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Abstract
As the bestselling nursing research text, Understanding Nursing Research: Building an Evidence-Based Practice, 6th Edition offers unique insights into understanding, appraising, and applying published research to evidence-based practice. It is known for its authoritative content, time-tested systematic approach, and unique research example format — newly redesigned for the sixth edition to better demonstrate how the steps of the research process relate to evidence-based nursing.
"This would be excellent for student nurses, nurses new to research or any nurse with an interest in research." Reviewed by: Helen Reeves, St Giles Walsall Hospice on behalf of Nursing Times, December 2015
- Authoritative content is written by two of the true pioneers in nursing research, who offer unique, first-hand insights into the field.
- Research examples provide practice in working with published studies, with many of the examples including Critical Appraisal and Implications for Practice sections.
- Clear, step-by-step organization introduces the research process and demonstrates how this systematic framework relates to evidence-based practice.
- Strong emphasis on evidence-based practice helps you develop skills in studying and appraising published research, so you are prepared for your role in working with research evidence.
- Critical Appraisal Guidelines boxes provide step-by-step guidance in appraising published research studies.
- Emphasis on critical appraisal versus critique reflects contemporary usage in nursing research and evidence-based practice.
- Balanced coverage of qualitative research prepares you to approach research questions and clinical questions with an unbiased view of the researcher's methodology.
- Presentation of two different appraisal processes covers both the traditional in-depth critical appraisal process that prepares you for graduate-level work in research, and the concise, practice-focused research appraisal process that equips you for quick and accurate evaluation of the applicability of research findings to clinical practice.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Front Cover | Cover | ||
Inside Front Cover | ES2 | ||
Contents | i | ||
Understanding Nursing Research: Building an Evidence-Based Practice | iii | ||
Copyright | iv | ||
Contributor and Reviewers | v | ||
Dedication | vii | ||
Preface | viii | ||
Learning Resources to Accompany Understanding Nursing Research, 6th edition | x | ||
Evolve Instructor Resources | x | ||
Test Bank | xi | ||
PowerPoint Slides | xi | ||
Image Collection | xi | ||
NEW TEACH for Nurses Lesson Plans | xi | ||
Evolve Student Resources | xi | ||
Study Guide | xii | ||
Acknowledgments | xiii | ||
Chapter 1: Introduction to Nursing Research and Evidence-Based Practice | 1 | ||
WHAT IS NURSING RESEARCH? | 3 | ||
WHAT IS EVIDENCE-BASED PRACTICE? | 3 | ||
PURPOSES OF RESEARCH FOR IMPLEMENTING AN EVIDENCE-BASED NURSING PRACTICE | 6 | ||
Description | 6 | ||
Explanation | 7 | ||
Prediction | 7 | ||
Control | 8 | ||
HISTORICAL DEVELOPMENT OF RESEARCH IN NURSING | 9 | ||
Florence Nightingale | 11 | ||
Nursing Research: 1900s through the 1970s | 11 | ||
Nursing Research: 1980s and 1990s | 12 | ||
Nursing Research: in the Twenty-First Century | 14 | ||
Current Actions of the National Institute of Nursing Research | 14 | ||
Linking Quality and Safety Education for Nursing Competencies and Nursing Research | 15 | ||
ACQUIRING KNOWLEDGE IN NURSING | 15 | ||
Traditions | 16 | ||
Authority | 16 | ||
Borrowing | 16 | ||
Trial and Error | 17 | ||
