Tag Archives: nursing research

nursing history, oral history, research, Uncategorized

Oral History Research: “The Black Angels: The Untold Story of the Nurses who Helped Cure Tuberculosis”

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Below is a YouTube recording of this week’s presentation from the Midwest Nursing History Research Center. The author presents an overview of her book and where you can learn more.

According to the Oral History Association:

Oral history is a field of study and a method of gathering, preserving and interpreting the voices and memories of people, communities, and participants in past events. Oral history is both the oldest type of historical inquiry, predating the written word, and one of the most modern, initiated with tape recorders in the 1940s and now using 21st-century digital technologies.

In Doing Oral History, Donald Ritchie explains, “Oral History collects memories and personal commentaries of historical significance through recorded interviews.  An oral history interview generally consists of a well-prepared interviewer questioning an interviewee and recording their exchange in audio or video format.  Recordings of the interview are transcribed, summarized, or indexed and then placed in a library or archives. These interviews may be used for research or excerpted in a publication, radio or video documentary, museum exhibition, dramatization or other form of public presentation. Recordings, transcripts, catalogs, photographs and related documentary materials can also be posted on the Internet.“  Oral history does not include random taping, such as President Richard Nixon’s surreptitious recording of his White House conversations, nor does it refer to recorded speeches, wiretapping, personal diaries on tape, or other sound recordings that lack the dialogue between interviewer and interviewee.”

For thought: Whom within your circle could contribute to our healthcare history? What a wonderful contribution if you could collect their oral history using resources from the Oral History Association and elsewhere!!

Descriptive research, Research design

Primer on Research Design: Part 1-Description

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A research design is the investigator-chosen, overarching study framework that facilitates getting the most accurate answer to a hypothesis or question. Think of research design as similar to the framing of a house during construction. Just as house-framing provides structure and limits to walls, floors, and ceilings, so does a research design provide structure and limits to a host of protocol details.

Tip. The two major categories of research design are: 1) Non-experimental, observation only and 2) Experimental testing of an intervention.

DESCRIPTIVE STUDIES

Non-experimental studies that examine one variable at a time.

When little is known and no theory exists on a topic, descriptive research begins to build theory by identifying and defining key, related concepts (variables). Although a descriptive study may explore several variables, only one of those is measured at a time; there is no examination of relationships between variables. Descriptive studies create a picture of what exists by analyzing quantitative or qualitative

data to answer questions like, “What is [variable x]?” or “How often does it occur?” Examples of such one-variable questions are “What are the experiences of first-time fathers?” or “How many falls occur in the emergency room?” (Variables are in italics.)  The former question produces qualitative data, and the latter, quantitative.

Descriptive results raise important questions for further study, and findings are rarely generalizable. You can see this especially in a descriptive case study: an in-depth exploration of a single event or phenomena that is limited to a particular time and place. Given case study limitations, opinions differ on whether they even qualify as research.

Descriptive research that arises from constructivist or advocacy assumptions merits particular attention. In these designs, researchers collect in-depth qualitative information about only one variable and then critically reflect on that data in order to uncover emerging themes or theories. Often broad data are collected in a natural setting in which researchers exercise little control over other variables. Sample size is not pre-determined, data collection and analysis are concurrent, and the researcher collects and analyzes data until no new ideas emerge (data saturation). The most basic qualitative descriptive method is perhaps content analysis, sometimes called narrative descriptive analysis, in which researchers uncover themes within informant descriptions. Figure 4 identifies major qualitative traditions beyond content analysis and case studies.

Alert! All qualitative studies are descriptive, but not all descriptive studies are qualitative.

