.
QUESTION 2: WHAT IS THE PURPOSE OF THIS STUDY
Every research study aims to achieve a certain goal at its conclusion; this is what is referred to as the purpose of the study. As stated in the paper’s introductory chapters (Hill, Winert and Cudney, 2006), participation in support groups has been shown to improve the overall mental health status of chronically ill patients. However, patients in rural areas are geographically isolated from the institution/centres that host these support groups. Mobility issues caused by the chronic illness, whether financially or due to their health statuses, further reduce their access to support group. The purpose of this research study is to identify whether computer delivered support groups platforms could have a positive impact on geographically isolated, chronically ill patients. Nursing Research Essay Assignment Papers.
QUESTION 3: DOES THE REPORT HAVE A HYPOTHESIS? IF NOT, WHAT WOULD ONE BE?
A hypothesis is a prediction statement that is provided in the research design phase that will either be supported or disproved by the research findings (Pickard, 2012). Hypotheses can only be applied to quantitative studies as qualitative studies are exploratory in nature and lack the mathematical analysis to test the hypothesis. The opposite outcome of a hypothesis is known as the null hypothesis (Ary et al., 2013).
This research study does not have a specified hypothesis. In the introductory paragraphs establish that support groups have a positive impact on the mental health of chronically ill patients. Therefore, it would be reasonable to expect the computer delivered intervention to also have a positive impact on the mental well being of the rural patients. An appropriate hypothesis for this study would be “computer delivered interventions have a positive impact on the mental health of the intervention group” with the null hypothesis being that “there will be no significant difference between the metal health status of the control group and the intervention group after the research study”. Nursing Research Essay Assignment Papers.
QUESTION 4: DID THE REPORT PRESENT CONCEPTUAL DEFINITIONS OF KEY CONCEPTS? WHAT ARE THEY?
This research study has three conceptual terms that are specifically listed, with their definitions contained in the text’s body. These are:-
Chronic illness: This is defined in comparison with acute illnesses. Chronic illnesses are lifelong, incurable diseases while acute illness is potentially curable. Nursing Research Essay Assignment Papers.
Computer Based Intervention: This is defined as an online provided platform that can act as a substitute for a support group. The research utilizes a computer based intervention that incorporates the functions of a support group as well as simultaneously providing health education. This intervention has a platform for group discussions as well as an inbox feature for private messaging and is available 24 hours a day, 7 days a week.
Psychological outcomes: these are the results from the seven psychological indicators being measured in the study which are: social support, self esteem, empowerment, self efficacy, stress, depression and loneliness. Nursing Research Essay Assignment Papers.
References
Ary, D., Jacobs, L. C., Sorensen, C. K., & Walker, D. (2013). Introduction to research in education. Cengage Learning.
Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.
Hill, W., Weinert, C., & Cudney, S. (2006). Influence of a computer intervention on the psychological status of chronically iII rural women: Preliminary results. Nursing research, 55(1), 34.
Neuman, W. L., & Robson, K. (2012). Basics of social research: Qualitative and quantitative approaches.
Pickard, A. (2012). Research methods in information. Facet publishing.
Chapter 1: The Role of Research in Nursing
The challenges associated with nursing’s rapid pace of growth can best be met by integrating evidence-informed knowledge into nursing practice. Nursing
research provides specialized scientific knowledge
that
empowers nurses to anticipate and meet these constantly
shifting challenges and maintain the profession’s societal relevance. Through the conducting of research, they produce knowledge that is reliable and useful for clinical practice. The methods and findings of studies provide evidence that is evaluated, and their applicability to practice is used to inform clinical decisions. Nursing Research Essay Assignment Papers.
Research is the systematic, rigourous, logical investigation that aims to answer questions about nursing phenomena.
Phenomena can be defined as occurrences, circumstances, or facts that are perceptible by the senses. Phenomena, such as the expression of pain or loss, are the circumstances of interest to nurses.
Much of the evidence used as a basis for practice is from research that has been completed, written about in papers, and then published. Published research studies are assessed so that decisions about application to clinical practice can be made, which results in practice that is evidence based.
Evidence – informed practice; building upon the foundation of evidence-based practice, evidence-informed practice also involves acknowledging and considering the myriad factors beyond such evidence as local indigenous knowledge, cultural and religious norms, and clinical judgement. With evidence-informed practice, the methods for gathering evidence (use of published research studies) are the same as the processes used for evidence-based practice; however, the evidence also incorporates expert opinion, clinical expertise, patient preference, and other resources. It is important to remember that evidence-informed practice focuses on a more inclusive and interactive process:
Evidence-informed decision-making is a continuous interactive process involving the explicit, conscientious and judicious consideration of the best available evidence to provide care. It is essential to optimize outcomes for individual clients, promote healthy communities and populations, improve clinical practice, achieve cost-effective nursing care and ensure accountability and transparency in decision-making within the health-care system.
