Nursing Research Module

Prepared By: Joel C. Estacio, MA, RN, RM

The conduct of research almost always happens with a set of research subjects or a number of
participants. As a researcher, you need to conduct a sound sample plan in order to make the research more
scientific and representative of the target population. You may not be able to get data of the entire
population; so, you must be able to select a representative of the population. Findings from such sample
can then be drawn to make conclusions that can be generalized (at least in quantitative research).

Learning Outcomes:
After the teaching-learning activities, you will be able to:
1. Understand the importance of doing sampling plan.
2. Compare and contrast basic terms used in planning for samples in research.
3. Explain various sampling techniques used in nursing research.
4. Develop a sampling plan for the conceptualized research proposal.

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What is a sampling plan?

A sampling plan is developed in advance to specify how participants are going to be
selected in the research process. In your sampling plan, you must be able to explain the process
as well as the reasons for doing so.

LET US DEFINE SOME BASIC CONCEPTS:

1. Population

• A population is the entire aggregation of cases in which a researcher is interested.

Examples:
• If you are interested in doing research among primiparous women in the province of La
Union, your population will be all women who are considered primiparous residing in the
province.
• A population can also be all children diagosed to have been diagnosed with Acute
Glomerulonephritis in a particular hospital.

Remember that a population is the entire group of people you plan to study. Your population can
be accessible population or a target population.

Target population
– this is the aggregate of cases about which the researcher would like to generalize.

Accessible population
– this is the aggregate of cases that has your criteria and are accessible for the study.

To make the difference between the two concepts clearer, let us set some examples.
• Going back to the example of primiparous women, your target population will include all
primiparous women in the province. Your accessible population can be the ones who are
coming to health centers for prenatal check up, or the ones included in the list of rural
health midwives.

Imagine the green circle to include all primiarous women

in La Union. Since not all may have come for prenatal
check up, some have not yet known they are pregnant, or
some are still planning to have their check up, they are not
included in the blue triangle. The Blue triangle represents
the accessible population – those who have had their
prenatal check ups.

Take note that accessible population includes those who can be accessed for
the study!

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2. Eligibility criteria
This refers to the criteria or set of characteristics that specify your population. Sometimes, the
term eligibility criteria is similar to Inclusion Criteria. In contrast, Exclusion Criteria is
sometimes defined. Exclusion criteria include characteristics that must not be possessed to be
included in the study.

A study’s construct validity is enhanced when there is a good match between the eligibility
criteria and the population construct. The criteria you choose to define your population may have
implications for the interpretation and generalizability of the findings.

For example, you would like to conduct a study about doing a health intervention for
primiparous women. In order to specify the target population, you will set some criteria which
makes the primiparous woman “eligible”. Thus you set eligibility criteria. You plan to include
those who are 18 years and above and Filipino Citizen. These are your Inclusion criteria. You
may also set criteria that exclude them to be part of the study. Example, those who have multiple
pregnancy (i.e. twin), those who have preexisting condition (such as heart disease).

3. Sample
- This refers to a part of the population, which is the most basic unit about which data are
collected.
- A representative sample is one whose key characteristics closely approximate those of
the population.

In quantitative study, two elements about sample must be met:

representativeness and size.

If the sample is not representative of the population, the study’s external

validity and construct validity are at risk.

4. Strata

- Sometimes, it is useful to think of populations as consisting of subpopulations, or strata.

Strata or Stratum (singular) is a mutually exclusive segment of a population, defined by
one or more characteristics.

In our example of primiparous women in La Union, strata can be defined by geographic location.
One stratum in Agoo, one in Aringay, and so on. Strata are often used in sample selection to
enhance the sample’s representativeness.

5. Staged Sampling

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- Samples are sometimes selected in multiple phases, in what is called multistage

sampling.

6. Sampling bias
- This refers to the systematic over- or underrepresentation of a population segment
on a characteristic relevant to the research question.
- Sampling bias can be conscious or unconsciously done.

To cite an example, you plan to do a health education intervention study for primiparous
women. You plan to select participants who are coming in the rural health unit for prenatal
check ups. You excluded one patient because she is ‘not friendly’ although the patient is
considered eligible for the study.

Sampling Methods

There are two categories of sampling methods.

