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- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Serie: Notes On (Nursing)
- Sprache: Englisch
Generate and apply high-quality research in a nursing context with this accessible guide
The production and application of rigorous, effective research can have a significant impact on nursing care. Notes On… Nursing Research offers an overview of nursing research, its relationship with clinical practice and patient outcomes, and its positive effects on the nursing professional. Beginning with an introduction to the fundamental principles of nursing research, it moves through the stages of designing and conducting research studies before concluding with specific applications of research to clinical practice and patient care.
Notes On… Nursing Research readers will also find:
- A step-by-step guide to formulating and answering a research question
- Detailed discussion of research methodologies including data collection and analysis, inferential statistics, multivariate statistics, evidence synthesis, and much more
- Specific examples showing how research has improved patient care and outcomes
Notes On… Nursing Research is ideal for undergraduate nurses, as well as a valuable resource for qualified and practicing nurses and other health professionals looking to develop their understanding of research.
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Seitenzahl: 245
Veröffentlichungsjahr: 2024
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Table of Contents
Cover
Table of Contents
Title Page
Copyright Page
Preface
Acknowledgements
About the Authors
About the Notes On… Series
1 An Introduction to Nursing Research
1.1 Introduction
1.2 What Is Research?
1.3 Why Is Research Important to Nursing?
1.4 Evidence‐based Nursing
1.5 Research Methodologies: An Overview
1.6 Research Aims and Objectives
1.7 Prioritising Patient and Public Involvement
1.8 Summary
2 Identifying Areas of Inquiry
2.1 Introduction
2.2 The Hierarchy of Evidence
2.3 What Is a Literature Review?
2.4 Relevance of Literature Reviews in Nursing
2.5 Developing a Literature Review Question
2.6 Literature Searching
2.7 Screening against Inclusion and Exclusion Criteria
2.8 Critical Appraisal
2.9 Reporting the Findings
2.10 Limitations of the Literature Review
2.11 Summary
3 Qualitative Research
3.1 Introduction
3.2 What Is Qualitative Research?
3.3 Qualitative Research Design and Approaches
3.4 Sampling in Qualitative Research
3.5 Sample Populations
3.6 Recruitment in Qualitative Research
3.7 Data Generation in Qualitative Research
3.8 Data Analysis in Qualitative Research
3.9 Summary
4 Quantitative Research
4.1 Introduction
4.2 What Is Quantitative Research?
4.3 Quantitative Research Designs and Approaches
4.4 Key Concepts in Quantitative Research
4.5 Sampling in Quantitative Research
4.6 Data Collection Methods in Quantitative Research
4.7 Data Analysis and Interpretation in Quantitative Research
4.8 Summary
5 Mixed Methods Research
5.1 Introduction
5.2 Strengths and Limitations of Qualitative Research
5.3 Strengths and Limitations of Quantitative Research
5.4 Mixed Methods Research
5.5 Summary
6 Ethics and Integrity in Research
6.1 Introduction
6.2 What Are Research Ethics?
6.3 Ethical Principles in Research
6.4 Applying Ethical Principles to the Conduct of a Research Study
6.5 Research Governance
6.6 Avoiding Potential Ethical Pitfalls
6.7 Ethical Considerations Following Completion of the Research Study
6.8 Equality, Diversity, and Inclusion in Research
6.9 Summary
7 Evidence Synthesis
7.1 Introduction
7.2 What Is Evidence Synthesis?
7.3 Evidence Synthesis or a Literature Review?
7.4 Types of Evidence Synthesis
7.5 Conducting a Systematic Review
7.6 Summary
References
Index
End User License Agreement
List of Illustrations
Chapter 1
Figure 1.1 Determinants of evidence‐based practice (EBP).
Chapter 2
Figure 2.1 The hierarchy of evidence.
Chapter 4
Figure 4.1 A normal distribution bell‐curve.