Research and the evidence-informed practice processes, both begin with a question. The difference is that
in a research study
, the question is tested with a design appropriate for the question and with specific methods (sample, instruments, procedures, and data analysis). In the
evidence-informed practice
process, a question is used to search the literature for studies already completed that you will critically appraise in order to answer your clinical question.
All nurses share a commitment to the advancement of nursing science by conducting research and using research evidence in practice. Scientific investigation promotes
accountability,
which is one of the hallmarks of the nursing profession and a fundamental competency for all registered nurses. Nursing Research Essay Assignment Papers.
Research links theory, education, and practice.
How education in nursing research links theory and practice? First, learning about nursing research will provide you with an appreciation and understanding of the research process so that you can more easily become a participant in research activities. Second, learning the value of nursing research helps you to become an intelligent consumer of research → Nurses must understand all steps of the research process and their interrelationships. The registered nurse interprets, evaluates, and determines the credibility of research findings. The nurse discriminates between interesting findings for which further investigation is required and those that are sufficiently supported by evidence before applying findings to practice. The nurse should then use these competencies to advance the nursing or interdisciplinary evidence-informed practice.
As a professional, you must take time to read research studies and evaluate them, using the standards congruent with scientific research. Also, you will need to use the critiquing process in order to identify the strengths and weaknesses of each study. Bearing in mind that each study has its limitations, you should consider whether sound and relevant evidence from one particular study can be used in other settings as well.
Historical Perspective:
Nineteenth Century;
nursing as a formal discipline began to take root with the ideas and practices of Florence Nightingale. Her concepts have contributed to, and are congruent with, the current priorities of nursing research. Promotion of health, prevention of disease, and care of the sick were central ideas of her practice and publications. Nightingale believed that systematic collection and exploration of data were necessary for nursing. Her collection and analysis of data on the health status of British soldiers during the Crimean War led to a variety of reforms in health care.
Twentieth Century;
research focused mainly on nursing education, but some patient- and technique-oriented research was also evident. Nursing Research Essay Assignment Papers.
Changes in the educational system for nurses were crucial for the development of nursing research. In Canada, the establishment of university nursing courses in 1918, followed by master’s degree programs in the 1950s and 1960s and by doctoral programs in the 1990s and 2000s, was key to the development of nursing research.
The two major factors in the development of nursing research have been the establishment of research training through doctoral programs and the establishment of funding to support nursing research.
Growing awareness of the importance of nursing research gradually led to the availability of research funds.
Nursing research has focused progressively on evidence-informed practice in response to demands to justify care practices and systems by improving patient outcomes and controlling costs. Nursing Research Essay Assignment Papers.
The existence of the many nursing journals shows the growth in the variety, quality, and depth of research available for potential use in practice. In a report funded by the CHSRF, an analysis of the CIHR database revealed a wide diversity of nursing research topics in Canada. Of the studies, 67% were conducted in the areas of health issues, health service organizations, and health promotion. Not surprisingly, the research on health issues was dominant; the majority of studies focused on (1) chronic illness; (2) reproductive health; (3) pain; and (4) end-of-life/palliative care.
Future Directions: the continuing expansion of nursing research provides numerous opportunities for nurses to study important research questions, promote health care, and ameliorate the side effects of illness and the consequences of treatment while also optimizing the health outcomes of patients and their families.
Major shifts in the delivery of health care include the following:
An emphasis on community-based care
An emphasis on reducing disparities in health care
A focus on health promotion and risk reduction
An increase in severity of illness in inpatient settings
An increased incidence of chronic illness
An expanding population of older people
An emphasis on provider accountability through a focus on quality and cost outcomes
The use of technology to serve human needs
In accordance with these trends, nurse researchers are beginning to focus on the development of quantitative and qualitative research programs and clinically based outcome studies.
Depth in nursing science becomes evident when research is replicated (research programs that include a series of studies in a similar area, each of which builds on a prior investigation). Moreover, to maximize use of resources and to prevent duplication, researchers must develop intradisciplinary and interdisciplinary networks in similar areas of study (researchers from a variety of professions can come together to delineate common and unique aspects of patient care.
Nurse researchers should also be committed to developing publicly and privately funded research programs and to subscribing to a life of periodic education and retraining supported by awards, grants, and fellowships. Research programs facilitate growth in the depth and breadth of research expertise and recognize that some researchers must be retrained as they develop or shift the emphasis of their research, seek to broaden their scientific background, and acquire new research capabilities. Nursing Research Essay Assignment Papers.
Because of nursing’s emphasis on the cultural aspects of care and the influence of such factors on practice, international research is likely to increase. Access to multiple populations as a function of globalization allows the testing of nursing science from various perspectives. Interaction with colleagues from other countries provides a rich context for the generation and dissemination of research.
Funding agencies often determine research priorities on the basis of their particular needs and interests. These are established after consultation with health sector administrators, policymakers, and researchers across Canada.
Key Points
Nursing research expands the unique body of scientific knowledge that forms the foundation of evidence-informed nursing practice. Research is the component that links education, theory, and practice.
