Research for Nursing and Midwifery

Experimental design

*- Treatment vs control - Randomisation* - Scientific investigation using specific protocol and explicit criteria - Manipulated, controlled and randomised - Used to test cause and effect relationships - Inferring causality requires: * Relationship b/w explanatory (causal) and outcome (effect) variables * Cause to precede the effect * Relationships not explained by other extraneous variables

Qualitative research concepts

*Phenomena* - Explored with holistic and humanistic context - Relationships explored in a real world setting

Quantitative research concepts

*Variables* - Can vary (pain, anxiety and properties that differ such as height and age) - Concepts of interest can also be examined through documentary evidence

Qualtitative sampling

- *Convenience* - *Purposeful* *Snowball *Emergent/Opportunistic - occurs in field as themes emerge *Maximum variation - variety of characteristics of interest to researcher (maximise diversity of info relevant to research question) *Extreme/Deviant - highly unusual and considered an outlier *Typical - ordinary - *Theoretical* *Used for grounded theory studies *Sample of participants who have experienced process of interest and can help deveop well rounded theory *E.g. Discriminant - new group of participants recruited to compare their experiences with the process of interest that was created in the grounded theory study

What is a research question

- A question about the relationship between two or more concepts - Is the foundation of research study - Everything revolves around it - First step in any research project

Value of Delphi Study

- Ability to harness many opinions across geographical distance - The freedom of individuals to express their opinion without being influenced by other group members - Allowing individuals to participate at a convenient time, and relatively small expense. - Performed over relatively short periods of time

Research participants

- All applied and health research projects need participants - Usually human participants but sometimes human specimens - To provide "best evidence" the goal is to recruit participants that are *representative* of the population *AND* -To be able to make a statement about how the results might *generalise* to the wider population

The value of action research

- Allows health professionals to learn about their local situation and facilitate the implementation and evaluation of research into this situation. - Ongoing evidence-based practice change contributing a beneficial body of evidence for the research organisation, and for other organisations to consider and learn from - Offers the flexibility for research projects to evolve naturally

*E.g of Non Probability Sampling:* Snowball Sampling

- Chain referral - participants put the researcher in touch with other potential participants - Really useful for hidden populations

Manipulation

- Changing a variable in order to determine its causal power - A researcher manipulates the causal or 'explanatory (independent) variable' by introducing a 'treatment' or 'intervention'. The intervention (treatment) group receives manipulation of the explanatory variable, while the control group does not

Communicating findings in qualitative data analysis

- Conference presentations - Other professional meetings - Research reports - Journal articles - Media releases

Rigour and applicability

- Critically appraise the research evidence - Were results meaningful? - Can they be applied to clinical setting? *Are the results accurate, believable and meaningful?*

Hypothesis

- Definitive statement that there is a relationship between independent and dependent variables - Relationships specify * How the value of one variable changes in relation to another * May be either positive, negative or the two variables may have no relationship * Not necessarily correlations

Representative sample

- Demographic profile of the sample is the same as the population - every person has an equal chance of being included - Sample bias is minimised

Quantitative (deductive)

- Describes - Infers - Resolves problems using maths/stats - Focuses on numbers and aims to resolve problems using maths and statistics. - As with qualitative research, quantitative research is also used to describe situations, but it uses numbers to inform the description. - Examples of quantitative research include national surveys like the census, experimental studies and student feedback forms. - May be exploratory or descriptive - Usually focus on one concept or idea - Generally doesn't make comparisons among groups - Usually pertain to the actions or perceptions of participants.

Qualitative (inductive)

- Describes - Interprets - Creates meaning using words/pictures - Involves interpretation of situation, set of behaviours or a setting - Analysis must take place within a context - different findings may occur in different settings or situations - Different researchers may view same situation and obtain different results - Assumes no one right or wrong answer - Comes from particular set of assumptions or theories about how research should take place

Observational design: Case control studies

- Epidemiologcal approach examining participants on basis of study outcome (clinical characteristic, condition or disease) - Study direction is retrospective - Cases are matched with 'controls' (people who come from same study base) - Selection bias may exist if 'cases' are not from a well defined study base in time and place - Finding naturally occurring groups of participants similar in all respects except for their exposure to variable of interest is very difficult - Case control studies are unable to draw a causal link between the two variables

Observational design: Cohort studies

- Epidemiological approach where the direction is from the exposure to the outcome, or cause to presumed effect - Researcher studies development of particular health outcome - Used to examine relationships retrospectively and prospectively - Can be cross-sectional and longitudinal - Participants selected from known population referred to as the cohort - Participants studied over long period of time to determine who develops the outcomes of interest