Guide
Cover Page
Table of Contents
Title Page
Copyright Page
Preface
Acknowledgements
About the Authors
About the Notes On… Series
Begin Reading
References
Index
WILEY END USER LICENSE AGREEMENT
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Notes On… Nursing Research
Dominic Roche
Clare L. Bennett
This edition first published 2025© 2025 John Wiley & Sons Ltd
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Preface
Welcome to Notes on… Nursing Research. The purpose of this book is to enable you to build your understanding of research and research methods and to recognise how research can support evidence‐based nursing practice. We will explore how research evidence is generated and help you to develop your understanding of research methodologies and methods. We will also provide you with the tools to be able to demonstrate critical analysis of research and to offer a systematic evaluation of existing research around a specific topic. We will also explore the role of nurses and service users in developing and conducting research, as well as disseminating research findings. This will help you to develop your understanding of how research evidence can be used to inform and support changes in nursing practice to ensure safe, high‐quality patient care.
Broadly speaking, research can be explained as the process of generating, communicating, and implementing primary evidence. Research is important to nursing as it helps us develop new and more effective treatments, interventions, care, and services for patients. It also helps to support the provision of the best possible nursing care and allows nursing as a profession to continually improve. Research also underpins evidence‐based nursing, helping us to develop our knowledge base for clinical decision‐making and the delivery of nursing care.
In Chapter 1 you will be introduced to what is meant by the term nursing research and why it is so important to health and care today. We also give you an overview of different approaches to research and formulating research questions and objectives. In Chapter 2 you will start your journey into the beginnings of nursing research – identifying areas of inquiry through searching the literature. In this chapter you will have the opportunity to learn how to conduct various stages of a literature review. Chapter 3 introduces you to qualitative research design as well as approaches to sampling, recruitment, data generation, and data analysis. In Chapter 4 you will explore quantitative approaches to nursing research. Chapter 5 introduces you to mixed methods research. Chapter 6 enables you to think further about the conduct of nursing research and its potential ethical implications. Finally, Chapter 7 focuses on evidence synthesis and will guide you through how to conduct a systematic review.
Reflective Activities within each chapter will help you to explore and extend your learning and assist you in realising your potential as a nurse researcher. A summary at the end of every chapter will help you to reflect on your learning and reinforce your understanding of the key points.
Nursing is a great career where you can enhance the lives of many, but if you can understand, critique, conduct, and implement research, you can make an even greater, potentially international, contribution to the quality of care delivery. This is the beginning of a fantastic journey into the world of research, so immerse yourself, unleash your potential, and make your mark as a nurse researcher!
Acknowledgements
In writing this book, we realised that we know a lot about research methods! We can't take direct credit for this though – it reflects the insightful and stimulating research methods teaching and practice that we have been privileged to enjoy throughout our respective nursing careers. From our undergraduate nursing programmes to our master's degrees and through to our doctoral study, we have been taught by outstanding nurse researchers. In our research practice too, we have been extremely fortunate in having inspiring mentors and colleagues. So, although our names appear on the cover, this book has been informed by a large number of nurse researcher colleagues and scholars to whom we are indebted. Although there are too many colleagues to mention by name, we would like to particularly acknowledge the influence of our past and current colleagues in the School of Healthcare Sciences at Cardiff University who have been so significant in shaping our understandings of research methods and have instilled in us an enduring passion for nursing research.
We would also like to thank the team at Wiley‐Blackwell who have provided so much support throughout this project. And last, but certainly not least, we wish to express our sincere gratitude to our writing colleagues, David Stanley and Alison James, who have helped motivate us and guide us in our work as a part of this fantastic project.
About the Authors
Dominic Roche PhD, MSc, PGCE, BN (Hons), RNDominic is a senior lecturer in adult nursing in the School of Healthcare Sciences at Cardiff University, where he has worked since 2014. He has a range of experience of undergraduate and postgraduate teaching and learning and is a registered nurse, qualified teacher, and researcher. Dominic retrained as an adult nurse, gaining his degree from Swansea University in 2008, and was then awarded a scholarship to undertake a MSc, studying whilst working as a staff nurse in stroke rehabilitation and general medicine. Outside of clinical nursing practice, he spent time working with Public Health Wales as part of a national quality improvement programme. His PhD research study explored patient involvement in a patient safety initiative, which was funded by Health and Care Research Wales. He has a wealth of experience teaching research methods to students across undergraduate and postgraduate programmes and is an experienced MSc and doctoral supervisor. He currently leads a MSc core research methods module and a MSc systematic review dissertation module. His academic areas of interest lie in qualitative research methods and evidence synthesis. He is particularly interested in studying and supporting the role of service users in the development, organisation, and delivery of healthcare services and exploring how nurse‐patient communication strategies can influence patient care.