Nurses become knowledgeable consumers of research through educational processes and practical experience. As consumers of research, nurses must have a basic understanding of the research process and must demonstrate critical appraisal skills to evaluate the strengths and weaknesses of research before applying the research to clinical practice. Nursing Research Essay Assignment Papers.
Nursing research blossomed in the second half of the twentieth century: Graduate programs in nursing expanded, research journals began to be published, and funding for graduate education and nursing research increased dramatically.
All nurses, whether they possess baccalaureate, master’s, or doctoral degrees, have a responsibility to participate in the research process.
The role of the baccalaureate graduate is to be a knowledgeable consumer of research. Nurses with master’s and doctoral degrees are obliged to be researchers and sophisticated consumers of research studies.
A collaborative research relationship within the nursing profession will extend and refine the scientific body of knowledge that provides the grounding for theory-informed practice.
The future of nursing research will focus on the extension of scientific knowledge. Collaborative research relationships between education and practice will multiply. Programs of research studies and replication of studies will become increasingly valuable. Nursing Research Essay Assignment Papers.
Research studies will emphasize clinical issues, problems, and outcomes. Priority will be given to research studies that focus on health promotion, care for the health needs of vulnerable groups, and the development of cost-effective health care systems.
Both consumers of research and nurse researchers will engage in a collaborative effort to further the growth of nursing research and accomplish the profession’s research objectives.
Chapter 2 Theoretical Framework
On a daily basis, nurses devise clinical questions that, if answered, improve upon the care they provide to individuals, families, and communities. Each question requires that clinicians/nurse researchers engage in a knowledge development process. Nursing Research Essay Assignment Papers.
The process begins with the
identification of knowledge gaps:
the absence of theoretical or scientific knowledge relevant to the phenomenon of interest.
Knowledge generation
next occurs, with the conduct of research that provides answers to well-thought-out research questions.
This knowledge is
then distributed
through journal articles, textbooks, and public presentations to nurses.
Next, the
knowledge is adopted,
as nurses alter their practice on the basis of published information or as health care organizations develop policies and protocols that are informed by newly generated knowledge.
Finally, knowledge is
reviewed and revised
as new health issues arise, advances in clinical practice occur, or knowledge becomes outdated. In this chapter, we focus specifically on theoretical frameworks and how they guide and inform knowledge generation. Nursing Research Essay Assignment Papers.
Theoretical/empirical knowledge is most commonly referred to as scientific knowledge (currently serves as the guide for evidence-informed practice). Theoretical knowing is concerned with developing or testing theories or ideas that nurse researchers have about how the world operates. Theoretical knowing is informed by empirical knowing, which involves observations of reality. Observations may include the following:
Speaking with people about their life experiences (e.g., living with Alzheimer’s disease) and using their responses to specific and general questions to understand the phenomenon
Observing social or cultural interactions (e.g., homeless individuals interacting with service providers) as they naturally occur, interpreting what the interactions might mean for both parties, and using those interpretations to develop theories about health service delivery for that population Nursing Research Essay Assignment Papers
Delivering an intervention (e.g., a school health program for obese children) and assessing changes in health care–related behaviours (e.g., type of foods consumed, amount of daily exercise) after the delivery of the intervention
Using surveys or a questionnaire to ask a large group of men and women questions about experiences of violence and their current symptom levels with regard to pain, digestive problems, or depression.
All research is based on philosophical beliefs about the world; these beliefs are the motivating values, concepts, principles, and the nature of human knowledge of an individual, group, or culture, and they are the basis of a worldview, or paradigm. Nursing Research Essay Assignment Papers.
Paradigms (patterns) represent a “sets of beliefs and practices, shared by communities of researchers” that guide the knowledge development process. Therefore, knowing and comprehending these beliefs and practices is important in understanding and using research findings. These beliefs are not right or wrong; rather, they represent different views of the world, and their use the goals of the research.
Nursing research is guided by
three research paradigms
: post-positivism, constructivism, and social critical theory.
Post – positivism is a philosophical orientation that suggests that a material world exists; that is, things can be sensed (i.e., seen, touched, heard, tasted). Furthermore, it is governed by the expressed belief that although not all things can be understood or explained, many things can be. In fact, our world can be observed, events and phenomena can be categorized, and we can create theories to explain why some things like illness and health occur or do not occur. Post-positivism emphasizes the proving/disproving of theories for the purpose of explaining, predicting, and controlling specific outcomes.
Post-positivism values objectivity (e.g., observations from a neutral rather than a subjective position) and encourages the intense scrutiny of research findings for the purpose of excluding knowledge that was not developed through a rigorous process. Nursing Research Essay Assignment Papers
Constructivism is a philosophical orientation that suggests reality and the way in which we understand our world are largely dependent on our perception. Truth, as viewed by post-positivists, is flawed because truth is never absolute. Truth and our understanding of the world are determined by our life experiences, which in turn inform how we view the world. Knowledge development, from the perspective of the constructivists, is not valuable if it is used simply to prove or disprove theories. Rather,
the value of knowledge development lies in the ability to understand how people perceive their world.