1. Probability
All participants in the target population have equal chances to be selected in the sample.

2. Non-Probability
Sample is selected in a non-systematic process that does not guarantee equal chances for
each subject in the target population

Non-Probability Sampling Probability Sampling

•Convenience Sampling •Simple Random

•Snowball Sampling •Stratified Random
•Quota Sampling •Multi-Stage Cluster
•Consecutive Sampling •Systematic
•Puposive Sampling

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NON-PROBABILITY SAMPLING

Convenience Sampling

In convenience sampling, you enroll subjects or participants according to their availability and
accessibility. This method is quick, inexpensive, and convenient. It is called convenient sampling
because you select the sample elements according to their convenient accessibility and
proximity.

Snowball Sampling

You use this when the population cannot be located in a specific place and therefore, it is
difficult to access the population. To do this, you ask each participant to give you access to his
colleagues from the same population. Early sample members are also called seeds.

Quota Sampling

You identify population strata and determine how many participants are needed from
each stratum.

Example:

Suppose we were interested in studying nursing students’ attitude toward working with
AIDS patients. The accessible population is a school of nursing with 500 undergraduate
students; a sample of 100 students is desired. The easiest procedure would be to distribute
questionnaires in classrooms through convenience sampling. Suppose, however, that we
suspect that male and female students have different attitudes.

*Excerpt from: Polit, D. F., & Beck, C. T. (2017). Nursing Research: Generating and Assessing Evidence for
Nursing Practice (10th Edition); p. 370.

Consecutive Sampling

You recruit all of the people from an accessible population who meet the eligibility
criteria over a specific time interval, or for a specified sample size.

For example, in a study of ventilator-associated pneumonia in ICU patients, if the accessible

population were patients in an ICU of a specific hospital, a consecutive sample might consist of

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all eligible patients admitted to that ICU over a 6-month period. Or, it might be the first 250
eligible patients admitted to the ICU, if 250 were the targeted sample size.

(*Excerpt from: Polit, D. F., & Beck, C. T. (2017). Nursing Research: Generating and Assessing Evidence for
Nursing Practice (10th Edition); p. 371.)

Consecutive sampling is often the best possible choice when there is “rolling enrollment” into a
contained accessible population.

Purposive Sampling

This is when you use your knowledge about the population to make selections. You decide
purposely to select people who are judged to be particularly knowledgeable about the issues
under study.

PROBABILITY SAMPLING

Simple Random Sampling

This is the bost probability sampling design. To do this, you The sampling frame is
would follow the following fundamental steps. An example is the technical name for
provided for each step. the list of elements
from which the sample
will be chosen.

Step Example
1. Establish a sampling If your acccessible population include students in a
frame State University, then your sampling frame will be the
list of enrolled students in that state university.
2. Number each element In your roster of students, assign a number for each
consecutively student.

3. Use a table of random
numbers or computer-
generated list of random
numbers to draw a sample
of the desired size.
If your desired size for the state university is 100, then
randomly select one participant after another. If you
choose to use a table of random digits (example prvided
below), blidly place your finger at any part of the table
to pinpoint a number to be selected from the assigned
numbers. For example, you blindly pointed on 16. The
student assigned with the number 16 will be the first
participant, and so on.
You can also use computer-generated list of random
numbers. Example: https://www.randomizer.org/

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Excerpt from: Polit, D. F., & Beck, C. T. (2017). Nursing Research: Generating and Assessing Evidence for Nursing
Practice (10th Edition), p. 280.

Stratified Random Sampling

The population is first divided into two or more strata, with the goal of enhancing
representativeness. You then subdivide the population into homogeneous subsets (e.g., based on
gender or illness severity), from which elements/participants are selected at random.
If stratification divides the population into unequal subpopulations. Do proportionate stratified
sampling, wherein you select participants in proportion to the size of the population stratum.

Multi-Stage Cluster Sampling

If you are going to do a large-scale survey, you would most likely do a multi stage cluster
sampling. In here, you start by clusters. Cluster sampling involves selecting broad groups
(clusters). For example, you want to study a particular attribute of nursing students in the
Philippines. You might start doing cluster sampling of nursing schools in the country and
then draw samples of students from each nursing school.

Systematic Sampling
This involves selecting every kth case from a list, such as every 10th person on a patient list or
every 25th person on a student roster. To do this, you must know the number of population and
the desired sample size. Compute for the sampling interval ‘k’ by dividing the population by the
sample size.