Personal Experience | 17 | ||
Role Modeling | 17 | ||
Intuition | 18 | ||
Reasoning | 18 | ||
PARTICULAR INSTANCES | 18 | ||
GENERAL STATEMENT | 18 | ||
PREMISES | 18 | ||
CONCLUSION | 18 | ||
ACQUIRING KNOWLEDGE THROUGH NURSING RESEARCH | 19 | ||
Introduction to Quantitative and Qualitative Research | 19 | ||
Types of Quantitative and Qualitative Research | 20 | ||
Introduction to Outcomes Research | 21 | ||
UNDERSTANDING BEST RESEARCH EVIDENCE FOR PRACTICE | 21 | ||
Strategies Used to Synthesize Research Evidence | 22 | ||
Levels of Research Evidence | 24 | ||
Introduction to Evidence-Based Guidelines | 25 | ||
WHAT IS YOUR ROLE IN NURSING RESEARCH? | 25 | ||
KEY CONCEPTS | 27 | ||
REFERENCES | 28 | ||
Chapter 2: Introduction to Quantitative Research | 31 | ||
WHAT IS QUANTITATIVE RESEARCH? | 32 | ||
Types of Quantitative Research | 33 | ||
Descriptive Research | 33 | ||
Correlational Research | 33 | ||
Quasi-Experimental Research | 34 | ||
Experimental Research | 34 | ||
Defining Terms Relevant to Quantitative Research | 35 | ||
Basic Research | 35 | ||
Applied Research | 35 | ||
Rigor in Quantitative Research | 36 | ||
Control in Quantitative Research | 36 | ||
Extraneous Variables | 37 | ||
Sampling | 37 | ||
Research Settings | 38 | ||
Study Interventions | 38 | ||
PROBLEM-SOLVING AND NURSING PROCESSES: BASIS FOR UNDERSTANDING THE QUANTITATIVE RESEARCH PROCESS | 38 | ||
Comparing Problem Solving with the Nursing Process | 38 | ||
Comparing the Nursing Process with the Research Process | 39 | ||
IDENTIFYING THE STEPS OF THE QUANTITATIVE RESEARCH PROCESS | 40 | ||
Research Problem and Purpose | 41 | ||
Review of Relevant Literature | 41 | ||
Study Framework | 42 | ||
Research Objectives, Questions, or Hypotheses | 43 | ||
Study Variables | 44 | ||
Study Design | 45 | ||
Population and Sample | 46 | ||
Measurement Methods | 46 | ||
Data Collection | 47 | ||
Data Analysis | 47 | ||
Discussion of Research Outcomes | 48 | ||
READING RESEARCH REPORTS | 49 | ||
Sources of Research Reports | 50 | ||
Content of Research Reports | 51 | ||
Abstract Section | 51 | ||
Introduction Section | 52 | ||
Methods Section | 53 | ||
Results Section | 53 | ||
Discussion Section | 54 | ||
References Section | 54 | ||
Tips for Reading Research Reports | 54 | ||
PRACTICE READING QUASI-EXPERIMENTAL AND EXPERIMENTAL STUDIES | 55 | ||
Quasi-Experimental Study | 56 | ||
Experimental Study | 60 | ||
KEY CONCEPTS | 63 | ||
REFERENCES | 64 | ||
Chapter 3: Introduction to Qualitative Research | 66 | ||
VALUES OF QUALITATIVE RESEARCHERS | 67 | ||
RIGOR IN QUALITATIVE RESEARCH | 68 | ||
QUALITATIVE RESEARCH APPROACHES | 68 | ||
Phenomenological Research | 69 | ||
Philosophical Orientation | 69 | ||
Phenomenology's Outcome | 70 | ||
Grounded Theory Research | 70 | ||
Intended Outcome | 71 | ||
Ethnographic Research | 74 | ||
Intended Outcome | 75 | ||
Exploratory-Descriptive Qualitative Research | 76 | ||
Philosophical Orientation | 77 | ||
Intended Outcome | 77 | ||
Historical Research | 78 | ||
Philosophical Orientation | 78 | ||
Intended Outcome | 79 | ||
QUALITATIVE RESEARCH METHODOLOGIES | 81 | ||
Selection of Participants | 82 | ||
Researcher-Participant Relationships | 82 | ||
DATA COLLECTION METHODS | 82 | ||
Interviews | 83 | ||
Focus Groups | 85 | ||
Observation | 86 | ||
Text as a Source of Qualitative Data | 87 | ||
DATA MANAGEMENT | 88 | ||
Organizing Data Files | 88 | ||
Transcribing Interviews | 88 | ||
DATA ANALYSIS | 88 | ||
Codes and Coding | 89 | ||
Themes and Interpretation | 89 | ||
KEY CONCEPTS | 90 | ||
REFERENCES | 91 | ||
Chapter 4: Examining Ethics in Nursing Research | 93 | ||
