NURS 3150 Assignments – Foundations Nursing Research Papers
NURS 3150 Assignments – Foundations Nursing Research Papers
Nurses must understand research in order to effectively participate in the provision of evidence-based nursing care. Students in this course learn the foundational elements of the research process, refine information-literacy skills, and develop an understanding of ethical research. Students investigate each step of the research process and complete a critical examination of quantitative and qualitative research relevant to their nursing practice. Students are given the tools to analyze nurse-sensitive indicators and clinical practice guidelines.
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NURS 3151 Foundations of Nursing Research Course Readings
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Baum, E., Rosenbaum, P., Wilkins, S., Stratford, P. & Mahlberg, N. (2015). Exploring client-centered care experiences in in-patient rehabilitation settings. Global Qualitative Nursing Research, 2, 1-11.
Cook, C.A.L., Guerrerio, J.F. & Slater, V.E. (2004). Healing touch and quality of life in women receiving radiation treatment for cancer: a randomized controlled trial. Alternative Therapies in Health and Medicine, 10(3), 34-41.
Labrague, L. & McEnroe-Petitte, D. (2016). Influence of music on preoperative anxiety and physiological parameters in women undergoing gynecologic surgery. Clinical Nursing Research, 25(2), 157-173.Nurs 3150 Foundations Nursing Research Assignment Papers.
Martinez, K., Battaglia, R., Start, R., Mastal, M.F., & Matlock, A.M. (2015). Nursing sensitive indicators in ambulatory care. Nursing Economics, 33(1), 59-64.
Sand-Jecklin, K., & Sherman, J. (2014). A quantitative assessment of patient and nursing outcomes of bedside nursing report implementation. Journal of Clinical Nursing, 23(19/20), 2854–2863.
Sarvestani, R., Moattari, M., Nasrabadi, A., Momennasab, M., & Yektatalab, S. (2015). Challenges of nursing handover: A qualitative study. Clinical Nursing Research, 24(3), 234-252.
Steelman, V., Graling, P. & Perkhounkova, Y. (2013). Priority patient safety issues identified by perioperative nurses. AORN Journal, 97(4), 402-418.Nurs 3150 Foundations Nursing Research Assignment Papers.
Stiffler, D., Cullen, D. & Luna, G. (2014). Diabetes barriers and self-care management: The patient perspective. Clinical Nursing Research, 23(6), 601-626.
Walsh, A., Meagher-Stewart, D. & Macdonald, M. (2015). Persistent optimizing: How mothers make food choices for their preschool children. Qualitative Health Research, 25(4), 527-539.
NURS 3151 Foundations of Nursing Research Study Guides & Discussion Essay Assignment Papers
Track I (student has RN license and associate’s degree or diploma in nursing)
Foundations Course
NURS 3151 – Foundations of Nursing Research
Foundational Coursework
NURS 3151 – Foundations of Nursing Research
NURS 4006 – Topics in Clinical Nursing
NURS 4211 – Role of the Nurse Leader in Population Health
NURS 4221 – Leadership Competencies in Nursing and Healthcare
Core Courses
NURS 6050 – Policy and Advocacy for Improving Population Health
NURS 6051 – Transforming Nursing and Healthcare Through Technology
NURS 6052 – Essentials of Evidence-Based Practice
NURS 6053 – Interprofessional Organizational and Systems Leadership
Specialization Course. NURS 3151 Foundations of Nursing Research Study Guides & Discussion Essay Assignment Papers.
NURS 6630 – Psychopharmacologic Approaches to Treatment of Psychopathology
Field Experience Courses
NURS 6640 – Psychotherapy With Individuals
NURS 6650 – Psychotherapy With Groups and Families
NURS 6660 – Psychiatric Mental Health Nurse Practitioner Role I: Child and Adolescent
NURS 6670 – Psychiatric Mental Health Nurse Practitioner Role II: Adults and Older Adults
NURS 3151 Foundations of Nursing Research Study Guides & Discussion Essay Assignment Papers
Nurses must understand research in order to effectively participate in the provision of evidence-based nursing care. Students in this course learn the foundational elements of the research process, refine information literacy skills, and develop an understanding of ethical research. Students investigate each step of the research process and complete a critical examination of quantitative and qualitative research relevant to their nursing practice. Students are given the tools to analyze nurse-sensitive indicators and clinical practice guidelines.Nurs 3150 Foundations Nursing Research Assignment Papers.
Nurses must understand research in order to effectively participate in the provision of evidence-based nursing care. Students in this course learn the foundational elements of the research process, refine information literacy skills, and develop an understanding of ethical research. Students investigate each step of the research process and complete a critical examination of quantitative and qualitative research relevant to their nursing practice. Students are given the tools to analyze nurse-sensitive indicators and clinical practice guidelines. NURS 3150 Assignments – Foundations Nursing Research Papers
NURS 3150 Foundations of Nursing Research Study Guides & Discussion Essay Assignment Papers
NURS 3150 Foundations of Nursing Research Course Readings
After clicking on a citation below, enter your myWalden user name and password at the prompt.
Please Ask a Librarian if you have any questions about the links.
Baum, E., Rosenbaum, P., Wilkins, S., Stratford, P. & Mahlberg, N. (2015). Exploring client-centered care experiences in in-patient rehabilitation settings. Global Qualitative Nursing Research, 2, 1-11.
Cook, C.A.L., Guerrerio, J.F. & Slater, V.E. (2004). Healing touch and quality of life in women receiving radiation treatment for cancer: a randomized controlled trial. Alternative Therapies in Health and Medicine, 10(3), 34-41.Nurs 3150 Foundations Nursing Research Assignment Papers.
Labrague, L. & McEnroe-Petitte, D. (2016). Influence of music on preoperative anxiety and physiological parameters in women undergoing gynecologic surgery. Clinical Nursing Research, 25(2), 157-173.
Martinez, K., Battaglia, R., Start, R., Mastal, M.F., & Matlock, A.M. (2015). Nursing sensitive indicators in ambulatory care. Nursing Economics, 33(1), 59-64.
Sand-Jecklin, K., & Sherman, J. (2014). A quantitative assessment of patient and nursing outcomes of bedside nursing report implementation. Journal of Clinical Nursing, 23(19/20), 2854–2863.Nurs 3150 Foundations Nursing Research Assignment Papers.
Sarvestani, R., Moattari, M., Nasrabadi, A., Momennasab, M., & Yektatalab, S. (2015). Challenges of nursing handover: A qualitative study. Clinical Nursing Research, 24(3), 234-252.
Steelman, V., Graling, P. & Perkhounkova, Y. (2013). Priority patient safety issues identified by perioperative nurses. AORN Journal, 97(4), 402-418.
Stiffler, D., Cullen, D. & Luna, G. (2014). Diabetes barriers and self-care management: The patient perspective. Clinical Nursing Research, 23(6), 601-626.
Walsh, A., Meagher-Stewart, D. & Macdonald, M. (2015). Persistent optimizing: How mothers make food choices for their preschool children. Qualitative Health Research, 25(4), 527-539.
It is an exciting—and challenging—time to be a nurse. Nurses are managing their clinical responsibilities at a time when the nursing profession and the larger health care system require an extraordinary range of skills and talents of them. Nurses are expected to deliver the highest possible quality of care in a compassionate manner, while also being mindful of costs. To accomplish these diverse (and
sometimes conflicting) goals, nurses must access and evaluate extensive clinical information, and
incorporate it into their clinical decision-making. In today’s world, nurses must become lifelong learners,
capable of reflecting on, evaluating, and modifying their clinical practice based on new knowledge. And,
nurses are increasingly expected to become producers of new knowledge through nursing research.
What Is Nursing Research? NURS 3150 Assignments – Foundations Nursing Research Papers
Research is systematic inquiry that uses disciplined methods to answer questions or solve problems.
