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Transcribed by: Patricia O. Loanzon, PHRN, USRN July 3, 2023

RESEARCH RESEARCH ETHICS

Nursing research – is a systematic inquiry designed to  Protection of research subjects
develop trustworthy evidence related to nursing  Priority in research is SAFETY

Goal – enhance client care NUREMBERG CODE “EUGENICS”

Outcome – evidence based-practice  First code; informed consent is required

SOURCES OF EVIDENCE/NURSING KNOWLEDGE DECLARATION OF HELSINKI

1. Tradition – least reliable; usog, pasma, red  Vulnerable population should receive special
underwear protection
2. Authority – deemed experts of the field
3. Clinical experience – richest source of RESEARCH ETHICS
information; knowledge, skills, and attitude are  Code of Ethics for Nurses
guaranteed  Bon Resolution No. 220 S 2004
4. Trial and error – least reliable “Preserve Health At All Cost”
5. Intuition – least reliable
 R.A. 9173 – Nursing Law
6. Logical reasoning – deductive vs. inductive
7. Disciplined research – most sophisticated
RESEARCH ETHICAL PRINCIPLES
method
1. Beneficence (doing good) and Non-maleficence
(do no harm) – right: freedom from harm
PURPOSES OF NURSING RESEARCH
 All nursing procedure is non-
BASIC APPLIED
maleficence because there is a risk of
 Desire to expand  Higher level than harm
knowledge; basic research  Health teaching is beneficence
contribute new  Finds solution to 2. Justice – fairness; equal risks and benefits;
information problems equal distribution of resources (physical time)
 Curiosity driven  Masteral, PHD 3. Autonomy (Self-determination) – voluntary
 May not necessarily decision
lead to an invention 4. Veracity (Truthfulness) – complete information;
or solution to a right: full disclosure
problem 5. Confidentiality – data not revealed (medical
 Undergrads information); right: privacy (personal info of the
patient)
A study on how to treat patients with insomnia – applied
A study looking at how alcohol consumption impacts the ***Anonimity – data is not linked to person; identifying
brain – basic information removed; not an example of ethical principle

QUANTITATIVE QUALITATIVE INFORMED CONSENT

Positivism (logical) Naturalistic  Decision to accept or decline participation to
paradigm – world beliefs or (constructivism) research
view  Protects right to self-determination

There exists only one There exist multiple ELEMENTS OF INFORMED CONSENT
reality realities  Voluntary. AUTONOMY
Inquirer is independent Inquired interacts with  Informed, fully understood. VERACITY
from those being those being researched  Competent (of legal age, coherent, not in the
researched influence of substance)
Objective Subjective  Signature (subject and witness)
Empirical; uses of 5 Human experience ***Witness: ensure validity of signature, understanding
senses
Logical, planned Flexible CHARACTERISTICS OF NURSING RESEARCH
Numeric values (numbers, Narrative description 1. Systematic – follows step by step procedure
statistics) (words) Conceptual First and most important
Deductive (general to Inductive (specific to step: identify a problem
specific) general) Design and Select research and
planning sampling design
Empirical Collection of data; most
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Transcribed by: Patricia O. Loanzon, PHRN, USRN July 3, 2023