Types of research that knowledge sources come from

- Epidemiology/Public health - Evaluation of services - Healthcare interventions - Experiences of illness - Service use among patients

Respect for Cultural Diversity

- Ethnicity - Religious affiliations - Age - Disability - Sexual orientation

Observational design: Correlational studies

- Examine relationships between pairs of variables as well as a comparison between groups - Used to quantify strength of relationship between variables - Cannot test a cause and effect relationship - Common misuse = attempt to conclude a causal relationship between variables

Observational design: descriptive/exploratory studies

- Exploratory/descriptive/survey - Purpose is only to relate one variable to another - Limited interaction with participants - Approaches include * observation * questioning participants vs interview or questionnaire * heath service data set

Phenomonology

- Focuses on people's lived experiences - Looks at people's meanings, interpretations and understandings in everyday life - Descriptive and interpretative

Describing a relationship between two continuous variables

- Generally looking for a correlation between them - A statistic called Pearson's R (b/w -1 and +1) describes the strength of the relationship between two metric variables

Randomised Controlled Trial

- Gold standard for testing cause and effect relationships in clinical research - Random allocation of participants to control or experimental group - Use of control group - treatment or intervention given only to those in experimental group - All extraneous variables controlled - Outcome variable measured in groups before and after intervention

The process of action research

- Group members are brought together to collaboratively explore and address an issue affecting them. - Cyclical in design - Forms the basis for reflection on the success of plans and the possibility of modifying them and starting another cycle of planning, action, data collection, analysis, evaluation and reflection

Limitations of Delphi Study

- Inadequate descriptions of panellist characteristics (especially in terms of identifying who or what constitutes an expert) - Subjective researcher interpretation of definitions and measures of consensus - High wastage of respondents due to response fatigue. - Findings of a Delphi study represent expert opinion but not indisputable fact

Ethical principles of research

- Informed consent and autonomy - Privacy and confidentiality - Justice and rights - Beneficence and non maleficence - Respect for cultural diversity

Barriers to research utilisation

- Insufficent time to read research - Lack of authority to effect change - Lack of confidence and skill in accessing and evaluating research

Qualitative data collection methods

- Interviews (primary method) * Can be used for qualitative or quantitative * *unstructured* = no specific questions developed; is informal and conversational; tends to start with broad question * *semi structured* = ask a set of predetermined questions (called probes) - Focus groups * Small structured groups with selected participants led by facilitator * Useful for obtaining different perspectives * Offer a collective view - Field notes * Crucial in ethnographic studies and kept throughout study * Record physical and social context, as well as events, actions, ease of difficulty or access * Analysed as written, while taking observations - Observation * Observing daily life in natural setting * Traditionally adopted by ethnographers * Mostly unstructured * *covert observation; observer as participant; participant as observer; complete observer* - Occurs within social or cultural setting that sets the context for qualitative studies

Sources of knowledge that inform nursing practice

- Intrinsic wisdom - Expert opinion - Government reports - Policy documents - Textbooks - Journal articles

Independant (cause) variable

- It is a variable that stands alone and isn't changed by the other variables you are trying to measure. - Its value does not depend on any other variables in the study.

Qualitative questions ...

- May be exploratory or descriptive - Usually focus on one concept or idea - Generally dont make comparisons among groups - Usually pertain or actions or perceptions of participants

*E.g of Probability Sampling:* Simple Random Sampling

- Needs a really good sample frame - Easier if the population is geographically concentrated - Often used for large surveys - Usually uses a computer program to make the sample

Observational design

- No control - No randomisation - Used to construct picture of phenomenen occurring naturally in the environment - Used to observe variables of interest - Explore relationships between those variables - Used when there is little information about the topic - Used phenomena of interest not amenable to experimental designs - No active manipulation; however control and rigour still important *descriptive/exploratory studies* *correlational studies* *cross sectional studies* *case control studies*

Parametric statistical tests

- Normal distribution - Sample size over 30 - No outliers

Limitations of action research

- Not easy to set up or initiate. - Great effort, enthusiasm, equal participation, trust and prolonged engagement are necessary for effective action research - Process and outcomes are often difficult to predict and researchers are not able to guarantee group actions - Action researchers face situations where they may not know exactly what to investigate, when and where to start, or even when the research is likely to be complete. Therefore participants are often unaware of exactly where their research 'journey' will take them - Has implications for gaining funding, organisational support and seeking human research ethics approval

Implementation

- Organisation policy and procedures - Feasability; cost vs risk benefit; patient preference *Can findings be implemented in practice setting?*

