NURSING RESEARCH

WHAT IS RESEARCH?
Is it the person conducting structured interview with a group of chosen people? Or, is it a white-coated
scientist in the lab finding something?
One, carrying out research, where the conditions are created and controlled, where he make sure that
what is being investigated based on aims and objectives. And, the other, working in real world, to deal
with difference between selected people in which they may be interviewed.
But, all is likely to claim that they are investigating or searching answers to question in their chosen
areas using some typical method. With this, we can understand that, all are trying to search some
answers to their question in their area of interest, in an acceptable procedure for research.
Thereby, we can say that the research is a scientific inquiry / search for answer to question about facts,
and relationship between the facts. In simple words, the research is systematic inquiry that uses
disciplined methods to answer questions or solve problems in any branch of knowledge.

WHAT IS NURSING RESEARCH?

It is a scientific enquiry to generate new knowledge about the nursing profession. An ultimate aim of
nursing research is to develop, refine and expand a nursing knowledge as the research results are
verifiable, measurable and observable.

WHY NURSING RESEARCH?

The nursing profession evolved to adopt Quality Assurance (QA) and Evidence Based Practice (EBP) for
best nursing service with clinical evidence. There is a universal acceptance that findings of research
studies constitute the best type of clinical evidence for nurses for their nursing care, nursing
administration and nursing education.
With the emphasis on EBP, every nurse is engaged in nursing research directly or indirectly. The nurses
those who read research reports to keep up to date knowledge, and applies research findings in their
practice are, Consumers of nursing research. At the other end, the nurses those who actively
participate in designing and implementing the nursing studies are Producers of nursing research.
Research with human involves two sets of people; those who conduct research & those who provide
information. The person who undertakes research is referred as The Researcher / Investigator. And,
when the study is undertaken by more than one person / by a team and the person is directing an
investigation is referred as The Principal Investigator (PI) and the others are, Co-investigators.
In quantitative study, the people who are being studied are referred as The Subject / Participant, and
the people who provide information to researcher by answering question directly may be called as The
Respondents.
In qualitative study, the individuals play an active rather than a passive role in research, and are usually
referred to as The Study Participants / Informants.
Collectively, both in qualitative and quantitative studies, the individuals contributing information are
considered as The Samples, those who represent entire population.

HOW TO A PPROACH NURSING RESEARCH?

The preliminary concern of a person in conducting research is to know whether the study is necessary,
if necessary, whether the data already exists, or we need to collect new data. Based on the nature of
data collection, the nursing research may be classified as quantitative, qualitative or mixed approach.
Because, the approach to nursing research is grossly depend on type and nature of information needed
for the study. When the data need to be gathered in numeric form through specified formal
measurement, and that is analyzed with statistics, is considered as quantitative approach whereas the
qualitative approach is concerned with collection & analysis of narrative materials or subjective
assessment of attitude, opinion and behavior.
However, in spite of quantitative or qualitative data, the research approaches are broadly classified in
to primary and secondary.
Primary approach is considered when data are collected specifically for study which may be
exploratory or confirmatory in nature. The exploratory research is conducted when we are not aware
of any other studies in this area, or there is no definite answer in the literature. The confirmatory
research is conducted when a theory has already propounded, and we are trying to confirm that
theory.
Secondary approach is a valid of conducting research and should be used if sufficient primary research
has already been conducted. The retrospective studies are useful in demonstrating what is happening,
thus drawing our attention to issues that one perhaps would otherwise not fully aware of. The meta-
analysis is the technique to present an aggregate view of the results of all studies.

