1
Q
research
A
Systematic inquiry about phenomena (follows logical steps)
- Logical and rigorous
A phenomena - occurrences, circumstances, or facts, that are perceptible by the senses (eg. experience of pain)
Challenges assumptions
Knowledge development
2
Q
significance of research to practice
A
- Expands the body of scientific knowledge
- Forms the foundation for evidence-informed decision making (EIDM)
- Enables practice to change
- Maintains the profession’s relevance
3
Q
RN Role in Research
A
- consumer of research
- investigator
- Primary – someone leading a study (PhD or master)
- Secondary - someone involved in research but not designing research (helping role) (nurses recruit people for a research study) (collecting data)
- Partner – assisting with different parts of study, involved with carrying out the study
4
Q
ways of knowing
A
personal ethical empirical aesthetic emancipatory
5
Q
personal way of knowing
A
- process of self knowing
- Who you are as a person affects your behaviour, attitudes, and values both positively and negatively
- Reflection on assumptions, beliefs, etc.
- Process of reflection in order to understand how your feelings may affect your nursing care
- Assists in building therapeutic relationships.
- Can build/break relationships
- Assists in minimizing biases that interfere with caring for patients
6
Q
ethical way of knowing
A
- About making judgements: what is good, bad, responsible
- What ought to be done
- Nurses bring to practice their own moral understandings
- Relativism – what is right varies for everyone (its relative to the person)
- Principle of beneficence (to do good) (acting for the benefit of others) (putting their needs above your own)
- Focuses on reflection, discussion, and debate of what is ethical/moral
- Important to clarify values and explore alternatives in order to gain new ethical knowledge and apply it to practice.
7
Q
Aesthetic Knowledge Development
A
- the art of nursing
- Focuses on understanding unique situations and individual differences
- Entails drawing on experiences in health/illness; nursing; drawing from different ways of knowing (personal, ethical)
- Reflects what we know and how we do
- Ask: What does this mean? How is it significant?
- Grasping meaning of an encounter
- Establishing connection
- Performing in moral and appropriate way
- Helps us know how to deal with circumstances that are unique and unpredictable
8
Q
Emancipatory way of knowing
A
- Critical lens to challenge and address social and political contexts to create change.
- Praxis- critical reflection and action used to achieve emancipatory knowledge
- Examining relations of power- dominance of certain ideologies, beliefs, values, or views of the world over other possible viewpoints.
- What are the barriers to equality ?
- What changes need to be made?
- Who benefits?
- What is wrong with this picture?
- Identifies the social and political barriers that prevent health and well-being for all people.
- Assists in addressing injustices and discrimination
9
Q
Empirical way of knowing
A
- The science of nursing
- Knowledge grounded in theory, science (research)
- Expressed as theories, statement of fact, descriptions, interpretations of objects, events
- Through logical reasoning and systematic methods
- Testing hypotheses
- Generating theory
- Describing phenomenon
- Knowledge about abstracted generalities (what we can expect in a certain situation)
- Evidence for practice
10
Q
Evidence Informed Decision Making
A
The incorporation of empirical research, clinical expertise, client preferences, and other available resources to make decisions about patients
11
Q
Evidence Based Practice
A
Evidence based practice (EBP) is the process of collecting, processing, and implementing research findings to improve clinical practice, the work environment, or patient outcomes
12
Q
EIDM Steps
A
1) develop a research question
2) gather evidence
3) appraise studies
4) synthesize study findings
5) adapt to practice
6) implement
7) evaluate
Don’t Go Aiming Shotguns At Idle Emo’s
13
Q
PICOT
A
Population Intervention Comparison Outcome Time
14
Q
Hierarchy of Evidence
A
Highest level
- Resources where evidence is rigorously processed and filtered to ensure its reliability (ie. systematic reviews, meta-analysis, guidelines)
Middle level
- Individual studies such as well conducted randomized controlled trial’s with a similar population of study, as well as observational studies
Lowest level
- Include case reports and expert opinions
15
Q
Assessing Strength of Evidence
A
- quality
Extent to which the study design minimizes bias - quantity
Number of studies that have evaluated the research question, including sample size across studies - consistency
Degree to which studies have similar and different designs yet the same research question and similar findings
16
Q
sources
A
Primary sources
- Studies: theory development or scholarly discussion by original author
- Peer-reviewed
Secondary sources
- Material written by individuals other than the person who conducted study or developed theory
- May be commentary or critique
17
Q
History of Nursing
A
- Nursing has been around forever, but it wasn’t always called nursing (there has always been a need for the care they provide)
- Nurses played a role in caring for the ill since beginning of recorded history.
- Religious orders provided care. (mostly men)
- Prior to 1800’s nurses were classified as any women who cared for ill family members.
- Became less of a religious focus, became more of an untrained, very low prestige, unpaid, volunteer work (not something people aspired to do) (became women’s work)
- During this time nursing was not evidenced based, instead it was influenced by healing traditions within society.