The ultimate goal of research is to develop, refine, and expand a body of knowledge.
Nurses are increasingly engaged in disciplined studies that benefit the profession and its patients,
Introduction to Nursing Research and that contribute to improvements in the entire health care system. Nursing research is systematic inquiry designed to develop knowledge about issues of importance to the nursing profession, including nursing practice, education, administration, and informatics. In this book, we emphasize clinical nursing research, that is, research designed to generate knowledge to guide nursing practice and to improve the health and quality of life of nurses’ clients.
Nursing research has experienced remarkable
growth in the past three decades, providing nurses
with an increasingly sound base of knowledge from
which to practice. Yet as we proceed into the 21st
century, many questions endure and much remains
to be done to incorporate research-based knowledge into nursing practice.
Examples of nursing research
questions:
• What are the factors that determine the length
of stay of patients in the intensive care unit
undergoing coronary artery bypass graft
surgery (Doering, Esmailian, Imperial-Perez,
& Monsein, 2001)?
• How do adults with acquired brain injury perceive their social interactions and relationships
(Paterson & Stewart, 2002)?
The Importance of Research
in Nursing
Nurses increasingly are expected to adopt an
evidence-based practice (EBP), which is broadly
defined as the use of the best clinical evidence in
making patient care decisions. Although there is
not a consensus about what types of “evidence”
are appropriate for EBP (Goode, 2000), there is
general agreement that research findings from
rigorous studies constitute the best type of evidence for informing nurses’ decisions, actions,
and interactions with clients. Nurses are accepting the need to base specific nursing actions and
decisions on evidence indicating that the actions
are clinically appropriate, cost-effective, and
result in positive outcomes for clients. Nurses
who incorporate high-quality research evidence
into their clinical decisions and advice are being
professionally accountable to their clients. They
are also reinforcing the identity of nursing as a
profession.Nurs 3150 Foundations Nursing Research Assignment Papers.
Another reason for nurses to engage in and
use research involves the spiraling costs of health
care and the cost-containment practices being
instituted in health care facilities. Now, more than
ever, nurses need to document the social relevance
and effectiveness of their practice, not only to the
profession but to nursing care consumers, health
care administrators, third-party payers (e.g., insurance companies), and government agencies. Some
research findings will help eliminate nursing
actions that do not achieve desired outcomes.
Other findings will help nurses identify practices
that improve health care outcomes and contain
Nursing research is essential if nurses are to
understand the varied dimensions of their profession. Research enables nurses to describe the characteristics of a particular nursing situation about
which little is known; to explain phenomena that
must be considered in planning nursing care; to
predict the probable outcomes of certain nursing
decisions; to control the occurrence of undesired
outcomes; and to initiate activities to promote
desired client behavior. NURS 3150 Assignments – Foundations Nursing Research Papers
Example of an EBP project:
• The Association of Women’s Health, Obstetric,
and Neonatal Nurses (AWHONN) is one
nursing organization that has demonstrated a
strong commitment to evidence-based nursing
practice. For example, AWHONN undertook a
project that developed and tested an evidencebased protocol for urinary incontinence in
women, and then designed procedures to
facilitate the protocol’s implementation into
clinical practice (Samselle et al., 2000a, 2000b).
More recently, AWHONN and the National
Association of Neonatal Nurses designed and
tested an evidence-based protocol for neonatal
skin care, and also instituted procedures for
implementing it (Lund, Kuller, Lane, Lott,
Raines, & Thomas, 2001; Lund, Osborne,
Kuller, Lane, Lott, & Raines, 2001).
The Consumer–Producer Continuum
in Nursing Research
With the current emphasis on EBP, it has become
every nurse’s responsibility to engage in one or more
roles along a continuum of research participation. At
one end of the continuum are those nurses whose
involvement in r
publication, Notes on Nursing (1859), describes her
early interest in environmental factors that promote
physical and emotional well-being—an interest that
continues among nurses nearly 150 years later.
Nightingale’s most widely known research contribution involved her data collection and analysis
relating to factors affecting soldier mortality and
morbidity during the Crimean War. Based on her
skillful analyses and presentations, she was successful in effecting some changes in nursing care—
and, more generally, in public health.
For many years after Nightingale’s work, the
nursing literature contained little research. Some
attribute this absence to the apprenticeship nature of
nursing. The pattern of nursing research that eventually emerged at the turn of the century was closely
aligned to the problems confronting nurses. Most
studies conducted between 1900 and 1940 concerned nurses’ education. For example, in 1923, a
group called the Committee for the Study of
Nursing Education studied the educational preparation of nurse teachers, administrators, and public
health nurses and the clinical experiences of nursing
students. The committee issued what has become
known as the Goldmark Report, which identified
many inadequacies in the educational backgrounds
of the groups studied and concluded that advanced
educational preparation was essential. As more
nurses received university-based education, studies
concerning nursing students—their differential
characteristics, problems, and satisfactions—
became more numerous. NURS 3150 Assignments – Foundations Nursing Research Papers
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During the 1940s, studies concerning nursing education continued, spurred on by the unprecedented demand for nursing personnel that resulted from World War II. For example, Brown (1948) reassessed nursing education in a study initiated at the request of the National Nursing Council for War
Service. The findings from the study, like those of the Goldmark Report, revealed numerous inadequacies in nursing education. Brown recommended that the education of nurses occur in collegiate settings.
Many subsequent research investigations concerning the functions performed by nurses, nurses’ roles and attitudes, hospital environments, and nurse—patient interactions stemmed from the Brown report.
tiveness and enhancing their professional lives. NURS 3150 Assignments – Foundations Nursing Research Papers
These activities include the following:
• Participating in a journal club in a practice setting, which involves regular meetings among
nurses to discuss and critique research articles
• Attending research presentations at professional
conferences
• Discussing the implications and relevance of
research findings with clients
• Giving clients information and advice about
participation in studies
• Assisting in the collection of research information (e.g., distributing questionnaires to patients)
• Reviewing a proposed research plan with
respect to its feasibility in a clinical setting and
offering clinical expertise to improve the plan
• Collaborating in the development of an idea for
a clinical research project
• Participating on an institutional committee that
reviews the ethical aspects of proposed research
before it is undertaken
• Evaluating completed research for its possible
use in practice, and using it when appropriate
In all these activities, nurses with some
research skills are in a better position than those
without them to make a contribution to nursing
knowledge. An understanding of nursing research
can improve the depth and breadth of every nurse’s
professional practice.
NURSING RESEARCH:
PAST, PRESENT, AND
FUTURE
Although nursing research has not always had the
prominence and importance it enjoys today, its long
and interesting history portends a distinguished
future. Table 1-1 summarizes some of the key events
in the historical evolution of nursing research.
