Reading

Schmidt & Brown (2021). Evidence-Based Practice for Nurses:

• Chapter 2.1: Research: What Is It?

• Chapter 4.3: Formulating EBP Questions

• Chapter 6: Linking Theory, Research, and Practice

Objective

• Define research

• Discuss the contribution of research to evidence-based practice (EBP)

• Categorize types of research

• Distinguish between quantitative and qualitative research approaches

• Define the terms theory and research as they relate to the practice of nursing

• Distinguish between conceptual and operational definitions

• Describe how theory and research influence each other in a professional discipline

• Apply the language of the discipline in describing the relevance of linking theory, research, and practice in nursing

• Discuss how research, EBP, and Quality Improvement (QI) differ

What is Research?

Nursing is often described as "the art and science of nursing"

• Science

  • = Knowledge derived from rigorous observation and experimentation to systematically study the physical world for the purpose of testing or developing theories

• Research

  • = Systematic study that leads to new knowledge and/or solutions to problems or questions

• 2. Basic vs. Applied

  • Basic research

    • = Research to gain knowledge for the sake of gaining knowledge; bench research

  • Applied research

    • = Research to discover knowledge that will solve a clinical problem

• 3. Quantitative vs. Qualitative

  • Quantitative research

    • = Research that uses numbers to obtain precise measurements

    • Empirical evidence

      • = Evidence that is verifiable by experience through the five senses or experiment

  • Qualitative research

    • = Research that uses words to describe human behaviors

  • Mixed methods

    • = A design that combines both quantitative and qualitative data gathering and evaluation

Early Methods of Resuscitation

An example of practice based on untested theory by focusing only on the respiratory system

• Sylvester's method for adults resuscitation in 1912

  • Patient placed flat on his back

  • Grasp the patient's elbows and press them close to his sides, pushing in the ribs to expel air from the chest

  • Slowly pull the arms over the head, allowing the chest to expand

  • Lower the arms to put pressure on the chest

  • Repeat the cycle

  • Perform at the rate of 18 to 20 cycles per minutes

• Byrd's method for infant resuscitation in 1912

  • Hold the infant's legs in one hand, and the head and back in the other

  • Double the child over by pressing the head and the knees against the chest

  • Extend the knees to undouble the child

  • Repeat the cycle, but "not too rapidly"

  • At intervals, dip the child into a mustard bath in the hope that this would also stimulate respiration

  • Continue the cycle until help arrives

• New Schafer method in 1942

  • Place the patient in a prone position

  • The nurse would straddle the thighs, facing the patient's head, and alternatively apply and remove pressure to the thorax

• Current practice

  • Cardiopulmonary resuscitation techniques based on updated research and theories

The Special Language of Theory

• Theory

  • = A set of concepts linked through propositions to explain a phenomenon

  • Metaparadigm

    • = Four broad concepts core to nursing: person, environment, health, and nursing

• Construct

  • = A word or phrase used to communicate a specific key idea to others

• Concepts

  • = Words or phrases that convey a unique idea that is relevant to a theory

  • Proposition

    • A statement about the relationship between two or more concepts

The Special Language of Research

Research can be deductive, inductive, or reproductive. It can be quantitative, qualitative, or combination of both approaches.

• 1. Deductive research

  • = Research involving quantitative designs; begins by deriving testable ideas from theories

  • Two kinds of definitions

    • Conceptual definitions

      • = Definitions of concepts contained in a theory that sound like dictionary definitions

      • e.g. "Quality of Life" by World Health Organization (WHO)

        • = "an individual's perception of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns"

    • Operational definitions

      • = Definitions that explicitly state how the variable will be measured or operationalized; empirical definitions

      • e.g. "Quality of Life" by WHO, see "WHOQOL Use Manual" below

        • See Table 1.4 on page 19 for the 6 domains of QOL

        • See Appendix 4 on page 72 for the scale

      • Empirical indicators

        • = Measures of the variables being studied

  • Variable

    • = An observation that can be measured by assigning a number to each dimension

  • Hypotheses

    • = Formal statements regarding the expected or predicted relationship among two or more variables

  • Theoretical framework

    • = The structure of a study that links the theory concepts to the study variables; a section of a research article that describes the theory used

    • Model

      • = Pictorial representation of concept and their interrelationships

    • See images below the QOL articles

• 2. Inductive research

  • = Research used to develop theory; is usually qualitative

• 3. Reproductive research

  • = Research focused on improving theory through reasoning