RESEARCH AND STATISTICS I

GNS: 217

Learning Objectives

• At the end of this course, learners should be able to:

• Define Nursing Research

• Explain the steps in the Research Process

• Describe the importance of research to Nursing as a profession

• Discuss the contribution of research to enhance Nursing Practice, Education and Management.

• Describe the steps in the Research Process.

• Apply the principles of Hypothesis formulation, Data Collection, Analysis and Interpretation of
the Research Findings

OVERVIEW OF RESEARCH AND EVIDENCE BASED PRACTICE

INTRODUCTION

• The march towards professionalism and the stability of a profession requires intellectual capacity
which comes with great responsibility. A profession must have a strong knowledge base and
capable of modifying it, including its application to remain relevant and compete favourably
among other professions. Nursing is a key area of practice in the healthcare industry requiring an
independent but inter-dependent body of knowledge for the realization of an improved health
status for the population.

• In the early practice of Nursing, approaches to care were based on healthcare instruction,
rituals/traditions and personal choice. Cares provided were either just as ordered or that they
followed usual practice. These approaches can no longer be used as basis for the provision of
sound quality Nursing care. The strength and source of information in client care must be
considered. Nurses educated at all levels must use research and Evidence Based Practice to
improve on patient care. An all-embracing principle that guides healthcare practice is to provide
quality care to all irrespective socioeconomic status and individual characteristics. In carrying out
client care, the professional nurse ensures that available, current health information are utilized as
they related to the client, with a view to improving the quality of care and patients outcomes.

• The march towards professionalism and the stability of a profession requires intellectual capacity
which comes with great responsibility. A profession must have a strong knowledge base and
capable of modifying it, including its application to remain relevant and compete favourably
among other professions. Nursing is a key area of practice in the healthcare industry requiring an
independent but inter-dependent body of knowledge for the realization of an improved health
status for the population.

• The body of knowledge must be regularly reviewed to meet with current trend so that the
profession and her practice are not left behind by time. Nursing research is a key tool to
developing and improving on Nursing education and practice.

• Nursing research is not a new concept though for most nurses it sounds an academic interest not
necessary for the Nurse-Practitioner. Nurses have for decade unconsciously collaborated with
 other healthcare workers to perform research but failed for many years to initiate and conduct
Nursing research until recently when this requirement has come to the fore. Evidence abound in
literature that even before Nursing was taken to institutions of higher learning, some scientific
enquire had begun.

• As a practice profession, research, education and practice forms a tripods upon which the
profession stands. The relationship between then is reciprocal. Research emanates from clinical
practice and developed concepts, theories and models that form the content for teaching in
education. Education provides and produces nurses that are equipped to practice at the clinical
setting and to conduct research. The ultimate goal of the inter relationship between these tripods
is provision of quality care to the clients.

• For most nurses, anxiety in raised over the issue of research because it does not fit naturally into
work schedule. However, most practitioners in care settings have been able to identify situations
that need to be reevaluated. Observations in some aspects of Nursing care raise the question of
why some activities are done in some ways when there are possible better alternatives to meet
clients needs and expectations

• DEFINITION OF KEY TERMS

• Nursing: According to ICN Nursing encompasses autonomous and collaborative care of

individuals of all ages, families, and communities, sick or well and in all settings. Nursing include
the promotion of health, prevention of illness as the care of the ill, disabled and dying people.
Advocacy, promotion of safe environment, research participation in shaping health policy in
patients, health system management and education are all key nursing roles.

• Research: Research has been defined by different authorities using different approaches but
much with the same meaning.

• Anyaegbunam (2004) defined research as the planned, organized, systematic and scientific
process of seeking information or answer to an existing problem. Research traditionally means to
search again (re-search). Though knowledge already exist, there is the need to further search,
evaluate existing knowledge develop new theories or refine existing theories with a view to
improving on knowledge base or practice.

• All authorities who have defined research point towards certain components to included:

• a. It is a search for knowledge

• b. The search is planned, systematic and scientific

• c. It is directed towards solving a problem or improving knowledge.

• Research therefore refers to a careful, unbiased, systematic investigation into some field of
knowledge to establish facts or principles following scientific steps of procedure.

• Nursing Research: Ploit, Beck and Hungler (2001) defined Nursing Research as the systematic
inquiry, designed to develop knowledge about issues of importance to Nurses including Nursing
Practice, Nursing Education and Nursing Administration. Nursing Research is therefore
concerned with any systematic enquiring into the problem encountered in Nursing practice and
into the modalities of client care.
• Nursing Research addresses how care can be better provided to meet the client’s need and
expectation because:

• It seems to address the care need of the patient appropriately.