The Early Years: From Nightingale to
the 1950s
Most people would agree that research in nursing
began with Florence Nightingale. Her landmark
CHAPTER 1 Introduction to Nursing Research ■ 5
6
YEAR EVENT
1859 Nightingale’s Notes on Nursing published
1900 American Nursing Journal begins publication
1923 Columbia University establishes first doctoral program for nurses
Goldmark Report with recommendations for nursing education published
1930s American Journal of Nursing publishes clinical cases studies
1948 Brown publishes report on inadequacies of nursing education
1952 The journal Nursing Research begins publication
1955 Inception of the American Nurses’ Foundation to sponsor nursing research
1957 Establishment of nursing research center at Walter Reed Army Institute of Research
1963 International Journal of Nursing Studies begins publication
1965 American Nurses’ Association (ANA) begins sponsoring nursing research conferences
1966 Nursing history archive established at Mugar Library, Boston University
1968 Canadian Journal of Nursing Research begins publication
1971 ANA establishes a Commission on Research
1972 ANA establishes its Council of Nurse Researchers
1976 Stetler and Marram publish guidelines on assessing research for use in practice
1978 The journals Research in Nursing & Health and Advances in Nursing Science begin publication
1979 Western Journal of Nursing Research begins publication
1982 The Conduct and Utilization of Research in Nursing (CURN) project publishes report
1983 Annual Review of Nursing Research begins publication
1985 ANA Cabinet on Nursing Research establishes research priorities
1986 National Center for Nursing Research (NCNR) established within U.S. National Institutes of Health
1987 The journal Scholarly Inquiry for Nursing Practice begins publication
1988 The journals Applied Nursing Research and Nursing Science Quarterly begin publication
Conference on Research Priorities (CORP #1) in convened by NCNR
1989 U.S. Agency for Health Care Policy and Research (AHCPR) is established
1992 The journal Clinical Nursing Research begins publication
1993 NCNR becomes a full institute, the National Institute of Nursing Research (NINR)
CORP #2 is convened to establish priorities for 1995–1999
The Cochrane Collaboration is established
The journal Journal of Nursing Measurement begins publication
1994 The journal Qualitative Health Research begins publication
1997 Canadian Health Services Research Foundation is established with federal funding
1999 AHCPR is renamed Agency for Healthcare Research and Quality (AHRQ)
2000 NINR issues funding priorities for 2000–2004; annual funding exceeds $100 million
The Canadian Institute of Health Research is launched
The journal Biological Research for Nursing begins publication
TABLE 1.1 Historical Landmarks Affecting Nursing Research
for the educational preparation of nurses and,
increasingly, for nursing research.
Nursing research began to advance worldwide
in the 1960s. The International Journal of Nursing
Studies began publication in 1963, and the
Canadian Journal of Nursing Research was first
published in 1968.Nurs 3150 Foundations Nursing Research Assignment Papers.
Example of nursing research breakthroughs in the 1960s:
• Jeanne Quint Benoliel began a program of
research that had a major impact on medicine,
medical sociology, and nursing. Quint explored
the subjective experiences of patients after diagnosis with a life-threatening illness (1967). Of
particular note, physicians in the early 1960s
usually did not advise women that they had
breast cancer, even after a mastectomy. Quint’s
(1962, 1963) seminal study of the personal
experiences of women after radical mastectomy
contributed to changes in communication and
information control by physicians and nurses.
Nursing Research in the 1970s
By the 1970s, the growing number of nurses conducting research studies and the discussions of theoretical and contextual issues surrounding nursing
research created the need for additional communication outlets. Several additional journals that focus
on nursing research were established in the 1970s,
including Advances in Nursing Science, Research in
Nursing & Health, the Western Journal of Nursing
Research, and the Journal of Advanced Nursing.
In the 1970s, there was a decided change in
emphasis in nursing research from areas such as
teaching, curriculum, and nurses themselves to the
improvement of client care—signifying a growing
awareness by nurses of the need for a scientific base
from which to practice. Nursing leaders strongly
endorsed this direction for nursing studies.
Lindeman (1975), for example, conducted a study to
ascertain the views of nursing leaders concerning the
focus of nursing studies; clinical problems were
identified as the highest priorities. Nurses also began
to pay attention to the utilization of research findings
A number of forces combined during the 1950s
to put nursing research on a rapidly accelerating
upswing. An increase in the number of nurses with
advanced educational degrees, the establishment of
a nursing research center at the Walter Reed Army
Institute of Research, an increase in the availability
of funds from the government and private foundations, and the inception of the American Nurses’
Foundation—which is devoted exclusively to the
promotion of nursing research—were forces providing impetus to nursing research during this period.
Until the 1950s, nurse researchers had few
outlets for reporting their studies to the nursing
community. The American Journal of Nursing, first
published in 1900, began on a limited basis to
publish some studies in the 1930s. The increasing
number of studies being conducted during the
1950s, however, created the need for a journal in
which findings could be published; thus, Nursing
Research came into being in 1952.
Nursing research took a twist in the 1950s not
experienced by research in other professions, at
least not to the same extent as in nursing. Nurses
studied themselves: Who is the nurse? What does
the nurse do? Why do individuals choose to enter
nursing? What are the characteristics of the ideal
nurse? How do other groups perceive the nurse?
Nursing Research in the 1960s
Knowledge development through research in nursing began in earnest only about 40 years ago, in the
1960s. Nursing leaders began to express concern
about the lack of research in nursing practice.
Several professional nursing organizations, such as
the Western Interstate Council for Higher Education
in Nursing, established priorities for research investigations during this period. Practice-oriented
research on various clinical topics began to emerge
in the literature.
The 1960s was the period during which terms
such as conceptual framework, conceptual model,
nursing process, and theoretical base of nursing
practice began to appear in the literature and to
influence views about the role of theory in nursing
research. Funding continued to be available both
CHAPTER 1 Introduction to Nursing Research ■ 7
in nursing practice. A seminal article by Stetler and
Marram (1976) offered guidance on assessing
research for application in practice settings.
In the United States, research skills among
nurses continued to improve in the 1970s. The
cadre of nurses with earned doctorates steadily
increased, especially during the later 1970s. The
availability of both predoctoral and postdoctoral
research fellowships facilitated the development of
advanced research skills.
Example of nursing research breakthroughs in the 1970s:
• Kathryn Barnard’s research led to breakthroughs in the area of neonatal and young child
development. Her research program focused on
the identification and assessment of children at
risk of developmental and health problems,
such as abused and neglected children and
failure-to-thrive children (Barnard, 1973, 1976;
Barnard & Collar, 1973; Barnard, Wenner,
Weber, Gray, & Peterson, 1977). Her research
contributed to work on early interventions for
children with disabilities, and also to the field of
developmental psychology.
Nursing Research in the 1980s
The 1980s brought nursing research to a new level of
development. An increase in the number of qualified
nurse researchers, the widespread availability of
computers for the collection and analysis of information, and an ever-growing recognition that research is
an integral part of professional nursing led nursing
leaders to raise new issues and concerns. More attention was paid to the types of questions being asked,
the methods of collecting and analyzing information
being used, the linking of research to theory, and the
utilization of research findings in practice.
Several events provided impetus for nursing
research in this decade. For example, the first
volume of the Annual Review of Nursing Research
was published in 1983. These annual reviews
include summaries of current research knowledge
on selected areas of research practice and encourage
utilization of research findings.
Of particular importance in the United States
was the establishment in 1986 of the National
Center for Nursing Research (NCNR) at the
National Institutes of Health (NIH) by congressional mandate, despite a presidential veto that was
overridden largely as a result of nurse-scientists’
successful lobbying efforts. The purpose of NCNR
was to promote—and financially support—
research training and research projects relating to
patient care. In addition, the Center for Research
for Nursing was created in 1983 by the American
Nurses’ Association. The Center’s mission is to
develop and coordinate a research program to serve
as the source of national information for the profession. Meanwhile, funding for nursing research
became available in Canada in the 1980s through the
National Health Research Development Program
(NHRDP).
Several nursing groups developed priorities for
nursing research during the 1980s. For example, in
1985, the American Nurses’ Association Cabinet
on Nursing Research established priorities that
helped focus research more precisely on aspects of
nursing practice. Also in the 1980s, nurses began to
conduct formal projects designed to increase
research utilization. Finally, specialty journals such
as Heart & Lung and Cancer Nursing began to
expand their coverage of research reports, and several new research-related journals were established: Applied Nursing Research, Scholarly
Inquiry for Nursing Practice, and Nursing Science
Quarterly. The journal Applied Nursing Research
is notable for its intended audience: it includes
research reports on studies of special relevance to
practicing nurses.
Several forces outside of the nursing profession in the late 1980s helped to shape today’s nursing research landscape. A group from the
McMaster Medical School in Canada designed a
clinical learning strategy that was called evidencebased medicine (EBM). EBM, which promulgated
the view that scientific research findings were far
superior to the opinions of authorities as a basis for
clinical decisions, constituted a profound shift for
medical education and practice, and has had a
major effect on all health care professions.
