Research & Biostatistics for Nurses R Sudha
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  • 1. Introduction to Nursing Research
  • 2. Problem Statement
  • 3. Review of Literature
  • 4. Conceptual Framework
  • 5. Research Approaches and Designs
  • 6. Population and Sample
  • 7. Data Collection
  • 8. Pilot Study
  • 9. Research Ethics
  • 10. Interpretation, Communication and Utilization of Research Findings2

Introduction to Nursing Research1

  • After reading this chapter, you will be able to:
  • • Explain the sources of knowledge
  • • Explain scientific method and problem-solving
  • • State the meanings and definition of research and nursing research
  • • List the characteristics of good research
  • • Enlist the principles of research
  • • Explain the purposes of research and nursing research
  • • Explain the scope of nursing research
  • • Describe the types of research
  • • Explain the steps of research process
  • • Explain the role of a nurse in the promotion of nursing research.
Research is undertaken within all professions and in all discipline. More than a set of skills, it is a way of thinking—examining critically the various aspects of one's professional work. It is a habit of questioning what we do, and a systematic examination of the observed information to find answers with a view to instituting appropriate changes for a more effective professional service. Research is a process of collecting, analyzing and interpreting information to answer questions. The foundation for effective research is the strong desire and motivation to do research.
Nursing research involves a systematic process which aims to inquire about issues related to nursing. The aim of research in any discipline is to gain new knowledge, verify and clarify the concepts and existing facts. Nursing is a discipline with its own body of knowledge that focuses on promotive, preventive, curative and rehabilitative care of the individual and the group. According to the Flexner's criteria of a profession, and discipline in order to be a profession, it should have its own body of knowledge. Research is one such important aspect which helps to create and develop own body of knowledge for any discipline.
Research is a systematic inquiry into a specific subject or problem that uses various methods, approaches or techniques. Research involves finding out the solutions for problems, discover new knowledge, verify or clarify the existing facts. Research follows specific principles and steps of procedure.
Research is search for knowledge, it is rediscovering existing knowledge and it adds to the existing knowledge or theory. The art of scientific investigation could be termed as research. It is a careful investigation or inquiry specially through 4search for new facts in any branch of knowledge or discipline. As human beings are endowed with thinking, questioning and various other brain activities, he uses this capacity for the welfare of self and others. He gains knowledge through various mental functions. At the same time, men are never satisfied with whatever knowledge they possess. They are interested and curious to know more and more. Further vistas of knowledge are mastered by them as a result of this urge to know, to explain, control and predict. This means the human mind will always search for facts and knowledge. Men acquire knowledge through various methods/sources ranging from totally unreliable to reliable sources.
The methods adopted by men for acquiring knowledge can be categorized under the following heads:
Appeal to authority and seeking authority's advice was a well-established method of solving problem, even in the earliest civilizations. Even now we seek advice from authorities for the solution of the problem faced by us. The authorities may be the persons who have had long experience related to the problem. When factual evidence cannot be obtained to solve a problem, one may have to rely upon authoritative opinion temporarily as the only possible method for solution. In such cases, care must be employed in choosing authorities. In nursing, we seek senior nurses in the hospital for overcoming problem related to clinical issues and we seek the help of principal in an educational institution to solve problems related to academic issues.
Closely related to authority is tradition, upon which man depends for solutions to many of his problems. Man unquestioningly accepts many traditions of his forefathers or culture, such as the way of dressing, food, speech, etc. In clinical setting, nurses follow many techniques and procedures which are being practiced years together. Although automatic acceptance of tradition and custom is often necessary, one should not always assume that everything that has customarily been done is right and valid. If we look into the past, we could find that many theories and concepts based upon tradition, which prevailed for years, were later found to be erroneous and had to be rejected. One should, therefore, evaluate custom and tradition carefully before it is accepted as a truth.
Our own personal experience or that of others is the most primitive and yet most familiar and fundamental source of knowledge. When confronted with a problem, man often tries to seek its answers from his own personal experience or from others with which he is familiar. A junior nurse consults with the senior nurse for solving problems or to gain new knowledge believing that 5the senior nurse is more experienced and can contribute toward problem-solving or learning.
Trial and Error
Learning by trial and error is another way of gaining knowledge. This method of learning is practical, but it is unsystematic and may or may not result in desirable outcome. Making mistakes or repeatedly trying various ways of accomplishing something will eventually result in problem-solving. Nursing is a science which deals with patient care where trial and error is not an appropriate way of acquiring new knowledge.
Intuition: It is power of knowing without recourse to inference or reasoning. It is a frequently used method of problem-solving. Intuition is a leap of understanding, grasping of a larger concept unreachable by other intellectual means, yet still it is fundamentally an intellectual process. Intuition and practical reasoning form the base of all reasoning including the scientific reasoning and creation of scientific knowledge.
Deductive Reasoning
A significant contribution towards the development of a systematic method for obtaining reliable knowledge was made by the ancient Greek philosophers like Aristotle and his followers. Aristotle developed the syllogism which can be described as a thinking process in which one proceeds from general to specific statements by deductive reasoning. It provides a means of testing the validity of any given conclusion or idea by proceeding from the known to unknown.
The syllogistic reasoning consists of:
  • A major premise based on a self-evident truth or previously established fact or relationship.
  • A minor premise concerning a particular case to which the truth, fact or relationship invariably applies.
  • A conclusion. If the major and minor premises can be shown to be true, the conclusion arrived at is necessarily true. This can be understood with the following example:
    • All living things are mortal
    • Lion is a living thing
    • Therefore, lion is mortal, i.e. lion will die.
The conclusion of a syllogism is always derived from the content of the premises. So, if one of the premises is erroneous, the conclusions arrived at will not be valid. The limitation of the deductive reasoning is its dependence upon verbal symbolism. Though it proceeds from known to unknown, but it cannot be relied upon as a self-sufficient method for securing reliable knowledge.
Inductive Reasoning
The conclusions derived from generalities and from statements of presumed authorities by deductive reasoning are true only if they are based upon true 6premises. To determine whether the premises are true, Francis Bacon stressed the need for formulating premises based upon direct observations. This is known as inductive reasoning that is moving from the particular to general. Rather than accepting premises laid down by authorities as absolute truths, Bacon advised man to observe nature closely to experiment to understand all the facts, to study these facts in order to reach minor generalizations and then to proceed from minor generalizations to greater ones.