HISTORICAL EVENTS INFLUENCING THE DEVELOPMENT OF ETHICAL CODES AND REGULATIONS | 95 | ||
Nazi Medical Experiments | 95 | ||
Nuremberg Code | 95 | ||
Declaration of Helsinki | 96 | ||
Tuskegee Syphilis Study | 97 | ||
Willowbrook Study | 97 | ||
Jewish Chronic Disease Hospital Study | 97 | ||
Department of Health, Education, and Welfare, 1973: Regulations for the Protection of Human Research Subjects | 98 | ||
National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research | 98 | ||
Current Federal Regulations for the Protection of Human Subjects | 99 | ||
PROTECTING HUMAN RIGHTS | 100 | ||
Right to Self-Determination | 101 | ||
Violation of the Right to Self-Determination | 101 | ||
Persons with Diminished Autonomy | 101 | ||
Study participants with legal and mental diminished autonomy | 101 | ||
Neonates | 102 | ||
Children | 102 | ||
Pregnant women and fetuses | 104 | ||
Persons with mental illness or cognitive impairment | 104 | ||
Terminally ill subjects | 104 | ||
Persons confined to institutions | 104 | ||
Right to Privacy | 105 | ||
De-Identifying Protected Health Information under the Privacy Rule | 106 | ||
Limited Data Set and Data Use Agreement | 106 | ||
Right to Anonymity and Confidentiality | 106 | ||
Right to Fair Selection and Treatment | 107 | ||
Fair Selection and Treatment of Subjects | 107 | ||
Right to Protection from Discomfort and Harm | 108 | ||
No Anticipated Effects | 108 | ||
Temporary Discomfort | 108 | ||
Unusual Levels of Temporary Discomfort | 109 | ||
Risk of Permanent Damage | 109 | ||
Certainty of Permanent Damage | 109 | ||
Critical Appraisal Guidelines to Examine Protection of Human Rights in Studies | 109 | ||
UNDERSTANDING INFORMED CONSENT | 111 | ||
Essential Information for Consent | 111 | ||
Comprehension of Consent Information | 112 | ||
Competence to Give Consent | 112 | ||
Voluntary Consent | 113 | ||
Documentation of Informed Consent | 113 | ||
Written Signed Consent Waived | 114 | ||
Written Short Form Consent Documents | 114 | ||
Formal Written Consent Document | 114 | ||
Health Insurance Portability and Accountability Act Privacy Rule: Authorization for Research Uses and Disclosure | 115 | ||
Critical Appraisal Guidelines to Examine Informed Consent in Studies | 115 | ||
UNDERSTANDING INSTITUTIONAL REVIEW | 117 | ||
Levels of Reviews Conducted by Institutional Review Boards | 117 | ||
Influence of Health Insurance Portability and Accountability Act Privacy Rule on Institutional Review Boards | 118 | ||
EXAMINING THE BENEFIT-RISK RATIO OF A STUDY | 119 | ||
Critical Appraisal Guidelines for Examining the Ethical Aspects of Studies | 120 | ||
UNDERSTANDING RESEARCH MISCONDUCT | 122 | ||
Role of the Office of Research Integrity in Promoting the Conduct of Ethical Research | 122 | ||
EXAMINING THE USE OF ANIMALS IN RESEARCH | 123 | ||
KEY CONCEPTS | 125 | ||
REFERENCES | 125 | ||
Chapter 5: Research Problems, Purposes, and Hypotheses | 129 | ||
What Are Research Problems and Purposes? | 131 | ||
IDENTIFYING THE PROBLEM AND PURPOSE IN QUANTITATIVE, QUALITATIVE, AND OUTCOMES STUDIES | 133 | ||
Problems and Purposes in Types of Quantitative Studies | 133 | ||
Problems and Purposes in Types of Qualitative Studies | 136 | ||
Problems and Purposes in Outcomes Research | 140 | ||
DETERMINING THE SIGNIFICANCE OF A STUDY PROBLEM AND PURPOSE | 140 | ||
Influences Nursing Practice | 140 | ||
Builds on Previous Research | 141 | ||
Promotes Theory Testing or Development | 142 | ||
Addresses Nursing Research Priorities | 142 | ||
EXAMINING THE FEASIBILITY OF A PROBLEM AND PURPOSE | 143 | ||