8 ■ PART 1 Foundations of Nursing Research
the Canadian Health Services Research Foundation
was established in 1997 with an endowment from
federal funds, and plans for the Canadian Institute
for Health Research were underway.
Several research journals were established
during the 1990s, including Qualitative Health
Research, Clinical Nursing Research, Clinical
Effectiveness, and Outcomes Management for
Nursing Practice. These journals emerged in
response to the growth in clinically oriented and indepth research among nurses, and interest in EBP.
Another major contribution to EBP was inaugurated
in 1993: the Cochrane Collaboration, an international network of institutions and individuals,
maintains and updates systematic reviews of hundreds of clinical interventions to facilitate EBP.Nurs 3150 Foundations Nursing Research Assignment Papers.
Some current nursing research is guided by priorities established by prominent nurse researchers
in the 1990s, who were brought together by NCNR
for two Conferences on Research Priorities
(CORP). The priorities established by the first
CORP for research through 1994 included low birth
weight, human immunodeficiency virus (HIV)
infection, long-term care, symptom management,
nursing informatics, health promotion, and technology dependence.
In 1993, the second CORP established the
following research emphases for a portion of
NINR’s funding from 1995 through 1999: developing and testing community-based nursing models;
assessing the effectiveness of nursing interventions
in HIV/AIDS; developing and testing approaches to
remediating cognitive impairment; testing interventions for coping with chronic illness; and identifying
biobehavioral factors and testing interventions to
promote immunocompetence.
Example of nursing research breakthroughs in the 1990s:
• Many studies that Donaldson (2000) identified
as breakthroughs in nursing research were conducted in the 1990s. This reflects, in part, the
growth of research programs in which teams of
researchers engage in a series of related research
on important topics, rather than discrete and
unconnected studies. As but one example,
In 1989, the U.S. government established the
Agency for Health Care Policy and Research
(AHCPR). AHCPR (which was renamed the Agency
for Healthcare Research and Quality, or AHRQ, in
1999) is the federal agency that has been charged
with supporting research specifically designed to
improve the quality of health care, reduce health
costs, and enhance patient safety, and thus plays a
pivotal role in the promulgation of EBP.
Example of nursing research breakthroughs in the 1980s:
• A team of researchers headed by Dorothy
Brooten engaged in studies that led to the development and testing of a model of site transitional
care. Brooten and her colleagues (1986, 1988,
1989), for example, conducted studies of nurse
specialist–managed home follow-up services
for very-low-birth-weight infants who were discharged early from the hospital, and later
expanded to other high-risk patients (1994). The
site transitional care model, which was developed in anticipation of government cost-cutting
measures of the 1980s, has been used as a
framework for patients who are at health risk as
a result of early discharge from hospitals, and
has been recognized by numerous health care
disciplines. NURS 3150 Assignments – Foundations Nursing Research Papers
Nursing Research in the 1990s
Nursing science came into its maturity during the
1990s. As but one example, nursing research was
strengthened and given more national visibility in
the United States when NCNR was promoted to full
institute status within the NIH: in 1993, the
National Institute of Nursing Research (NINR)
was born. The birth of NINR helps put nursing
research more into the mainstream of research
activities enjoyed by other health disciplines.
Funding for nursing research has also grown. In
1986, the NCNR had a budget of $16.2 million,
whereas 16 years later in fiscal year 2002, the budget for NINR was over $120 million. Funding
opportunities for nursing research expanded in other
countries as well during the 1990s. For example,
CHAPTER 1 Introduction to Nursing Research ■ 9
several nurse researchers had breakthroughs
during the 1990s in the area of psychoneuroimmunology, which has been adopted as the model
of mind—body interactions. Barbara Swanson
and Janice Zeller, for example, conducted several
studies relating to HIV infection and neuropsychological function (Swanson, Cronin-Stubbs,
Zeller, Kessler, & Bielauskas, 1993; Swanson,
Zeller, & Spear, 1998) that have led to discoveries
in environmental management as a means of
improving immune system status. NURS 3150 Assignments – Foundations Nursing Research Papers
Future Directions for Nursing Research
Nursing research continues to develop at a rapid
pace and will undoubtedly flourish in the 21st century. Broadly speaking, the priority for nursing
research in the future will be the promotion of
excellence in nursing science. Toward this end,
nurse researchers and practicing nurses will be
sharpening their research skills, and using those
skills to address emerging issues of importance to
the profession and its clientele.
Certain trends for the beginning of the 21st
century are evident from developments taking
shape in the 1990s:
• Increased focus on outcomes research.
Outcomes research is designed to assess and
document the effectiveness of health care services. The increasing number of studies that can
be characterized as outcomes research has been
stimulated by the need for cost-effective care
that achieves positive outcomes without compromising quality. Nurses are increasingly
engaging in outcomes research focused both on
patients and on the overall delivery system.
• Increased focus on biophysiologic research.
Nurse researchers have begun increasingly to
study biologic and physiologic phenomena as
part of the effort to develop better clinical evidence. Consistent with this trend, a new journal
called Biological Research for Nursing was
launched in 2000. NURS 3150 Assignments – Foundations Nursing Research Papers
• Promotion of evidence-based practice.
Concerted efforts to translate research findings
into practice will continue and nurses at all
levels will be encouraged to engage in evidencebased patient care. In turn, improvements will
be needed both in the quality of nursing studies
and in nurses’ skills in understanding, critiquing,
and using study results.
• Development of a stronger knowledge base
through multiple, confirmatory strategies.
Practicing nurses cannot be expected to change
a procedure or adopt an innovation on the basis
of a single, isolated study. Confirmation is usually needed through the deliberate replication
(i.e., the repeating) of studies with different
clients, in different clinical settings, and at different times to ensure that the findings are
robust. Replication in different settings is especially important now because the primary setting for health care delivery is shifting from
inpatient hospitals to ambulatory settings, the
community, and homes. Another confirmatory
strategy is the conduct of multiple-site investigations by researchers in several locations.
CLICK HERE TO ORDER YOUR NURS 3150 ASSIGNMENTS
• Strengthening of multidisciplinary collaboration. Interdisciplinary collaboration of nurses
with researchers in related fields (as well as
intradisciplinary collaboration among nurse
researchers) is likely to continue to expand in
the 21st century as researchers address fundamental problems at the biobehavioral and psychobiologic interface. As one example, there are
likely to be vast opportunities for nurses and
other health care researchers to integrate breakthroughs in human genetics into lifestyle and
health care interventions. In turn, such collaborative efforts could lead to nurse researchers
playing a more prominent role in national and
international health care policies.
• Expanded dissemination of research findings. The
Internet and other electronic communication have
a big impact on the dissemination of research
information, which in turn may help to promote
EBP. Through such technological advances as online publishing (e.g., the Online Journal of
Knowledge Synthesis for Nursing, the Online Journal of Clinical Innovation); on-line resources
such as Lippincott’s NursingCenter.com; elec10
NURS 3150 Assignments – Foundations Nursing Research Papers
■ PART 1 Foundations of Nursing Research
• Responding to compelling public health concerns (e.g., reducing health disparities in cancer
screening; end-of-life/palliative care). NURS 3150 Assignments – Foundations Nursing Research Papers
SOURCES OF EVIDENCE
FOR NURSING PRACTICE
Nursing students are taught how best to practice
nursing, and best-practice learning continues
throughout nurses’ careers. Some of what students
and nurses learn is based on systematic research,
but much of it is not. In fact, Millenson (1997) estimated that 85% of health care practice has not been
scientifically validated.
Clinical nursing practice relies on a collage of
information sources that vary in dependability and
validity. Increasingly there are discussions of evidence hierarchies that acknowledge that certain
types of evidence and knowledge are superior to
others. A brief discussion of some alternative
sources of evidence shows how research-based
information is different. NURS 3150 Assignments – Foundations Nursing Research Papers
Tradition
Many questions are answered and problems solved
based on inherited customs or tradition. Within
each culture, certain “truths” are accepted as given.