TERMINOLOGY
Population – is a set of individuals having same characteristics, where the results of study sample are
applicable.
Generalization – is an application of findings of study sample to the broader population / situation.
Samples – is the portion of population those who represent entire population.
Variable – is an attribute of person or objects that varies, that is, takes on different values. E.g., body
temperature, age, heart rate. Nearly all aspects of human being and their environment are variable.
Dependent variable – is that the variable assumes to depend on or be caused by another variable. e.g.,
presumed cause (smoking) is independent variable and the presumed effect (lung cancer) is dependent
variable.
Independent variable – is that the variable that is believed to cause or influence another variable. e.g.,
presumed cause (smoking) is independent variable and the presumed effect (lung cancer) is
dependent.
Objectives-are statements which attempts to give both shape & direction to set more detailed
intentions for study.
Assumption – are basic principles that are accepted as being true on the basis of logic or reason,
without proof of verification.
Prediction – is an empirical evidence to make forecasts about how variables of interest will behave in
new setting and with different individuals.
Hypothesis – is a statement of predicted relationships between variable of research question.
Operational definition - is an explanation of concepts or variables in terms of how they are defined for
a particular study. It is a specification of the operations that the researcher will perform to collect the
data.
Experiment / Intervention – is a manipulation / control over variable in the research study.
Manipulation – is a treatment introduced by the researcher in an experimental group.
Randomization – is an assignment of subject to treatment condition in a random manner.
Instrument/tool - is the written device that researcher used to collect the data.
Parameter – is a characteristic of a population e.g., the mean age of Indian population.
Data – is the piece of information obtained from the subject / participant in the course of study.
Thesis / Dissertation – is the document where the research steps are completed in order to answer the
question.
Abstract – is a brief description of completed or proposed research study.
OVERVIEW OF NURSING RESEARCH PROCESS IN QUANTITATIVE STUDY - A researcher moves from the
beginning point of study (the posing of a question) to the end point (the obtaining of an answer) in a
logical sequence of predetermined steps.

 Formulating and delimiting the problem - Researcher generally proceeds from the selection of
broad topic areas to development of specific question / statement of problem that are
amenable to empirical enquiry.
 Reviewing the related literature - Research is typically conducted within the context of
previous knowledge to build an existing theory or research. It strives to understand what
already known about the research problem by critical review of scholarly publications,
unpublished scholarly print materials, audiovisual materials and personal communications.
 Defining theoretical / Conceptual framework or model – The concepts are building blocks, and
knitted together to explain relationship among variables in some rational scheme by virtue of
their relevance to common theme of theory. They are; person, environment, health and
nursing.
 Formulating hypothesis – is a statement of researcher’s expectations or prediction of expected
outcome about relationship between the two or more variables.
 Selecting a research design - is the overall plan (blue print) for obtaining answer to question in
the study. The design is based on how we approach to research.
 Identifying population to be studied - It aggregate or total of objects/subjects available for
particular study.
 Specifying methods to measure the research variables - The researcher will measure the
research variables as accurately as possible by using structured or semi-structured tools
 Designing the sampling plan - Researcher use subjects only a small fraction of the population.
The advantage is that, it is less costly than collecting data from entire population.
 Finalizing and reviewing the research plan - The research plan should be reviewed with validity
and reliability to minimize unforeseen problems in the due course of study. The effect of such
problem may be negligible, but in other cases, may be so severe that the study has to be
stopped. For this reason it may be advisable to carry out a pilot study, which is small scale
version, or trial run, of the major study.
  Collecting the data - the researcher’s plan typically specifies procedure for actual data
collection: where, when and how, describing study participants, obtaining consent, training the
individuals etc.
 Analyzing the data - Assigning numbers, coding, translating verbal data in to category or
numeric forms. Use descriptive & inferential statistics for analysis.
 Interpreting the results - Results to be organized and interpreted in systematic fashion.
 Communicating the results - The results of research investigation are of little utility if they not
communicated to others. Researcher prepares research report in the forms of dissertation,
Journal article, Internet etc.

WHAT IS RESEARCH PROBLEM OR QUESTION?