• Fit the current accepted provision of care.

• Whether patient situation can be better addressed through other method of care.

• If Nurses do not read and evaluate research findings to know relevance to the practice of the
profession, they run the risk of practicing in a way that is either ineffective or possibly even
harmful to patient care.

• EVIDENCE BASED PRACTICE (EBP)

• According to Boswell and Cannon (2020) EBP is the process of using confirmed evidence
(Research and Quality Improvement), decision making and Nursing Expertise to guide the
delivery of holistic patient care by Nurses. Holistic Nursing Care requires the clinical expertise of
the Nurse, psychological aspects, ethical considerations and biological components. The EBP has
established itself as the foremost process for addressing clinical problems directed at improving
the quality of care.

• Nursing care decision should be based on research findings and scientific data and remain the
best method for the provision of care.

• EBPs expectation is that all care givers will become involved in the identification, examination
and implementation of research-founded, evidence-tested healthcare that can result in the
provision of effective, validated client care.

• Nurses have a responsibility to ensure that the care they provide is based on sound nursing
knowledge and not routines. Nurses need to be actively involved at all levels in the conduct and
utilization of research in client care.

• Statistics: This is the scientific method of collecting, organizing, analyzing, interpreting and
drawing valid conclusion from the data. It also includes the application of the findings to the
human population. Statistics are broadly divided into two categories:

• Descriptive Statistics: This includes Tabulations and Graphs. It also includes Measures of
Central Tendency, Range, Variance and Standard Deviation.

• Inferential statistics: This deals with hypothesis testing. The commonly used forms are the Chi-
Square and the Student T-Test.

• Population: The term universe and population are used interchangeably and refer to the same
concept. A population refers to an aggregate of units that makes up a defined space i.e a
population in a research refers to any group of individuals, items or things which have one or
more characteristics or features in common that are of interest to the researcher. It may be all
individuals of a particular or a restricted part of that group of women e.g. childbearing age.
Population can be classified into two: target population and accessible population.
• VARIABLE

• This is a measurable or potentially measurable component of an object or an event that may

fluctuate in quality and quantity from one individual object or events and from time to time in the
same class.

• It may also be defined as any characteristic or attribute or phenomenon of nature, capable of

changing or varying in different condition and which can be measured and quantified.

• Three types of variable are particularly important in research. These are

• Independent Variable: This refers to the phenomenon in the hypothesis that is manipulated by
the researcher to produce an effect. Thus, it comes first in time, stand alone and its manipulated
by the researcher eg. In a hypothesis linking smoking with lung cancer, smoking becomes the
independent variable.

• Dependent Variable: This occurs only as a result of the manipulation of the independent
variable. It is not manipulated but accepted as the effect of whatever treatment is applied e.g in
hypothesis linking smoking with lung cancer. Lung cancer is the dependent variable.

• Extraneous Variable: There are features that exist about which the researcher collects no data.
They are not of specific interest to the research but are present in the research situation and if not
controlled influenced the findings concerning relationship among variables. They must therefore
be identified and controlled.

• HYPOTHESIS

• This is a statement of the predicted relationship between the variables or among the variables. It
is often referred to as the researcher’s intelligent or calculated guess to the study question answer.

• The statement evolves from the problem and states the relationship that the researcher expects to
find between two or more variables. Forming hypothesis is making a tentative generalization
about a problem under investigation. It translates the problem statement into precise unambiguous
prediction of expected outcomes.

• A hypothesis is therefore an assumption about the relationship between variable which the
researcher is set to verify.

• There are two types of hypothesis

• 1. Statistical or Null Hypothesis (HO): This states the expectation of the researcher to the
negative direction. This statement may not reflect the expected outcome based on theoretical
framework or existing knowledge. It is the hypothesis being tested by the researcher.

• It states that there is no relationship between variables and that the observed relationship is due to
sampling error.

• 2. The Alternative Hypothesis (H1): This is any other assumption about the relationship
between variables under investigation the researcher is set to accept if he should reject the null
hypothesis. It states that a relationship exists between variables and that the observed is more than
can be expected from a sampling error alone.