In deductive reasoning, the premises or generalizations must be known before a conclusion can be reached. On the other hand, in inductive reasoning, a conclusion is reached by observing instance and generalizing from instances to the whole phenomenon. In order to be absolutely certain of an inductive conclusion, all instances must be observed. But practically, it is not possible to observe all instances. One may arrive at a generalization by observing only some instances that make up the phenomenon. This is the limitation of inductive reasoning.
The exclusive use of Bacon's inductive method resulted in the accumulation of isolated bits of information which made little contribution to the advancement of human knowledge. Moreover, inductive reasoning alone could not solve many problems. So, the scientific method emerged which generally attributed to Charles Darwin. According to this method, man first operates inductively from known or observed information towards a meaningful whole or hypotheses and then deductively from suggested whole or hypothesis to the particular parts in order to find valid relationships. Scientific method involves working inductively from observations to hypotheses and then deductively from the hypotheses to the logical implications of the hypotheses in relation to what is already known.
Good and Hatt defined science as a method of approach to the entire empirical world. It is said to be more an approach, which does not aim at persuasion, at knowing the ultimate truth. It refers to the body of systematic and organized knowledge which makes use of the scientific method to advance knowledge in a particular field of enquiry. It refers to clear concepts, theory and other accumulated knowledge developed by scientific method and the best of hypothesis. It may be treated as a ‘method of approach to the entire empirical world’. The scientific method is a method of systematic analysis leading to observations, propositions and testing of hypotheses and contributes to the organized body of knowledge. Facts and theories are the two sides of the same coin, which is the scientific method. A consistent interaction between these two elements results in scientific knowledge. The collection of facts and their theoretical treatment are the tools of the scientific method. Theory provides the basis for the scientific method. Theory-based studies are strong in conceptual framework and classification of facts, enabling the research to crystallize the problem and choose the data relevant to it. The possibility for extrapolation from the known to the unknown is the result of a strong theoretical base.7
George A Lundberg defined scientific method which consists of systematic observation, classification and interpretation of data.
L L Bernard defined science as six major processes that take place within it. These are testing, verification, definition, classification, organization and orientation which includes prediction and application. The scientific method is systematic method of investigation, evaluation, experimentation, interpretation and theorizing.
Bases of scientific methods are as follows:
Scientific method is a set of rules consisting of certain assumptions, attitudes, goals and procedures for creating and answering questions about nature.
  • Reliance on empirical evidence: Scientific method relies upon the observable evidence, the real facts or truth. The conclusion is drawn only based on the evidence obtained from the use of appropriate methods, such as observation and experimentation. Evidence must be empirical, meaning learned by observation.
  • Problem to solve: Every inquiry must have a definite problem and enquiry without problem is of no use. The problem should be verifiable, observable, replicable and be useful to humanity.
  • Verifiability: The results drawn out of scientific methods should be verifiable at any point of time. This indicates that phenomenon is capable of being observable and measurable. Verification can be done by replication under similar conditions to check its accuracy, to modify or to invalidate them.
  • Generality: The scientific method tries to achieve a rational interconnection of facts. It attempts to establish general propositions. Science seeks to ascertain the common characteristic of types of objects and general laws or conditions of events.
  • Predictability: Scientific results can be predicted with sufficient accuracy. Scientific method assures the predictability of the phenomenon, events or incidents.
  • Objectivity: Objectivity is the willingness and ability to examine evidence dispassionately. Objectivity is that everyone should arrive at the same conclusion about the phenomenon. Science requires objectivity. This means that ideally a researcher's personal biases, attitudes or subjective impressions do not influence the observations or conclusions. Any measurement should be as empirical, objective and precise as possible.
  • Systematic nature: Systematic means that observations are obtained in a methodical step-by-step fashion. The results out of scientific method are arrived out of systematic method. It is only under these conditions that the results can be verified. Scientific method involves accepted method of investigation and the results are accurate.
  • Control: Evidence must be obtained under controlled conditions.
The scientific approach has two components, namely the procedural and the personal. The procedural component involves the major steps as given below:
The personal component involves the abilities and skills of the scientist, such as scientific imagination, resourcefulness, manipulative skill and pursuance 8to carry through the experiment, knowing what is essential and nonessential and scientific reasoning. The scientist must have sincerity, honesty, integrity and perseverance. He must possess the spirit of independence and the spirit of originality.
The procedural component consists of following five definite steps:
  1. Identification and definition of the problem: A scientific inquiry starts with the identification of a problem that is in need of solution. The problem identified must be defined in such a manner that observation or experimentation in the natural world can provide a solution.
  2. Formulation of a hypothesis: Once the problem is defined, the next step is to formulate the hypothesis, which provides an intelligent guess for the solution of the problem. It requires a critical review of the knowledge or information related to the problem.
  3. Implications of hypothesis through deductive reasoning: The next step after the formulation of a hypothesis is to deduce the implications of the suggested hypothesis that is what would be observed if the hypothesis is true.
  4. Collection and analysis of evidence: Collecting relevant evidence related to them through observation, testing and experimentation tests the deduced implications of the hypothesis.
  5. Verification, rejection or modification of hypothesis: Once the evidence has been collected and analyzed, the result is also analyzed in order to verify whether the evidences support the hypothesis. It may be noted that the characteristics of scientific method are not to prove the hypothesis in terms of absolute truth but to conclude that the evidence does or does not support the hypothesis.
Research and Problem-solving
Research is the scientific investigation of the problem whereas problem-solving involves informal application of methods to solve a problem. Pro-blem-solving may not follow scientific techniques. Problem-solving is a systematic approach to the solution or alleviation of problem by undertaking following activities:
  • Identification of the problem
  • Defining the problem and its elements
  • Gathering relevant information regarding the problem
  • Analysis, synthesis and interpretation of the collected facts
  • Deciding on the various possible solutions to the problem
  • Selecting specific course of action to solve the problem
  • Implementation of the course of action
  • Observation and evaluation of the course of action.
Research is the scientific investigation of phenomena which includes collection, presentation, analysis and interpretation of facts that lines an 9individual's speculation with reality. The word research is used to describe a number of similar and often overlapping activities involving a search for information. Research involves scholarly or scientific investigation or inquiry.
