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Chapter 002
1.
1Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Chapter 2 Evolution of Research in Building Evidence-based Nursing Practice
2.
2Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Historical Development of Research in Nursing Florence Nightingale Evolution of nursing research topics throughout the 20th century and into the 21st century Eventual movement toward Evidence-Based Practice (EBP) Are there any commonalities that you see among the types of research done over the past 150 years?
3.
3Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Florence Nightingale Data collection—gathered data on soldier morbidity and mortality rates Statistical analysis Instigated attitudinal, organizational, and social changes
4.
4Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Nursing Research 1900 to 1950 Research led to advances in nursing education 1940s—trend started that focused on organization/delivery of nursing services
5.
5Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Nursing Research 1950s and 1960s ANA initiated research into nursing functions and activities; ANA sponsored research conferences Educational studies Growing number of clinical studies focused on quality care and the development of criteria to measure patient outcomes
6.
6Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Nursing Research 1970s Focus on nursing process First Nursing Diagnosis Conference held which has evolved into today’s NANDA-I Studies involving implementation and outcomes of primary nursing care delivery models Archie Cochrane’s Effectiveness and Efficiency: Random Reflections on Health Services published
7.
7Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Nursing Research 1980s and 1990s Focus on conduct of clinical nursing WICHE and CURN projects launched to promote the use of research-based nursing interventions in practice NCNR created to support the conduct of basic and clinical nursing research and the dissemination of findings Emergence of outcomes research Term evidence-based was first used by David Eddy in 1990
8.
8Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Nursing Research 21st Century Central vision: Conducting quality studies using a variety of methodologies, synthesizing study findings into best research evidence, and using research evidence to guide practice Strong focus on EBP Focus of healthcare research and funding has expanded from illness treatment to include health promotion and illness prevention Key organizations promoting use of research to provide EBP: AHRQ, NINR, and ANA
9.
9Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Classification of Research Methods for this Course Quantitative research Qualitative research Outcomes research Intervention research
10.
10Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Scientific Method Incorporates all procedures that scientists have used, currently use, or may use in the future to pursue knowledge Would both quantitative and qualitative studies fall under this umbrella?
11.
11Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Comparison of Quantitative and Qualitative Research Quantitative research—a formal, objective, systematic process implemented to obtain numerical data for understanding aspects of the world (currently the predominantly used method of scientific investigation in nursing) Qualitative research is a systematic, interactive, subjective, holistic approach used to describe life experiences and give them meaning
12.
12Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Comparison of Quantitative and Qualitative Research (Cont’d) The problem and purpose to be studied determines the type of research to be conducted Would you use quantitative or qualitative research to study… whole person’s response to pain? effects of nutritional education on serum lipid levels?
13.
13Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Quantitative Research Describes and examines relationships and determines causality among variables Useful for testing a theory by testing the validity of the relationships that compose the theory Requires control to identify and limit the problem to be researched and attempts to limit the effects of extraneous or other variables that are not the focus of the study Requires the use of structured interviews, questionnaires, or observations; scales; or physiological measures that generate numerical data Control, instruments, and statistical analyses are used to ensure that the research findings accurately reflect reality so that the study findings can be generalized; generalization involves the application of trends or general tendencies (which are identified by studying a sample) to the population from which the research sample was drawn
14.
14Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Quantitative Research Methods Descriptive: accurate portrayal or account of characteristics of a particular individual, situation, or group Correlational: systematic investigation of relationships between or among two or more variables that have been identified in theories, observed in practice, or both (nature of relationship NOT cause-and-effect) Quasi-experimental: used to identify causal relationships, to examine the significance of causal relationships, to clarify why certain events happened, and for a combination of these objectives Experimental: objective, systematic, controlled investigation conducted for the purpose of predicting and controlling phenomena (examines causality)
15.
15Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Qualitative Research Generates knowledge about meaning through discovery Inductive and dialectic reasoning are predominant Researchers use observations, interviews, and focus groups to gather data (interactions are guided but not controlled) Qualitative data take the form of words and are analyzed according to the qualitative approach that is being used Findings from a qualitative study are unique to that study, and it is not the researcher’s intent to generalize the findings to a larger population
16.
16Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Qualitative Research Methods Phenomenological research: humanistic study of phenomena Grounded theory research: emphasizes interaction, observation, and development of relationships among concepts; useful for discovering what problems exist in a social setting and the processes people use to handle them Ethnographic research: research attempts to tell the story of people’s daily lives while describing the culture in which they live Exploratory-descriptive qualitative research: conducted to address an issue or problem in need of a solution and/or understanding Historical research: narrative description or analysis of events that occurred in the remote or recent past
17.
17Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Outcomes Research and Intervention Research Outcomes research examines the results of care and measures the changes in health status of patients Intervention research investigates the effectiveness of a nursing intervention in achieving the desired outcome or outcomes in a natural setting
18.
18Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Best Research Evidence for Practice What is it? A summary of the highest-quality, current empirical knowledge in a specific area of health care that is developed from a synthesis of quality studies in that area Who does it? At least two researchers, or even a team of expert researchers and healthcare providers
19.
19Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Research Evidence Synthesization Processes Systematic review: structured, comprehensive synthesis of the research literature Meta-analysis: statistically pooling the results from previous studies (usually quasi-experimental or experimental types) into a single quantitative analysis that provides one of the highest levels of evidence about an intervention’s effectiveness Meta-synthesis: systematic compiling and integration of qualitative study results to expand understanding and develop a unique interpretation of study findings in a selected area (focus is on interpretation rather than the combining of study results) Mixed-methods systematic review: synthesizing both quantitative and qualitative studies
20.
20Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Continuum of Research Evidence
21.
21Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Continuum of Research Evidence (Cont’d) Strongest/best research evidence: systematic research reviews and meta-analyses of high- quality experimental studies Weakest evidence: expert opinions or opinions expressed in committee reports Best research evidence generated from systematic reviews, meta-analyses, and integrative reviews is used most often to develop standardized or evidence-based guidelines for practice
22.
22Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Evidence-Based Practice Guidelines Rigorous, explicit clinical guidelines based on the best research evidence available in that area Usually developed by a team or panel of expert researchers; expert clinicians; and sometimes consumers, policymakers, and economists
23.
23Copyright © 2013,
2009, 2005, 2001, 1997 by Saunders, an imprint of Elsevier Inc. Sources for Evidence Based Guidelines National Guideline Clearinghouse (NGC) Cochrane Collaboration and Library The Joanna Briggs Institute Professional nursing organizations
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