Knowledge development occurs through observation or dialogue with people, or both, and as a result of paying attention to the language people use to describe life experiences
. Constructivists value subjectivity (personal knowing) versus objectivity (quantified knowing), inasmuch as the aim of this form of research is to create an understanding of people and their life experiences from their point of view.
Critical social thought is a philosophical orientation that suggests that reality and our understanding of reality is constructed by people with the most power at a particular point in history. Reality, and our understanding of the world, is always changing, and at all times we have an imperfect understanding of our world.
Critical social thought places a strong emphasis on understanding health and illness within the context of history.
Nursing Research Essay Assignment Papers This perspective supports the understanding that health and other aspects of reality are shaped by numerous social, political, economic, and cultural factors (gender, social and economic status, minority versus majority status, and even a country’s status as a developed versus developing nation).
A strong emphasis is placed on understanding how power imbalances associated with these factors influence health and well-being.
As in constructivism,
objectivity is not a goal.
Rather, understanding people’s experiences from their perspective is highly valued. In addition, the goal of knowledge development is to provide evidence that will support change or the transformation of reality. Critical social thought incorporates feminist theory and what has come to be known as action research.
These approaches to research examine how an individual’s or a group’s position in society shapes that individual’s or group’s experiences and causes differential or unequal access to resources, power, autonomy, and privilege.
The post – positivist paradigm is the basis of most quantitative research and, to a smaller extent, qualitative research. Grounded theory, as originally developed by Barney Glaser and Anselm Strauss ( 1967 ), is very much based on the cause-and-effect philosophy of the post-positivist paradigm. The constructivist paradigm is the basis of most qualitative research that grants importance to hermeneutics, which is the interpretation of written, oral, and visual communication. In critical social theory, both qualitative and quantitative researches are used to highlight historical and current experiences of suffering, conflict, and collective struggles.
Research Methods: Qualitative and Quantitative
If a researcher wishes to test a
cause-and-effect relationship
, such as how social support (cause) leads to high blood pressure (effect), quantitative methods are most appropriate. If, however, a researcher wishes to
discover and understand the meaning of an experience
or process such as death and dying, a qualitative approach would be appropriate.
Qualitative research is a systematic, interactive, and subjective research method used to describe and give meaning to life experiences. A researcher would choose to conduct a qualitative research study if the question to be answered concerns understanding the meaning of a human experience, such as grief, hope, or loss. Although the methods of qualitative research are systematic, a subjective approach is used; that is, the emphasis is on capturing the personal perceptions of the study participants. Thus, data from qualitative studies help nurses understand experiences or phenomena that affect patients, and this information in turn leads to improved care and stimulates further research.
Quantitative research systematically describes a phenomenon. A researcher would choose to conduct a quantitative research study if the question to be answered concerned testing for the presence of specific relationships, assessing for group differences, clarifying cause-and-effect interactions, or explaining how effective a nursing intervention was. Quantitative methods entail the use of objective, precise, and highly controlled measurement techniques to gather information that can be analyzed and summarized statistically.
The determinant of health framework guides the researcher in addressing the relationship between health and any of the following factors:
Socio-economic environment including income, income distribution, and social status; social support networks; education; employment and working conditions; and social environments
Physical environment
Healthy child development
Personal health practices
Individual capacity and coping skills
Biology and genetic endowment
Health and social services
Gender
Culture/ethnicity
Inductive and deductive reasoning are basic in frameworks for research.
Inductive reasoning: a process of starting with the details of experience and moving to a general picture, involves the observation of a particular set of instances that belong to and can be identified as part of a larger set. It is the pattern of “figuring out what is there” from the details of the nursing practice experience and is the foundation for most qualitative inquiry. Research questions related to the issue of the meaning of experience for the patient (can be addressed with the inductive reasoning of qualitative inquiry). Nursing Research Essay Assignment Papers.
Deductive reasoning: a process of starting with the general picture (ex, the theory of attentively embracing story) and moving to a specific direction for practice and research. In deductive reasoning, the researcher uses two or more related concepts that, when combined, enable the researcher to suggest relationships between the concepts. Deductive reasoning begins with a structure that guides searching for “what is there.” (would be addressed with the deductive reasoning of quantitative inquiry).
Frameworks, Theories, and Concepts
A theory is a set of interrelated concepts that serves the purpose of explaining or predicting phenomena. A theory is like a blueprint, a guide for modelling a structure. A blueprint depicts the elements of a structure and the relationship of each element to the other, just as a theory depicts both the concepts that compose it and how they are related.
A concept is an image or symbolic representation of an abstract idea. Each concept creates a mental image that is explained further through the conceptual definition.
A hypothesis is a best guess or prediction about what one expects to find about the variable outlined in the study. The variables represent the most concrete components of the ladder of abstraction and are derived from the identified concepts of a theory. They represent the measurable properties (what can be observed, measured, or both) of a quantitative study.
A mismatch between what is known or commonly accepted as fact and what we experience creates a hypothesis-generating moment.