The word ‘research’ is composed of two syllables, ‘re’ and ‘search’. ‘Re’ is a prefix meaning ‘again’, ‘anew’ or ‘over again’ and ‘search’ is a verb meaning ‘to examine closely and carefully’, ‘to test and try’, or ‘to probe’. Together they form a noun describing a careful, systematic, patient study and investigation in some field of knowledge, undertaken to establish facts or principles. It is a systematic investigation to establish facts or principles or to collect information on a subject. It is the systematic investigation into and study of materials and sources in order to establish facts and reach new conclusions
The word ‘research’ is derived from the Middle French ‘recherche’, which means ‘to go about seeking’, the term itself being derived from the Old French term ‘recerchier’, a compound word from ‘re-’ + ‘cerchier’, or ‘sercher’, meaning ‘search’. The earliest recorded use of the term was in 1577.
A broad definition of research is given by Martin Shuttleworth. In the broadest sense of the word, the definition of research includes any gathering of data, information and facts for the advancement of knowledge.
Another definition of research is given by Creswell which states that ‘Research is a process of steps used to collect and analyze information to increase our understanding of a topic or issue’. It consists of three steps: Pose a question, collect data to answer the question and present an answer to the question.
The Merriam Webster Online Dictionary defines research in more detail as ‘a studious inquiry or examination’ especially, investigation or experimentation aimed at the discovery and interpretation of facts, revision of accepted theories or laws in the light of new facts, or practical application of such new or revised theories or laws.
According to Cambridge Dictionaries Online, 2003, ‘Research is a detailed study of a subject, especially in order to discover (new) information or reach a (new) understanding’.
According to John Best, ‘Research is the systematic and objective analysis and recording of controlled observations that may lead to the development of generalizations, principles, or theories, resulting in prediction and possibly ultimate control of events’.
Research is an abstraction and selection from an infinite variety of possible things that one might study (Godwin and Milman).
Research is a careful enquiry or examination in seeking facts or principles, a deligent investigation to ascertain something (Clifford Woody).
Research is a process which systematically searches for new facts and relationships (Notter).
Research is a systematic, formal, rigorous and precise process used to gain solutions to problems or discover and interpret new facts and relationships (Waltz and Bausell, 1981).10
Research is a process in which observable, verifiable data are collected from the empirical world to describe, explain, predict or control events (Seaman, 1987).
Research is systematic enquiry that uses disciplined methods to answer or solve problems. The ultimate goal of research is to develop, refine, and expand a body of knowledge.
Nursing research is a systematic inquiry designed to develop knowledge about issues of importance to the nursing profession, including nursing practice, education, administration and informatics.
Characteristics of Research
  • Need-based: A research should be need-based. There should be a strong need supporting the study.
  • Usability: Any research should benefit the humanity. The ultimate aim of any research should be for the welfare of human beings.
  • Empirical: Research is based on the direct experience or observation by the researcher.
  • Logical: Research is based on valid procedures and principles.
  • Objectivity: It refers to scientific nature of the inquiry process which is free from personal bias of the researcher.
  • Scientific: Any research is scientific when it follows scientific methods, principles and procedures.
  • Cyclical: Research is a cyclical process because it starts with a problem and ends with a problem.
  • Ethical: The methods and steps of research should be ethically sound, and follows the principles of research ethics. It should not be harmful in any way to the research participants.
  • Rigorous: Researcher must be scrupulous in ensuring that the procedures followed to find answers to questions are relevant, appropriate and justified. Again, the degree of rigor varies markedly between the physical and social sciences and within the social sciences.
  • Critical: Critical scrutiny of the procedures used and the methods employed is crucial to a research enquiry. The process of investigation must be foolproof and free from drawbacks. The process adopted and the procedures used must be able to withstand critical scrutiny.
  • Controlled: In real-life experience, there are many factors that affect an outcome. In research, there are variables or factors that influence our study variables. The controlled factors or variables should have to be controlled rigorously so as to get accurate results. In pure sciences, it is very easy to control such elements because experiments are conducted in laboratory but in social sciences, it becomes difficult to control these factors because of the nature of research.
  • Analytical: Research utilizes statistical methods such as descriptive and inferential statistics in order to analyze and interpret the data gathered. Research needs careful and precise judgement to find the solution to the problem.
  • 11Methodical: Research should be conducted in a methodical manner without bias.
  • Systematic: Research is an organized activity which involves using systematic methods and procedures.
  • Feasibility: Research should be practical in nature and it should use possible methods and procedures.
  • Economic: It should be cost-effective in terms of men, money and material used in conducting research.
  • Problem-solving: Research is directed towards solution of a problem.
  • Replicability: It refers to the ability of a research being repeated by other researchers. The research design and procedures are replicated or repeated to enable the researcher to arrive at valid and conclusive results.
  • Reliability: A research is reliable when it yields similar results each time it is undertaken with similar population and with similar procedures. The more the results are similar, the more the reliability is present in the research. It shows the consistency of the methods and procedures used.
  • Validity: Validity determines the applicability of research. A research which is valid will be applicable and generalizable to the population.
  • Verifiability: It is another nature of research. Most of the researches carried on human behavior are of verification type only. The principles, generalizations, theories arrived at based on research under natural and controlled conditions are tested and found to be true and workable in empirical conditions.
  • Credibility: Credibility is obtained with the use of best source of information and best procedures in research.
  • Accuracy: Any research should be accurate in order to obtain the best possible results.
  • Generalizability: It is the extent to which research findings can be applied to larger population. Only when there is wider application, research has social and economic values.
Characteristics of Research according to John Best
  • Directed towards solution of a problem
  • Emphasizes the development of generalizations, principles or theories
  • Based upon observable experiences
  • Demands accurate observations and descriptions
  • Involves gathering of new data
  • Requires carefully designed procedures applying vigorous analysis
  • Strives to be objective and logical
  • Involves quest for answers to the unsolved problems.
Principles of Good Research
  • A research should be need-based. There should be a strong need supporting the study.
  • There should be a clear, definite objectives and aims for the study which should be derived from the research problem.
  • 12Research problem should be based on the sound literature review.
  • A good research should be ethically sound. A researcher should follow ethical principles, maintain confidentiality and have appropriate documentation, etc.
