Nursing Research

Nursing Research Introduction

Claire Espiritu
BSN2-A

 Potentials of the researcher

 Feasibility of the Problem
Nursing Research
Formal, systematic, rigorous and intensive process used for FEASIBILITY OF THE PROBLEM
solutions to nursing problems, or to discover and interpret new facts  Time
and trends in clinical practice, nursing education or nursing  Availability of subjects
administration.  Administrative and group support
GOALS OF NURSING RESEARCH  Resources
1. Efficiency and Effectiveness in Nursing  Experience of the Research
2. Worthiness and Value of Nursing profession to society.  Ethics
3. Identifying, implementing and evaluating effective health care ALTERNATIVE ROUTES TO PROBLEM SOLVING
modalities. 1. Ignore or redefine the problem
4. Provide Quality Care of Clients 2. Faith, habit or traditional practice
3. Authority
RESEARCH FOR CONDUCTING NURSING RESEARCH 4. Human experience
1. Gather data on nursing situation where little knowledge is 5. Trial and Error
available. 6. Logical Reasoning
2. Provide scientific knowledge base from which nursing theories 7. Common Sense
emerge and develop PROBLEM SOLVING AND NURSING PROCESS
3. Corrects, clarify, validate and expand Perceptions
4. Provides theoretical and scientific basis for nursing practice
5. Defines the parameters of nursing and identifies its boundaries.
6. Documents the social relevance and efficiency of nursing
practice.
7. Describes characteristics of nursing situation.
8. Provides probable outcome of nursing decisions.
9. Provide knowledge for problem solving and decision making
10. Develop and evaluates nursing theories, concepts and
practice for clarity and validity of nursing actions
11. Prevents undesirable patients reaction
12. Develop considerable degree of confidence.

Purposes of Research
 Description
 Exploration
 Explanation
 Prediction and Control
 Identification
Characteristics of Research
 Orderly and Systematic
 Control
 Empiricism ( From the patient and people)
 Generalization

ORDERLY AND SYSTEMATIC

 Problem identification IMRAD RESEARCH FORMAT
 Purpose of the study
 Review of Related Literature  CHAPTER 1 - PROBLEM AND ITS SETTING
 Theoretical / Conceptual Framework ( based on SOP)  Introduction
 Study Assumptions  Literature Review
 Study Limitation ( No participant )  Conceptual Framework
 Hypothesis Formulation  Statement of the Problem
 Variable Definition  Scope and Delimitation
 Research Design  Significance of the Study
 Target Population  CHAPTER 2 - Methodology
 Sample  Research Design ( with discussion of the method
 Field Testing used but no diagram / paradigm )
 Selectionn Instruments
CRITERIA FOR CHOICE OF A RESEARCH PROBLEM  Data Gathering Procedure
 Significance of the problem  Data Analysis
 Problem researchability
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  Ethical Considerations  “ right, safety, and well-being of trial subjects are the most
 Chapter 3 - RESULTS important considerations and should prevail over the
 Presentation of Data interest of science and society”( ICH-GCP)
 Textual Presentation of Key Findings  Preserve credibility/trust/accountability
 Presentation of themes into general findings  Reduce liabilities, wasted time and resources
 CHAPTER 4- DISCUSSION  Turns useless, harmful. Worthless to useful, helpful, worthy
 Justification of Research RESEARCH IN THE PHILIPPINES
 Implication of Findings  Surge in number of researchers
 Conclusion  Change in research topics
 Recommendations .  Preponderance of restrorative studies and industry sponsored
drug trials
INTRODUCTION TO ETHICS IN RESEARCH  Clinical trails globalization “ helicopter” research
DEFINITIONS :  Primary area for our sourcing
RESEARCH  Promoted as research hub
 An activity that inquires into a particular subject with the aim to PHILIPPINE HEALTH RESEARCH LANDSCAPES
develop or contribute to generalization knowledge (  PROBLEMS:
including theories, principle and relationships ) or any  Politics and commercialization
accumulation of information using scientific methods,  Increased researches without a proportionate increased in
observation, interference and analysis. trained researchers or research ethics committees
 Not medical treatment, surveillance, audit, program evaluation  More than 15,000 filipino research participants but no
 Not unsystematic, disorganized without focus participant advocacy group
 Not experiment  Unclear responsibilities, overlapping mandates
RESEARCH WITH HUMAN BEINGS  Ethical misconduct
 Any social science, biomedical or epidemiologic activity that CONSIDERATIONS
entails systematic collection or analysis of data with intent 1. Learn from the past
to generate new knowledge in which human beings are  Every scientific breakthrough was paid with people’s lives
exposed to manipulation, intervention, observation or other  Good people have acted in bad ways
interaction with investigators either directly, or through  Some researchers will act inappropriately
alteration of their environment or become individually  Efforts towards ethical research have been unsatisfactory
identifiable through investigator’s collection, preparation, or
use of biological material or medical or other records (
WHO 2009)
CLINICAL TRIAL
 Any investigation in human participants intended to discover
or verify the clinical, pharmacological and or
pharmacodynamic effects, identify any adverse reactions,
study absorption, distribution, metabolism and excretion of
investigational product/s with the object of ascertaining its
safety and / or efficacy ( and registering it for public use)
ETHICS
 Moral Behavior
 ETHICS IN RESEARCH : framework applying broad ethical
principles to the responsible conduct of research and to use
any outcomes resulting from research ( university of
reading )
 Focus on research participant but consider community and
environment in ethics.
RESEARCHER
 A qualifies scientist who undertakes responsibility for the
scientific and ethical integrity of a research at a specific site
 INVISTIGATOR : responsible for the conduct of the clinical
trial at a trial site ( if u only do 1 research sa mismong site )
 TECHNICIAN : collector of data
PROTOCOL
 A document that provides the background, rationale and
objectives of a research and describes its design,
methodology, organization, including ethical and statistical
considerations ( proposal is the submitted protocol for
approval )
SPONSOR
 An individual, company, institution or organization responsible
for the initiation of a clinical investigation management or
financing of clinical trial
IMPORTANCE OF ETHICS IN RESEARCH
 RIGHT THING TO DO
 Protection of research participants
 Provide advocates for research participants