A conceptual framework is a structure of concepts, theories, or both that is used to construct a map for the study. It presents a theory, which explains why the phenomenon being studied exists. Generally,
a conceptual framework is constructed from a review of the literature or is developed as part of a qualitative research project.
A theoretical framework may also be defined as a structure of concepts, theories, or both that is used to construct a map for the study. However, it is based on a philosophical or theorized belief or understanding of why the phenomenon under study exists.
Appraising the evidence: throughout the entire critiquing process, from worldview to operational definitions, you are evaluating whether the theoretical framework is appropriate. At the end of a research article, you can expect to find a discussion of the findings as they relate to the model. This final point enables readers to evaluate the framework for use in further research. The discussion may suggest necessary changes to enhance the relevance of the framework for continuing study and thus focus the direction of future research. Evaluating frameworks for research requires skill that can be acquired only through repeated critique and discussion with other nurses who have critiqued the same publication. The novice reader of research must be patient while these skills are developed. With continuing education and a broader knowledge of potential frameworks, you will build a repertoire of knowledge to enable you to judge the foundation of a research study, the framework for research.
Key Points
The scientific approaches used to generate nursing knowledge reflect both inductive and deductive reasoning.
The interaction among theory, practice, and research is central to knowledge development in the discipline of nursing.
Conceptual frameworks are created by the researcher, whereas theoretical frameworks are identified in the literature.
The use of a framework for research is important as a guide to systematically identify concepts and to link appropriate study variables with each concept.
Conceptual and operational definitions are critical in the evolution of a study, regardless of whether they are explicitly stated.
In developing or selecting a framework for research, knowledge may be acquired from other disciplines or directly from nursing. In either case, that knowledge is used to answer specific nursing questions.
Theory is distinguished by its scope. Grand theories are the broadest in scope and at the highest level of abstraction, whereas microrange theories are the most narrow in scope and at the lowest level of abstraction. Midrange theories are in the middle.
Midrange theories are at a level of abstraction that enhances their usefulness for guiding practice and research.
When you critique a framework for research, examine the logical, consistent link between the framework, the concepts for study, and the methods of data collection.
Chapter 3 Critical Reading Strategies: Overview of the Research Process
Critical thinking is the rational examination of ideas, inferences, assumptions, principles, arguments, conclusions, issues, statements, beliefs, and actions. In other words, being a critical thinker means that you are consciously thinking about your own thoughts and what you say, write, read, or do, as well as what other people say, write, or do. While thinking about all of this, you are also questioning the appropriateness of the content, applying standards or criteria, and seeing how the information measures up.
Developing the ability to critically evaluate research articles requires both critical thinking skills and critical reading skills. Critical reading is “an active, intellectually engaging process in which the reader participates in an inner dialogue with the writer”. Nursing Research Essay Assignment Papers. A critical reader actively looks for assumptions (accepted truths), key concepts and ideas, reasons and justifications, supporting examples, parallel experiences, implications and consequences, and any other structured features of the text so as to interpret and assess the text accurately and fairly.
Preliminary: familiarizing yourself with the content (skimming the article)
Comprehensive: understanding the researcher’s purpose or intent
Analysis: understanding the parts of the study
Synthesis: understanding the whole article and each step of the research process in a study
Critiquing a research study requires several readings (three or four times). The first strategy is to keep your research textbook at your side as you read.
Identify the steps of the research process and how the study was conducted
Clarify unfamiliar concepts or terms
Question assumptions and rationale
Assess the study for validity
A critical thinking decision path related to each step of the research process will sharpen your decision-making skills as you critique research articles. Nursing Research Essay Assignment Papers.
This rating system represents an evidence hierarchy for judging the strength of a study’s design, which is just one level of assessment that influences how confident the reader is about the conclusions drawn by the researcher. Assessing the strength of scientific evidence or potential research bias provides a vehicle to guide nurses in evaluating research studies for their applicability in clinical decision-making. In addition to identifying the level of evidence needed to grade the strength of a body of evidence, there are the three domains of quality, quantity, and consistency
Quality: the extent to which a study’s design, implementation, and analysis minimizes bias
Quantity: the number of studies in which the research question has been evaluated, including overall sample size across studies, as well as the strength of the findings from the data analyses
Consistency: the degree to which similar findings are reported from investigations of the same research question in studies that have similar and different designs
An abstract is a short, comprehensive synopsis or summary of a study at the beginning of an article. An abstract quickly focuses the reader on the main points of a study. A well-presented abstract is accurate, self-contained, concise, specific, nonevaluative, coherent, and readable. Nursing Research Essay Assignment Papers.
Systematic Reviews: Meta-Analyses, Integrative Reviews, and Meta-Syntheses
Systematic reviews include meta-analyses, integrative reviews, and meta-syntheses. The components of these types of articles are as follows:
Background: The introduction covers content related to the background of the clinical question and clarifies the specific question that the review answers. The article’s authors clarify the definitions of the concepts in the question so that the reader understands the concepts that were used in assessment.