Privacy and Confidentiality

- Participants have a right to privacy - Protection of identity of participants - Achieved by assigning a number or psedonym - Anonymity should be assured; easier in survey data collection techniques than qualitative data collection - Anonymity is different to confidentiality

Researchable problems are identified through

- Personal experience - Investigation of a particular nursing or midwifery practice in the clinical area - Evaluation of the effectiveness of an intervention or understand how it works - State of knowledge in the field - Hot topics under discussion - Gaps in the research and theoretical literature

Paradigm

- Position or understanding of a viewpoint of the world in which we live (world-view or view-of-the-world) which covers philosophical assumptions that are shared by a community of scholars. - Research paradigms are therefore sets of beliefs and practices shared by all researchers that serve to govern inquiry within disciplines

The significance of research problem statements to nursing or midwifery should be in relation to

- Potential for patients, heath professionals, community and society to benefit from the study - Extending the knowledge base of nursing and midwifery - Providing theoretical relevance - Findings supporting untested assumptions - Findings informing nursing practices or policies

Descriptive research approach

- Qualitative or quantitative - Describes phenomena

Exploratory research approach

- Qualitiative (inductive method) - Reasoning from specifics to theory - Concerned with generation of new theory - Uses research questions to narrow scope of study - incorporates values and perspectives of both researcher and participants

Explanatory research approach

- Quantitative (deductive method) - Reasoning from general theories to specific instances - Aimed at testing a theory - Begins with hypothesis - Researchers to be objective

Why do researchers used mixed methods?

- Quantitative vs qualitative can produce a paradigm tension - Neither quantitative not qualitiative methods alone are sufficient - Maybe mixing the methods can resolve the tension

Sampling humans in the real world

- Rare to recruit perfecty representative sample - E.g: no accessible sample frame; too costly; time consuming; hidden populations

Research framework theories

- Research frameworks that are embedded in the methodology provide the knowledge and theory basis for conducting research studies. - Theoretical research frameworks represent known and tested theories. There are many 'tried and tested' theories in nursing and midwifery that researchers can cross-reference. - Foundational knowledge serves as a 'frame of reference' from which researchers can either predict or explain their study outcomes.

Conducting a search of the research literature

- Scope and size of search - Using keywords (PIC and PICOT) - Selecting a database - Using search filters - Search grey literature - Report the search strategy

Defining a population

- Set of units that the sample represents using clear *inclusion* and *exclusion* criteria - The *sample* is only some members of that population

ANOVA (analysis of variance)

- Spread of the data - F Statistic: Variation b/w treatment groups / Variation within the groups - Used when DV is continuous and IV is categorical with 3 or more groups

Creating order in qualitative data analysis

- Storage and retrieval * A procedural step * Security and protection * Data management software - Familiarisation - read and reread, view and review * An intellectual step * Immersed in the data * Usually an individual activity

Observational design: Cross sectional studies

- Surveys that measure data at one point in time, only collected once with same participants - Also called analytic - Uses inferential stats to infer a relationship between two or more variables - Limitation is that the outcome of interest and the causal factor are measured simultaneously. Lack of time provides weak evidence of causality

Rationales for mixed-methods study

- The complexity of the phenomena being studied - Overlapping and different facets of the phenomen - Triangulation - Completeness - Off-setting weaknesses and providing stronger inferences - Adding scope and depth - Potential hypotheses development and testing - Possible instrument development and testing

Ethnography

- The scientific description of the customs of individual peoples and cultures. - Fieldwork (observation) and interviews - Artifacts and documentation - Context is important *culture*

Methodological triangulation

- The use of multiple methods to study a single problem - Method should complement the other, making them of equal value in conducting the research study. - Some argue that one method is complete and acts as the core, whilst the other(s) are different, incomplete and supplemental, serving mainly to complement the core component of the study. - Hence, when published, mixed-methods studies ideally report their findings as a whole study rather than as separate components with discrete findings. Two or more methods are triangulated if they - both relate to the same topic area - both planned prior to the research program commencing - one informs the other - all expand the related field of inquiry.