For example, as citizens of democratic societies,
most of us accept, without proof, that democracy is
the highest form of government. This type of
knowledge often is so much a part of our heritage
that few of us seek verification.
Tradition offers some advantages. It is efficient
as an information source: each individual is not
required to begin anew in an attempt to understand
the world or certain aspects of it. Tradition or custom
also facilitates communication by providing a common foundation of accepted truth. Nevertheless, tradition poses some problems because many traditions
have never been evaluated for their validity. Indeed,
by their nature, traditions may interfere with the
ability to perceive alternatives. Walker’s (1967)
research on ritualistic practices in nursing suggests
that some traditional nursing practices, such as the
routine taking of a patient’s temperature, pulse, and
tronic document retrieval and delivery;
e-mail; and electronic mailing lists, information
about innovations can be communicated more
widely and more quickly than ever before. NURS 3150 Assignments – Foundations Nursing Research Papers
• Increasing the visibility of nursing research.
The 21st century is likely to witness efforts to
increase the visibility of nursing research, the
onus for which will fall on the shoulders of
nurse researchers themselves. Most people are
unaware that nurses are scholars and
researchers. Nurse researchers must market
themselves and their research to professional
organizations, consumer organizations, and the
corporate world to increase support for their
research. They also need to educate upper-level
managers and corporate executives about the
importance of clinical outcomes research. As
Baldwin and Nail (2000) have noted, nurse
researchers are one of the best-qualified groups
to meet the need in today’s world for clinical
outcomes research, but they are not recognized
for their expertise.
Priorities and goals for the future are also under
discussion. NINR has established scientific goals
and objectives for the 5-year period of 2000 to
2004. The four broad goals are: (1) to identify and
support research opportunities that will achieve scientific distinction and produce significant contributions to health; (2) to identify and support future
areas of opportunity to advance research on high
quality, cost-effective care and to contribute to the
scientific base for nursing practice; (3) to communicate and disseminate research findings resulting
from NINR-funded research; and (4) to enhance the
development of nurse researchers through training
and career development opportunities. For the years
2000, 2001, and 2002, topics identified by NINR as
special areas of research opportunity included:
• Chronic illnesses or conditions (e.g., management
of chronic pain; care of children with asthma;
adherence to diabetes self-management)
• Behavioral changes and interventions (e.g.,
research in informal caregiving; disparities of
infant mortality; effective sleep in health and
illness)
CHAPTER 1 Introduction to Nursing Research ■ 11
respirations, may be dysfunctional. The Walker
study illustrates the potential value of critical
appraisal of custom and tradition before accepting
them as truth. There is growing concern that many
nursing interventions are based on tradition, customs, and “unit culture” rather than on sound evidence (e.g., French, 1999).
Authority: NURS 3150 Assignments – Foundations Nursing Research Papers
In our complex society, there are authorities—people
with specialized expertise—in every field. We are
constantly faced with making decisions about matters with which we have had no direct experience;
therefore, it seems natural to place our trust in the
judgment of people who are authoritative on an issue
by virtue of specialized training or experience. As a
source of understanding, however, authority has
shortcomings. Authorities are not infallible, particularly if their expertise is based primarily on personal
experience; yet, like tradition, their knowledge often
goes unchallenged. Although nursing practice would
flounder if every piece of advice from nursing
educators were challenged by students, nursing education would be incomplete if students never had
occasion to pose such questions as: How does the
authority (the instructor) know? What evidence is
there that what I am learning is valid?
Clinical Experience, Trial and Error, and Intuition
Our own clinical experiences represent a familiar
and functional source of knowledge. The ability to
generalize, to recognize regularities, and to make
predictions based on observations is an important
characteristic of the human mind. Despite the obvious value of clinical expertise, it has limitations as
a type of evidence. First, each individual’s experience is fairly restricted. A nurse may notice, for
example, that two or three cardiac patients follow
similar postoperative sleep patterns. This observation may lead to some interesting discoveries with
implications for nursing interventions, but does one
nurse’s observations justify broad changes in
nursing care? A second limitation of experience is
that the same objective event is usually experienced
or perceived differently by two individuals.
Related to clinical experience is the method of trial and error. In this approach, alternatives are
tried successively until a solution to a problem is found. We likely have all used trial and error in our
lives, including in our professional work. For example, many patients dislike the taste of potassium chloride solution. Nurses try to disguise the taste of the medication in various ways until one method meets with the approval of the patient. Trial and error may offer a practical means of securing knowledge, but it is fallible. This method is haphazard, and the knowledge obtained is often unrecorded and, hence, inaccessible in subsequent clinical situations.
Finally, intuition is a type of knowledge that cannot be explained on the basis of reasoning or prior
instruction. Although intuition and hunches undoubtedly play a role in nursing practice—as they do in the conduct of research—it is difficult to develop policies and practices for nurses on the basis of intuition.
Logical Reasoning
Solutions to many perplexing problems are developed by logical thought processes. Logical reasoning as a method of knowing combines experience,
intellectual faculties, and formal systems of
thought. Inductive reasoning is the process of
developing generalizations from specific observations. For example, a nurse may observe the anxious
behavior of (specific) hospitalized children and conclude that (in general) children’s separation from
their parents is stressful. Deductive reasoning is
the process of developing specific predictions from
general principles. For example, if we assume that
separation anxiety occurs in hospitalized children
(in general), then we might predict that (specific)
children in Memorial Hospital whose parents do not
room-in will manifest symptoms of stress.
Both systems of reasoning are useful as a means
of understanding and organizing phenomena, and
both play a role in nursing research. However, reasoning in and of itself is limited because the validity
of reasoning depends on the accuracy of the information (or premises) with which one starts, and
12 ■ PART 1 Foundations of Nursing Research
PARADIGMS FOR NURSING RESEARCH: NURS 3150 Assignments – Foundations Nursing Research Papers
A paradigm is a world view, a general perspective
on the complexities of the real world. Paradigms
for human inquiry are often characterized in terms
of the ways in which they respond to basic philosophical questions:
• Ontologic: What is the nature of reality?
• Epistemologic: What is the relationship between
the inquirer and that being studied?
• Axiologic: What is the role of values in the inquiry?
• Methodologic: How should the inquirer obtain
knowledge?
Disciplined inquiry in the field of nursing is
being conducted mainly within two broad paradigms,
both of which have legitimacy for nursing research.
This section describes the two alternative paradigms
and outlines their associated methodologies.
The Positivist Paradigm
One paradigm for nursing research is known as positivism. Positivism is rooted in 19th century
thought, guided by such philosophers as Comte,
Mill, Newton, and Locke. Positivism is a reflection
of a broader cultural phenomenon that, in the
humanities, is referred to as modernism, which
emphasizes the rational and the scientific. Although
strict positivist thinking—sometimes referred to as
logical positivism—has been challenged and
undermined, a modified positivist position remains
a dominant force in scientific research.Nurs 3150 Foundations Nursing Research Assignment Papers.
The fundamental ontologic assumption of positivists is that there is a reality out there that can be
studied and known (an assumption refers to a
basic principle that is believed to be true without
proof or verification). Adherents of the positivist
approach assume that nature is basically ordered
and regular and that an objective reality exists independent of human observation. In other words, the
world is assumed not to be merely a creation of the
human mind. The related assumption of determinism refers to the belief that phenomena are not haphazard or random events but rather have antecedent
causes. If a person has a cerebrovascular accident,
reasoning may be an insufficient basis for evaluating
accuracy.