  • Research questions, hypothesis and assumptions formulated should be based on the literature review and existing knowledge.
  • Research questions and hypotheses should be testable.
  • It follows appropriate methodology, which includes selection of research design, population, sample, sample size, sampling techniques, methods and tools of data collection, etc.
  • It uses appropriate statistical methods for analysis.
  • From the beginning, the research should have appropriate and sufficient resources in terms of people, time, transport, money, etc. allocated to it.
  • The people conducting the research should have adequate knowledge in research. In general, research is carried out personally by the researcher or anybody recruited for this purpose. In any case, they should have knowledge in relation to research problem, research issues, setting, data collection methods and research methodology.
  • A good research is utilizable, applicable and transferable.
  • Research should be beneficial to the humanity.
Purposes of Research
  • Description: Research is conducted to describe situations and events. Descriptive work aims to gather information that illuminates relation- ships, patterns and links between variables. The researcher observes and then describes what he or she observed. One example of descriptive social research is the census. The goal of the census is to describe accurately and precisely several characteristics of the population, including race/ethnicity, age, sex, household size, income, etc.
  • Speculation: Research is conducted to speculate the future problems and identify the possible solutions for it. Sometimes research is implemented strategically, where researchers take account of current situations and speculate as to their future implications.
  • Explanation: A third major purpose of research is to explain things. While descriptive studies attempt to answer the what, when, where, and how, explanatory studies attempt to answer the why. For example, reporting the maternal mortality rates of different states is descriptive. Identifying the variables that explain why some states have higher maternal mortality rates than others involves explanation. Likewise, reporting the frequency of patient attendance to various outpatient departments is descriptive, but reporting why some people attend some OPDs of the Government Hospitals while others do not is explanatory. Explanatory research aims to show why relationships, patterns and links occur.
  • Exploration: A great deal of social research is conducted to explore a topic or familiarize oneself with a topic. This typically occurs when a researcher becomes interested in a new topic or when the subject of study itself is 13relatively new. This type of research investigates an area or issue on which little previous work has been carried out. In an organizational setting, it may be used to discover whether or not a problem exists. Exploratory studies are typically done for three purposes:
    • To satisfy the researcher's curiosity and desire for better understanding
    • To test the feasibility of undertaking a more extensive study
    • To develop the methods to be employed in any subsequent studies.
  • Prediction and control: Research is also conducted to forecast things. The purpose of this type of research is to predict the likely course of events that can occur in particular circumstances or with given intervening variables. Control is an important facet of research in which a deductive approach is used, such as experimental studies. The researcher uses control in order to prove the outcome of the study.
  • Evaluation: Research is done to evaluate the impact of something; for example, a new policy, event, law, treatment regime, teaching program or the introduction of a new system. It also helps us to analyze the effectiveness of some intervention or protocol used in the research.
Why Nurses Should Read and Conduct Research?
The need to conduct a research can be discussed under two headings. One is the purpose for which any researcher or investigator undertakes a research.
The reasons for the student or beginner researcher may be to fulfill a requirement for getting a degree, or one of the requirements in the course itself. For anybody who had already undertaken the course on research, the reasons may be many. These are:
  • To further learn and strengthen the research knowledge by conducting various researches
  • To fulfill the requirement in postgraduate or doctoral programs
  • To study the issues of importance to nursing by conducting research and also publish many empirical studies so as to make oneself visible in the profession
  • To advance oneself in career ladder, research is conducted
  • To undertake research project by obtaining research grants/fellowship from University Grants Commission and various other funding agencies. This is mainly to develop new knowledge for the profession
  • To promote evidence-based nursing practice by studying the various problems related to nursing.
Importance of Research in Nursing
  • For evidence-based practice
  • To make clinical decisions
  • For cost containment
  • To improve health care outcomes
  • To understand varied dimensions of profession
  • 14To control the occurrence of undesired outcomes
  • To promote desired client behavior
  • To provide a scientific basis for the nursing profession
  • To develop and evaluate new techniques for delivering patient care
  • To provide solutions to problems concerning health care
  • To prepare students to be a diligent practitioner of research
  • To generate knowledge for nursing
  • To fill the gaps in the knowledge and practice
  • Providing/identifying new measures in nursing practice
  • Helps to improve the standards of nursing education
  • Discover and evaluate nursing theories.
Significance of Research
  • For students of any discipline who are to write Masters or PhD thesis research meaning fulfilling a requirement which helps them to complete course and earn degree. Thus, it helps them to choose their career.
  • For professionals in research, research is a source of livelihood.
  • For philosophers and thinkers, research may mean the outlet for new ideas and insights.
  • For educated men and women, research may mean the development of new styles and creative work.
  • For analysts and intellectuals, research may mean the generalizations of new theories.
Scope of Nursing Research
The scope of nursing research is as wide and as deep as the humanity is concerned. The research in nursing can be conducted on the following areas.
Based on major areas of nursing
  • Nursing education
  • Nursing administration
  • Nursing practice
  • Nursing informatics
  • Nursing research.
Based on specialty in nursing
  • Medical surgical nursing
  • Community health nursing
  • Child health nursing
  • Mental health nursing
  • Maternity nursing.
Based on the developmental stages of human beings
Nursing research can be conducted in:
  • Infants including newborn
  • Children of various age groups
  • Adolescents
  • Adults
  • Old age.
15Based on the areas of health
  • Nursing research in preventive areas
  • Nursing research in promotive areas
  • Nursing research in curative areas
  • Nursing research in rehabilitative areas.
Based on the settings
Nursing research can be conducted among human beings in various settings, such as:
  • Hospital
    Outpatient departments
    Inpatient departments
    General wards
    Palliative care areas
    Intensive care units
  • Community areas
    • Urban
    • Rural
  • Schools and colleges
  • Industry of various types
  • Natural and artificial or laboratory settings.
Types of Research
Research can be classified from three perspectives:
  1. Application of research study
  2. Objectives in undertaking the research
  3. Inquiry mode employed.
From the point of view of application, there are two broad categories of research:
  • Pure or basic research
  • Applied research.