Dependant (outcome) variable

- The variable that is measured for change. The variable that is affected by the test (independent) variable. - Value depends on the cause

Limitations of mixed methods research

- Time-consuming nature - Complexity of concurrently conducting qualitative and quantitative phases (simultaneous triangulation) - Complexity of usually involving other team members - Resource-intensiveness - Need for the principal researchers to have a sound working knowledge of both quantitative and qualitative paradigms - One paradigm interferes with or affects the way the other is designed and used, possibly eroding method rigour or trustworthiness

Eliciting meaning in qualitative data analysis

- Timing of data analysis 1. Following data collection 2. Simultaneously with data collection - Application of inductive reasoning - Data collection and analysis influenced by methodological assumptions (theoretical stance or perspective: a theoretical lens) - Coding, categorising and theming * Process of identifying recurrent words or concepts in the data *Code* is representation of words that apply to same concept *Category* groups codes in terms of theor relationships to each other *Theme* group of related categories

Quasi-experimental design

- Treatment vs control - No randomisation - Researcher manipulates an experimental treatment (intervention; explanatory variable) - Some characteristic of "true" experiment lacking: either control or randomisation - Able to test cause and effect relationships - Lack of control threatens study's internal validity and weakens causal inference * Non equivalent control group settings * After only non equivalent control group design * One group pre-test post-test design * Time series design

Quantitative research: what can be measured?

- Variables * Are things that can vary * Between differences (height weight, IQ) * Different geographical locations and variations within those locations * Different points in time (e.g. person's level of pain)

*E.g of Non Probability Sampling:* Convenience Sampling

- Very common in qualitative research and pilot studies - Potential participants are conveniently available regarding access, location, time and willingness - Fast and easy way to recruit participants

Values of mixed method research

- Wider scope for constructive, contained and appropriate research, with the potential to present a more complete and comprehensive understanding of the research topic. - Assist in resolving the issue of methodological dominance and order - Enable a rich and comprehensive picture to develop of the issue under investigation. - Weaknesses in one method can be counter-balanced by strengths in another.

Complementary approaches that aid data analysis

- Writing memos (coding memos; theoretical memos; operation; field notes) - Drawing diagrams to map growing understanding about the research focus - Situational maps - helpful when working out possible links between concepts - Diagrams useful to develop an 'explanatory schema.'

Declaration of Helsinki (1964)

-Review by independent committee. -Informed consent. -Research by qualified individuals. -Research benefits should exceed risks.

Joanna Briggs Institute Model for Evidence Based Healthcare

1. Health Care Evidence Generation 2. Evidence Synthesis 3. Evidence/Knowledge Transfer 4. Evidence Utilisation

Basic structure of research cycle

1. Identify research topic 2. Ask research question 3. Propose method to answer question 4. Data collection 5. Data analysis = structure and connect data 6. Formulate answer 7. Draw conclusions and report

Research process

1. Identifying the (clinical) problem/issue 2. Critically searching and appraising the available primary (research-based) and conceptual (theory-based) literature 3. Refining research ideas, questions, statements or hypotheses 4. Identifying and minimising ethical issues and procedures 5. Identifying and justifying an appropriate research methodology and method 6. Sampling (choosing) appropriate research populations (participants/elements) 7. Collecting or generating research data from participants/elements 8. Analysing collected research data 9. Interpreting and making sense of research results/findings 10. Disseminating (sharing) research findings to wider audiences.

Delphi process

1. Selection of the expert panel 2. Formulation of the question(s) 3. Generation of statements 4. Reduction and categorisation of statements 5. Rating of statements and analysis 6. Iiteration

Steps of the literature search and review process

1. formulating a review question (or might be an assignment question) 2. conducting a comprehensive search of the literature 3. assessing studies for inclusion in the review 4. critically appraising the selected studies 5. synthesising findings from individual studies 6. reporting results and recommendations for practice.

Getting evidence into practice (JBI)

1. searching for the best available international evidence 2. appraising the evidence 3. summarising and disseminating usable and valid evidence 4. embedding appraised and rated evidence in practice and organisational systems 5. utilising the evidence 6. evaluating the impact of EB practices and policies on outcomes.

Mixed methods research

A blend of qualitative and quantitative methods that capitalizes on the strengths of each to examine a research question from multiple perspectives Research in which the investigator collects and analyses data, integrates the findings, and draws inferences using both qualitative and quantitative approaches or methods in a single study or program of inquiry - Use of mixed methods depends on research question - Consider understanding mixed methods as a tool for, not a theoretical approach to conducting research - Data collection may be atheoretical or amethodological Must be integrated into a single whole

Phenomenon

A fact or event which can be observed and/or documented

Histogram (continuous data)

A graph of vertical bars representing the frequency distribution of a set of data.

Directional hypothesis

A hypothesis that makes a specific prediction about the direction of the relationship between two variables

Boxplot

A plot of data that incorporates the maximum observation, the minimum observation, the first quartile, the second quartile (median), and the third quartile.

Research statement

A remark about what the researcher wants to learn - without making a claim about what might be causing the issue at hand.