Method: The methods used for searching the literature are detailed. The exact electronic databases, the dates, and the key words used to conduct the search are provided. In addition, the article details the inclusion and exclusion criteria by which the literature was chosen to review and critique. If a number of articles were found and not used, the authors detail why articles were excluded from the review.
Appraisal of the literature: The articles that are included in the literature review are discussed in the body of the article, and an evidence table is used to present the highlights of each article. The author uses the evidence table to compare and contrast the articles, critique them for scientific validity, and discuss how well they answer the clinical question. If the author uses a meta-analysis format, a summary of the data is presented.
Conclusions/summary: In the conclusions or summary, the strength, quality, and consistency of the data are described as they apply to practice. This section contains recommendations about which aspects of practice are supported by the data in the articles and for which aspects further research is needed to more fully answer the question posed in the review.
Nursing Research Essay Assignment Papers
Clinical guidelines are systematically developed statements or recommendations that serve as a guide for practitioners. Guidelines have been developed to assist in bridging practice and research. Guidelines are developed by professional organizations, government agencies, institutions, and convened expert panels. Guidelines provide clinicians with an algorithm for clinical management or for decision making with regard to specific diseases (e.g., colon cancer) or treatments (e.g., pain management).
Key Points
Critical thinking and critical reading skills will enable you to question the appropriateness of the content of a research article, apply standards or critiquing criteria to assess the study’s scientific merit for use in practice, and consider alternative ways of handling the same topic.
Critical reading involves active interpretation and objective assessment of an article and searching for key concepts, ideas, and justifications.
Critical reading requires four stages of understanding: preliminary (skimming), comprehensive, analysis, and synthesis. Each stage is characterized by specific strategies to increase your critical reading skills.
Critically reading for preliminary understanding is accomplished by skimming or quickly and lightly reading an article in order to familiarize yourself with its content and to provide you with a general sense of the material.
Critically reading for a comprehensive understanding is designed to increase your understanding both of the concepts and research terms in relation to the context and of the parts of the study in relation to the whole study, as presented in the article.
Critically reading for analysis understanding is designed to divide the content into parts so that each part of the study is understood. The critiquing process begins at this stage.
Critical reading to reach the goal of synthesis understanding combines the parts of a research study into a whole. During this final stage, the reader determines how each step of the research process relates to all the other steps, how well the study meets the critiquing criteria, and the usefulness of the study for practice.
Critiquing is the process of objectively and critically evaluating the strengths and weaknesses of a research article for scientific merit and application to practice, theory, and education. The need for more research on the topic or clinical problem is also addressed at this stage.
Each article should be reviewed for level of evidence as a means of judging the application of the findings to practice.
Research articles have different formats and styles, depending on journal manuscript requirements and whether they are quantitative or qualitative studies.
The basic steps of the research process are presented in journal articles in various ways. Detailed examples of such variations can be found in chapters throughout this text.
Evidence-informed practice begins with the careful reading and understanding of research articles. Nursing Research Essay Assignment Papers.
Chapter 4 Developing Research Questions, Hypotheses, and Clinical Questions
Research questions are usually generated from situations or problems that emerge from practice. These are often articulated in a problem statement.
The research question presents the idea that is to be examined in the study and is the foundation of the research study. Once the research question is clear, the researcher selects the most appropriate research design. If the research question is primarily explorative, descriptive, or theory generating, the researcher opts for qualitative methods. In these studies, a hypothesis is not formulated. For studies in which the researcher is seeking a specific answer to a research question, however, a hypothesis is generated and tested. Nursing Research Essay Assignment Papers.
Hypotheses can be considered intelligent hunches, guesses, or predictions that help researchers seek the solution or answer to the research question. Hypotheses are a vehicle for testing the validity of the theoretical framework assumptions and provide a bridge between theory and actuality.
For a clinician making an evidence-informed decision about a patient care issue, a clinical question—such as whether chlorhexidine or povidone-iodine is more effective in preventing infections in central catheters— would guide the nurse in searching for and retrieving the best available evidence. This evidence, combined with clinical expertise and patient preferences, would provide an answer on which to base the most effective decision about patient care for the affected population. Nursing Research Essay Assignment Papers.
Research questions or hypotheses often appear at the beginning of research articles
. However, because of space constraints or stylistic considerations in journal publications, the research question or hypothesis may be embedded in the purpose, aims, goals, or even the results section of the research report. Both the consumer and the producer of research need to understand the importance of research questions and hypotheses as the foundational elements of a research study.
A researcher spends a great deal of time refining a research idea or problem into a research question. The final research question usually does not appear in the research article unless the study is qualitative rather than quantitative. Nursing Research Essay Assignment Papers.