- Did not have a body of knowledge
18
Q
Lady of the Lamp (Florence Nightingale) (1850’s)
A
- Founder of modern day nursing
- From an upper class family, educated, fought against social norms of the time (going into nursing)
- Started working in street hospitals in London
- British Crimean War - more soldiers were dying in the hospitals than the war field
- She discovered the hospital conditions were very unclean (unhygienic), she cleaned it up and attended to the environment
- She collected data on what she was doing to the environment and the outcomes of the patients (show cause and effect that nursing and the environment has an effect on the patient) → evidence based practice
- Improved educational standards
- Started first school of nursing in London
Legacy
- Empirical knowledge
- Educational standards
- Believed nursing was distinct from medicine
19
Q
1900’s-1950’s change in nursing
A
- loss of nightingale ideal
- apprenticeship learning was how you became a nurse
- persistence of nursing ideal-nursing leaders
20
Q
Margaret newman
A
- Health as expanding Consciousness
- Health is about patients finding meaning/connections in their life
- Health of all persons regardless of the presence of absence of disease.
- Understanding of the whole person
21
Q
Jean Watson
A
- Theory of Human Caring
- Caring Consciousness
- Connection of human beings through caring
22
Q
Education in Nursing
A
Crucial to development of nursing research
1918: establishment of university courses
UBC 1919
1950-1960: master’s program
1990 -2000: doctorate
University of Alberta 1991 PhD program
2000: degree entry to practice
1969 - Canadian Journal of Nursing Research
23
Q
why is history important to nursing?
A
Need for nursing leadership
Expand the role and scope of nurses
Encourages critical thinking
Knowing about the history of a profession is important
24
Q
paradigm
A
- A set of beliefs and practices, shared by communities of researchers that guide the knowledge development process
- The way we think/do things
25
framework
Provides a general orientation to understand phenomenon
Structure of concepts and theories
Framework of concepts that make up a phenomenon (social determinants of health)
26
theory
to explain or predict phenomenon
| Set of interrelated concepts
27
concepts
`things we make up to describe phenomenon
28
variables
elements that can be observed
29
research paradigms
post positivist
constructivist
critical social
30
post positivist
There is a common reality and we have to find it
We all experience reality the same
Proves or disproves theories to explain, predict, and control certain outcomes.
Values objectivity
Intense scrutiny of research findings
Usually quantitative research
Researcher is separate from the research (avoid bias)
How effective is tamoxifen in reducing breast cancer risk among women?
31
constructivism
```
Largely dependent on perception
Truth is not absolute
Focuses on observation and interaction
Values subjectivity
Usually qualitative research
We all experience reality differently cause we come from different environments
We construct our reality independently
```
What is the lived experience of women who are being treated for breast cancer?
32
critical social
Power differentials at play and reality is influenced by power
Historical perspective
Health is shaped by social, political, economical, and cultural factors
Understanding power imbalances
Can be qualitative and quantitative research
How does access to cancer treatment vary by racial/ethnic groups? Why? How do we do something about this?
33
ontology
the science or study of "reality/being"
| what can be said to exist?
34
epistemology
Addresses the issue of "truth"
what is knowledge?
How do we know what we know?
35
deductive reasoning
Start with a general picture and move to specific
Generalizations to specific conclusions
Starts with a structure that guides searching for what is there
Quantitative
Theory → hypothesis → data/observation → analysis → repeat
36
inductive reasoning
Start with specific and move to a general picture
Figuring out what is there
Specific observations to reach a general conclusion
Based on what is observed
Qualitative
37
methodology
study design
overarching approach to the study
qualitative, quantitative, experimental, RCT
38
methods
how the study is done
| eg. how the researcher recruited people, how they split up people into groups, how data was analyzed
39
qualitative research
- Used to explore personal meanings and context of an experience, culture, human patterns, and processes
- Data usually consist of words or text
- Conducted in the natural setting (where the phenomena is happening, not in a lab)
40
Quantitative research
- Test relationships, assess differences, and try to explain cause-and-effect interactions among the variables being studied
- Data is numerical
- Statistics are used
41
ethics
discipline dealing with the principles of moral values and moral conduct
42
Nuremberg Code
- Consent must be voluntary
- Results should be for the good of society
- Study should be based on an animal study that will predict the outcomes
- Risk be less than humanitarian importance of the study
- Study should only be conducted by qualified people
- Informed consent
- Experiment should avoid harm, injury, suffering
- Terminate if intervention showing harm
- Participant may discontinue study at any time
43
basic ethics principles
- respect for persons
- beneficence
- justice
44
protection of human rights
Right to:
- self determination (autonomy)
- privacy and dignity
- anonymity and confidentiality
- fair treatment
- protection from discomfort and harm (beneficence)
45
national regulation and policy (ethics)
- Canadian Nurses Association Code of Ethics – Nurses must uphold human rights and report violations