Researcher Expertise | 144 | ||
Money Commitment | 144 | ||
Availability of Subjects, Facilities, and Equipment | 144 | ||
Ethical Considerations | 145 | ||
EXAMINING RESEARCH OBJECTIVES, QUESTIONS, AND HYPOTHESES IN RESEARCH REPORTS | 145 | ||
Research Objectives or Aims | 145 | ||
Research Questions | 147 | ||
Hypotheses | 149 | ||
Types of Hypotheses | 149 | ||
Associative versus causal hypotheses | 149 | ||
Simple versus complex hypotheses | 150 | ||
Nondirectional versus directional hypotheses | 150 | ||
Statistical versus research hypotheses | 151 | ||
Testable Hypothesis | 152 | ||
UNDERSTANDING STUDY VARIABLES AND RESEARCH CONCEPTS | 153 | ||
Types of Variables in Quantitative Research | 153 | ||
Independent and Dependent Variables | 153 | ||
Research Variables | 154 | ||
Extraneous Variables | 154 | ||
Conceptual and Operational Definitions of Variables in Quantitative Research | 155 | ||
Research Concepts Investigated in Qualitative Research | 156 | ||
Demographic Variables | 157 | ||
KEY CONCEPTS | 158 | ||
REFERENCES | 158 | ||
Chapter 6: Understanding and Critically Appraising the Literature Review | 162 | ||
PURPOSE OF THE LITERATURE REVIEW | 163 | ||
Purpose of the Literature Review in Quantitative Research | 163 | ||
Purpose of the Literature Review in Qualitative Research | 164 | ||
SOURCES INCLUDED IN A LITERATURE REVIEW | 165 | ||
Types of Publications | 166 | ||
Content of Publications | 166 | ||
Quality of Sources | 167 | ||
CRITICALLY APPRAISING LITERATURE REVIEWS | 168 | ||
Critical Appraisal of a Literature Review in a Quantitative Study | 168 | ||
Critical Appraisal of a Literature Review in a Qualitative Study | 172 | ||
REVIEWING THE LITERATURE | 176 | ||
Preparing to Review the Literature | 176 | ||
Clarify the purpose of the literature review | 176 | ||
Select electronic databases and search terms | 177 | ||
Conducting the Literature Review | 178 | ||
Search the selected databases | 178 | ||
Use a table or other method to document the results of your search | 178 | ||
Refine your Search | 178 | ||
Review the abstracts to identify relevant studies | 179 | ||
Obtain full-text copies of relevant articles | 179 | ||
Ensure that information needed to cite the source is recorded | 180 | ||
Processing the Literature | 180 | ||
Read the articles | 180 | ||
Appraise, analyze, and synthesize the literature | 180 | ||
Writing the Review of the Literature | 183 | ||
Develop an outline to organize the information from the review | 183 | ||
Write each section of the review | 184 | ||
Create the reference list | 184 | ||
Check the review and the reference list | 185 | ||
KEY CONCEPTS | 186 | ||
REFERENCES | 186 | ||
Chapter 7: Understanding Theory and Research Frameworks | 189 | ||
WHAT IS A THEORY? | 190 | ||
UNDERSTANDING THE ELEMENTS OF THEORY | 191 | ||
Concepts | 191 | ||
Relational Statements | 193 | ||
LEVELS OF THEORETICAL THINKING | 194 | ||
Grand Nursing Theories | 194 | ||
Middle Range and Practice Theories | 195 | ||
Study Frameworks | 198 | ||
EXAMPLES OF CRITICAL APPRAISAL | 199 | ||
Framework from a Grand Nursing Theory | 199 | ||
Framework Based on Middle Range Theory | 202 | ||
Framework from a Tentative Theory | 204 | ||
Framework for Physiological Study | 205 | ||
KEY CONCEPTS | 207 | ||
REFERENCES | 207 | ||
Chapter 8: Clarifying Quantitative Research Designs | 210 | ||
IDENTIFYING DESIGNS USED IN NURSING STUDIES | 212 | ||
DESCRIPTIVE DESIGNS | 212 | ||
Typical Descriptive Design | 214 | ||
Comparative Descriptive Design | 216 | ||
CORRELATIONAL DESIGNS | 217 | ||
Descriptive Correlational Design | 218 | ||