Clare L. Bennett D.Nurs., MA, PGCE, BSc (Hons), DipHE, RGN, SFHEA, CFClare is a nurse and a Reader in Knowledge Translation and Health Improvement at the School of Healthcare Sciences at Cardiff University. She is also co‐director of the Wales Centre for Evidence Based Care: A JBI Centre of Excellence. Clare's career in nursing began in the early 1990s. After having worked in a variety of surgical and medical settings, she developed an interest in HIV, first working with children and babies who were HIV positive in Romania and later with adults, at the West Midlands Regional Centre for HIV. She then went on to work in sexual health before becoming a Research Nurse at Birmingham University and a Clinical Nurse Specialist/Advanced Nurse Practitioner in Immunology. In 1999 she began her academic career in London whilst continuing to work clinically. Her research interests are primarily focused on young people's well‐being and service organisation and delivery. She is widely published and has led a number of research studies funded by bodies such as NIHR, European Cancer Organisation, and Health Education England. Clare teaches research methods and supervises research projects on undergraduate, MSc, and doctoral programmes internationally.
About the Notes On… Series
Florence Nightingale wrote two health‐focused books, Notes on… Nursing and Notes on… Hospitals. However, this series of short books inspired by her use of the ‘Notes on’ title is developed to address a range of nursing and health professional specific topics in brief or note form. Each book in the series offers a comprehensive overview of information on a wide range of topics for nurses, midwives, and other health professionals. It is hoped the books with be especially useful for health professional students in a number of professions with the books providing key, relevant, concise, information in an accessible way. Notes On… Research in Nursing is the third book in the series.
1An Introduction to Nursing Research
1.1 Introduction
In this chapter, we will introduce you to what nursing research is, why it is important, how it is approached, and how to develop research questions that you may want to ask about nursing practice. By doing so, we also aim to empower you to recognise nursing practice that is ritualised or entrenched, rather than evidence based, and to be able to identify whether the evidence underpinning a particular practice is outdated or weak. These skills will allow you to see how research influences and informs our nursing practice – why we do the things we do and the ways that we do them. This will also equip you in critiquing care delivery and in ascertaining whether we could produce better outcomes if we had stronger evidence to support our nursing practice.
Reflective Activity 1.1
To begin, an important question to consider is, ‘What is research?’ Make a list of everything you currently know about research and use this to create your own definition.
1.2 What Is Research?
A good place to start when exploring what we mean by ‘research’ is to consider how research differs from other sources of knowledge that may inform nursing practice, such as beliefs, tradition, intuition, habit, and common sense. In the United Kingdom (UK), research is defined by the Research Excellence Framework (REF) as ‘the process of investigation leading to new insights, shared effectively’ (REF 2019). Research can also be defined as the ‘study of phenomena by the rigorous and systematic collection and analysis of data’ (Parahoo 2014, p 30). There is also a difference between collecting information, for example through an audit, and undertaking research. So, compared to other sources of knowledge, research is a systematic way of knowing, in which the methods used must be available for scrutiny. This emphasis on a systematic and transparent approach gives researchers their particular claims to knowledge. Research systematically investigates ideas to increase knowledge and devise new interventions and new and better ways of working by establishing or confirming facts, reaffirming previous knowledge, solving problems, and supporting or developing new theories. In nursing, we can then use this new knowledge to inform our practice, by providing the evidence to support our evidence‐based practice (EBP).
Reflective Activity 1.2
Discuss with your colleagues why they think research is important to nursing.
1.3 Why Is Research Important to Nursing?
So far, we have discussed what research is, but why should research command attention in our nursing practice? As registered nurses it is important that we understand the need to base our decisions about patient care on contemporary research evidence, factoring in the relevant legal, regulatory, and governance requirements and specific policies and ethical frameworks. This does not mean that nurses should always be engaged in research, but there is an expectation that we engage in practice which is based on the best available evidence. To do this effectively requires that we understand the different approaches and methods of research and that we have the skills and knowledge to be able to review and apply critical appraisal and critical thinking to different sources of knowledge around particular topics of relevance or interest. Ultimately, to identify what good practice is requires us to be able to test, measure, and evaluate it and so we need to know how to go about doing these things through the use of research.