Pure, fundamental or theoretical research is basic or original in nature. It is said that it is undertaken for the sake of knowledge without formal intention of applying it in practice. Pure research involves developing and testing theories and hypotheses that are intellectually challenging to the researcher but may or may not have practical application at the present time or in the future. The knowledge produced through pure research is sought in order to add to the existing body of research methods. Gathering knowledge for knowledge's sake is termed ‘pure’ or ‘basic’ research. Research concerning some natural phenomenon or concerning human behavior carried on with a view to make generalizations about human behavior are also examples of fundamental or pure research.
Applied research is done to solve specific, practical questions, and for policy formulation, administration and understanding of a phenomenon. It aims at finding a solution for an immediate problem facing a society or an 16organization. It can be exploratory, but is usually descriptive. It is almost always done on the basis of basic research.
From the viewpoint of objectives, a research can be classified as:
  • Descriptive research: It attempts to describe systematically a situation, problem, phenomenon, service or program, or provides information about any variables under study, e.g. living condition of a community, or describes attitudes toward an issue.
  • Correlational research: It attempts to discover or establish the existence of a relationship/interdependence between two or more aspects of a situation or variables of a research.
  • Explanatory research: It attempts to clarify why and how there is a relationship between two or more aspects of a situation or phenomenon.
  • Exploratory research: It is undertaken to explore an area where little is known or to investigate the possibilities of undertaking a particular research study (feasibility study/pilot study). The objective of the exploratory research is the development of hypotheses rather than their testing.
In practice, most studies are a combination of the first three categories.
Inquiry Mode
From the process adopted to find answers to the research questions – the two approaches are:
  • Structured approach
  • Unstructured approach.
  • Structured approach: The structured approach to inquiry is usually classified as quantitative research. Quantitative research is based on the measurement of quantity or amount. It is applicable to phenomena that can be expressed in terms of quantity. In quantitative research, objectives, design, sample, and the tool to collect data from respondents are predetermined. It is more appropriate to determine the extent of a problem, issue or phenomenon by quantifying the variation, e.g. how many people have a particular problem? How many people hold a particular attitude?
  • Unstructured approach: The unstructured approach to inquiry is usually classified as qualitative research. This is especially important in behavioral sciences where the aim is to discover the underlying motives of human behavior. This approach allows flexibility in all aspects of the research process. It is more appropriate to explore the nature of a problem, issue or phenomenon without quantifying it. The main objective is to describe the variation in a phenomenon, situation or attitude, e.g. description of an observed situation, the historical enumeration of events, an account of different opinions different people have about an issue, description of working conditions in a particular industry.
17The entire research process can be discussed under five major headings or components. There are many substeps or activities under each component. These are:
  • Problem statement
  • Review of literature
  • Planning research design and methods
  • Data collection
  • Data analysis, interpretation and utilization.
  • Problem statement
    • Determining the research need
    • Identifying and formulating the research problem/questions
    • Review of literature
    • Gathering background information
    • Refining research problem and statement of hypothesis and objectives.
  • Review of literature
    • Reviewing the literature
    • Preparing conceptual framework.
  • Planning research design and methods
    • Selecting a research design
    • Deciding on population and samples
    • Selecting sampling techniques and methods
    • Deciding on setting for the study
    • Deciding on methods and preparation of tool for data collection
    • Deciding on the methods of analysis
    • Verifying on research ethics
    • Conducting pilot study.
  • Data collection
    • Collecting data
    • Preparing data for analysis.
  • Data analysis, interpretation and utilization
    • Analyzing and interpreting findings
    • Utilizing research findings
    • Communicating and disseminating research findings.
Problem Statement
  • Determining the research need: In general, to undertake any activity, there must be a reason behind it. We do not do things simply. As professionals, nurses must have a strong need to perform any professional activity. All nursing interventions are based on a patient's need and there is a rationale behind it. The same way, a nurse should identify the need to undertake any research activity. The need arises from the problem experienced by the researcher. A research problem, in general, refers to some felt difficulty which the investigator experiences in the context of the theoretical or practical situation and for which he feels the urge to solve. A 18research problem is a situation or circumstance that requires a solution to be described, explained or predicted. The research problem identifies the knowledge gap that needs to be filled. The felt difficulty or the problem to solve is the need to conduct the study.
  • Identifying and formulating the research problem/questions: A research study begins as a question that a researcher would like to answer or as a problem that a researcher would like to solve. A research problem is the first step and the most important requirement in the research process. It serves as the foundation of a research study. According to Kerlinger, in order for one to solve a problem, one must know what the problem is. The large part of the problem is knowing what one is trying to do. A well-formulated problem is already a half-solved problem. A proper definition of research problem will enable the researcher to be on the track whereas an ill defined problem may create hurdle. Thus, proper definition of a research problem is a prerequisite for any study and is a step of the highest importance. The research problem can be written as a statement or as a research question.
  • Review of literature: Research studies are undertaken within the context of an existing knowledge base. A careful review of existing resources, such as journals, books, thesis and other related literature is one of the major steps in any research study. It allows the researcher to acquaint and familiarize himself with current knowledge in the area where he proposed to conduct research. A literature review surveys scholarly articles, books and other sources (e.g. dissertations, conference proceedings) relevant to a particular issue, area of research, or theory, providing a description, summary, and critical evaluation of each work. The literature review is done in the initial process for identification and selection of research problem as well as to gather relevant information on the selected problem.
  • Gathering background information: By careful reviewing of the literature, one could get adequate information regarding existing work on a particular problem and the gaps in previous research. In this step, the researcher can broaden his knowledge on the selected problem, bring clarity and focus to the research problem and delimit the problem. He can search for information from primary and secondary sources.
  • Refining research problem and statement of hypothesis and objectives: The background information about a research problem helps in refining the research problem and objectives. The research problem should be stated in such a way that it would lead to analytical thinking on the part of the researcher with the aim of possible concluding solutions to the stated problem. Research problems can be stated in the form of either questions or statements. The research problem should always be formulated grammatically correct and as completely as possible. Meaningless words should be avoided. It is important to keep in mind that the clearer the research objectives, the more actionable the research findings will be. Aims are broad statements of desired outcomes, or the general intentions of the research. Aims and objectives should be presented concisely and 19briefly and be interrelated. The aim is what the investigator wants to achieve, and the objectives describe how the investigator is going to achieve that aim.