Predictive Correlational Design | 220 | ||
Model Testing Design | 221 | ||
UNDERSTANDING CONCEPTS IMPORTANT TO CAUSALITY IN DESIGNS | 222 | ||
Multicausality | 223 | ||
Probability | 223 | ||
Bias | 223 | ||
Control | 224 | ||
Manipulation | 224 | ||
EXAMINING THE VALIDITY OF STUDIES | 224 | ||
Statistical Conclusion Validity | 224 | ||
Low Statistical Power | 226 | ||
Reliability or Precision of Measurement Methods | 226 | ||
Reliability of Intervention Implementation | 226 | ||
Extraneous Variances in the Study Setting | 226 | ||
Internal Validity | 226 | ||
Subject Selection and Assignment to Groups | 227 | ||
Subject Attrition | 227 | ||
History | 227 | ||
Maturation | 227 | ||
Construct Validity | 227 | ||
Inadequate Definitions of Constructs | 228 | ||
Mono-operation Bias | 228 | ||
Experimenter Expectancies (Rosenthal Effect) | 228 | ||
External Validity | 228 | ||
Interaction of Selection and Treatment | 229 | ||
Interaction of Setting and Treatment | 229 | ||
Interaction of History and Treatment | 229 | ||
ELEMENTS OF DESIGNS EXAMINING CAUSALITY | 229 | ||
Examining Interventions in Nursing Studies | 230 | ||
Experimental and Control or Comparison Groups | 230 | ||
QUASI-EXPERIMENTAL DESIGNS | 232 | ||
Pretest and Post-test Designs with Comparison Group | 233 | ||
EXPERIMENTAL DESIGNS | 237 | ||
Classic Experimental Pretest and Post-test Designs with Experimental and Control Groups | 237 | ||
Post-test-Only with Control Group Design | 239 | ||
RANDOMIZED CONTROLLED TRIALS | 241 | ||
INTRODUCTION TO MIXED-METHODS APPROACHES | 243 | ||
KEY CONCEPTS | 245 | ||
REFERENCES | 246 | ||
Chapter 9: Examining Populations and Samples in Research | 248 | ||
UNDERSTANDING SAMPLING CONCEPTS | 249 | ||
Populations and Elements | 250 | ||
Sampling or Eligibility Criteria | 251 | ||
REPRESENTATIVENESS OF A SAMPLE IN QUANTITATIVE AND OUTCOMES RESEARCH | 252 | ||
Random and Systematic Variation of Subjects Values | 252 | ||
Acceptance and Refusal Rates in Studies | 253 | ||
Sample Attrition and Retention Rates in Studies | 253 | ||
Sampling Frames | 254 | ||
Sampling Methods or Plans | 255 | ||
PROBABILITY SAMPLING METHODS | 257 | ||
Simple Random Sampling | 259 | ||
Stratified Random Sampling | 260 | ||
Cluster Sampling | 261 | ||
Systematic Sampling | 262 | ||
NONPROBABILITY SAMPLING METHODS COMMONLY USED IN QUANTITATIVE RESEARCH | 263 | ||
Convenience Sampling | 264 | ||
Quota Sampling | 265 | ||
SAMPLE SIZE IN QUANTITATIVE STUDIES | 266 | ||
Effect Size | 267 | ||
Types of Quantitative Studies | 267 | ||
Number of Variables | 267 | ||
Measurement Sensitivity | 268 | ||
Data Analysis Techniques | 268 | ||
SAMPLING IN QUALITATIVE RESEARCH | 270 | ||
Purposeful or Purposive Sampling | 270 | ||
Network Sampling | 271 | ||
Theoretical Sampling | 273 | ||
SAMPLE SIZE IN QUALITATIVE STUDIES | 274 | ||
Scope of the Study | 274 | ||
Nature of the Topic | 274 | ||
Quality of the Information | 275 | ||
Study Design | 275 | ||
RESEARCH SETTINGS | 276 | ||
Natural Setting | 277 | ||
Partially Controlled Setting | 277 | ||
Highly Controlled Setting | 278 | ||
KEY CONCEPTS | 278 | ||
REFERENCES | 279 | ||
Chapter 10: Clarifying Measurement and Data Collection in Quantitative Research | 281 | ||
CONCEPTS OF MEASUREMENT THEORY | 283 | ||
Directness of Measurement | 283 | ||
Levels of Measurement | 284 | ||
Nominal-Level Measurement | 284 | ||
Ordinal-Level Measurement | 284 | ||
Interval-Level Measurement | 285 | ||
Ratio-Level Measurement | 286 | ||
Measurement Error | 286 | ||
Reliability | 287 | ||
Reliability Testing | 288 | ||
Validity | 290 | ||
ACCURACY, PRECISION, AND ERROR OF PHYSIOLOGICAL MEASURES | 292 | ||