A working nurse, examine all symptoms of patients concerning to a problem before he/she can make
nursing diagnosis and nursing care. During this process of nursing care, in some occasions, she/he may
encounter or experience some queries in context of intellectual / technical problems or issues related
to pattern of nursing care service. On working with such problems or issues again & again, he/she
thinks of an alternative solution / new idea on their own that challenges in their work as a health
professional. This kind of topic of issue, give rise to discuss with their peer group or other members of
health team, making them brainstorming with possible research question such as; what it is, why it is,
where it is, what are other possibilities, when, how the other solution influence?
However, some of these questions can be answered by present knowledge, an extensive search of
present literature related to problems or issues. When there is no definite or authoritative answer in
the literature, then, one has to write the problem / issue in simple and clear words. Further, delimit the
problem by proceeding from selection of broad areas of interest to specific research question, and
refine several times, until it is amenable to empirical enquiry.
A research problem / research question, in general, refers to some specific queries where a researcher
wants to answer to the question. A refined or formulated nursing research question, in Indian context,
it is popularly known as statement of the problem.
Researcher must define each concept (operational definitions), how the variables are interrelated, and
how to be observed & measured in statement of problem. The style chosen for statement of problem is
largely preference of the researcher. It has two forms; declarative and interrogative.
Examples of statement of problem
  Effect of structured teaching module on knowledge regarding breast feeding among mothers
residing in Vidarbha region of Maharashtra, India (declarative form).
 What is the effect of structured teaching module on knowledge regarding breast feeding among
mothers residing in Vidarbha region of Maharashtra, India? (interrogative form)
 Assess the knowledge on iron deficiency anemia among adolescence girls residing in rural
Vidarbha region of Maharashtra, India (declarative form).
 What is the level of knowledge on iron deficiency anemia among adolescence girls residing in
rural Vidarbha region of Maharashtra, India (interrogative form)

Criteria for selecting statement of problem

 Original – the queries related to research question/problem should have been aroused from
personal experiences of researcher.
 Significant – does its results contribute to nursing profession.
 Solvable – not all problems are amenable to study through scientific investigation. It should be
capable of being empirically tested (too narrow or too vague must be avoided).
 Feasible – in terms of methods, sampling, time, money, personnel, equipment.
 Interest – the researchers own interest in the research question / problem.

Characteristics of good problem statement

 Clear – frame the words very clearly with logical sequence which makes meaningful sentence.
 Simple – make it as simple as possible by avoiding vague and narrow terms. And also, avoid
words which indicate dual meaning or the words puts us under perplexing situation.
 Concise – for better comprehension, it should not be to lengthy, write only necessary terms,
and avoid repetitive words.

Components of statement of problem

 Variables – the research question must have minimum of two variables i.e., usually one
independent variable, and one or more dependent variables.
 Relationship between variables – the research question must describe how the variables are
interrelated. The independent variable should cause or influence on dependent variable. And,
dependent variable should show its dependency or is a consequence of independent variable.
  Population – the research question should clearly mention that among whom the study being
conducted e.g., anemic girls, patients with tuberculosis, mothers with under five children etc.
 Approach – the research question should clearly indicate whether it is experimental approach
or non-experimental approach.
 Setting – the research question will be complete, only when the researcher specifies the place
of study for data collection.

Exercise-1: Effect of structured teaching module on knowledge regarding breast feeding among
mothers residing in Vidarbha region of Maharashtra, India.
 Independent variable – the structured teaching module
 Dependent variables – the knowledge regarding breast feeding (one dependent variable)
 Population – the mothers
 Approach – the effect of: experimental approach
 Setting – the Vidarbha region

Exercise-2: Effect of structured teaching module on knowledge, practice and attitude regarding breast
feeding among mothers residing in Vidarbha region of Maharashtra, India.
 Independent variable – the structured teaching module
 Dependent variables – the knowledge, practice and attitude regarding breast feeding (three
dependent variables)
 Population – the mothers
 Approach – the effect of: experimental approach
 Setting – the Vidarbha region

