Exploring Nursing Research in Canada

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Exploring Nursing Research in Canada

• Class One
• September 16, 2009
• Judith Shaw, Ph.D.,R.N.

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What is research?

• to search again
• diligent and systematic inquiry
• to discovery

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Define

• Nursing Research

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Nursing Research

• a scientific process that
• validates and refined existing
• knowledge, and
• generates new knowledge that
• directly and indirectly
• influences nursing practice

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Nursing Research

• Provides the scientific basis for the
• practice of the profession.
• (American Association of College of Nursing)

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Definition of Nursing Research

• Requires an understanding
• of
• what knowledge is relevant for nursing-

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Definition of Nursing Research

• Specifically-
• what knowledge is needed to improve
• nursing practice
• (Burns Grove, 2007)

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Metaparadigm

• A global statement that identifies the
• subject matter of each discipline or field
• of study.
• (Fawcett, 2005)

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Metaparadigm ofNursing

• Human beings
• The environment
• Health
• Nursing

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Nursing Research

• A formal, systematic, and rigorous process of
  inquiry used to generate and test theories about
  the health-related experiences of human beings
  within their environments and about the actions
  and processes that nurses use in practice
• (Fawcett Garity, 2009)

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ComparisonNursing Process Nursing Research

• Selection of a social context
• Formulation of research question explication of
  researchers beliefs

1. Assessment Interpretation of Data
2. Diagnosis of problem

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ComparisonNursing Process Nursing Research

• Development and
• implementation of
• plan of care

• Develop and implement methodology plan
• Cyclical process of data collection, analysis,
  and concept formation and modification

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ComparisonNursing Process Nursing Research

1. Evaluation of plan of care

• Interpretation of findings
• May involve review of literature at this stage
• Validation of findings with participants

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ComparisonNursing Process Nursing Research

1. Revision of plan based on evaluation

• Communication of the findings.
• Implications and recommendations

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• OR

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Nursing Process ?Nursing Research (Fawcett,
2005)

1. Assessment
2. Planning
3. Implementation
4. Evaluation
5. Documentation

• Statement of the problem
• Research Methods
• Conduct of the Research
• Interpretation of results
• Research Report

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The Importance of Research in Nursing

• Description
• (what is)

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The Importance of Research in Nursing

• Explanation
• (relationship nursing interventions
  with client outcomes)

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The Importance of Research in Nursing

• Prediction
• (probability of a certain outcome in a specific
  situation)

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The Importance of Research in Nursing

• Control
• (to produce the desired outcome)

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Kinds of Nursing Knowledge

• Traditions
• Authority
• Borrowing
• Trial and Error
• Personal Experience
• Role-Modeling
• Intuition
• Reasoning
• Research

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Epistemology

• -the study of the nature of knowledge
• How we know what we know

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Ways of Knowing

• Aesthetics
• Ethical Knowing
• Personal Knowing
• Empirical Knowing (Carper, 1978)
• Socio-Political (White, 1995)
• Unknowing in Knowledge (Heath,1998 Munhall,
  1993)

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Aesthetics

• The nature of beauty or art
• art of nursing

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Ethical Knowing

• The obligation, moral component
• what should be done
• what is good, right and desired

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Personal Knowledge

• Interpersonal interactions and relationships
  between the nurse and a client
• therapeutic use of self
• authentic personal relationship

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Empirical Knowledge

• Knowledge of the experienced or empirical world

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Socio-Political

• Situates nursing practice in the world of
  society, community life, culture, economics, and
  politics
• Whos voice is heard?
• Whose voice is silenced.

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Unknowing in Knowledge

• All knowledge is tentative and dynamic.
• Openness, qualitative receptivity to what may be
  learned.
• Not all important questions have been asked.
• Many answers to both scientific and philosophical
  questions remain elusive.

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How does nursing thought flow from both
concrete to abstract thinking?
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The World of Nursing Research

• Philosophy Abstract
• Knowledge
• Science Abstract Theory
• Thought Processes
• Reality Testing
• (Research)
• Empirical World
• (Nursing Practice) Concrete

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Research Nursing Knowledge

• More reliable
• vs.
• Other Kinds of Nursing Knowledge

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Philosophy in Nursing Research

• Framework for identifying central concept
• Assumptions for theory development
• Relates nursing to practice world
• Information on how to learn about the world

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Philosophical Position

• Qualitative Research
• Approaches

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Assumptions

• - interpretive worldview
• multiple realities
• - many sources of information
• - knowing how social experience constructs
  reality is important

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Philosophy

• philosophical research
• notions question
• of
• scientific
• truth

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Philosophy

• Research Methods
• Question of
• Inquiry in
• Nursing

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Qualitative Research

• Six Characteristics

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1. Multiple Realities

• The individual
• - active participates in social action
• - comes to know and understand
• phenomena in very different ways