Assembled Information
In making clinical decisions, health care professionals also rely on information that has been
assembled for a variety of purposes. For example,
local, national, and international bench-marking
data provide information on such issues as the
rates of using various procedures (e.g., rates of
cesarean deliveries) or rates of infection (e.g.,
nosocomial pneumonia rates), and can serve as a
guide in evaluating clinical practices. Cost data—
that is, information on the costs associated with
certain procedures, policies, or practices—are
sometimes used as a factor in clinical decision making Quality improvement and risk data, such as medication error reports and evidence on
the incidence and prevalence of skin breakdown,can be used to assess practices and determine the
need for practice changes.
Such sources, although offering some information that can be used in practice, provide no
mechanism for determining whether improvements
in patient outcomes result from their use.
Disciplined Research
Research conducted within a disciplined format is
the most sophisticated method of acquiring evidence that humans have developed. Nursing
research combines aspects of logical reasoning with other features to create evidence that, although fallible, tends to be more reliable than other methods of knowledge acquisition.
The current emphasis on evidence-based health care requires nurses to base their clinical practice to
the greatest extent possible on research-based findings rather than on tradition, authority, intuition, or
personal experience. NURS 3150 – Foundations of Nursing Research Essay Paper. Findings from rigorous
research investigations are considered to be at the pinnacle of the evidence hierarchy for establishing
an EBP. As we discuss next, disciplined research in nursing is richly diverse with regard to questions
asked and methods used.
CLICK HERE TO ORDER YOUR NURS 3150 ASSIGNMENTS
CHAPTER 1 Introduction to Nursing Research ■ 13
the scientist in a positivist tradition assumes that there must be one or more reasons that can be
potentially identified and understood. Much of the
activity in which a researcher in a positivist paradigm is engaged is directed at understanding the
underlying causes of natural phenomena.
Because of their fundamental belief in an objective reality, positivists seek to be as objective as possible in their pursuit of knowledge. Positivists attempt
to hold their personal beliefs and biases in check insofar as possible during their research to avoid contaminating the phenomena under investigation. The
positivists’ scientific approach involves the use of
orderly, disciplined procedures that are designed to
test researchers’ hunches about the nature of phenomena being studied and relationships among them.
The Naturalistic Paradigm
The naturalistic paradigm began as a countermovement to positivism with writers such as Weber
and Kant. Just as positivism reflects the cultural phenomenon of modernism that burgeoned in the
wake of the industrial revolution, naturalism is an outgrowth of the pervasive cultural transformation
that is usually referred to as postmodernism.
Postmodern thinking emphasizes the value of deconstruction—that is, of taking apart old ideas
and structures—and reconstruction—that is, putting ideas and structures together in new ways.
The naturalistic paradigm represents a major alternative system for conducting disciplined research
in nursing. Table 1-2 compares the major assumptions of the positivist and naturalistic paradigms.
14 ■ PART 1 Foundations of Nursing Research
ASSUMPTION POSITIVIST PARADIGM NATURALISTIC PARADIGM
Ontologic (What is Reality exists; there is a real Reality is multiple and subjective,
the nature of reality?) world driven by real natural mentally constructed by individuals.
causes.
Epistemologic (How is The inquirer is independent The inquirer interacts with those
the inquirer related to from those being researched; being researched; findings are
those being researched?) findings are not influenced by the creation of the interactive
the researcher. process. NURS 3150 – Foundations of Nursing Research Essay Paper.
Axiologic (What is the role Values and biases are to be Subjectivity and values are
of values in the inquiry?) held in check; objectivity inevitable and desirable.
is sought.
Methodologic (How is Deductive processes Inductive processes
knowledge obtained?) Emphasis on discrete, specific Emphasis on entirety of some
concepts phenomenon, holistic
Verification of researchers’ Emerging interpretations grounded
hunches in participants’ experiences
Fixed design Flexible design
Tight controls over context Context-bound
Emphasis on measured, Emphasis on narrative information;
quantitative information; qualitative analysis
statistical analysis
Seeks generalizations Seeks patterns
TABLE 1.2 Major Assumptions of the Positivist and Naturalistic Paradigms
For the naturalistic inquirer, reality is not a
fixed entity but rather a construction of the individuals participating in the research; reality exists
within a context, and many constructions are possible. Naturalists thus take the position of relativism:
if there are always multiple interpretations of reality that exist in people’s minds, then there is no
process by which the ultimate truth or falsity of the
constructions can be determined.
Epistemologically, the naturalistic paradigm
assumes that knowledge is maximized when the
distance between the inquirer and the participants
in the study is minimized. The voices and interpretations of those under study are crucial to understanding the phenomenon of interest, and subjective
interactions are the primary way to access them. NURS 3150 Assignments – Foundations Nursing Research Papers
The findings from a naturalistic inquiry are the
product of the interaction between the inquirer and
the participants.
Paradigms and Methods: Quantitative
and Qualitative Research
Broadly speaking, research methods are the techniques used by researchers to structure a study and to
gather and analyze information relevant to the
research question. The two alternative paradigms
have strong implications for the research methods to
be used. The methodologic distinction typically
focuses on differences between quantitative
research, which is most closely allied with the positivist tradition, and qualitative research, which is
most often associated with naturalistic inquiry—
although positivists sometimes engage in qualitative
studies, and naturalistic researchers sometimes collect quantitative information. This section provides
an overview of the methods associated with the two
alternative paradigms. Note that this discussion
accentuates differences in methods as a heuristic
device; in reality, there is often greater overlap of
methods than this introductory discussion implies.
The “Scientific Method” and
Quantitative Research
The traditional, positivist “scientific method”
refers to a general set of orderly, disciplined procedures used to acquire information. Quantitative
CHAPTER 1 Introduction to Nursing Research ■ 15
researchers use deductive reasoning to generate
hunches that are tested in the real world. They typically move in an orderly and systematic fashion
from the definition of a problem and the selection
of concepts on which to focus, through the design
of the study and collection of information, to the
solution of the problem. By systematic, we mean
that the investigator progresses logically through a
series of steps, according to a prespecified plan of
action.
Quantitative researchers use mechanisms
designed to control the study. Control involves
imposing conditions on the research situation so
that biases are minimized and precision and validity
are maximized. The problems that are of interest to
nurse researchers—for example, obesity, compliance with a regimen, or pain—are highly complicated
phenomena, often representing the effects of various forces. In trying to isolate relationships
between phenomena, quantitative researchers
attempt to control factors that are not under direct
investigation. For example, if a scientist is interested
in exploring the relationship between diet and heart
disease, steps are usually taken to control other
potential contributors to coronary disorders, such
as stress and cigarette smoking, as well as additional factors that might be relevant, such as a
person’s age and gender. Control mechanisms are
discussed at length in this book.
Quantitative researchers gather empirical
evidence—evidence that is rooted in objective
reality and gathered directly or indirectly through
the senses. Empirical evidence, then, consists of
observations gathered through sight, hearing,
taste, touch, or smell. Observations of the presence or absence of skin inflammation, the heart
rate of a patient, or the weight of a newborn infant
are all examples of empirical observations. The
requirement to use empirical evidence as the basis
for knowledge means that findings are grounded
in reality rather than in researchers’ personal
beliefs.
Evidence for a study in the positivist paradigm
is gathered according to a specified plan, using formal instruments to collect needed information.
Usually (but not always) the information gathered
in such a study is quantitative—that is, numeric
information that results from some type of formal
measurement and that is analyzed with statistical
procedures.
An important goal of a traditional scientific
study is to understand phenomena, not in isolated
circumstances, but in a broad, general sense. For
example, quantitative researchers are typically not
as interested in understanding why Ann Jones has
cervical cancer as in understanding what general
factors lead to this carcinoma in Ann and others.