- Health Canada—Good Clinical Practice: Consolidated Guidelines, 1997
- Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans(CIHR, SSERC, NSERC) TCPS2
46
informed consent
- Information of potential benefits and risks of study
- Consent must be given without manipulation, undue influence, or coercion
- Ongoing process of communication and mutual understanding
47
Research Ethics Boards (REB's)
Review research and assess that ethical standards are met
1) At least five expert members of various backgrounds
2) One non-scientific member
3) One member from outside the institution
4) Members have mandatory training
5) Responsible for protecting subjects from undue risk and loss of personal rights and dignity
48
REB Approval Criteria
```
Risks minimized
Risks balanced by benefits
Subject selection equitable
Procedures for obtaining informed consent
Procedures for consent documentation
Data monitoring provisions
Privacy and confidentiality measures
Safeguards for vulnerable subjects
```
49
ethics: vulnerable persons
```
Children
Prisoners
Mentally disabled persons
Economically disadvantaged
Educationally disadvantaged
Subtle vulnerability: language, culture, pregnancy, students, employees, substance abuse, health status
```
50
scientific fraud and misconduct
fraudulent studies
- falsified data
- coerced participants
misconduct and unauthorized studies
- product testing (testing medical devices)
nurses are obligated to report if they witness
51
types of research reports
- presentations at professional conferences (oral, posters)
- journal articles (peer reviewed)
- technical reports (WHO)
52
types of journal articles
- research studies
- reviews
- conceptual/theory articles
- summary articles
53
content of a research article
IMRAD
```
Abstract
Introduction
Method
Results
Discussion
```
54
qualitative
```
Identification of the phenomenon
Purpose of research study question
Literature review
Design
Sample
Legal–ethical issues
Data-collection procedure
Data analysis
Results/findings
Discussion and recommendation
References
```
55
quantitative
```
Research problem
Purpose
Literature review
Theoretical framework, conceptual framework or both
Hypothesis/research questions
Research design
Sample: type and size (always bigger sample size than qualitative)
Legal–ethical issues
Instruments (measurement tools)
Validity and reliability (objectivity) (post positivist)
Data-collection procedure
Data analysis
Results
Discussion of findings and new findings
Implications, limitations, and recommendations
References
```
56
abstract
- Short comprehensive synopsis
- Summary of what the article is about
- Objective, background, methods, results and conclusion
- 100 to 300 words
57
introduction
- Background picture
- Context of situation
- Definitions of terms
58
purpose
- At end of introduction or framework or literature review
- Before the methods
- The objective/aim of this article is to present the estimation of the intervention effects on breast milk production outcomes
59
Literature Review
- Theoretical framework and/or review of the literature
- Current knowledge/literature on a topic
- Tells what is known
- Tells what is not known
- Argues for why study is needed
60
research question
```
Depends on methodology/method
- Depends on the paradigm
Sometimes embedded
- Not always explicitly stated
Important as the study answers or addresses this question
May include a hypothesis
- Only quantitative
```
61
Method: Research Design
Quantitative
- Research question is quantitative
- Test, compare, effect, associated
- Hypotheses stated or implied
- Control of treatment group
- Random or convenience sample
- Reliability or validity of instruments used to measure
- Statistical analysis used
Qualitative
- Research question is qualitative
- Experience, perception, views
- No numbers – text/words, photos, diagrams
- Qualitative terms used
- Informants, participants
- Lived experience, perceptions
62
Method: Sampling
Population of interest
Found under
- Methods, methodology
- Subjects, participants, sample (subset of the population)
Who are the participants and how were they selected?
Smaller sample size for qualitative
63
Method: procedures/data collection
Qualitative
- Interviews, observations, focus groups, document reviews
Quantitative
- Measurements (scales, instruments, tools)
64
Method: Data Analysis Results/Findings
```
Data analysis procedures
- Statistical tests used
- How researchers came to findings
Results/findings
- Tables, statistics
- Text, themes, direct quotations from participants
```
65
Discussion
- Findings compared to existing literature
- Interpretations of results (why they found what they found)
- Recommendations
- Implications
- Limitations
66
Critical Reading Process
```
Preliminary understanding
- Skim abstract and article; highlight/underline; review unfamiliar terms
Comprehensive understanding
- Understand main points of each section; understand terms
Analysis understanding
- Understand parts, critique soundness
Synthesis understanding
- Put together and make sense
```
67
critiquing a research study
```
Is it a study?
Read 3 to 4 times!!!
Identify steps of the research process (how study was conducted)
Clarify terms and concepts
Question assumptions and rationale
Assess study for validity
Use a table
```
68
Assessing strength of a study
Quality
- Extent to which a study’s design minimizes bias
Quantity
- Number of studies that have evaluated the research question, including sample size across studies
Consistency
- Degree to which studies have similar and different designs yet the same research question and similar findings
Nurs 1351
flashcards
Decks in class (3)
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