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2. Multiple Ways of Understanding

• Finding a method or approach
• to
• appropriately answer
• the question

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3. Participants Point of View

• To present the participants view of reality
• - understand the context of what is
• researched

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4. Context

• Alter as little as possible

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5. Researcher- Part of the Study

• Researcher as instrument
• -subjective bias

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6. Reporting

• Participants perspective
• -rich, literary style
• -participants quotes,
• commentaries, and stories

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Development of Nursing Science

• Three perspectives
• 1. Positivist
• 2. Interpretive
• 3. Critical Social Theory

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Positivist Perspective

• Strict rules of logic, truth, axioms,
• and predictions

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Interpretive Perspective

• Reality is based on personal perceptions
• What we know has meaning only within a given
  context

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Critical Perspective

• Human behavior consist of different groups
  attempting to enhance their interests at the
  expense of less powerful groups

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Three Levels of Quantitative Research

• Construct axiom Construct
• relationship between constructs
• Concept proposition Concept
• relationship between concepts
• Indicators hypotheses Indicators
• different authors reverse these Gillis and
  Jackson (2002) reverse the order

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Qualitative Research

• Naming - discovering meanings in
• contexts
• - process and meaning are described

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Qualitative ResearchCyclical Process

• Researcher moves back and forth between the data
  collection and analysis stages
• -to identify and describe the
• participants perspective

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QUESTIONS ASKED
HOW/WHAT
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Triangulation

• Use of multiple methods
• to generate and collect data
• about one phenomenon

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Triangulation

• Within-Methods
• Between-Methods

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Within-Methods Triangulation

• Example
• -different types of qualitative data collections
  strategies

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Between-MethodsTriangulation

• Example
• - both qualitative/quantitative data collection
  procedures

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Unit of Analysis

• The element or set of elements selected to study
• -individual
• -aggregrate group, community

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LINK OF PRACTICE, THEORY, AND RESEARCH

• Practice
• Theory Research

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NURSING RESEARCH PRIORITIES

• To Improve
• Nursing as a Profession
• Nursing Practice
• Patient Outcomes

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Quantitative QualitativeResearch
Characteristics

• Quantitative Research
• Hard Science
• Focus Concise Narrow
• Reductionistic
• Objective
• Reasoning Logistic, Deductive
• Basis of Knowing Cause Effect, Relationships

• Qualitative Research
• - Soft Science
• - Focus Complex Broad
• - Holistic
• - Subjective
• - Reasoning Dialectic, Inductive
• - Basis of Knowing Meaning, Discovery

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Quantitative Qualitative Research
Research

• Tests Theory
• Control
• Instruments
• Basic Element of Analysis Numbers
• Statistical Analysis
• Generalization

• Develop Theory
• Shared Interpretation
• Communication Observation
• Basic Element of Analysis Words
• Individual Interpretation
• Uniqueness

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RESEARCH-MINDEDNESS
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Research-based Practice
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Deterrents to Conducting Research
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Deterrents to Conducting Research

• limited number of nurses prepared to conduct
  research
• nurse researchers may not be involved with or
  knowledgeable about nursing practice
• difficulty in asking the research question

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Deterrents to Conducting Research

• lack of congruency between research purposes and
  research methods
• insufficient time
• access to patients

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Deterrents to Disseminating Applying Research

• Understanding by practicing nursing
• Faculty not involved in research
• Lack of scientific rationale/nursing textbooks
• Inadequate preparation

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Promotion of Research Research-Based Practice

• Increase number of B Sc..N, Masters doctoral
  prepared nurses
• Emphasize students learn to critique research for
  quality data
• Develop a climate that rewards research

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Promotion of Research Research-Based Practice

• Strengthen collaboration of practice/research/educ
  ation
• Research-based protocols
• Research interest groups
• Increase opportunities for publishing

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FINANCING NURSING RESEARCH IN CANADA
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Federal Support for Research

• 3 categories research grants, research
  fellowships, auxiliary grants (indirect )
• 1971-McGill, first Center for Nursing research
• gradual increase in funding
• increase in doctoral programs/increase in
  research

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FUNDING

• Canadian Institutes of Health Research (CIHR)
  Medical Research Council, National Health
  Research Development Program
• Charitable organizations
• Canadian Nurses Fund
• Canadian Health Services Research Foundation
  (CHSRF)
• Social Science Humanities Research Council of
  Canada (SSHRC)
• Nova Scotia Health Research Foundation

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PRAXIS WITHIN NURSING

• theory, practice and research
• informing the others
• to produce
• powerful new forms of knowledge