The desire to go beyond the specifics of the situation is an important feature of the traditional scientific approach. In fact, the degree to which research
findings can be generalized to individuals other
than those who participated in the study (referred
to as the generalizability of the research) is a
widely used criterion for assessing the quality of
quantitative studies. NURS 3150 Assignments – Foundations Nursing Research Papers
The traditional scientific approach used by
quantitative researchers has enjoyed considerable
stature as a method of inquiry, and it has been used
productively by nurse researchers studying a wide
range of nursing problems. This is not to say, however, that this approach can solve all nursing problems. One important limitation—common to both
quantitative and qualitative research—is that
research methods cannot be used to answer moral or
ethical questions. Many of our most persistent and
intriguing questions about the human experience fall
into this area—questions such as whether euthanasia
should be practiced or abortion should be legal.
Given the many moral issues that are linked to health
care, it is inevitable that the nursing process will
never rely exclusively on scientific information.
The traditional research approach also must
contend with problems of measurement. To study a
phenomenon, quantitative researchers attempt to
measure it. For example, if the phenomenon of
interest is patient morale, researchers might want to
assess if morale is high or low, or higher under certain conditions than under others. Although there
are reasonably accurate measures of physiologic
phenomena, such as blood pressure and body temperature, comparably accurate measures of such
psychological phenomena as patient morale, pain,
or self-image have not been developed.
Another issue is that nursing research tends
to focus on human beings, who are inherently
complex and diverse. Traditional quantitative
methods typically focus on a relatively small portion of the human experience (e.g., weight gain,
depression, chemical dependency) in a single
study. Complexities tend to be controlled and, if
possible, eliminated, rather than studied directly,
and this narrowness of focus can sometimes
obscure insights.
Finally and relatedly, quantitative research conducted in the positivist paradigm has sometimes
been accused of a narrowness and inflexibility of
vision, a problem that has been called a sedimented
view of the world that does not fully capture the
reality of human experience.
Naturalistic Methods and Qualitative Research
Naturalistic methods of inquiry attempt to deal with
the issue of human complexity by exploring it
directly. Researchers in the naturalistic tradition
emphasize the inherent complexity of humans, their
ability to shape and create their own experiences,
and the idea that truth is a composite of realities.
Consequently, naturalistic investigations place a
heavy emphasis on understanding the human experience as it is lived, usually through the careful collection and analysis of qualitative materials that are
narrative and subjective. NURS 3150 Assignments – Foundations Nursing Research Papers
Researchers who reject the traditional “scientific method” believe that a major limitation of the
classical model is that it is reductionist—that is, it
reduces human experience to only the few concepts
under investigation, and those concepts are defined
in advance by the researcher rather than emerging
from the experiences of those under study. NURS 3150 Assignments – Foundations Nursing Research Papers
Naturalistic researchers tend to emphasize the
dynamic, holistic, and individual aspects of human
experience and attempt to capture those aspects in
their entirety, within the context of those who are
experiencing them.Nurs 3150 Foundations Nursing Research Assignment Papers.
Flexible, evolving procedures are used to capitalize on findings that emerge in the course of the
study. Naturalistic inquiry always takes place in the
field (i.e., in naturalistic settings), often over an
extended period of time, while quantitative research
16 ■ PART 1 Foundations of Nursing Research
desirable trend in the pursuit of new evidence for
practice. Although researchers’ world view may be
paradigmatic, knowledge itself is not. Nursing
knowledge would be thin, indeed, if there were not
a rich array of methods available within the two
paradigms—methods that are often complementary
in their strengths and limitations. We believe that
intellectual pluralism should be encouraged and
fostered.Nurs 3150 Foundations Nursing Research Assignment Papers.
Thus far, we have emphasized differences
between the two paradigms and their associated
methods so that their distinctions would be easy to
understand. Subsequent chapters of this book will
further elaborate on differences in terminology,
methods, and research products. It is equally
important, however, to note that these two paradigms have many features in common, only some
of which are mentioned here:
• Ultimate goals. The ultimate aim of disciplined
inquiry, regardless of the underlying paradigm,
is to gain understanding about phenomena. Both
quantitative and qualitative researchers seek to
capture the truth with regard to an aspect of the
world in which they are interested, and both
groups can make significant contributions to
nursing knowledge. Moreover, qualitative studies often serve as a crucial starting point for
more controlled quantitative studies.
• External evidence. Although the word empiricism has come to be allied with the traditional
scientific approach, it is nevertheless the case
that researchers in both traditions gather and
analyze external evidence that is collected
through their senses. Neither qualitative nor
quantitative researchers are armchair analysts,
relying on their own beliefs and views of the
world for their conclusions. Information is gathered from others in a deliberate fashion.
• Reliance on human cooperation. Because evidence for nursing research comes primarily from
human participants, the need for human cooperation is inevitable. To understand people’s characteristics and experiences, researchers must
persuade them to participate in the investigation
and to act and speak candidly. For certain
takes place both in natural as well as in contrived
laboratory settings. In naturalistic research, the collection of information and its analysis typically
progress concurrently; as researchers sift through
information, insights are gained, new questions
emerge, and further evidence is sought to amplify or
confirm the insights. Through an inductive process,
researchers integrate information to develop a theory
or description that helps explicate processes under
observation.Nurs 3150 Foundations Nursing Research Assignment Papers.
Naturalistic studies result in rich, in-depth
information that has the potential to elucidate varied
dimensions of a complicated phenomenon. Because
of this feature—and the relative ease with which
qualitative findings can be communicated to lay
audiences—it has been argued that qualitative methods will play a more prominent role in health care
policy and development in the future (Carey, 1997).
The findings from in-depth qualitative
research are rarely superficial, but there are several
limitations of the approach. Human beings are used
directly as the instrument through which information is gathered, and humans are extremely intelligent and sensitive—but fallible—tools. The subjectivity that enriches the analytic insights of skillful
researchers can yield trivial “findings” among less
competent inquirers.
The subjective nature of naturalistic inquiry
sometimes causes concerns about the idiosyncratic
nature of the conclusions. Would two naturalistic
researchers studying the same phenomenon in the
same setting arrive at the same results? The situation is further complicated by the fact that most
naturalistic studies involve a relatively small group
of people under study. Questions about the generalizability of findings from naturalistic inquiries
sometimes arise.
Multiple Paradigms and Nursing Research: NURS 3150 Assignments – Foundations Nursing Research Papers
Paradigms should be viewed as lenses that help to
sharpen our focus on a phenomenon of interest, not
as blinders that limit intellectual curiosity. The
emergence of alternative paradigms for the study of
nursing problems is, in our view, a healthy and
CHAPTER 1 Introduction to Nursing Research ■ 17
topics, the need for candor and cooperation is a
challenging requirement—for researchers in
either tradition.
• Ethical constraints. Research with human beings
is guided by ethical principles that sometimes
interfere with research goals. For example, if
researchers want to test a potentially beneficial
intervention, is it ethical to withhold the treatment from some people to see what happens? As
discussed later in the book (see Chapter 7),
ethical dilemmas often confront researchers,
regardless of their paradigmatic orientation.
• Fallibility of disciplined research. Virtually all
studies—in either paradigm—have some limitations. Every research question can be
addressed in many different ways, and
inevitably there are tradeoffs. Financial constraints are universal, but limitations exist
even when resources are abundant. This does
not mean that small, simple studies have no
value. It means that no single study can ever
definitively answer a research question. Each
completed study adds to a body of accumulated
knowledge. If several researchers pose the
same question and if each obtains the same or
similar results, increased confidence can be
placed in the answer to the question. The fallibility of any single study makes it important
to understand the tradeoffs and decisions that
investigators make when evaluating the adequacy of those decisions.
CLICK HERE TO ORDER YOUR NURS 3150 ASSIGNMENTS
Thus, despite philosophic and methodologic
differences, researchers using the traditional quantitative approach or naturalistic methods often
share overall goals and face many similar constraints and challenges. The selection of an appropriate method depends on researchers’ personal
taste and philosophy, and also on the research question. If a researcher asks, “What are the effects of
surgery on circadian rhythms (biologic cycles)?”
the researcher really needs to express the effects
through the careful quantitative measurement of
various bodily properties subject to rhythmic variation. On the other hand, if a researcher asks,
“What is the process by which parents learn to
cope with the death of a child?” the researcher
would be hard pressed to quantify such a process.