Q methodology

A research approach used to assess individuals' subjective understanding

Qualitative meta-synthesis

A review of qualitative studies that combines a number of studies based on pre-established selection criteria and systematic appraisal of study quality

Non-probability samples

A sampling technique in which there is no way to calculate the likelihood that a specific element of the population being studied will be chosen - Convenience - Snowball - Judgement - Quota

Pilot study

A small study carried out to test the feasibility of a larger one

Pearson's R

A statistic that measures the direction and strength of the linear relation between two variables that have been measured on an interval or ratio scale

The T Test

A statistical test about a sample "mean" where the continuous variable is the same - One sample T Test hypothesis - Paired T Test hypothesis - Independent T Test hypothesis

Chi-square test

A statistical test about the relationship between two categorial variables

Population correlation coefficient

A statistical test about the relationship between two different continuous variables

Bracketing

A strategy used by qualitative researchers to set aside personal interpretations to avoid bias

Blinded

A study or experiment in which the participants do not know what they are being evaluated on. In a single blind study, either the investigator or the subject does not know the treatment being received.

Study population

Aggregation of elements from which the sample is actually selected

Grounded theory

An inductive method of generating theory from data by creating categories in which to place data and then looking for relationships among categories Systematic approach used to gather data and simultaneously analyse data to contruct a theory - Interviews and fieldwork - Artifacts and documentation *Outcome must be development of the theory* *interactions* Recruitment: Theoretical sampling Data collection: Constant comparison

Secondary research

Analyzing information from previously conducted research projects.

Variable

Any property of a person, thing, event, setting that is not fixed *Independent variable* Determines, influences or produces change in other main variable *Dependent variable* Dependent on or influenced by independent variables *Extraneous variables* Refers to other variables that may affect dependent variable

Research utilisation

Application of evidence to policies, programs and practice to improve outcomes.

Beneficence and Non Maleficence

Beneficence Doing good and maximising possible benefits Non Maleficence Doing no harm

LOM: Categorical

Binary: 2 categories (dead or alive) Nominal: More than two categories (male, female or other) Ordinal: Have logical order(F P C D HD) - Bar or pie chart - Modes and %

Reliability

Can the results be interpreted consistently under the same conditions? Test-retest reliability

Evidence-based practice

Clinical decision making that integrates the best available research with clinical expertise and patient characteristics and preferences

Ehtical Frameworks

Code of Ethics for Nurses in Australia (2008) Code of Ethics for Midwives in Australia (2008) Code of Professional Conduct for Nurses in Australia (2008) Code of Professional Conduct for Midwives in Australia (2008) National Statement on Ethical Conduct in Human Research (2007) - Respect for human beings - Research merit - Integrity, justice and beneficence

Meta analysis review

Combines the results of several studies that address a set of related research hypotheses

Research idea/question

Consider the ways in which your study might enhance understanding and knowledge of the topic.

Critical

Critical approaches generally use qualitative methods to examine phenomena of interest.

Describing a relationship between two categorical variables (cross tab)

Cross tab explains the correlation

Subjectivity

Decisions based on personal feelings rather than facts

Characteristics of a written review of literature

Description Analysis Synthesis

Difference bewteen descriptive and inferential statistics

Descriptive stats = describe data from sample Inferential stats = use data to say something about whole population from which population was drawn Statistic = sample Parameter = population E.g: If a stat gives us a sample estimate (mean score) we want to know the boundaries where we believe the population will fall - boundaries called the confidence interval

Measurement error

Direct (height, weight) Indirect (self report: pain, anxiety) Whatever we measure must make sense and be comparable over time and in different situations E.g: our weight is a universal truth but scales can differ and error occurs Towards the development of standardised units of measurement

Quantitative questions...

Directed - specifies assumed relationship between two concepts - Descriptive, comparative or relationship based - At least two variables - Used to prove or disprove causal relationship between variables - Expressed as opinion or expectated future outcome - Logically linked to theory

Validity

Does the instrument actually measure what it sets out to measure? Criterion validity Concurrent validity Internal validity Predictive validity

Case Study

Enables a detailed examination of a complex or simple single 'case' or 'unit' within a real-life and contemporary context using multiple data sources The case (phenomenon of interest) can be individuals, a group or community, an organisation, a process or an event. Exploratory, observational and responsive to the social context and therefore qualitative in terms of its philosophical position Full range of data collection strategies

Systematic review

Explicitly reports all aspects of the literature search and review process

Quantitative Hypothesis

Expressed as a relationship between two variables (cause and outcome)

Randomisation

Extraneous variables are equally distributed across the treatment and control groups

The Cochrane Collaboration

Focuses on the systematic review of randomised controlled trials for specific medical conditions, client groups or specific health professional interventions