Box 1. Descriptive Qualitative Designs

DesignFocusDiscipline of Origin
EthnographyUncovers phenomena within a given culture, such as meanings, communications, and mores.Anthropology
Grounded TheoryIdentifies a  basic social problem and the process that participants use to confront it.Sociology
PhenomenologyDocuments the “lived experience” of informants going through a particular event or situation.Psychology
Community participatory actionSeeks positive social change and empowerment of an oppressed community by engaging them in every step of the research process.Marxist political theory
FeministSeeks positive social change and empowerment of women as an oppressed group.Marxist political theory
Clinical practice guidelines, EBP, Evidence based nursing, evidence based practice, nursing research, Outcome measurement

“How many articles are enough?” Is that even the right question?

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How do you know when you have found enough research evidence on a topic to be able to use the findings in clinical practice? How many articles are enough? 5? 50? 100? 1000? Good question!

You have probably heard general rules like these for finding enough applicable evidence: Stick close to your key search terms derived from PICOT statement of problem; Use only research published in the last 5-7 years unless it is a “classic; & Find randomized controlled trials (RCTs), meta-analyses, & systematic reviews of RCTs that document cause-and-effect relationships. Yes, those are good strategies. The only problem is that sometimes they don’t work!

Unfortunately, some clinical issues are “orphan topics.” No one has adequately researched them. And while there may be a few, well-done, valuable published studies on the topic, those studies may simply describe bits of the phenomenon or focus on how to measure the phenomenon (i.e., instrument development). They may give us little to no information on correlation and causation. There may be no RCTs. This situation may tempt us just to discard our clinical issue and to wait for more research (or of course to do research), but either could take years.

In her classic 1998 1-page article, “When is enough, enough?” Dr. Carol Deets, argues that asking how many research reports we need before applying the evidence may be the wrong question! Instead, she proposes, we should ask, “What should be done to evaluate the implementation of research findings in the clinical setting?”

When research evidence is minimal, then careful process and outcome evaluation of its use in clinical practice can: 1) Keep patient safety as the top priority, 2) Document cost-effectiveness and efficacy of new interventions, and 3) Facilitate swift, ethical use of findings that contributes to nursing knowledge. At the same time, Deets recognizes that for many this idea may be revolutionary, requiring us to change the way we think.

So back to the original question…How many articles are enough? Deets’ answer? “One study is enough” if we build in strong evaluation as we translate it into practice.

Reference: Deets, C. (1998). When is enough, enough? Journal of Professional Nursing, 14(4), 196. doi.org/10.1016/S8755-7223(98)80058-6

Descriptive research, Qualitative research, quantitative research, research, Research design

Research: What it is and isn’t

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WHAT RESEARCH IS

Research is using the scientific process to ask and answer questions by examining new or existing data for patterns. The data are measurements of variables of interest. The simplest definition of a variable is that it is something that varies, such as height, income, or country of origin. For example, a researcher might be interested in collecting data on triceps skin fold thickness to assess the nutritional status of preschool children. Skin fold thickness will vary.

Research is often categorized in different ways in terms of: data, design, broad aims, and logic.

Qualitative Data
  • Design. Study design is the overall plan for conducting a research study, and there are three basic designs: descriptive, correlational, and experimental.
    1. Descriptive research attempts to answer the question, “What exists?” It tells us what the situation is, but it cannot explain why things are the way they are. e.g., How much money do nurses make?
    2. Correlational research answers the question: “What is the relationship” between variables (e.g., age and attitudes toward work). It cannot explain why those variables are or are not related. e.g., relationship between nurse caring and patient satisfaction
    3. Experimental research tries to answer “Why” question by examining cause and effect connections. e.g., gum chewing after surgery speeds return of bowel function. Gum chewing is a potential cause or “the why”
  • Aims. Studies, too, may be either applied research or basic research. Applied research is when the overall purpose of the research is to uncover knowledge that may be immediately used in practice (e.g., whether a scheduled postpartum quiet time facilitates breastfeeding). In contrast, basic research is when the new knowledge has no immediate application (e.g., identifying receptors on a cell wall).
  • Logic. Study logic may be inductive or deductive. Inductive reasoning is used in qualitative research; it starts with specific bits of information and moves toward generalizations [e.g., This patient’s pain is reduced after listening to music (specific); that means that music listening reduces all patients pain (general)]. Deductive reasoning is typical of quantitative research; it starts with generalizations and moves toward specifics [e.g., If listening to music relaxes people (general), then it may reduce post-operative pain (specific)]. Of course the logical conclusions in each case should be tested with research!