Exercise-3: Assess the knowledge on iron deficiency anemia among adolescence girls residing in rural
Vidarbha region of Maharashtra, India.
 Independent variable – the iron deficiency anemia
 Dependent variables – the knowledge (one dependent variable)
 Population – the adolescence girls
 Approach – the assessment: non-experimental approach
 Setting – the Vidarbha region
Exercise-4: Assess the knowledge and practice on iron deficiency anemia among adolescence girls
residing in rural Vidarbha region of Maharashtra, India.
 Independent variable – the iron deficiency anemia
 Dependent variables – the knowledge and practice (two dependent variables)
 Population – the adolescence girls
 Approach – the assessment: non-experimental approach
 Setting – the Vidarbha region

Research aims or objectives

The researcher delimits statement of problem which gives information regarding variable, sample,
research approach and place of study. Merely reading of problem statement, it is difficult to assume
the type of actual design, sampling, statistics etc. Hence, to make it more clear, the researcher frame
the aims and objectives to answer research question accurately what he/she intends to do.
Aims or objectives are specific accomplishments that the researcher hopes to achieve by conducting
study. The research objectives are declarative statements, which give shape and direction to answer
researcher question.
After formulating the research question, the researcher has to frame the objectives in such a way that,
each variable in the objective should be amenable to empirical enquiry. In other words, every objective
of the study should give direction to test the variables e.g., assessment, t test, chi square test,
correlation, f test etc.

Common terms used in objectives: following are the most common terms prefixed in objectives, and
used to collect data on dependent variable under study. They are; to assess, to identify, to find out, to
determine, to compare, to correlate, to associate etc.

Exercise - Formulate the objectives for following problem statements:

Example - 1: Effect of video assisted teaching module on cardio-pulmonary resuscitation among staff
nurses working in selected medical college hospitals, Maharashtra.
Objectives: (if the study permits RCT, with one dependent variable)
1. To assess the knowledge of SN regarding CPR before intervention in control and experimental
groups (pre-test using SAQ, and data presented using descriptive statistics, e.g., percentage,
mean & SD).
 2. To assess the knowledge of SN regarding CPR after intervention in control and experimental
groups or/ To assess the effect of VATM on CPR among SN in control and experimental groups
( post-test using SAQ, and data analyzed using inferential statistics, e.g., t test / z test for testing
of hypothesis).
3. To find out the association between posttest knowledge score on CPR and selected
demographic variables of SN in experimental group (inferential statistics using chi-square to test
hypothesis).
Objectives: (if the study permits RCT, with two dependent variable)
1. To assess the knowledge of SN regarding CPR before intervention in control and experimental
groups (pre-test using SAQ, and data presented using descriptive statistics, e.g., percentage,
mean & SD).
2. To assess the skill of SN regarding CPR before intervention in control and experimental groups
(pre-test using SAQ, and data presented using descriptive statistics, e.g., percentage, mean &
SD).
3. To assess the knowledge of SN regarding CPR after intervention in control and experimental
groups or/ To assess the effect of VATM on knowledge regarding CPR among SN in control and
experimental groups ( post-test using SAQ, and data analyzed using inferential statistics, e.g., t
test / z test for testing of hypothesis).
4. To assess the skill of SN regarding CPR after intervention in control and experimental groups or/
To assess the effect of VATM on skill regarding CPR among SN in control and experimental
groups ( post-test using SAQ, and data analyzed using inferential statistics, e.g., t test / z test for
testing of hypothesis).
5. To find out the correlation between posttest knowledge score and posttest skill score on CPR
among SN (descriptive statistics using r test to test hypothesis).
6. To find out the association between posttest knowledge score on CPR and selected
demographic variables of SN in experimental group (inferential statistics using chi-square to test
hypothesis).
7. To find out association between posttest skill score on CPR and selected demographic variables
of SN in experimental group (inferential statistics using chi-square to test hypothesis).