Nursing research is integral to nursing practice in a diverse range of areas including education, ethics, clinical skills, and clinical practice, and nurses engage with research for several reasons. If you have ever used healthcare services, then you are a user of research. You are also likely to be a consumer of research through reading research papers, writing literature reviews, attending lectures or seminars, or when learning in practice. You are also using research when following clinical guidelines. Nurses can also be promoters of research, by providing evidence‐based information to patients and service users, through supporting peers and colleagues to update their practice, and by developing and disseminating evidence‐based guidelines and policies. Nurses might also be participants in research and the experiences and involvement of nurses, including nursing students, in research studies helps to inform the nursing evidence base. Nurses' involvement in research can also help to improve communication within nursing practice, build relationships and partnerships with other practitioners and disciplines, and help to further develop the critical evaluation of evidence‐based nursing care. Involvement in research can also help nurses to develop competence and confidence in practice.
There are many different ways in which nurses might be involved in research, ranging from developing one's awareness of research methods and applying research evidence to clinical practice, through to contributing to research studies, and on to undertaking and leading research projects or a programme of research. All these approaches help to develop and promote a positive research culture in nursing. You may also be, or indeed aspire to be, an activist in research. This involves taking part in the design, conduct, and dissemination of research studies – and again, there are many roles a nurse can fulfil in these areas. Activists in research may be driven or inspired by personal, professional, organisational, or societal issues that lead them to develop and conduct research studies and programmes of research. For example, at a personal level, there may be phenomena faced by nurses in their own lives, or issues faced by service users, patients, or clients that lead to the development of research studies. Nurses can also encounter professional problems or challenges that generate research ideas, helping to advance the nursing profession and improve patient care. Organisational issues may also be evident, such as the ongoing evolution and development of the diverse roles of registered nurses, and changes to the way care is organised and delivered, including the continuing drive to advance nursing services in community‐based care. There are also changes to the way nurses are educated and our continuing professional development needs. As nurses take on different challenges and demands of care, this requires strong supporting evidence, generated through research. There are also broader societal issues that warrant attention through nursing research, such as health inequalities, climate change, sustainability, and the impact of innovative technology such as artificial intelligence. Leaders in research set the agenda for research in areas of practice, facilitate and support others to undertake their research, or lead in other ways at both national and international levels. While this may seem a long way away for you at the moment, it is definitely something that we would advocate that you aspire to!
1.4 Evidence‐based Nursing
As we have discussed, research can provide evidence for clinical practice, healthcare service organisation and delivery, and the patient and service user experience. Research can also help us to evaluate and innovate new interventions, policies, and practice. And of course, as with all contemporary healthcare, nursing practice should be based on the best available evidence, and this evidence should be robust and reliable. EBP (and thus evidence‐based nursing) is a key requirement to support safe, effective patient care. There have been a range of formative definitions offered for this concept, including:
“The conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients”
(Sackett et al. 1996, p 71).
This definition of evidence‐based healthcare was later updated to incorporate what we know as the three pillars of evidence, which requires nurses and other healthcare professionals to combine the best available research evidence with clinical expertise and patient values and preferences to guide our decision‐making, as outlined below and in Figure 1.1:
“Evidence‐based medicine (EBM) is the integration of best research evidence with clinical expertise and patient values. […] By patient values we mean the unique preferences, concerns and expectations each patient brings to a clinical encounter and which must be integrated into clinical decisions”
(Sackett et al. 2000, p 1).
“Decision making that considers the feasibility, appropriateness, meaningfulness, and effectiveness of healthcare practices […] may be informed by the best available evidence, the context in which care is delivered, the individual patient and the professional judgement and expertise of the health professional informs this process.”