The research question should reflect a refinement of the researcher’s initial thinking. The evaluator of a nursing research study should be able to discern that the researcher has done the following:
Defined a specific topic area
Reviewed the relevant scientific literature
Examined the question’s potential significance in nursing
Pragmatically examined the feasibility of studying the research question
Qualitative and quantitative researchers conduct literature reviews differently. For qualitative researchers, the value of the literature review is controversial. Many researchers believe that an extensive literature review causes investigators to develop biases or beliefs that limit their openness to exploring the phenomenon under study. As a general rule, qualitative researchers usually start with a very cursory or general review of the literature to help focus the study, whereas quantitative researchers begin their study with an extensive review of the literature on their research questions and related topics. The literature review also helps researchers determine whether their study can contribute to the field of nursing. Qualitative researchers conduct a literature review during the data analysis or discussion of the findings to “tell the reader how the findings fit into what is already known about the phenomenon”.
As a quantitative researcher finalizes a research question, the following three characteristics should be evident:
The variables under consideration are clearly identified.
The population being investigated is specified.
The possibility of empirical testing is implied.
Researchers call the properties that they study variables, for example age, weight, height, religion, and ethnicity
An independent variable, usually symbolized by X, is the variable that has the presumed effect on the dependent variable. In experimental research studies, the researcher manipulates the independent variable.
The dependent variable, represented by Y, is often referred to as the consequence or the presumed effect that varies with a change in the independent variable. The dependent variable is not manipulated. It is observed and assumed to vary with changes in the independent variable. Predictions are based on how changes to the independent variable will affect the dependent variable. The researcher is interested in understanding, explaining, or predicting the response of the dependent variable.
A research hypothesis, also known as a scientific hypothesis, consists of a statement about the expected relationship of the variables. A research hypothesis indicates what the outcome of the study is expected to be. A research hypothesis is also either directional or no directional. If the researcher obtains statistically significant findings for a research hypothesis, the hypothesis is supported.
According to a statistical hypothesis (also known as a null hypothesis), there is no relationship between the independent and dependent variables. If, in the data analysis, a statistically significant relationship emerges between the variables at a specified level of significance, the statistical hypothesis is rejected. Rejection of the statistical hypothesis is equivalent to acceptance of the research hypothesis.
A directional hypothesis specifies the expected direction of the relationship between the independent and dependent variables. The reader of a directional hypothesis may observe not only that a relationship is proposed but also the nature or direction of that relationship.
A no directional hypothesis indicates the existence of a relationship between the variables; it does not specify the anticipated direction of the relationship.
When you evaluate a hypothesis, note that directional hypotheses have several advantages that make them appropriate for use in most studies:
Directional hypotheses indicate that a theory base was used to derive the hypotheses and that the phenomena under investigation have been critically examined and interrelated. You should note that nondirectional hypotheses may also be deduced from a theory base. Because of the exploratory nature of many studies for which the hypotheses are nondirectional, in contrast, the theory base may not be as developed.
Directional hypotheses provide a specific theoretical frame of reference within which the study is being conducted.
They suggest that the researcher believes that the evidence is indicative of a particular outcome, and as a result, the analyses of data can be accomplished in a statistically more sensitive way.
The important point about the directionality of the hypotheses is whether the rationale for the choice the researcher has proposed is sound.
A clinical question has five components (PICOT):
Population
Intervention
Comparison
Outcome
Time
When critiquing the research question, the reader looks for the presence of the three key elements:
Does the research question express a relationship between two or more variables or, at least, between an independent variable and a dependent variable?
Does the research question specify the nature of the population being studied?
Does the research question imply the possibility of empirical testing? Nursing Research Essay Assignment Papers
If this process of developing a research question is clarified at the outset of a research study, the report that follows can develop logically. Readers will have a clear idea of what the report should convey and can knowledgeably evaluate the material that is presented. When you critically appraise clinical questions, remember that they should be focused and specify the patient or problem being addressed, the intervention, and the outcome for a particular patient population. The author should provide evidence that the clinical question guided the literature search and that the question suggests the design and level of evidence to be obtained from the study findings
Key Points
Formulation of the research question and stating the hypothesis are key preliminary steps in the research process.
The research question is refined through a process that proceeds from the identification of a general idea of interest to the definition of a more specific and circumscribed topic. Nursing Research Essay Assignment Papers.
A preliminary literature review reveals related factors that appear to be critical for the research topic of interest and helps further define the research questions.
The significance of the research question must be identified in terms of its potential contribution to patients, nurses, the medical community in general, and society. The applicability of the question for nursing practice and its theoretical relevance must be established. The findings should also have the potential for formulating or altering nursing practices or policies.
The feasibility of a research question must be examined in light of pragmatic considerations: for example, time; the availability of participants, money, facilities, and equipment; the nurse’s experience; and ethical issues.
The final research question consists of a statement about the relationship of two or more variables. The question clearly identifies the relationship between the independent variables and dependent variables, specifies the nature of the population being studied, and implies the possibility of empirical testing.
Focused clinical questions arise from clinical practice and guide the literature search for the best available evidence to answer the clinical question.
A hypothesis is an attempt to answer the research question. When the validity of the assumptions of the theoretical framework is tested, the hypothesis connects the theory and reality.