time consuming part

Analytical Data analysis SIGNIFICANCE OF THE STUDY
Disseminating Utilize findings in  Aim of the study; purpose of the study
practice; publication of  Goal: general
findings 2nd to the last  Objective: specific
step  Should be: SMART – challenging, specific,
measurable, attainable, realistic, time bound
2. Control – all variables except those that are
tested/experimented upon are kept constant to RESEARCH QUESTION CLINICAL UESTION
minimize bias (PIRD) (PICO)
Used in typical research; Used in clinical research
Independent Dependent Extraneous BASIC (Evidenced based
Variable Variable Variable practice); APPLIED
Presumed Presumed Can affect the  Population  Population
cause: being effect; study outcome;  Independent variable  Intervention (new
manipulated researchers (being manipulated) treatment you want to
want to  Relationship prove effective)
understand, (more/less, inc/dec)  Comparison (existing
explain or  Dependent variable traditional/false
predict; being (being measured) treatment/placebo)
measured  Outcome (results)
Antecedent Outcome Confounding,
variable variable, uncontrollable,
criterion interfering
DEFINITION OF TERMS
variable
1. Operational – how the term is used in the study
2. Conceptual – universal meaning; dictionary
 The effect of pre-boards anxiety to meaning; official definition
students’ pnle scores: pre-boards anxiety
is independent HYPOTHESIS
 The effect of caffeinated coffee to nurses’  Predicted relationship of variables; educational
bedside performance: bedside guess; declarative form
performance is dependent
 The effect of substance abuse to DIRECTIONAL NON-DIRECTIONAL
development of schizophrenia: substance Increase/decrease Associated with related to
abuse is independent
1 tailed 2 tailed
 The effect of maternal age to infant’s birth
weight: birth weight is dependent
SIMPLE COMPLEX
Reflects relationship Reflects relationship
3. Empirically testable – measurable and can be
between two variables between more than 2
observed using 5 senses
variables
4. Generalizability – can be applied to other
1 independent 2 or more independent and
settings
1 dependent dependent variable
CHAPTER 1: INTRODUCTION
CHAPTER 2: REVIEW OF RELATED LITERATURE
 Curiosity and interest of the researcher
 Review of what is already known about the topic;
SOURCES: CLIENT existing information available
 Clinical experience. NIFU. DAIKIN’S SOLUTION
CHARACTERISTICS: CUPB
BID
 Comprehensive
 Literature (previous studies). DRUGS,
SMOKING, ALCOHOLISM, TEENAGE  Up to date (latest 5 years)
PREGNANCY, EXCEPT THOSE THAT HAS NO  Paraphrased, not copy paste
ABSOLUTE TRUTH  Balanced (no bias)
 Issues (social)
 External sources ELECTRONIC DATABASE
1. CINAHL: most appropriate database for nurses;
 Nursing. ENVIRONMENTAL THEORY
cumulative index to nursing and allied health
 Theory
literature
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Transcribed by: Patricia O. Loanzon, PHRN, USRN
2. MEDLINE: medical literature online
3. COCHRANE: most abundant electronic
database for research
TYPES OF DATA
 Neither, it depends on the study
1. Primary – original study (thesis, journal)
2. Secondary – synthesizing/ summarized based
on primary study (book, published studies)
CHAPTER 3: METHODOLOGY
BASIC CONCEPTS
1. Bias - something that causes error, low validity;
the higher the bias, the lower the accuracy of
results
a. Recall bias – respondents’ memories of
the past (socially unacceptable topics);
FALSE MEMORY
b. Selection bias – under-represented or
over-represented samples
 to eliminate selection bias, use
randomization
c. Observation bias (Hawthorne effect) –
participants in a study are aware that
they are being observed by researchers
d. Confirmation bias – favouring that
confirms previously existing beliefs or
biases
2. Validity – you measure what you intend to
measure
a. Internal – less bias and confounding
variable (blinding and randomization)
THREATS TO INTERNAL VALIDITY
1. Selection bias – use
randomization to eliminate
2. Maturation – caused by
physiologic changes OVER TIME;
to eliminate, use control group
 Example: breastfeeding
improves infant’s length in 14
days
 EXP BF 54CM  → BF 14
DAYS → 59CM
3. Instrumentation change –
inaccurate reading of instruments
used
b. External – how generalizable the findings
are
3. Reliability – same setting, same results;
consistency of the instruments being used
4. Blinding – disguising information to prevent bias
a. Single blind – subjects (di niya alam kung
treatment or placebo marereceive niya)
b. Double blind – subjects and researchers
(both di alam, may third party na magbibigay
July 3, 2023
ng envelope kung ano yon like treatment or
placebo)
RESEARCH DESIGN
 Said to be the architectural backbone of the
study
 Overall plan for obtaining answers
 Tend to be highly structured and controlled
QUALITATIVE RESEARCH DESIGN
 In depth study of phenomena; HUMAN
EXPERIENCES
 Data collection is NARRATIVE; no statistics
involved
 Data collection is INTERVIEW (semi-structured)
 Researcher is involved with the participant
(PARTICIPANT’S OBSERVATION)
1. Phenomenological
a. Lived experiences of a person
b. Ends with data saturation – NO NEW INFO
OBTAINED
c. Data collection is interview (semi-structured)
 Exploring the lived experiences of women
undergoing breast biopsy
 Phenomenology study on nurse’s
experiences in understanding the comfort
of children at the end-of-life
 Examining the lived experiences of
mothers with terminally ill toddler children
2. Ethnographical
 Studies culture or tribe
 Language, beliefs, tradition, artifacts
 Data collection: IMMERSION
 Example: a study on health and hygiene
needs, strategies, and well-being of an Aeta
indigenous community in the Philippines
3. Grounded theory
 Social process and psychological stages
about a particular event
 Strive to generate an explanation
 Example - the experience of postpartum
depression: a grounded theory
4. Case study
 Generates in-depth, multi-faceted
understanding of a complex issue in its real
life context
 Example: military operations and the PTSD
recovery process, the negative influence of
instagram and distorted body image
5. Historical
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Transcribed by: Patricia O. Loanzon, PHRN, USRN July 3, 2023