Example - 2: Awareness of services under National Program for Control of Blindness for under five by
the mothers with under five children in rural Vidarbha, Maharashtra.
Objectives: (descriptive study with one dependent variable)
1. To assess the knowledge of mothers with under five children regarding NPCB for under five
(pre-test using interview, and data presented using descriptive statistics, e.g., percentage, mean
& SD).
2. To find out the association between knowledge score on NPCB for under five and selected
demographic variables of mothers with under five children (inferential statistics using chi-
square to test hypothesis).

Example - 3: Awareness and utilization of services under National Program for Control of Blindness
for under five by the mothers with under five children in rural Vidarbha, Maharashtra.
Objectives: (descriptive study with two dependent variables)
1. To assess the knowledge of mothers with under five children regarding NPCB for under five
(pre-test using interview, and data presented using descriptive statistics, e.g., percentage, mean
& SD).
2. To assess the utilization of service by mothers with under five children regarding NPCB for
under five (pre-test using interview, and data presented using descriptive statistics, e.g.,
percentage, mean & SD).
3. To find out the correlation between knowledge score and utilization of service score on NPCB
for under five among mothers with under five children (descriptive statistics using r test to test
hypothesis).
4. To find out the association between knowledge score on NPCB for under five and selected
demographic variables of mothers with under five children (inferential statistics using chi-
square to test hypothesis).
5. To find out the association between utilization of service score on NPCB for under five and
selected demographic variables of mothers with under five children (inferential statistics using
chi-square to test hypothesis).

Hypothesis
Researcher, after delimiting research question & objectives, formulate the tentative explanation
(statement) to research question that is still to be tested. This explanation (statement) is known as
hypothesis. Or, the hypothesis is predicted / assumed statement about relationship between two or
more variables of research question that gives an answer through statistics. In simple words, the
hypothesis converts / translates the research question in to precise declarative statement that allows
accepting or rejecting the outcome through statistical methods.
The hypothesis narrows or divides the research question in one or more elements, and identifies the
variables in measurable terms. And, it is classified in to research hypothesis and statistical/null
hypothesis. The formulated hypothesis must be stated in present tense/form. Content of hypothesis
includes; two variables (IV & DV), sample and statistical application. For example –
Research hypothesis:
H1: There is a significant difference between the pretest and posttest knowledge scores on CPR among
SN in control and experimental groups.
Null hypothesis:
HO1: There is no significant difference between the pretest and posttest knowledge scores on CPR
among SN in control and experimental groups.

Exercise: Effect of video assisted teaching module on cardio-pulmonary resuscitation among staff
nurses working in selected medical college hospitals, Maharashtra.
Objectives: (if the study permits RCT, with one dependent variable)
1. To assess the knowledge of SN regarding CPR before intervention in control and experimental
groups (pre-test using SAQ, and data presented using descriptive statistics, e.g., percentage,
mean & SD).
2. To assess the knowledge of SN regarding CPR after intervention in control and experimental
groups or/ To assess the effect of VATM on CPR among SN in control and experimental groups
( post-test using SAQ, and data analyzed using inferential statistics, e.g., t test / z test for testing
of hypothesis).
3. To find out the association between posttest knowledge score on CPR and selected
demographic variables of SN in experimental group (inferential statistics using chi-square test to
test hypothesis).

Hypothesis:
 HO1: There is no significant difference between the pretest and posttest knowledge scores on
CPR among SN in control and experimental groups.
 HO2: There is no significant difference between the posttest knowledge scores on CPR among
SN of control and experimental groups.
  HO3: There is no significant association between the posttest knowledge scores on CPR and
selected demographic variables of SN in experimental group.