The objectives of a research are derived from the problem statement which simplifies the step to be followed in a research. It communicates to the readers what the researcher intends to achieve by the study. These objectives should be closely related to the research problem.
The general objective of a study states what researchers expect to achieve by the study in general terms. The specific objectives are the logical steps formulated from the general objectives which explain what the researcher will do in her study.
The next step after defining the problem is to formulate a tentative explanation or solution of that problem in the form of a proposition. The tentative explanation or solution, the validity of which is still to be tested, is called the hypothesis. It is an informed/educated guess. It explains the researcher's expectation of a relationship existing between the variables. It indicates the expectations of the researcher regarding certain variables. While selecting a research problem, the topic or subject which is overdone should not be chosen in general. It will be difficult to throw any new light related to the problem. Also, controversial topics should preferably be avoided. It is not too late for one to decide any changes or modification of the selected problem.
Review of Literature
  • Reviewing the literature: It can be understood in two different meanings. One is the process of searching for specific content in available literature and the second one is the written summary of the searched content.
    • In the first context, ‘review of literature’ refers to the process of extensive, exhaustive and systemic examination of publications relevant to a specific topic. It is a broad, comprehensive, in-depth, systematic and critical review of scholarly publications, unpublished scholarly print materials, etc.
    • In the second context, ‘review of literature’ refers to a written report of information gathered from various sources/literature related to a selected topic. This report should be of an evaluative and critical nature and not simply copying from the sources. Such a well-written analytical report forms the theoretical base for any research. The primary purpose of writing the report is to personally understand as well as to convey to the reader what is already established on a topic and what are its strengths and weaknesses. It gives an overview of the key findings and key authors, the prevailing theories and hypotheses and methods and methodologies used. In order to write a relevant literature review, the person who writes should remember the research objectives, the problems or issues to be researched. Rather it should not be a descriptive summary of the available information. The researcher searches for information from the primary and secondary sources and finally makes a complete report of the review.
  • 20Preparing conceptual framework: A framework is a structure composed of many concepts proposed to serve as a support or guide for the building of something that expands the structure into something useful and meaningful. It is a broad overview, outline, or skeleton of interlinked concepts or items which support a major theme or overall concept. In nursing research, the conceptual/theoretical framework forms an important element. Conceptual framework is used in research to outline possible courses of action or to present a preferred approach to an idea or thought. Conceptual frameworks (theoretical frameworks) are a type of intermediate theory that attempt to connect to all aspects of inquiry (e.g. problem definition, purpose, literature review, methodology, data collection and analysis). Conceptual frameworks can act like a map that explains the logic to empirical inquiry. It clarifies the concepts on which the study is built. It specifies the relationship among the concepts. It identifies and states the assumptions and hypotheses underlying the study. It explains why a research is conducted in a particular way. It guides the researcher in the further course of action.
Planning Research Design and Methods
  • Selecting a research design: Research design is the researcher's overall plan to obtain answer to the problem. In order to obtain solution to the problem, the researcher follows the best possible technique among the alternatives available. Research approach is a broad term which explains how a problem can be approached. ‘Research design’ is a more specific term which explains how a problem is solved using a specific approach. The selection of research design is influenced by the research approach. The research design is a plan of action indicating the specific steps that are necessary to provide answers to those questions, test the hypotheses, and thereby achieve the research objective that is the outcome of the study. Research design is a conceptual structure or plan of how a research is conducted. The research design is the plan, structure and strategy of investigation conceived so as to obtain answers to research questions and to control variance. The research design constitutes the blueprint for the collection, measurement and analysis of data. In general. research approaches are either quantitative or qualitative. Quantitative approach to research uses experimental, quasiexperimental and nonexperimental designs, whereas qualitative approach to research uses case study, phenomenology, ethnography and grounded theory.
  • Deciding on population and samples: Population is generally a large collection of individuals or objects that is the main focus of a scientific query. It is for the benefit of the population that researches are done. Collection of data is an essential part of the research process. In order to collect data for any research problem, the researcher has to select a representative sample from the population so as to enable him to draw conclusions from the sample, which will hold good for the population. A 21sample is selected since it is neither possible nor feasible to gather data for the whole population. By correctly drawing a sample from a specific population, a researcher can analyze the sample and make inferences about population characteristics. However, due to the large sizes of populations, researchers often cannot test every individual in the population because it is too expensive and time-consuming. If the sample is representative of the population from which it is drawn, the researcher can have confidence in concluding that the results are generalizable to the entire population and setting studies. Sampling is done to save time and money. The target population refers to the entire group of individuals or objects to which researchers are interested in generalizing the conclusions. The accessible population is the population in research to which the researchers can apply their conclusions. This population is a subset of the target population and is also known as the study population. It is from the accessible population that researchers draw their samples. Accessible population is feasible for the researcher to access. The researcher can finalize the population and sample.
  • Selecting sampling techniques and methods: The sample refers to those individuals or units or elements who are selected for a study. A sample is simply a subset of the population. The concept of sample arises from the inability of the researchers to test all the individuals in a given population. The sample must be representative of the population from which it was drawn and it must have good size to warrant statistical analysis. Sampling is the process of selection of samples from a population. A sample design is a definite plan for obtaining a sample from the sampling frame. It refers to the technique or the procedure the researcher would adopt in selecting some sampling units from which inferences about the population are drawn. Sampling design is determined before any data are collected. There are two major types of sampling techniques. They are probability and nonprobability sampling techniques. The researcher selects an appropriate method of sampling technique based on his research problem.
  • Deciding on setting for the study: A setting is a place where a researcher can have access to the population. Setting may be a hospital, community, school or college, etc. A researcher has to get prior permission to select samples from the setting. A study can be conducted in a natural setting or in an artificial setting. Many laboratory experiments are conducted in other disciplines too. Setting can be selected based on the feasibility of conducting research and he should check whether he could select adequate samples for the study.
  • Deciding on methods and preparation of tool for data collection: Data collection is an important aspect of any type of research study. Inaccurate data collection can impact the results of a study and ultimately lead to invalid results. Collection of data is the first step in the statistical treatment of a problem. Data may be primary and secondary data. Primary data are original in character and it is collected for the first time. Secondary data refer to those which have been collected already by previous researchers and have gone through the process of standardization. The researcher has22 to decide about the data that should be collected during his investigation. A researcher may have to collect primary data or secondary data or both based on the requirement of his research. Data can be collected using three major data collection methods, such as self-report, observation and biophysiological measurements. A researcher can use variety of tools, such as interview schedule, questionnaire, rating scale, checklist, video camera, etc. to collect data. The method and tool selected should be an appropriate one, which would help the researcher to elicit the information for his study.