 Explore and explain the meanings and PRE-TEST TREATMENT POST TEST
phenomenon at a particular point of time in the EG 01 X 02
past CG 01 X 02

QUANTITATIVE RESEARCH DESIGN Design: Pre-test – post-test control group design

Most powerful design

EXPERIMENTAL NON-EXPERIMENTAL
There is manipulation There is no manipulation
(administration of
independent variable)
You will look for
participants whose
independent variable is
already inherent
Beneficial, massage, Harmful
guided imagery, music Unethical
therapy

EXPERIMENTAL – strongest design

Three elements:
1. Manipulation – administration of independent
variable
2. Randomized – random assignment to
experimental and control groups to avoid bias
3. Controlled – for basis of comparison; false
treatment; traditional; placebo

TRUE QUASI- PRE-

EXPERIMENTAL EXPERIMENTAL EXPERIMENTAL
Manipulation Manipulation Manipulation
Randomization Lacks either control Lacks both
Controlled or randomization controlled and
randomization
Groups: 2-4 1-2 groups 1 group
groups
1 group: series pre- 1 pre-test and post-
test and post-test test

2 groups: assigned

TRUE EXPERIMENTAL (2-4 GROUPS)

The effect of guided imagery in decreasing pain scale

among MVA patients

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Transcribed by: Patricia O. Loanzon, PHRN, USRN July 3, 2023

 Studies cause and effect of variables

(without manipulation) by comparing 2
groups

PRE-EXPERIMENTRAL (WEAKEST)

IDENTIFYING SAMPLE AND POPULATION

1. Element – the basic unit that represents
whatever is being sampled and from which
survey data are to be gathered
2. Sample – specific group that the researcher will
collect data from
3. Population – entire group that the researcher
want to draw conclusions about

NON-EXPERIMENTAL
A. Descriptive (Observational research)
 Weakest; exploration of a phenomena
 Gather characteristics, occurrence, prevalence

B. Descriptive correlational
 Studies the relationship of variables that co-
exist
 Positive correlation – directly proportional
same direction
 Negative correlation – indirectly proportional
opposite direction
C. Descriptive comparative
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Transcribed by: Patricia O. Loanzon, PHRN, USRN July 3, 2023

PROBABILITY
 Randomized, no bias

1. Simple random – elements selected at random; NON-PROBABILITY

DRAW LOTS; FISH BOWL METHOD; BINGO;
MOST LABOROUS
2. Stratified random – divided into subgroups, called
strata; get representative from EACH subgroup
3. Cluster – multi-staging; choose group rather than
individual
4. Systematic – every kth (e.g. every 5th element) or
member of the population is selected for the sample
after a random start is determined (N/n)
 Not randomized, biased
1. Convenience – accidental and incidental sampling;
selection of the most readily available people or
objects for a study; weakest
2. Quota – breakdown by percentage then using
convenience sampling
3. Purposive – handpicked; criteria
4. Snowball – network sampling; referral (sensitive,
socially unacceptable)