Accuracy | 292 | ||
Precision | 292 | ||
Error | 293 | ||
USE OF SENSITIVITY, SPECIFICITY, AND LIKELIHOOD RATIOS TO DETERMINE THE QUALITY OF DIAGNOSTIC AND SCREENING TESTS | 295 | ||
Sensitivity and Specificity | 295 | ||
Likelihood Ratios | 298 | ||
MEASUREMENT STRATEGIES IN NURSING | 298 | ||
Physiological Measures | 298 | ||
Observational Measurement | 300 | ||
Interviews | 302 | ||
Questionnaires | 304 | ||
Scales | 306 | ||
Rating Scales | 307 | ||
Likert Scale | 307 | ||
Visual Analog Scales | 308 | ||
DATA COLLECTION PROCESS | 310 | ||
Recruitment of Study Participants | 310 | ||
Consistency in Data Collection | 310 | ||
Control in the Study Design | 311 | ||
Studies Obtaining Data from Existing Databases | 311 | ||
KEY CONCEPTS | 313 | ||
REFERENCES | 314 | ||
Chapter 11: Understanding Statistics in Research | 317 | ||
UNDERSTANDING THE ELEMENTS OF THE STATISTICAL ANALYSIS PROCESS | 319 | ||
Management of Missing Data | 320 | ||
Description of the Sample | 320 | ||
Reliability of Measurement Methods | 323 | ||
Exploratory Analyses | 323 | ||
Inferential Statistical Analyses | 323 | ||
``Data Analysis | 324 | ||
UNDERSTANDING THEORIES AND CONCEPTS OF THE STATISTICAL ANALYSIS PROCESS | 324 | ||
Probability Theory | 324 | ||
Decision Theory, Hypothesis Testing, and Level of Significance | 325 | ||
Inference and Generalization | 326 | ||
Normal Curve | 326 | ||
Tailedness | 327 | ||
Type I and Type II Errors | 328 | ||
Power: Controlling the Risk of a Type II Error | 329 | ||
Degrees of Freedom | 329 | ||
USING STATISTICS TO DESCRIBE | 330 | ||
Frequency Distributions | 330 | ||
Ungrouped Frequency Distributions | 330 | ||
Grouped Frequency Distributions | 330 | ||
Percentage Distributions | 331 | ||
Measures of Central Tendency | 331 | ||
Mode | 331 | ||
Median | 333 | ||
Mean | 333 | ||
Measures of Dispersion | 333 | ||
Range | 333 | ||
Variance | 334 | ||
Standard Deviation | 334 | ||
Confidence Interval | 334 | ||
Standardized Scores | 335 | ||
Scatterplots | 335 | ||
Understanding Descriptive Statistical Results | 336 | ||
DETERMINING THE APPROPRIATENESS OF INFERENTIAL STATISTICS IN STUDIES | 337 | ||
Critical Appraisal Guidelines for Inferential Statistical Analyses | 338 | ||
USING STATISTICS TO EXAMINE RELATIONSHIPS | 340 | ||
Pearson Product-Moment Correlation | 340 | ||
Interpreting Pearson Correlation Analysis Results | 341 | ||
Testing the Significance of a Correlation Coefficient | 342 | ||
Factor Analysis | 343 | ||
USING STATISTICS TO PREDICT OUTCOMES | 344 | ||
Regression Analysis | 344 | ||
Interpreting Results | 345 | ||
USING STATISTICS TO EXAMINE DIFFERENCES | 347 | ||
Chi-Square Test of Independence | 347 | ||
Interpreting Results | 347 | ||
t-Test | 349 | ||
Interpreting Results | 349 | ||
Analysis of Variance (ANOVA) | 351 | ||
Interpreting Results | 351 | ||
Analysis of Covariance (ANCOVA) | 353 | ||
INTERPRETING RESEARCH OUTCOMES | 353 | ||
Types of Results | 353 | ||
Significant and Predicted Results | 353 | ||
Nonsignificant Results | 353 | ||
Significant and Unpredicted Results | 354 | ||
Mixed Results | 354 | ||
Unexpected Results | 354 | ||
Findings | 354 | ||
Exploring the Significance of Findings | 354 | ||
Clinical Importance of Findings | 355 | ||
Limitations | 355 | ||
Conclusions | 355 | ||
Generalizing the Findings | 356 | ||
Implications for Nursing | 356 | ||
Recommendations for Further Studies | 356 | ||
KEY CONCEPTS | 358 | ||
REFERENCES | 359 | ||
Chapter 12: Critical Appraisal of Quantitative and Qualitative Research for Nursing Practice | 361 | ||