Analysis

Formal interpretation of collected data to - Create order - Elicit meaning - Communicate findings

Levels of Measurement Summary (single variable)

Graphical summary Numerical summary

Peer reviewed journal

Has an editor or co-editors and an editorial board of experts in the discipline, and uses a panel of reviewers to peer-review submitted manuscripts for possible publication

Clinical relevance

How well a study proposal or the results addresses a meaningful issue related to practice *Do the findings of the study apply to your clinical situation?*

Ethical approval

Human Research Ethics Committees (HRECS) National Health and Medical Research Council (NHMRC) Australian Human Ethics Committee (AHEC) - Ensure conformity to ethical guidelines - Monitor studies - Follow up actions and surveillance - Authority to approve, reject or stop studies or request modifications All human research must be submitted to an ethics committee before data collection occurs

Research awareness

Important consideration necessary for providing superior nursing care

Data saturation

In qualitative research, the time when no new information is being obtained and repetition of information is consistently heard.

Informed Consent and Autonomy

Informed consent An ethical principle that research participants be told enough to enable them to choose whether they wish to participate. - Voluntary participation - Right to withdraw any time without penalty - Being advised of foreseeable risks or discomforts that might result from participating in study - Acknowledgment of any potential benefits resulting from study findings and conclusions - Assurance of confidentiality - Details about who to contact for further info Autonomy Participants decision to participate in study is self directed and self determined.

LOM: Continuous

Interval: Equal intervals (temp and can have minus numbers) Ratio: Equal intervals and true zero (weight and no minus numbers) - Histogram (skewed - Median and IQR) or boxplot (symmetrical - Mean and SD)

P - Value

Is the probability of obtaining a more extreme value for the test statistic than the one obtained when the null hypothesis is true The smaller the P Value, the stronger the evidence against the null hypothesis P usually set at 0.05 (which is 95% probability) Probability of value appearing in the frequency distribution tail

Justice and Rights

Justice The value of distributing benefits and burdens fairly Rights Based on broader notion of human rights Participants have right to - Full disclosure - Knowledge of how findings will be disseminated - Free from coercion - Withdraw anytime without penalty

Action research

Kurt Lewin 1946 Post WW2 Narrowing the gap between research recommendation and implementation so that democratic (inclusive and negotiated) inquiry could pave the way to group decisions and a commitment to organisational improvement. He wanted to develop a concrete procedure for translating evidence into action. - Social/community development - Organisational-change process

Sample frame

List of individuals from whom the sample will be drawn; with cluster sampling, a list of groups from which a sample of groups will be selected

Inductive reasoning

Logical thought process whereby conceptualisations are developed from specific observations—and where reasoning resides in the particular (it is always contextualised).

Operational definitions

Measurements used to observe or measure a variable and to the delineation of the procedures or operations required to measure, analyse or evaluate a concept. This procedure is necessary to provide clarity.

Research utlisation

Mechanism used to translate knowledge generated by research into clinical practice

What are the most important outcomes of using mixed method research?

Mixed methods can provide a deeper understanding of an area of interest than using either qualitative or quantiative methods alone (depending on research question) - Mixed methods can be used to generate evidence for effective practice and the delivery of high quality care

Delphi Technique

Mixed-methods design in that both qualitative and quantitative techniques are used to collect and analyse the questionnaire data. It normally takes on the structure of a methodological triangulation/data triangulation with a sequential combination method

Clinical governance

Monitoring performance of both institutions and individuals to maintain standards in healthcare. Formalises the accountability arrangements for quality assurance in healthcare.

Rich data

Multiple forms of data from different collection methods. Describes the subjective experience.

Styles of literature review

Narrative Systematic Meta-analysis Meta-synthesis Integrative

Probability samples

Ones in which members of the population have a known chance (probability) of being selected into the sample - Systematic - Cluster - Stratified - Simple random

Primary research sources

Original research, original development of theory, refereed journal articles and academic theses (honours, masters and doctoral levels)

Difference between the P Value and the CI

P Value only tells us if the difference between the sample mean (or proportion) and the null hypothesis is important The CI gives us an estimate of the possible differences in that mean (or proportion) at the population level

Paradigm tension

Paradigms of qualitative and quantitative research are often viewed as being in direct competition with each other

PICO/T

Patient, population or problem Intervention Comparison Outcome/Timeframe

PICo

Patient/Population Interest Context

PICO (quantitative question)

Patient/Population/Problem Intervention/Exposure Comparison Outcome

Positivism

Philosophical position that reflects the traditional scientific approach of objective observation, prediction and testing of causal relationships