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Transcribed by: Patricia O. Loanzon, PHRN, USRN July 3, 2023

 Classifying into categories; no ranking

involved
 Sex, marital status, religion
2. Ordinal
 Represents rank order
 Likert scale, wong baker scale
3. Interval
 Can specify both ranking and distance
 No absolute zero, temperature
4. Ratio
 Highest level; has absolute zero
 Height, weight, age
 HR 0

NON-PARAMETRIC DATA
(NOMINAL AND ORDINAL)
1. CHI SQUARE
2. KRUSKAL WALLIS

PARAMETRIC DATA (INTERVAL AND RATIO)

1. T TEST-
2. F TESTING ANOVA

MEASURES OF VARIABILITY
 Range: The amount between the smallest and
DATA COLLECTION METHODS largest item in the set. ARRANGE FROM
HIGHEST TO LOWEST;
TYPES OF RESEARCH INSTRUMENTS ***HIGHEST VALUE – LOWEST VALUE =
1. Questionnaire – most common RANGE
2. Interview – semi-structured  Variance: How spread out the data is. A small
3. Observation – quali and quanti number for the variance means the data set is
4. Records tightly clustered together and a large number
5. Delphi technique – invite experts to critic your means the values are more spread apart.
instrument  Standard deviation: How tightly the data is
6. Biophysiologic measure clustered around the mean (the average). A
1. In vivo (inside) small SD indicates that the data is tightly
2. In vitro (outside) – extract specimen clustered — will also have a taller bell curve; a
large SD tells that the data is more spread apart.
CHAPTER 4: ANALYSIS OF DATA

STATISTICS
Descriptive – summarizes characteristics of data set;
describes

Inferential – testing hypothesis by measuring statistical

sample

DESCRIPTIVE STATISTICS

MEASURES OF CENTRAL TENDENCY

 Mean: Average value
 Median: Central or middle value ONLY ONE;
GET
 Mode: Value that appears most often

MEASUREMENT OF VARIABLES
1. Nominal

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Transcribed by: Patricia O. Loanzon, PHRN, USRN July 3, 2023

COMMUNITY HEALTH NURSING  Active

HEALTH EDUCATION IS THE PRIMARY  Needs
RESPONSIBILITY
FAMILY: Home visit – family nurse contact
Health promotion – increase the level of health
 Diet – well balanced; follow nutrition guidelines Principles:
o Aim IBM (ideal body weight), check BMI;  Purpose/objective – to help the client
VMI = Weight (kg)/height (m)2 ; accdg to  Use of available information
WHO: 18-25, accdg to asia pacific: 18-  Needs
23  Involve the client
 Flexible

Public Health Bag (PHB) – carry, with equipment; bp app

and stet are separated

Bag Technique – tool utilized by the nurse in order to

render effective nursing care

Public health government nurse: salary grade 15 –

36,000 per month

Home health nurse: rehab care

PHCDS: Philippine Health Care Delivery System

1. Primary – basic heathcare; simple; accessible
within 30 minutes, within 3-5km; barangay health
station – smallest; pwede ipasa sa RHU
 BHS – satellite station
o X nurse
o X doctor
o + BHW
o Build healthy nutrition practices  RHU – main primary center; complete health care
o Choose food wisely team;
 Exercise: 30 minutes per session o public health midwife: frontline
o Moderate: almost o public health nurse: supervisor
o Intensity: o health officer/rural health
 Rest physician: manager
 Stop/avoid smoking o sanitary inspector:
environmental sanitation
Illness prevention – maintain health o dentist: dental health program
 Specific protection 2. Secondary – district hospital, emergency
hospital, provincial hospital
GOAL OF CHN: Optimum level of functioning) / high 3. Tertiary – advanced/complex; regional hospital;
level wellness medical center; national hospital