(Jordan et al. 2019)
We have established that evidence‐based healthcare and thus evidence‐based nursing focuses on the need to use interventions and conduct practice that is supported by the best‐quality and most up‐to‐date evidence or knowledge available. However, an important word here is ‘judicious’ – we need to use the best available quality evidence with judgement, taking into consideration individual needs and preferences. Adopting an evidence‐based approach to our nursing practice will help reduce (and hopefully eliminate) the risk of ritualised care or custom and practice. Evidence‐based nursing is important as it allows us to translate research evidence into everyday practice to provide the best possible patient care and explain the rationale for this care to patients, carers, and their loved ones. We can also justify the care provided if challenged or questioned and this evidence‐based approach reduces the risk of any litigation or perceived negligence in care. There are also professional reasons why nurses should engage with research evidence and research practice. For example, the importance of evidence‐based nursing is recognised and emphasised by nursing regulatory bodies, including the Nursing and Midwifery Council (NMC) in the UK, with evidence‐based skills and knowledge being a professional requirement for nurses working in the UK and for nursing students.
Figure 1.1 Determinants of evidence‐based practice (EBP).
Reflective Activity 1.3
Consider the potential risks associated with applying poor‐quality research evidence to healthcare delivery and nursing practice.
Applying poor‐quality research evidence in healthcare can have disastrous consequences for patient care and outcomes. It can also damage the reputation of healthcare providers and erode trust between service users and professionals. There are several infamous examples of ‘bad research’, one of which is the research conducted by Dr. Andrew Wakefield and his colleagues, published in the Lancet in 1998 and since retracted. In this study, Wakefield suggested that the measles, mumps, and rubella (MMR) triple vaccine may have been linked with the development of autism in children. Whilst Wakefield's research was subsequently debunked due to the poor methods used and the spurious nature of the conclusions, this incident put doubts into people's minds about vaccinations that continue to this day. These research findings were widely reported in the mainstream media, resulting in many parents choosing not to vaccinate their children, and subsequently unvaccinated children developing one of the three diseases either as children or later in life. Whilst this is a rare and extreme example of poor‐quality research, it does help to emphasise that nurses and other healthcare professionals must be able to understand how to critique research evidence to ensure that our practice is based on the best available evidence and not on poorly conducted, dubious research. A Rough Guide to Spotting Bad Science by Andy Brunning (2014) (www.compoundchem.com) is a useful online resource to help you to filter through the good and the not‐so‐good claims made in health research.
1.5 Research Methodologies: An Overview
Methodology and methods are two words that are synonymous with research and are sometimes, incorrectly, used interchangeably. However, it is important to note that they do not mean the same thing. Methodology refers to the philosophical and theoretical basis through which the phenomena of interest are investigated and analysed. Methods refer to the specific techniques used by researchers when investigating and analysing these phenomena. Therefore, the methodology informs the researcher's approach to the research by providing a structure and a guide to the research design, data collection techniques, and data analysis used to examine an issue, whereas the method relates to the specific techniques used by the researcher to collect and analyse the data – for example, questionnaires or interviews and statistical or thematic analysis. When designing a research study, the methodology usually dictates the methods it may be helpful to.
1.5.1 Deductive and Inductive Approaches
Inductive and deductive reasoning are two different approaches to research, which are more about the overall strategy of the research rather than specific methods or methodologies. Researchers can adopt either approach, usually dependent on factors such as the research question and the available data. Deduction is a form of reasoning which can be explained as working from the general to the specific – a top‐down approach. The researcher will begin with a theory about the topic under investigation before narrowing it down. This can be done by developing a hypothesis and then testing this hypothesis by collecting and analysing data, which allows the initial theory to be confirmed or disproved.
A good example of a deductive approach is that of Chang et al. (2021), who examined the impact of a simulation‐based mobile app on student learning. The authors began by developing a general theory and a corresponding set of hypotheses that focused on student learning and satisfaction. They then went on to test whether these were supported by analysing outcomes among a group who used the mobile app (the intervention group) compared to those who used usual paper‐based learning (the control group). Through analysis of the findings, the team demonstrated use of a deductive approach to confirm a theory‐based hypothesis.
In contrast, induction is exploratory and allows us to build theory from data by moving from specific observations to broader generalisations and eventually to developing a theory. A researcher will begin by generating specific observations or data and will then try to identify patterns, themes, or relationships within the data to develop general theories or explanations about what they have observed. This approach is often linked with qualitative research, where data and observations from individual participants are analysed and subsequently drawn together to help form a general theory regarding the phenomenon being studied. For example, Alteren et al. (2021