Personal world views of researchers help to shape
their questions.
In reading about the alternative paradigms for
nursing research, you likely were more attracted to
one of the two paradigms—the one that corresponds most closely to your view of the world and
of reality. It is important, however, to learn about
and respect both approaches to disciplined inquiry,
and to recognize their respective strengths and limitations. In this textbook, we describe methods
associated with both qualitative and quantitative
research.
THE PURPOSES OF NURSING RESEARCH
The general purpose of nursing research is to
answer questions or solve problems of relevance
to the nursing profession. Sometimes a distinction is made between basic and applied research.
As traditionally defined, basic research is undertaken to extend the base of knowledge in a discipline, or to formulate or refine a theory. For
example, a researcher may perform an in-depth
study to better understand normal grieving
processes, without having explicit nursing applications in mind. Applied research focuses on
finding solutions to existing problems. For example, a study to determine the effectiveness of a
nursing intervention to ease grieving would be
applied research. Basic research is appropriate
for discovering general principles of human
behavior and biophysiologic processes; applied
research is designed to indicate how these principles can be used to solve problems in nursing
practice. In nursing, the findings from applied
research may pose questions for basic research,
and the results of basic research often suggest
clinical applications.
The specific purposes of nursing research
include identification, description, exploration,
explanation, prediction, and control. Within each
purpose, various types of question are addressed by
nurse researchers; certain questions are more
amenable to qualitative than to quantitative inquiry,
and vice versa. NURS 3150 Assignments – Foundations Nursing Research Papers
18 ■ PART 1 Foundations of Nursing Research
quantitative research, by contrast, the researcher
begins with a phenomenon that has been previously
studied or defined—sometimes in a qualitative
study. Thus, in quantitative research, identification
typically precedes the inquiry.Nurs 3150 Foundations Nursing Research Assignment Papers.
Qualitative example of identification:
Weiss and Hutchinson (2000) investigated
people with diabetes and hypertension to discover
the basic social problem that affects their adherence
Identification and Description
Qualitative researchers sometimes study phenomena
about which little is known. In some cases, so little
is known that the phenomenon has yet to be clearly
identified or named or has been inadequately defined
or conceptualized. The in-depth, probing nature of
qualitative research is well suited to the task of
answering such questions as, “What is this phenomenon?” and “What is its name?” (Table 1-3). In
CHAPTER 1 Introduction to Nursing Research ■ 19
TYPES OF QUESTIONS: TYPES OF QUESTIONS:
PURPOSE QUANTITATIVE RESEARCH QUALITATIVE RESEARCH
Identification What is this phenomenon?
What is its name?
Description How prevalent is the phenomenon? What are the dimensions of the
How often does the phenomenon occur? phenomenon?
What are the characteristics of the What variations exist?
phenomenon? What is important about the phenomenon?
Exploration What factors are related to the What is the full nature of the phenomenon?
phenomenon? What is really going on here?
What are the antecedents of the What is the process by which the
phenomenon? phenomenon evolves or is experienced?
Explanation What are the measurable associations How does the phenomenon work?
between phenomena? Why does the phenomenon exist?
What factors cause the phenomenon? What is the meaning of the phenomenon?
Does the theory explain the How did the phenomenon occur?
phenomenon?
Prediction What will happen if we alter a
phenomenon or introduce an
intervention?
If phenomenon X occurs, will
phenomenon Y follow?
Control How can we make the phenomenon ,
happen or alter its nature or
prevalence?
Can the occurrence of the phenomenon
be prevented or controlled? NURS 3150 Assignments – Foundations Nursing Research Papers
TABLE 1.3 Research Purposes and Research Questions
to health care directives. Through in-depth interviews with 21 clients, the researchers identified that
warnings of vulnerability was the basic problem
undermining adherence.
Description of phenomena is another important purpose of research. In a descriptive study,
researchers observe, count, delineate, and classify.
Nurse researchers have described a wide variety of
phenomena. Examples include patients’ stress and
coping, pain management, adaptation processes,
health beliefs, rehabilitation success, and time
patterns of temperature readings.
Description can be a major purpose for both
qualitative and quantitative researchers. Quantitative
description focuses on the prevalence, incidence,
size, and measurable attributes of phenomena.
Qualitative researchers, on the other hand, use indepth methods to describe the dimensions, variations, and importance of phenomena. Table 1-3
compares descriptive questions posed by quantitative and qualitative researchers.
Quantitative example of description:
Bohachick, Taylor, Sereika, Reeder, and
Anton (2002) conducted a study to describe quantitative changes in psychological well-being and
psychological resources 6 months after a heart
transplantation.
Qualitative example of description:
Bournes and Mitchell (2002) undertook an
in-depth study to describe the experience of waiting in a critical care waiting room.
Exploration
Like descriptive research, exploratory research begins
with a phenomenon of interest; but rather than simply
observing and describing it, exploratory research
investigates the full nature of the phenomenon, the
manner in which it is manifested, and the other factors
to which it is related. For example, a descriptive quantitative study of patients’ preoperative stress might
seek to document the degree of stress patients experience before surgery and the percentage of patients
who actually experience it. An exploratory study
might ask the following: What factors diminish or
increase a patient’s stress? Is a patient’s stress related
to behaviors of the nursing staff? Is stress related to
the patient’s cultural backgrounds?
Qualitative methods are especially useful for
exploring the full nature of a little-understood phenomenon. Exploratory qualitative research is
designed to shed light on the various ways in which
a phenomenon is manifested and on underlying
processes.
Quantitative example of exploration:
Reynolds and Neidig (2002) studied the
incidence and severity of nausea accompanying
combinative antiretroviral therapies among HIV infected patients, and explored patterns of nausea
in relation to patient characteristics.
Qualitative example of exploration:
Through in-depth interviews, Sadala and
Mendes (2000) explored the experiences of 18 nurses
who cared for patients who had been pronounced
brain dead but kept alive to serve as organ donors.
Explanation
The goals of explanatory research are to understand
the underpinnings of specific natural phenomena,
and to explain systematic relationships among phenomena. Explanatory research is often linked to theories, which represent a method of deriving, organizing, and integrating ideas about the manner in which
phenomena are interrelated. Whereas descriptive
research provides new information, and exploratory
research provides promising insights, explanatory
research attempts to offer understanding of the
underlying causes or full nature of a phenomenon.
In quantitative research, theories or prior findings are used deductively as the basis for generating explanations that are then tested empirically.
That is, based on a previously developed theory or
body of evidence, researchers make specific
predictions that, if upheld by the findings, add
credibility to the explanation. In qualitative studies,
researchers may search for explanations about how
or why a phenomenon exists or what a phenomenon
means as a basis for developing a theory that is
grounded in rich, in-depth, experiential evidence.
20 ■ PART 1 Foundations of Nursing Research
CHAPTER 1 Introduction to Nursing Research ■ 21
the study emphasized in the chapter. A review of
the full journal article likely would prove useful.
Research Example
of a Quantitative Study
McDonald, Freeland, Thomas, and Moore (2001)
conducted a study to determine the effectiveness of a
preoperative pain management intervention for relieving pain among elders undergoing surgery. Their
report appeared in the journal Research in Nursing &
Health.
McDonald (who had conducted medical characteristics, so that group differences in pain responses reflected the intervention and not some spurious factor. The research team members who measured pain responses were not aware of whether the elders were in the intervention group, so as not to bias the measurements. Finally, the findings are more persuasive because the team of researchers who conducted the study have developed a solid program of research on pain, and their research has contributed incrementally to understanding pain responses and appropriate nursing interventions. NURS 3150 Assignments – Foundations Nursing Research Papers