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2. Value the research participant
 Indispensable for the research ( partner )
 Choose to join
 Cannot be worse off by joining research
 “Considerations of well being of research participants take
precedence over the interest of science or society” (
helsinski , 2008)
 Protection of research participants is a universal concern
 Foremost responsibility of investigator is protection of rights,
safety and welfare of study participants
 As a person with inherent dignity who should be:
A. An end and not as means
B. Protected against harm and wrong
C. Respected as a person
D. Equal to other person
3. Value Self
 As honorable and trustworthy
4. Value Community
 Impact on community which participants represent both during
after research
5. Value environment
THE PRINCIPLES OF NON-MALEFICENCE AND
BENEFICENCE: WEIGHING BENEFITS AND RISK
BACKGROUND:
 Two of the required criteria of REC approval of a research
 Risk to participants are minimized
 Risk to participants are reasonable
 Risk must be reasonable in relationship to:
 Anticipated benefits, if any, to participants themselves
 The importance of the knowledge that may reasonably
be expected to results
DEFINITIONS
BENEFICENCE
 is action that is done for the benefit of others
 Beneficent actions can be take to help prevent or
remove harms or to simply improve the situation of
others
 It is a concept in research ethics states that researchers
should have the welfare of the participants as a goal of
any research.
NON-MALEFICENCE
 Means to “ do not harm”
 The pertinent ethical issue is whether the benefits
outweigh the burden / risks
 BENEFIT: a valued or desired outcome; an advantage
 RISK: the probability and magnitude of harm or injury
occurring as a result of participation in research study
MINIMAL RISK
 Where the probability and magnitude of harm or discomfort
anticipated in the proposed research are not greater, in and
of themselves, that those ordinarily encountered in daily
lives of the general population or during the performance of
routine physical or psychological examination or test.
OVERVIEW OF RISK AND BENEFITS
 To avoid confusion, speak of risk and benefits in terms of
probabilities
 Researchers should provide detailed information about
potential risks and benefits associated with the research, as
well as probability, magnitude and potential harms
associated with each risk
 RESEARCH ETHICS COMMITTEES SHOULD:
 Evaluate potential risk
 Weight the probability of the risk occurring
 Weight the magnitude of harm that may result
 Judge whether the anticipated benefit (either new
knowledge or of improved health for the research
participant) justifies inviting any person to undertake the
risk.
 Identify the risk associated with research as
distinguished from the risks of therapies the participants
would be receive even if not participating in research
 Determine that the risk will be minimized to the extent
possible
 Identify the probable benefits to be derived from the
research
 Determine that the risk are reasonable in relation to the
benefits to participants, if ant and the importance of the
knowledge to be gained.
 Assure the potential participants will be provided with an
accurate and fair description ( during consent) of the risk
or discomfort and the anticipated benefits.
TYPES OF RISK
1. PHYSICAL
2. PSYCHOLOGICAL
3. SOCIAL
4. ECONOMIC
PHYSICAL RISK
 Usually minor discomfort or pain
 Potentially serious or disabling
 Transient or permanent
PSYCHOLOGICAL RISK
 Stress, feeling of guilt or embarrassment, depression, loss of
self- esteem, confusion etc.
 From minimal or transient to serious
 INVASION OF PRIVACY - access to a person’s body or
behavior without consent
 BREACH OF COFIDENTUALITY - inability to safeguard
information that has been given voluntarily by one person to
another
SOCIAL HARM
 Labeled or stigmatized
 May cause embarrassment or criminal prosecution
ECONOMIC HARM
 Actual cost
 Loss of employment
WAYS TO MINIMIZE RISK
 Provide complete information in the research proposal
regarding the experimental design and scientific rationale
underlying the proposed research
 Assemble a research team with sufficient expertise and
experience to conduct a research
 Ensure that the projected sample size if sufficient to yield
useful results
 Collect data from standard-of-care procedures to avoid
unnecessary risk, particularly for invasive or risky procedures
(e.g spinal taps. Cardiac catheterization )
 Incorporate adequate standards into the research design such
as an appropriate data safety monitoring plan, the presence of
trained personnel who can respond to emergencies and
procedures to protect the confidentiality of the data (e.g.
encryption, codes and passowrds )