  • Deciding on the methods of analysis: A researcher has to have a plan of analysis. The analysis is based on the research problem, objectives and hypothesis. He should have a clear idea about what descriptive methods and inferential statistical method he is planning to use to analyze data.
  • Verifying on research ethics: The word ‘ethics’ means ‘moral principles’. ‘Ethical’ means ‘morally correct’. Ethics in nursing research can be defined as ‘the set of moral principles which the researcher has to follow while conducting nursing research to ensure the rights and welfare of persons and communities which are the subjects of his/her study’. Research ethics involve the application of fundamental ethical principles to a variety of topics involving scientific research. These include the design and implementation of research involving human experimentation and animal experimentation. Nursing research relies on the collaborations and partnerships based on mutual trust. When that trust is breached, the damage is irreversible. Honesty, openness, respect and sensitivity to others provide the cornerstones for ethical research. It is important that all nursing research is undertaken from a clear ethical stance, with ethical concerns.
  • Conduct pilot study: Pilot study is the study carried out at the end of the planning phase of research, in order to explore and test the research elements. It is a small-scale study that precedes as if it were the actual study, except for the fact that subjects who will participate in the actual study are not used. However, they may be selected at this point. The primary objective of the pilot study is to test as many elements of the research proposal as possible, in order to correct any part that does not work well. For example, the pilot study tests whether the variables defined by operational definition are actually observable and measurable. Pretesting of instrument is also carried in the pilot study. A pilot experiment, also called a pilot study, is a small-scale preliminary study conducted in order to evaluate feasibility, time, cost, adverse events, and effect size (statistical variability) in an attempt to predict an appropriate sample size and improve upon the study design prior to performance of a full-scale research project. It is smaller version of a larger study that is conducted to prepare for that study. A pilot study is an initial investigation to give information that will be necessary when designing a future trial or study. A pilot or feasibility study is a small experiment designed to test logistics and gather information prior to a larger study, in order to improve the latter's 23quality and efficiency. A pilot study can reveal deficiencies in the design of a proposed experiment or procedure and these can then be addressed before time and resources are expanded on large scale studies. There should be an outline of the future study for which the pilot is being used to gather information. As the sample size of a pilot study is seldom sufficient to draw reliable conclusions, the pilot should not be an end in itself.
Data Collection
  • Collecting data: In this step, the researcher collects information using predetermined methods and tools. He identifies the population, selects samples and collects data as tested in pilot study. It is an implementation process of the research.
  • Preparing data for analysis: Once data is collected, he has to prepare the data for analysis. This step involves editing, cleaning of the data, classification, coding, and transformation of data. Editing of data is a process of examining the collected raw data (specially in surveys) to detect errors and omissions and to correct these when possible. Editing involves a careful scrutiny of the completed questionnaires and/or schedules. Coding refers to the process of assigning numerals or other symbols to answers so that responses can be put into a limited number of categories or classes. Such classes should be appropriate to the research problem under consideration. A transformation is a mathematical procedure for systematically converting a set of scores into a different set of scores. One reason to transform data is to make different kinds of scores comparable. However, by transforming each score to a percent of total, we are no longer comparing apples to oranges. Second, we transform data because it makes scores easier to work with. Classification is the process of arranging the available data into various homogenous classes and subclasses according to some common characteristic or attribute or objective of an investigation. Tabulation or classification is the process by which data of long series of observation are systematically organized and recorded so as to enable analysis and interpretation.
Data Analysis, Interpretation and Utilization
  • Analyzing and interpreting findings: After collecting and analyzing the data, the researcher has to accomplish the task of drawing inferences. Interpretation refers to the task of drawing inferences from the collected facts after analysis. In fact, it is a search for broader meaning of research findings. Interpretation helps in establishment of some explanatory concepts. After analysis of data, we want to draw conclusions for the population. Drawing conclusion involves generalization of the findings for the population. Interpretation is essential for the simple reason that the usefulness and utility of research findings lie in proper interpretation. Through interpretation, the researcher can link his findings with that of others. The interpretation of the findings of exploratory research study 24often results into hypotheses for experimental research and, as such, interpretation is involved in the transition from exploratory to experimental research. Since an exploratory study does not have a hypothesis to start with, the findings of such study have to be interpreted on a post factum basis in which case the interpretation is technically described as ‘post factum’ interpretation. In case of studies aimed at hypothesis testing, the researcher either rejects or accepts the hypothesis.
  • Utilizing research findings: It refers to the use of some aspect of a scientific investigation in an application unrelated to the original research. The research findings are utilized by the investigator herself or any other who is interested in utilizing the findings. The dissemination (knowledge transfer) is the step prior to the utilization, which also varies from person to person. The nurse researcher's duty not only rests with conducting research, it also includes promotion for effective utilization, otherwise her research work is meaningless. By recognizing the difference between the dissemination and utilization, she can prepare model for utilization by which one can encourage effective utilization. Evidence-based practice (EBP) involves making clinical decisions on the basis of the best possible evidence. Usually, the best evidence comes from rigorous research, but EBP also uses other sources of credible information.
A nurse who wants to utilize or shows interest in research utilization undergoes the continuum ranging from receiving information without internalization to application of received information.
Stage 1: A nurse receives information but no internalization occurs.
Stage 2: A nurse receives information and internalization occurs but rejects or ignores to apply.
Stage 3: A nurse receives information, internalizes and partially applies or rejects.
Stage 4: A nurse receives information, internalizes and fully replicates.
Stage 5: A nurse receives information, internalizes, and fully adapts for application.