Research design

Planning of the research, the selection of methodology or design and associated methods for identifying and recruiting the sample/participant, collecting and analysing data. 1. Selecting the specific methodology and method/methods to be used (i.e. qualitative-phenomenology or quantitative-experimental); or potentially both in the case of mixed-methods research. 2. Determining ethical issues and obtaining ethical consent and approval. 3. Developing a sampling framework and technique (i.e. the rationale for choosing an appropriate population of research participants, subjects or elements to study), such as a random sample of first-year nursing or midwifery students. 4. For quantitative research, operationally defining variables. 5. In the case of many quantitative research studies, measuring instruments are developed, selected and evaluated through a pilot study before usage in the larger study 6. Employing data collection techniques 7. Analysing collected data 8. Evaluating results/findings 9. Discussing results and their applicability to practice if a clinical study is undertaken 10. Disseminating study outcomes through publication/presentations/seminars/workshops

PICo (qualitative question)

Population Interest Context

Non-directional hypothesis

Predicts the existence of a relationship, not its direction

Classification of sampling methods

Probability Non probability

Descriptive statistics

Procedures that allow researchers to describe, organise and summarise raw data

Methodology

Provides a framework (process) for conducting the study (e.g. 'How do we know the world, or gain knowledge of it?')

Sample sizes

Qualitative research: Smaller sample sizes (6-12) Quantitative research: Larger sample sizes - Surveys and epidemiological studies can have samples in the thousands - Experimental studies tend to have sample sizes >30 - Pilot studies can have small sample size

Non-parametric statistical tests

Rank data from lowest value to highest value and use mean ranks as the test statistic Wilcoxon Rank Sum or Mann Whitney Test (alternative to independent samples test) Wilcoxon Signed Rank Test (alternative to paired samples test)

Research consumer

Readers of nursing research whose objective is to apply findings to nursing practice or to use the findings to conduct further research

Level of measurement LOM

Relationship between what is being measured and the number

Odds ratio

Relative measure of effect, which allows the comparison of the intervention group of a study relative to the comparison or placebo group.

Criteria for research utilisation

Relevance + rigour and applicability + implementation

Literature databases

Repositories of published literature. They primarily contain journal articles but some link to other sources, such as books or theses. E.g CINAHL Cumulative Index to Nursing and Allied Health Literature or PubMed

Interpretive

Research aim to describe, explore and generate meaning within a social or practice context. The most common post-positivist examples of this approach are *phenomenology, grounded theory and ethnography*

Primary research

Research done firsthand for the first time

Epidemiological research

Research that looks at populations of people; it is often observational

Confidence Interval (CI)

Roughly speaking, the range of scores (that is, the scores between an upper and lower value) that is likely to include the true population mean; more precisely, the range of possible population means from which it is not highly unlikely that you could have obtained your sample mean

Empirical evidence

Scientific evidence obtained by careful observation and experimentation

Theoretical sampling

Selecting sample members based on earlier interviews that suggest that particular types of participants will help researchers better understand the research topic

Methodological triangulation combinations

Simultaneous (parallel triangulation): Convergent design' which combines qualitative and quantitative methods in one study at the same time—and where data analysis from each method is brought together during interpretation for the study findings Sequential triangulation: Including explanatory and exploratory designs, separates out the two paradigms and completes them in a linear (step-wise) fashion Transformative designs: are characterised by the use of a transformative theoretical framework which drives decisions about method mix and timing, such that change to participants, policy or ideology are realised Multi-phase mixed-methods designs: are longitudinal and very complex; combining both sequential and concurrent triangulation combinations over a period of time and within a single research project, the idea being that each phase addresses particular research sub-questions and sequentially builds to address the overarching research question(s) for the project

Standard deviation

Spread of distribution: tells you how much the data deviates from the mean

Frequency distribution

Statistical method for summarising the occurrences (frequencies) of events in a study.

Research rigor

Striving for excellence in research, which involves discipline, scrupulous adherence to detail, and strict accuracy

Ontology

Study of existence. It provides the 'world-view' that guides the study (e.g. 'What is the nature of reality?', 'What is it like to be a human being?')

Integrative review

Summarises past research and draws overall conclusions from the body of literature on a particular topic

Belmont Report (1979)

Summarizes the basic ethical principles and guidelines for the protection of human subjects of research. (Respect for persons, beneficence and justice)

Secondary research sources

Summary and critique of primary studies on a specific topic or in depth analysis of issue. Used when: 1. full-text primary sources are unavailable—this may occur with early classic papers or those written in publications with a limited distribution 2. a secondary source provides a different interpretation of an issue or problem—secondary sources help students develop the ability to see things from another reader's point of view, which is an essential aspect of critical reading 3. when the body of knowledge is so extensive that a comprehensive review provides the best available knowledge, enabling clinicians to make practice decisions without undertaking their own full review of the research literature 4. when an issue or topic is well researched within other disciplines but has not, as yet, been applied to nursing or midwifery practice.