WHEN ARE CRITICAL APPRAISALS OF STUDIES IMPLEMENTED IN NURSING? | 362 | ||
Students' Critical Appraisal of Studies | 363 | ||
Critical Appraisal of Studies by Practicing Nurses, Nurse Educators, and Researchers | 363 | ||
Critical Appraisal of Research Following Presentation and Publication | 364 | ||
Critical Appraisal of Research for Presentation and Publication | 364 | ||
Critical Appraisal of Research Proposals | 364 | ||
WHAT ARE THE KEY PRINCIPLES FOR CONDUCTING INTELLECTUAL CRITICAL APPRAISALS OF QUANTITATIVE AND QUALITATIVE STUDIES? | 365 | ||
UNDERSTANDING THE QUANTITATIVE RESEARCH CRITICAL APPRAISAL PROCESS | 366 | ||
Step 1: Identifying the Steps of the Research Process in Studies | 366 | ||
Guidelines for Identifying the Steps of the Research Process in Studies | 366 | ||
Step 2: Determining the Strengths and Weaknesses in Studies | 370 | ||
Guidelines for Determining the Strengths and Weaknesses in Studies | 371 | ||
Step 3: Evaluating the Credibility and Meaning of Study Findings | 374 | ||
Guidelines for Evaluating the Credibility and Meaning of Study Findings | 375 | ||
EXAMPLE OF A CRITICAL APPRAISAL OF A QUANTITATIVE STUDY | 375 | ||
UNDERSTANDING THE QUALITATIVE RESEARCH CRITICAL APPRAISAL PROCESS | 389 | ||
Step 1: Identifying the Components of the Qualitative Research Process in Studies | 389 | ||
Guidelines for Identifying the Components of the Research Process in Qualitative Studies | 389 | ||
Guidelines for Identifying the Components of a Qualitative Study | 390 | ||
Step 2: Determining the Strengths and Weaknesses in Studies | 391 | ||
Guidelines for Determining the Strengths and Weaknesses in Studies | 392 | ||
Step 3: Evaluating the Trustworthiness and Meaning of Study Findings | 394 | ||
Guidelines for Evaluating the Trustworthiness and Meaning of Study Findings | 394 | ||
EXAMPLE OF A CRITICAL APPRAISAL OF A QUALITATIVE STUDY | 394 | ||
KEY CONCEPTS | 410 | ||
REFERENCES | 411 | ||
Chapter 13: Building an Evidence-Based Nursing Practice | 414 | ||
BENEFITS AND BARRIERS RELATED TO EVIDENCE-BASED NURSING PRACTICE | 416 | ||
Benefits of Evidence-Based Nursing Practice | 416 | ||
Force 6: Quality Care | 417 | ||
``Research and Evidence-Based Practice | 417 | ||
Barriers to Evidence-Based Nursing Practice | 418 | ||
SEARCHING FOR EVIDENCE-BASED SOURCES | 419 | ||
CRITICALLY APPRAISING RESEARCH SYNTHESES | 421 | ||
Critically Appraising Systematic Reviews | 421 | ||
Step 1 | 423 | ||
Did the title indicate if a systematic review or meta-analysis was conducted? | 423 | ||
Step 2 | 423 | ||
Did the abstract include a structured summary of the research synthesis? | 423 | ||
Step 3 | 423 | ||
Was a significant, clear clinical question developed to direct the research synthesis? | 423 | ||
Step 4 | 424 | ||
Were the purpose and objectives or aims of the review expressed? | 424 | ||
Step 5 | 424 | ||
Was the literature search criteria clearly identified? | 424 | ||
Step 6 | 425 | ||
Was a comprehensive, systematic search of the research literature conducted? | 425 | ||
Step 7 | 425 | ||
Was publication bias addressed? | 425 | ||
Step 8 | 425 | ||
Was the process for selecting the studies for review detailed? | 425 | ||
Step 9 | 428 | ||
Were key elements of the studies presented? | 428 | ||
Step 10 | 428 | ||
Were the studies critically appraised? | 428 | ||
Step 11 | 428 | ||
Was a meta-analysis conducted as part of the systematic review? | 428 | ||
Step 12 | 428 | ||
Were the results of the review clearly presented? | 428 | ||
Step 13 | 429 | ||
Did the report conclude with a clear discussion section? | 429 | ||
Implications for practice | 430 | ||
Step 14 | 430 | ||