WHAT RESEARCH IS NOT:

Research as a scientific process is not going to the library or searching online to find information. It is also different from processes of applying research and non-research evidence to practice (called Evidence-Based Practice or EBP). And it is not the same as Quality Improvement (QI). See Two Roads Diverged for a flowchart to help differentiate research, QI and EBP.

Literature review, reading research, research

What’s in a Name?

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[this posting back by popular demand]

TITLES!! That’s what you get when you search for research online!

But, whether your search turns up 3 or 32,003 article titles….remember that a title tells you a LOT.  In fact, if well-written it is a mini-abstract of the study. 

For example take this research article title “What patients with abdominal pain expect about pain relief in the Emergency Department” by Yee et al. in 2006 in JEN.
• Variable (key factor that varies)?  Answer = Expectations about pain relief
• Population studied? Answer = ED patients with abdominal pain
• Setting? Answer = Maybe the ED (because they could’ve been surveyed after they got home or were admitted)
• Design?  Answer = not included, but you might guess that it is a descriptive study because it likely describes the patients’ expectations without any intervention.

There you have it! Now you know about TITLES!!

Now you try. Here’s your title: Gum chewing aids bowel function return and analgesic requirements after bowel surgery: a randomized controlled trial by Byrne CM, Zahid A, Young JM, Solomon MJ, Young CJ in May 2018

  • Variables? (this time there are 3 factors that vary–1 independent variable; & 2 dependent ones connected by “and”) Your answer is……
  • Population? (who is being studied; & if you have trouble identifying variables, identify the population first; then try) Your answer is….
  • Setting? (where; maybe not so clear; might have to go to abstract for this one) Your answer is….
  • Design of study? (it’s right there!) Your answer…..

Congratulate yourself!

Data, Data collection, Disseminating findings, Evidence based nursing, evidence based practice, Florence Nightingale, History of research, Outcome measurement, Professional Nursing, quantitative research, research, Uncategorized

Nightingale: Avant garde in meaningful data

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In honor of Nurse Week, I offer this tribute to the avant garde research work of Florence Nightingale in the Crimea that saved lives and set a precedent worth following.

Nightingale was a “passionate statistician” knowing that outcome data are convincing when one wants to change the world.  She did not merely collect the data, but also documented it in a way that revealed its critical meaning for care.

As noted by John H. Lienhard (1998-2002): Nightingale coxcombchart“Once you see Nightingale’s graph, the terrible picture is clear. The Russians were a minor enemy. The real enemies were cholera, typhus, and dysentery. Once the military looked at that eloquent graph, the modern army hospital system was inevitable.  You and I are shown graphs every day. Some are honest; many are misleading….So you and I could use a Florence Nightingale today, as we drown in more undifferentiated data than anyone could’ve imagined during the Crimean War.” (Source: Leinhard, 1998-2002)

As McDonald (2001) writes in the BMJ free, full-text,  Nightingale was “a systemic thinker and a “passionate statistician.”  She insisted on improving care by making policy & care decisions based on “the best available government statistics and expertise, and the collection of new material where the existing stock was inadequate.”(p.68)

Moreover, her display of the data brought its message home through visual clarity!

Thus while Nightingale adhered to some well-accepted, but mistaken, scientific theories of the time (e.g., miasma) her work was superb and scientific in the best sense of the word.   We could all learn from Florence.

CRITICAL THINKING:   What issue in your own practice could be solved by more data?  How could you collect that data?   If you have data already, how can you display it so that it it meaningful to others and “brings the point home”?

FOR MORE INFO:

HAPPY NURSE WEEK TO ALL MY COLLEAGUES.  

MAY YOU GO WHERE THE DATA TAKES YOU!