• SAMPLE/SAMPLING TECHNIQUE
• A sample is a subset or part of a population that has been selected for used in a study. The sample
is considered to be representative of the population from which it was drawn. Therefore, its
findings can be generalized to the entire population. The reason for the use of a sample in a study
is that in most cases, the population is so large that it would not be feasible to study all her
member in an attempt to understand the nature of the problem or event in the population for
generalization to be made. This is done to limit to the barest minimum the sampling error. The
researcher usually extrapolate the attribute of your sample to the universe. The larger the sample,
the clover it approximate the universe.

• METHODS OF INQUIRY/SOURCES OF HUMAN KNOWLEDGE

• As provided for by history, human beings have sought answers to their questions through five
major ways. These sources of human knowledge include:

• Experience or Habit: This is a familiar and well known source of knowledge. It forms the
shortest route without barriers. To learn from experience is considered a prime characteristic of
intelligence

• Its main weaknesses are: (i) that human being cannot have the opportunity to experience all
situations they need to know about. (ii)Experience is individually interpreted.

• Trial and Error: This is also called chance learning or knowledge. Its main weakness is that it is
not bounded by strict scientific proof.

• Authority: This refers to information from experts in the field of study. They can be located
through written records of face to face interview.

• Weakness: (i) Information might be obsolete

• (ii) Authorities can be wrong

• (ii) Experts usually disagree

• Deductive Reasoning: This was introduced by Aristotle and his followers. It can be described as
the thinking process in which one proceed for general to specific statements using prescribed
rules of logic. It is a system of generalizing known facts in order to reach a conclusion usually
done through a series of statements called syllogism. They usually have a major premise and a
minor premise. In deductive reasoning, previously unconnected facts are combined in such a way
as to imply a previously unconnected conclusion.

• Weakness

• The major premise cannot always be correct

• Not all aspects of knowledge can be reasoned out this way

• Not everybody can logically reason

• The conclusion of a syllogism can never exceed the content of the premises.

• Inductive Reasoning: This was introduced by Francis Beacon. It is a thinking process in which
we proceed from specific to general statements. He maintained that investigators should accept
general conclusions on the basis of facts gathered through direct observation. He established
observation, then generalization.
• Scientific Method: This constitutes the most adequate approach to the discovery of knowledge.it
is particularly evident in physical science because it is possible to carry out true test. Observation
is commonly done in human. Scientific methods can be categorized into steps which are
systematic in nature. The basic characteristics of scientific methods are: (1) Order and
systematization (2) Control (3) Empiricism (4) Generalization. It is the surest method for the
establishment of cause-effect relationship.

• Disadvantage: It cannot be applied in all research situation.

• CLASSIFICATIONS OF RESEARCH

• Researches are generally classified by purpose or by approach

• Classification by Purpose: Under this sub-head, there are two categories: Basic and Applied
research. They differ primarily in terms of focus and intent

• Basic Research: This is a research conducted to add to existing knowledge, gain new knowledge,
build a body of knowledge, develops or refines theories. Its findings may not be immediately
applicable to practical situations but they do provide basic knowledge that guide future research.
The knowledge gained is often times useful later. The research is done with little concern on how
it might ultimately be applied to practice.

• Applied Research: This is research whose findings has immediate utility value. It has direct
impact on practice as it is required to modify the current or existing practice(s). It is done to solve
practical problems as the findings from such are immediately required for practical application to
the solution of an existing problem. Most Nursing Research fall into this category as they are
applied for decision making on client care. This type of research may involve:

• The development of a new approach to care

• Modification of Nursing Care

• Development of Nursing care

• Evaluation of Nursing care

• Classification by Approach

• There are three major approaches under this classification: Historical, Experimental and Surveys.

• Historical Research: This is sometimes referred to as documentary research. It is oriented

towards the past. Issues based on the past are investigated to determine the accuracy of statement,
facts or events. Its major contribution is in the development of a broader, more complete
perspective to enhance our understanding of the present and our approach to the future.

• Experimental Research: This category is based on the manipulation of some specific conditions
in a controlled or laboratory setup in order to determine their effects or influence on the
outcomes.

• Survey Approach: This is the most widely used approach in research problems involving human
beings. It involves the collection of data from a sample of individuals through their responses to
questions. It allows for a variety of methods to recruit participants, collection of data and
instrumentation. The types of surveys include: Descriptive, Evaluative, Exploratory, Comparative
and Relational/Causal Surveys. Others are the Cohort and Case Control.
• AIMS OF RESEARCH

• The general purpose of research is to answer question or solve problems. However, we engage in
research for the following reasons:

• For Description: This is the main objective of many research topics. It relates to describing a
phenomenon in relation to a problem situation.