Nuremberg Code (1947)

Ten guidelines for the ethical treatment of human subjects in research

Mean

The arithmetic average of a distribution, obtained by adding the scores and then dividing by the number of scores

Sample bias

The effect of having a sample that does not represent all segments of the population

Null hypothesis

The hypothesis that there is no significant difference between specified populations, any observed difference being due to sampling or experimental error.

Control

The level of control the researcher has over extraneous variables

Clinical effectiveness

The measure of how well a health care intervention produces the desired or intended result; also known as clinical efficacy.

Median

The middle score in a distribution; half the scores are above it and half are below it

Mode

The most frequently occurring score(s) in a distribution

Empirical rule

The rules gives the approximate % of observations w/in 1 standard deviation (68%), 2 standard deviations (95%) and 3 standard deviations (99.7%) of the mean when the histogram is well approx. by a normal curve

Cultural awareness

The self-examination and in-depth exploration of one's own beliefs and values as they influence behaviour

Double blinded

The tester and the person being tested dont know what treatment they are getting/being given.

Data triangulation

The use of a variety of data sources in a study

Multi-disciplinary triangulation

The use of multiple disciplines to inform the research process

Triangulation

The use of multiple methods to study one research question

Theory triangulation

The use of multiple perspectives to interpret a single set of data

Investigator triangulation

The use of several different researchers or evaluators

Epistemology

Theoretical study of knowledge involved in the search for knowledge and truth(s). It provides a focus for the study (e.g. 'What is the relationship between the researcher and the area of study?')

Quantitative designs

Three main research designs - Experimental - Quasi experimental - Observational

Reviewing the research literature

To identify: • New knowledge that can lead to the development, testing or refinement of theories • Gaps or limitations in the literature that can lead to new directions in original research • The existing knowledge about a particular topic, concept or problem of clinical interest • Research findings that inform evidence-based practice activities

Research problem

Trying to solve a problem, or at least contribute to further understanding and possible solutions

Sampling and generalisability

Two broad conceptual approaches to generalisation in research: 1) Statistical generalisation through probability sampling - very common in survey research 2) Replication of the study using non-probability sampling - very common in experimental research

Grey literature

Unpublished reports, conference papers, and grant proposals

Narrative review

Useful for informing readers about the context of topics but their potential for being less systematic than other reviews means that they most likely do not provide any form of compelling evidence for practice change alone. Authors may have expert opinions (and biases) and find studies to support their preferred positions (selection bias).

Critical social theory

Why certain groups of people are predisposed to physical ailments and deficiencies. The goal of critical social theory within nursing teaching and practice is to identify and reduce socially related health disparities between patients.

Constant comparison

a procedure used in a grounded theory analysis wherein newly collected data are compared in an ongoing fashion with data obtained earlier, to refine theoretically relevant categories

Meta synthesis review

integrates, evaluates and interprets findings of multiple qualitative research studies and identifies common core elements and themes

Inferential statistics

numerical data that allow one to generalize- to infer from sample data the probability of something being true of a population

Purposes of a literature review

• A systematic summary of a series of original research papers; for example, a systematic review • A supporting background section for a clinical practice guideline or evidence-based recommendation • The background section of an original research proposal, grant application or published field research paper

Steps in a literature review

• Preliminary reading of available abstracts, which allows articles to be selected or discarded from the original search results • Obtaining a full-text print or electronic copy of all included articles to enable organisation for priority critical reading and eventual sorting into themes or categories • An initial read/skim/scan of all papers that will identify a set of core papers, others that are useful and peripheral to your questions, and perhaps some that are not as useful as first thought, and which may be discarded from the review • Describing the justification for discarding studies based on clear rationale • Organising papers into themes, allowing comparison and links between coherent studies during the review (perhaps using summary tables as a guiding and organisational tool) • Critical reading, which requires several readings, a certain level of knowledge across a broad range of methodological approaches and the use of a set of criteria to evaluate the studies.

Star Model of Knowledge Transformation Model

• knowledge discovery • evidence summary • translation into practice recommendations • integration into practice • evaluation

Qualitative research paradigms

• positivist —reductionist, empirical • critical —emancipatory • interpretive —naturalistic (constructivism)

Rogers Diffusion of Innovation Model

• the characteristics of the guideline • the users of the guideline • the methods of communicating the guideline • the social system in which it is being adopted.