Was a clear concise report developed for publication? | 430 | ||
Critically Appraising Meta-Analyses | 430 | ||
Clinical Question for a Meta-Analysis | 432 | ||
Purpose and Questions to Direct a Meta-Analysis | 432 | ||
Search Criteria and Strategies for Meta-Analyses | 432 | ||
Primary Study Search Strategies | 433 | ||
Possible Biases for Meta-Analyses and Systematic Reviews | 433 | ||
Results of Meta-Analysis for Continuous Outcomes | 435 | ||
Results of Meta-Analysis for Dichotomous Outcomes | 435 | ||
Critically Appraising Meta-Syntheses | 436 | ||
Framing for the Meta-Synthesis | 438 | ||
Searching the Literature and Selecting Sources | 439 | ||
Appraisal of Studies and Analysis of Data | 439 | ||
Discussion of Meta-Synthesis Findings | 440 | ||
Critically Appraising Mixed-Methods Systematic Reviews | 440 | ||
DEVELOPING CLINICAL QUESTIONS TO IDENTIFY EXISTING RESEARCH-BASED EVIDENCE FOR USE IN PRACTICE | 443 | ||
MODELS TO PROMOTE EVIDENCE-BASED PRACTICE IN NURSING | 447 | ||
Stetler Model of Research Utilization to Facilitate Evidence-Based Practice | 447 | ||
Phase I: Preparation | 448 | ||
Phase II: Validation | 448 | ||
Phase III: Comparative Evaluation/Decision Making | 448 | ||
Phase IV: Translation/Application | 449 | ||
Phase V: Evaluation | 449 | ||
Iowa Model of Evidence-Based Practice | 450 | ||
Application of the Iowa Model of Evidence-Based Practice | 450 | ||
IMPLEMENTING EVIDENCE-BASED GUIDELINES IN PRACTICE | 453 | ||
History of the Development of Evidence-Based Guidelines | 454 | ||
National Guideline Clearinghouse Resources | 454 | ||
Implementing Evidence-Based Guidelines for Management of Hypertension in Practice | 456 | ||
INTRODUCTION TO EVIDENCE-BASED PRACTICE CENTERS | 460 | ||
INTRODUCTION TO TRANSLATIONAL RESEARCH | 461 | ||
KEY CONCEPTS | 461 | ||
REFERENCES | 463 | ||
Chapter 14: Outcomes Research | 466 | ||
THEORETICAL BASIS OF OUTCOMES RESEARCH | 468 | ||
NURSING-SENSITIVE OUTCOMES | 469 | ||
ORIGINS OF OUTCOMES AND PERFORMANCE MONITORING | 472 | ||
FEDERAL GOVERNMENT INVOLVEMENT IN OUTCOMES RESEARCH | 473 | ||
Agency for Healthcare Research and Quality (AHRQ) | 473 | ||
American Recovery and Reinvestment Act | 473 | ||
National Quality Forum | 474 | ||
National Database of Nursing Quality Indicators | 474 | ||
Oncology Nursing Society | 476 | ||
ADVANCED PRACTICE NURSING OUTCOMES RESEARCH | 476 | ||
OUTCOMES RESEARCH AND NURSING PRACTICE | 477 | ||
Evaluating Outcomes of Care | 477 | ||
Evaluating Structure of Care | 478 | ||
Evaluating Process of Care | 480 | ||
Standards of Care | 480 | ||
Practice Styles, Practice Pattern, and Evidence-Based Practice | 481 | ||
METHODOLOGIES FOR OUTCOMES STUDIES | 481 | ||
Samples and Sampling | 481 | ||
Large Databases as Sample Sources | 483 | ||
Study Designs | 483 | ||
Prospective Cohort Studies | 484 | ||
Retrospective Cohort Studies | 485 | ||
Population-Based Studies | 487 | ||
Economic Studies | 488 | ||
Ethical Studies | 488 | ||
Measurement Methods | 488 | ||
STATISTICAL METHODS FOR OUTCOMES STUDIES | 491 | ||
Analysis of Change | 491 | ||
Analysis of Improvement | 491 | ||
CRITICAL APPRAISAL OF OUTCOMES STUDIES | 492 | ||
Questions Guiding the Critical Appraisal of Outcomes Studies | 492 | ||
Are the results valid? | 492 | ||
What are the results? | 493 | ||
In a study of an outcome such as health-related quality of life (HRQL): | 493 | ||
How can I apply the results to patient care? | 493 | ||
Example Critical Appraisal of an Outcomes Study | 493 | ||
KEY CONCEPTS | 494 | ||
REFERENCES | 495 | ||
Glossary | 500 | ||
Index | 515 | ||
Inside Back Cover | ES3 |