Objectives: (if the study permits RCT, with two dependent variable)
1. To assess the knowledge of SN regarding CPR before intervention in control and experimental
groups (pre-test using SAQ, and data presented using descriptive statistics, e.g., percentage,
mean & SD).
2. To assess the skill of SN regarding CPR before intervention in control and experimental groups
(pre-test using SAQ, and data presented using descriptive statistics, e.g., percentage, mean &
SD).
3. To assess the knowledge of SN regarding CPR after intervention in control and experimental
groups or/ To assess the effect of VATM on CPR among SN in control and experimental groups
( post-test using SAQ, and data analyzed using inferential statistics, e.g., t test / z test for testing
of hypothesis).
4. To assess the skill of SN regarding CPR after intervention in control and experimental groups or/
To assess the effect of VATM on CPR among SN in control and experimental groups ( post-test
using SAQ, and data analyzed using inferential statistics, e.g., t test / z test for testing of
hypothesis).
5. To find out the correlation between posttest knowledge score and posttest skill score on CPR
among SN (descriptive statistics using r test to test hypothesis).
6. To find out the association between posttest knowledge score on CPR and selected
demographic variables of SN in experimental group (inferential statistics using chi-square test to
test hypothesis).
Hypothesis:
 HO1: There is no significant difference between pretest and posttest knowledge scores on CPR
among SN in control and experimental groups.
 HO2: There is no significant difference between pretest and posttest skill scores on CPR among
SN in control and experimental groups.
 HO3: There is no significant difference between posttest knowledge scores on CPR among SN of
control and experimental groups.
 HO4: There is no significant difference between posttest skill scores on CPR among SN of
control and experimental groups.
  HO5: There is no significant correlation between posttest knowledge and skill scores on CPR
and selected demographic variables of SN in experimental group.
 HO6: There is no significant association between posttest knowledge scores on CPR and
selected demographic variables of SN in experimental group.
 HO7: There is no significant association between posttest skill scores on CPR and selected
demographic variables of SN in experimental group.

Reviewing the related literature - Research is typically conducted within the context of previous
knowledge to build an existing theory or research. It strives to understand what already known about
the research problem. It is defined as a broad, comprehensive, systematic and critical review of
scholarly publications, unpublished scholarly print materials, audiovisual materials and personal
communications. Primary source - First hand reports of facts, findings, or events. It is the original
report prepared by the investigator who conducted the study. Secondary source - Second hand
accounts of events or facts. Description of the study is prepared by other than the original researcher.
Flow of tasks in review of literature -
 Identify concepts and key words to be searched
 Screen references for its reference/irrelevance
 Read relevance references and take notes
 Organize, analyze and integrate materials
 Write review
One must remember that, a reviewed literature should correlate or support aims and objectives of the
study. For instance, if an investigator interested to find out the effect of video assisted teaching module
on cardio-pulmonary resuscitation among staff nurses working in selected medical college hospitals,
the literature related to concepts of study would be categorized as follows –
1. Significance / need for the study: in context of previous literature projecting the magnitude of
health problem related cardiac arrest at global, national and regional level. It also should
include lack of nurses’ knowledge and need for education on CPR in present health care delivery
system.
2. Incidence and prevalence of cardiac arrest : It is mandatory on the part of researcher to elicit the
facts & figures related incidence and prevalence of cardiac arrest by reviewing data of
international / national agencies, journals & periodicals in context of previous research studies.
 3. Cardiac arrest and its influencing factors : The researcher has to review related materials on
cardiac arrest, factors influencing cardiac arrest, s/s, and therapeutic measures.
4. Knowledge of nurses on CPR: literature related to CPR and nurses knowledge.
5. Role and responsibilities of nurses in CPR: books, journals & periodicals research studies etc.
6. Effect of health education on CPR : literature related to experimental studies on knowledge of
CPR.

Conceptual framework / model / scheme – The good research integrates through linking new research
and existing knowledge by developing an appropriate conceptual framework. In the conceptual
framework, concepts are building blocks, and knitted/assembled together to explain relationship
among variables in some rational scheme by virtue of their relevance to research question. There are
two types to build the conceptual framework, schematic model and statistical model.
A schematic model, which is most common in qualitative and quantitative research, and the concepts &
its relationship among variables are represented graphically by using boxes, arrows and symbols. On
the other hand, the statistical model used in quantitative research, and uses symbol to express
variables & its relationship in terms of quantity.