Example: You would like to study a number of students from a total of 40, 000 students. If your
sample size is 200, then:

k = 40, 000/200

k = 200

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Since k=200, then every 200th student in the list will be a part of the sample. Note however that
the first sample must be drawn randomly (perhaps through the use of random table). If the first
sample is #52, then the next sample will be #252, then #452, # 652, and so on.

Factors Affecting Sample Size Requirements in

Quantitative Research

Effect Size
Power analysis builds on the concept of an effect size, which expresses the strength of
relationships among research variables. If there is reason to expect that the independent and
dependent variables will be strongly related, then a relatively small sample may be adequate to
reveal the relationship statistically.

Homogeneity of the Population

If the population is relatively homogeneous, a small sample may be adequate. The greater the
variability, the greater is the risk that a small sample will not adequately capture the full range of
variation. For most nursing studies, it is probably best to assume a fair degree of heterogeneity,
unless there is evidence from prior research to the contrary.

Cooperation and Attrition

In most studies, not everyone invited to participate in a study agrees to do so. Therefore, in
developing a sampling plan, it is good to begin with a realistic, evidence-based estimate of the
percentage of people likely to cooperate. Thus, if your targeted sample size is 200 but you expect
a 50% refusal rate, you would have to recruit about 400 eligible people.

Subgroup Analyses
Researchers sometimes wish to test hypotheses not only for an entire population but also for
subgroups. For example, suppose we were interested in assessing whether a structured exercise
program is effective in improving infants’ motor skills. We might also want to test whether the
intervention is more effective for certain infants (e.g., low birth weight versus normal birth
weight infants). When a sample is divided to test for subgroup effects, the sample must be large
enough to support analyses with subsets of the sample.

Steps in Sampling in Quantitative Studies

1. Identify the population.

You should begin with a clear idea about the target population to which you would like to
generalize your results. Unless you have extensive resources, you are unlikely to have
access to the full target population, so you will also need to identify the population that is
accessible to you. Researchers sometimes begin by identifying an accessible population
and then decide how best to characterize the target population.

2. Specify the eligibility criteria.

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The criteria for eligibility in the sample should then be spelled out. The criteria should be
as specific as possible with regard to characteristics that might exclude potential
participants (e.g., extremes of poor health, inability to read English). The criteria might
lead you to redefine the target population.

3. Specify the sampling plan.

Next, you must decide the method of drawing the sample and how large it will be. If you
can perform a power analysis to estimate the needed number of participants, we highly
recommend that you do so. Similarly, if probability sampling is a viable option, that
option should be exercised. If you are not in a position to do either, we recommend using
as large a sample as possible and taking steps to build representativeness into the design
(e.g., by using quota or consecutive sampling).

4. Recruit the sample.

The next step is to recruit prospective participants (after any needed institutional
permissions have been obtained) and ask for their cooperation.

Additional Notes to Remember

• The larger the sample, the more representative of the population it is likely to be.
• Probability sampling is the best method of obtaining representative samples.
• Probability sampling allows researchers to estimate the magnitude of sampling error.
Sampling error refers to differences between sample values (e.g., the average age of the
sample) and population values (the average age of the population).
• Probability sampling is the preferred and most respected method of obtaining sample
elements but is often unfeasible.
• Quantitative researchers need to pay attention to the sample size needed to achieve
statistical conclusion validity. A procedure called power analysis (Cohen, 1988) can be
used to estimate sample size needs.
• G-power is a computer tool that is often used to determine sample size.

Activity:

Using the research topic you already have, develop your sampling strategy for
the research proposal. In your output, you discuss the population you want to
study. Then discuss the locale (or the place of study). Then discuss the
sampling strategies you plan to employ. This is a group work.

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References

Elfil, M., & Negida, A. (2017). Sampling methods in Clinical Research; an Educational Review.
Emergency (Tehran, Iran), 5(1), e52. https://doi.org/10.22037/emergency.v5i1.15215

Gerrish, K., & Lathlean, J. (Eds.). (2015). The Research Process in Nursing (7th Edition ed.). Chichester,
West Sussex, United Kingdom: John Wiley & Sons, Ltd.

Polit, D. F., & Beck, C. T. (2017). Nursing Research: Generating and Assessing Evidence for
Nursing Practice (10th Editi). Wolters Kluwer Health | Lippincott Williams & Wilkins.

www.randomizer.org

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