A hypothesis is a declarative statement about the relationship between two or more variables in which an expected outcome is predicted. The characteristics of a hypothesis include a relationship statement, implications regarding testability, and consistency with a defined theory base.
Hypotheses can be formulated directionally or nondirectionally. Hypotheses can be further categorized as either research or statistical (null) hypotheses. Nursing Research Essay Assignment Papers.
Research questions may be used instead of hypotheses in exploratory, descriptive, or qualitative research studies. Research questions may also be formulated in addition to hypotheses to answer questions related to ancillary data.
The purpose, research question, or hypothesis provides information about the intent of the research question and hypothesis and suggests the level of evidence to be obtained from the study findings.
The critiquing criteria are a set of guidelines for evaluating the strengths and weaknesses of the research question and hypotheses as they appear in a research report.
In critiquing, the reader assesses the clarity of the research question and the related subquestions, the specificity of the population, and the implications for testability.
The interrelatedness of the research question, the literature review, the theoretical framework, and the hypotheses should be apparent.
The appropriateness of the research design suggested by the research question is also evaluated.
The purpose of the study (i.e., why the researcher is conducting the study) should be differentiated from the research question. Nursing Research Essay Assignment Papers.
The reader evaluates the wording of the hypothesis in terms of the clarity of the relational statement, its implications for testability, and its congruence with theory. The appropriateness of the hypothesis in relation to the type of research design is also examined. In addition, the appropriate use of research questions is evaluated in relation to the type of study conducted. Nursing Research Essay Assignment Papers.
Chapter 5 Finding and Appraising the Literature
Meta – analysis is a statistical technique, not a research design. It is based on a
strict scientific approach in systematic reviews, in which the results of many studies in a specific area are synthesized and statistically summarized to formulate an overall conclusion.
Each study is a unit of analysis. The goal is to read all of the studies concerning a particular clinical question and, using rigorous inclusion and exclusion criteria, to determine which studies are similar and to analyze their results, in order to quantify the effectiveness of the intervention under study. This method is more powerful because it is a rigorous process of summarizing evidence rather than estimating the effect of the results derived from single studies alone. Nursing Research Essay Assignment Papers.
A systematic review provides the most powerful and useful evidence available to guide practice. The well-constructed scale, test, interview schedule, or other form of index should consist of an objective, standardized measure of samples of a behaviour that has been clearly defined. Observations should be made on a small but carefully chosen sampling of the behaviour of interest, thus creating confidence that the samples are representative. A new tool should be based on a thorough review of previous theoretical and research literature to ensure validity. The tool should be standardized; that is, a set of uniform items and response possibilities are uniformly administered and scored. Without specific criteria and rating procedures, the evaluations of the items would be based on the subjective impressions, which may have varied significantly between observers and conditions. The items of a measurement tool should be unambiguous; they should be clear-cut, concise, exact statements with only one idea per item. Negative stems or items with negatively phrased response possibilities result in ambiguity in meaning and scoring.
When you critically appraise a systematic review, some of the questions to consider are the following:
Does the systematic review address a focused research question?
Does the meta-analysis include specific inclusion and exclusion criteria for judging the studies?
Does a publication bias exist?
Are the included studies homogeneous in terms of purpose, sample, research methods?
Are the designs of the studies similar?
Are the interventions similar?
Are the outcome measures similar?
Think about the systematic review as progressively sifting and sorting data until the highest quality of evidence is used to establish the conclusions. First, the researcher combines the results of all of the studies that focus on a specific question. The studies considered of lowest quality are then excluded, and the quality of the remaining studies is reanalyzed. The researcher repeats this process sequentially, excluding studies until only the studies of highest quality available are included in the analysis. An alteration in the overall results as an outcome of this sifting and sorting process suggests the sensitivity of the conclusions to the quality of the studies included in the meta-analysis. Such considerations determine whether it is reasonable to combine the studies for analysis. The consumer of research should note that a researcher who conducts a meta-analysis does not conduct the original analysis of data in the area but instead synthesizes the data from already published studies by following a set of controlled and systematic steps. Systematic reviews with a meta-analysis can be used to synthesize results of both nonexperimental and experimental research studies.
Evidence-informed practice methods, such as systematic reviews, increase a nurse’s ability to manage the ever-increasing volume of information produced to develop the best practices that are evidence based Nursing Research Essay Assignment Papers.
Meta-analysis is not a type of study design but a research method in which the results of multiple studies (usually randomized controlled trials) are statistically combined to answer focused clinical questions through an objective appraisal of carefully synthesized research evidence. People sometimes use the terms meta – analysis and systematic review interchangeably; however, a meta-analysis is a quantitative analysis used in a systematic review.
Systematic review is the process whereby the investigators evaluate all relevant studies, published and unpublished, on the topic or question. At least two members of the review team independently assess the quality of each study, include or exclude studies on the basis of pre-established criteria, statistically combine the results of individual studies, and present a balanced and impartial summary of the findings that represents a “state-of-the-science” conclusion about the evidence supporting the benefits and risks of a given health care practice. Nursing Research Essay Assignment Papers.