  • Communicating and disseminating research findings: Research study is complete only when the findings have been shared with others. It is of no value unless the research finding is disseminated to the people. It is the researcher's responsibility to ensure that the research study, and its findings/recommendations are disseminated to as wide an audience as possible. Scientific communication takes place in many ways, including archival publication in scholarly journals and informal communication among groups of scientists, known as invisible colleges. For this, a report of entire study should be written by the researcher. The writing of research report necessitates specific methods depending on the purpose for which it is to be written and skill on the part of the researcher to write a report on one's own work. The purpose of writing a research report is to document the research findings, to share the results with other interested groups, and to apply the results in practice. It is a challenging job and requires imagination, 25creativity and resourcefulness. The research report aims at telling the readers the problems identified, investigated and methods adopted, the results found and the conclusion reached. Research outcome needs to be shared with other professionals, regardless of the study's outcome.
There are many ways of communicating one's research findings. These are:
  • Writing dissertation
  • Writing for publication in scholarly journals/books/newspapers
  • Writing and presenting at conferences
  • Writing for funding agencies
  • Preparing and doing poster presentation
  • Verbal report/presentation at meetings
  • Presentation at journal clubs
  • Presentation at continuing nursing education programs.
A nurse researcher plays various roles and performs many functions in research-related activities. The roles and functions of a nurse researcher are as follows:
  • Critical thinker: Critical thinking is the rational examination of ideas, inferences assumptions, principles, arguments, conclusions, issues, statements, beliefs and actions (Bandman and Bandman, 1998). She should possess critical thinking ability which will help her to do a better job in all works of research. Research requires thinking more than doing.
  • Disseminator/Communicator: To fulfill this role, a nurse researcher has to:
    • Communicate the problem faced in the work area
    • Communicate the need for undertaking any research
    • Communicate the progress of research to the concerned people, such as the research committee, or the management, etc.
    • Communicate the limitations, recommendations and findings
    • Communicate to peers in the journal club and also write for publication in journal
    • Present the findings in the conferences and seminars
    • Write to a professional organization for change of practice or implementation of newer skills.
  • Educator: The nurse researcher has to educate the research methodologies, preparation of measurement tools, importance of evidence-based practice, process of research utilization, etc. to other nurses. She can educate and offer consultation services to novice nurse researchers. She has to involve herself in educating the participants or subjects involved regarding the changed practice as well as nurses for evidence-based practice.
  • Motivator: She has to motivate the peers, novice researchers and others to undertake research. She can motivate them to select an appropriate researchable problem which will be of clinical significance. She has the responsibility of motivating them to communicate and disseminate findings.
  • 26Advocate: As an advocate, she gets approval from the research committee. She checks for the feasibility to conduct the research study. She gets permission from the appropriate agency/person to conduct the study in the selected setting. She acts as a liaison between the subjects and the approval agency. She voices out for the rights of the subjects if, in case, violated.
  • Strong believer of ethics: A nurse researcher, as a strong believer of ethics, has to perform certain functions:
    • She understands and analyzes the ethical issues pertaining to the research problem
    • She prepares and gets informed consent from the participants
    • She maintains confidentiality of the subjects
    • She sets the rules and regulations in conducting the specific study
    • She maintains morale in data collection and analysis
    • She avoids plagiarism during the whole process of research
    • She ensures benefits for the participants and community.
  • Problem-solver: She avoids unnecessary confusions in the research process. She is clear and precise in conducting the study. She follows research principles and methods. She is acquainted with the ethical concerns to avoid obstacles in the process of research.
  • Research problem creator: She is well-versed in finding out the research topic. She thinks about the pros and cons of each action-oriented research. She expects the possibilities of moving with the difficult situations (inadequacy of samples, miscommunication between the participants, delays in the process). She identifies the potential areas of research and the gap in the theory practice areas. She has ability in selecting appropriate research problems.
  • Evaluator: She analyzes the research findings. She evaluates the extent of involvement of each participant in the research process. She analyzes the work of the entire team (group project). She assesses the need for further research, awareness programs and communication of research findings and also evaluates the need for research utilization.
  • Critique: A nurse researcher should develop the ability to evaluate research critically for which one must have critical reading skills. As a critique, the nurse researcher:
    • Performs the research critique
    • Understands that critiquing is not finding fault and being objective in critiquing
    • Identifies appropriate evidence after critiquing for utilization
    • Critiques a research study for evidence-based practice
    • Identifies the major drawbacks in her study as well as in others.
  • Change agent: The nurse researcher, as a change agent:
    • Identifies the areas which need change
    • Introduces appropriate strategies for change
    • Selects the strategies based on scientific principles
    • Supports people during the change process
    • Motivates people to accept the changes.
  • 27Evidence-seeker: The nurse researcher:
    • Seeks actively evidence for practice
    • Participates in the research process
    • Reviews literature constantly
    • Updates herself with current information
    • Updates herself technically.
  • Other roles a nurse researcher plays are as follows:
    • As a trendsetter
    • As a role model
    • As a leader
    • Uses newer scientific methods
    • As a futuristic nurse.
  • Research is a process of collecting, analyzing and interpreting information to answer questions. The foundation for effective research is the strong desire and motivation to do research. Nursing research involves a systematic process aimed to inquire about the issues related to nursing.
  • Nursing research is systematic inquiry designed to develop knowledge about issues of importance to the nursing profession, including nursing practice, education, administration and informatics.
  • The methods adopted by man for acquiring knowledge are authority, tradition, experience, inductive and deductive reasoning and scientific methods.
  • The purpose of conducting research is to describe, speculate, explain, explore, evaluate and do prediction and control.
  • The scope of nursing research is as wide and deep as far as the humanity is concerned. The research in nursing can be conducted in the following areas such as based on the major areas of nursing, specialty areas, various developmental age groups of human beings, preventive, promotive, curative and rehabilitative areas. Research can also be conducted in various settings.
  • Research can be categorized into pure or basic research and applied research based on its application.
  • Pure research involves developing and testing theories and hypotheses that are intellectually challenging to the researcher but may or may not have practical application at the present time or in the future.
  • Applied research is done to solve specific, practical questions for policy formulation, administration and understanding of a phenomenon.
  • Research can be classified from the viewpoint of objectives, as descriptive, correlational, explanatory and exploratory research. From the process adopted to find answers to research questions—the two approaches are structured approach and unstructured approach. The structured approach to inquiry is usually classified as the quantitative research whereas the unstructured approach is classified as the qualitative research.
  • The major steps in research process are problem statement, reviewing of literature, planning research design and methods, data collection and data analysis, interpretation and utilization.