• Exploration: this begins with some phenomenon of interest but rather than just studying them
like in descriptive and explorative research, the researcher investigate to determine what factors
affect, influence or are correlated with the phenomenon.

• Explanation: This is designed to explain or get to the “why” of natural phenomenon. These are
generally linked to theories explaining interrelationship between phenomena. This type of
research offers understanding.

• Prediction and Control: With our current level of knowledge, technology and theoretical
progress, there are numerous problems that defies absolute comprehension and understanding, yet
it is frequently possible to make prediction and control phenomena based on findings from
scientific investigations even in the absence of a true understanding.

• CONCLUSION

• Research is a phenomena or activity common to all discipline. It can be used as an indication to

measure the progress of any discipline or profession. It is the only way to extend the frontiers of
knowledge. Nursing is a profession in transition. It is only through research that our body of
knowledge unique to nursing i.e theories, concepts, principles that will improve nursing practice
will develop.

• Nursing has benefitted from research. More researches as it applies to client care will greatly
improve the coverage of the population, improve the health status of the population and help to
realize the goal of “Health for All by the year 2000 and beyond.”

• CHARACTERISTICS/FEATURES OF RESEARCH

• Researches are conducted for the general reason to develop knowledge or solve a problem. This
endeavor is defined by some very specific features or characteristics that separate it from some
other fields of study.

• Some of these characteristics include:

• Empiricism: Considerable empirical evidence are provided by researcher to authenticate

findings. Research is based on observation and experimentation. Researches are concerned with
experience or observation rather than theory or pure logic.

• Systematization: A precise or standardized system or method is embraced by all researchers in

the process. Researches are conducted according to fixed plan or system which are usually
described as being well ordered, orderly, planned and meticulously executed. Ordered and
sequential procedure is adopted in the research process.

• Controlled: Researchers avoid all form of biases to ensure that investigations are carried out
under conditions that prevents error or the influence of extraneous factors. All variables except
those that are tested or experimented upon are kept constant or guarded.
• Employs Hypothesis: This is to guide the investigation process. There is usually a proposed
explanation based on limited evidence as a starting point for further investigation. This uides the
researchers focus and direct the course of the research at investigating the relationship between
the variable under investigation.

• Analytical: Researchers examine the variables under investigation in details to establish the
correlation. Statistical tools are employed to analyze data with a view to deriving the information
inherent in them. This is carried out on data to avoid error in their interpretation

• Objective, Unbiased and Logical: Findings are logically based on observation and
experimentation. The researcher does not allow his personal feelings or opinions to influence his
judgment while considering and presenting facts related to his study. He is unbiased,
unprejudiced, fair and open-minded.

• Employs Quantitative or Statistical Methods: Data collected are transformed into numerical
measures and are treated statistically. The two main statistical methods that are employed are the
descriptive and the inferential statistics.

• PROBLEMS AND LIMITATIONS OF RESEARCH

• Choice of Topic: Develop a doable topic in terms of time, money and people. Make sure the topic
is interesting also.

• Choosing the Right Methodology

• Ability to assemble a Research Team.

• Finding Study Participants

• Getting Institutions to Participate

• Dealing With Your Data. Insufficient Data. You must ground yourself in the research

• Dealing with biases: These could come from the researcher, the participants, publications interest,
observer(s), data collections, choice of the population and sample etc

• Lack of Scientific Training: Research requires scientific approach for which researcher is
supposed to have a good knowledge.

• Timing: The time frame available to conduct and report a study may limit its scope and depth.

• Quantity and Quality of available Literature

• Lack of Confidence

• Researchable

• Ethical sensitivity

• Legal sensitivity eg breaking confidentiality covenant, compelled disclosure,

• Participants recruitment and informed consent. Individual should have the freedom of choice to
participate or not to participate and to withdraw from the study at any time

• Scope of Study. Either too wide or too narrow.

• Library Management: Reference materials may not be available or that are not properly accessed.

• Some problems are not amenable to research

• Ethical consideration may limit the scope of a research

• OBSTACLES TO USING RESEARCH

• This refers to objects that impedes the utilization of research as guidance for practice. These
include:

• Education: The more education a Nurse has, the greater the chance that he will utilize research in
providing patient care.

• Beliefs and Attitude: There may be a negative attitude towards the conduct and utilization of
research. This applies to both Nurses and Organizations.

• Support/Resources: These include financial inadequacy, availability of Librarians and

computers, knowledge of use of search engines, computer skills etc.