4 CLIENTS Ottawa charter – Canada

 Individual Primary health care = basic health care
 Family – basic unit of service Alma Ata Conference – USSR (Kazakhstan)
 Group/Population – common characteristics LOI 949 – letter of instruction; legal basis of PHC
 Community – primary client Oct 1979 signed by President Marcos

PRINCIPLES Vision: health in the hands of the people / we want them

 Family to achieve SELF RELIANCE; increase opportunities that
 All people will manage their own health care
 Teaching Mission:
 Member
2 CORE:
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 Partnership (active) 1. Lagundi – ASCOF: asthma,

 Empowerment (transfer KSA – knowledge, skills, cough and fever (check toprank
attitude) intensive module para sa iba)
 Nutrition
4 PILLARS  Treatment (medical and emergency care, non-
1. Active community participation – most important communicable disease and mental health)
2. Intra and intersectoral linkages  Sanitation of the environment
 Intra – within the healthcare delivery
system EINC (Unang Yakap)
 Inter – outside the healthcare delivery Time bound – 4 priority
system; GO; NGO  Dry infant
3. Use of appropriate technology – use of local  Early skin to skin contact
indigenous resources  Delayed cord clamping (1-3 minutes)
4. Support mechanism made available  Breastfeeding
Non-time bound
CHARACTETRISTICS: CASASA  Apgar scoring
 Community-based  Anthropometric measurement (weight, head and
 Accessible chest circumference
 Sustainable  Wash after 6 hours
 Affordable – low cost approach; walang free Unnecessary – suctioning, milking cord, immediate
 Self-reliance clamping, slap/stimulate heel, wash immediately, foot
 Available printing

ELEMENTS
 Education for health EPI – Expanded Program Immunization
 Locally endemic and communicable disease  PD 996 – all children below 8 years old
control and treatment – epidemiology:  R.A. 10152 – Mandatory immunization below 5
occurrence and distribution of disease; years old (they don’t give bcg2 anymore)
backbone of preventing disease
o Classify:
1. Sporadic – occasionally (few cases) 5 ELEMENTS OF EPI: SICAT
madami immune, konti susceptible; 1. Surveillance – search – evaluation; last step
herd immunity 2. IEC – Information education and communication
2. Endemic – always present (immune – NID National Immunization Day every
= susceptible) Wednesday
3. Epidemic (outbreak) – sudden 3. Cold chain and logistic management - masisira
increase in cases in a short period of vaccine pag naiinitan;
time  most sensitive to heat: freezer –
4. Pandemic – WWE (worldwide Varicella, OPV, MMR
epidemic) several countries are  least sensitive to heat: body of ref (+2 to
affected +8 degree celscius)
o PD 651: Birth registration, death o pcv – to prevent pneumonia
registration o ipv – injectable polio
 Where? Civil registrar o rota vaccine
 Who? Birth attendant within 30 o tetanus toxoid
days 4. Assessment and evaluation
 Death: health officer, register in Vaccine Dose Schedule Route Dosage
civil registrar within 48 hours BCG 1 Given at ID 0.05
 Expanded program on immunization Hepa B 1 birth IM 0.5
 Maternal and child health and family planning Penta V 3 1 ½, 2 ½, IM 0.5
 Essential drugs 3½
o Herbal medicine law – R.A. 8423 OPV 3 1 ½, 2 ½, ORAL 2 gtts
 Traditional, Alternative, Medicine , 3½
Act (Research institute tropical PCV 3 1 ½, 2 ½, IM 0.5
medicine) 3½
 10 HERBAL MEDICINE (SANTA Rota V 2 1 ½, 2 ½ ORAL 1.5 ml
LUBBY)
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Transcribed by: Patricia O. Loanzon, PHRN, USRN July 3, 2023

IPV 2 3 ½, 4 ½ IM 0.5
MMR 2 9 months, SQ 0.5
12
months

5. Target setting
 Primary element
 Eligible population
1. Infant: Total population x 2.7%
2. Pregnant: Total population x 3.5%

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