The Research Process in Nursing E-Book

Kate Gerrish

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1477

Veröffentlichungsjahr: 2015

Beschreibung

Comprehensive and thorough in scope, The Research Process in Nursing 7th edition provides everything you could want to know about research methods. This established textbook reflects the significant advances in nursing research and the importance of evidence-based practice, and provides an invaluable resource for both the novice and the more experienced researcher.

It includes practical information and advice on:

• How to find and critique the evidence
• How to choose the right approach
• How to collect data
• How to make sense of the data
• How to put research into practice

Special features:

• A clear, explicit and easy to understand text which links theory with practical steps in the research process.
• Examples provided allow the reader to apply a variety of research concepts to theoretical learning and professional practice.
• Incorporates chapters, research examples, and policy from a range of international countries, including Canada, Australia, USA and Hong Kong.
• Provides detailed discussions around each example, which clearly link theory with practice
• Easy to read for novice researchers and undergraduate nursing students, but at the same time provides sufficient depth and detail to be of value to experienced researchers and practitioners.

Leseprobe

The Research Process in Nursing

Seventh Edition

Edited by

Kate Gerrish

CBE, PhD, MSc, B.Nurs, RN, RM, NDN Cert, FRCNProfessor of Nursing Research, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust

Judith Lathlean

DPhil (Oxon), MA, BSc (Econ) (Hons)Professor of Health Research, Faculty of Health Sciences, University of Southampton

This edition first published 2015 © 2015 by John Wiley & Sons, Ltd

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Library of Congress Cataloging-in-Publication Data

The research process in nursing. – Seventh edition/edited by Kate Gerrish, Judith Lathlean.p. ; cm.Includes bibliographical references and index.

ISBN 978-1-118-52258-5 (pbk.)I. Gerrish, Kate, 1955– , editor. II. Lathlean, Judith, editor.[DNLM: 1. Nursing Research–methods. 2. Data Collection–methods. 3. Research Design. WY 20.5]RT81.5610.73072–dc23

2014030766

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Contributors

Leanne M. AitkenPhD, B HSc (Nurs) (Hons), Int Care Cert, Grad Cert Mgt, Grad Dip Sc Med (ClinEpi), FACN, FAANProfessor of Critical Care Nursing, Griffith University & Princess Alexandra Hospital, Brisbane, Australia and Professor of Nursing, City University London, London, UK

Claire BeecroftMA, BA (Hons), DPS, FHEA, MCLIPInformation Specialist and University Teacher, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK

Andrew BoothPhD, MSc, Dip Lib, BA, MCLIPReader in Evidence Based Information Practice, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK

Jo BoothPhD, BSc (Hons), BA, RGN, RNTReader, School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK

Tracey BucknallPhD, RN, BN, ICU Cert, PGD Adv NursProfessor and Associate Head of School (Research), School of Nursing & Midwifery, Deakin University; Foundational Chair in Nursing, Alfred Health, Melbourne, Australia

Charlotte ClarkeDSocSc, PhD, MSc, PGCE, BA, RNProfessor of Health in Social Science and Head of the School of Health in Social Science, University of Edinburgh, Edinburgh, UK

Julie CooperPhD, PG Cert Academic Practice, BSc (Hons), DipHE, RGNSenior Lecturer Primary and Community Care, Faculty of Education & Health, University of Greenwich, London, UK

Kara DeCorbyMScFormerly Managing Director and Knowledge Broker – Health Evidence, School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada

Jo DumvillePhD, MScSenior Lecturer in Applied Health Research, School of Nursing, Midwifery & Social Work, University of Manchester, Manchester, UK

George T.H. EllisonDSc, PhD, MSc (Med), BSc (Hons)Associate Professor, Division of Epidemiology & Biostatistics, Faculty of Medicine & Health, University of Leeds, Leeds, UK

Catherine EvansPhD, MSc, BSc, RN, RHV, DNNIHR Clinical Lecturer in Palliative Care/CNS, King’s College London, London, UK

Jenny FreemanPhD, MSc, BSc (Econ), CSTAT, FHEA, CertLTAssociate Professor of Biostatistics, University of Leeds, Leeds, UK

Dawn FreshwaterPhD, BA (Hons), RN RNT, FRCNProfessor of Mental Health, University of Leeds, UK; Senior Deputy Vice Chancellor, University of Western Australia, Crawley, Australia

Kathleen T. GalvinPhD, BSc (Hons), RNProfessor of Nursing Practice and Associate Dean, Research and Enterprise, Faculty of Health and Social Care, University of Hull, Hull, UK

Leslie GellingPhD, MA, BSc (Hons), RN MICR FRSAReader in Research Ethics, Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge, UK

Kate GerrishCBE, PhD, MSc, B.Nurs, RN, RM, NDN Cert, FRCNProfessor of Nursing Research, School of Nursing and Midwifery, University of Sheffield and Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK

Claire GoodmanPhD, RN, FQNIProfessor of Health Care Research, Centre for Research in Primary and Community Care, University of Hertfordshire, Hertfordshire, UK

Peter GriffithsPhD, BA (Hons), RNChair of Health Services Research, Centre for Innovation and Leadership in Health Sciences, University of Southampton, Southampton, UK

Carol A. HaighPhD, MSc, BSc (Hons), RGNProfessor in Nursing, Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK

Felicity HassonPhD, MSc, PgDip, BA (Hons)Senior Lecturer, Institute of Nursing Research, School of Nursing, University of Ulster, Ulster, UK

Immy HollowayPhD, MA, BEd, CertEdProfessor Emeritus, School of Health and Social Care, Bournemouth University, Dorset, UK

Katherine HuntPhD, MSc, BSc, RNSenior Research Fellow, Faculty of Health Sciences, University of Southampton, Southampton, UK

Alison M. HutchinsonPhD, MBioeth, BAppSc (Adv Nsg), RN, Cert Nsg, Cert MidwiferyProfessor in Nursing, School of Nursing and Midwifery, Faculty of Health, Deakin University, Melbourne, Australia, and Chair in Nursing, Centre for Nursing Research – Deakin University and Monash Health Partnership, Monash Health, Melbourne, Australia

Martin JohnsonPhD, MSc, RN, RNTProfessor in Nursing, School of Nursing, University of Salford, Salford, UK

Martyn JonesPhD, CPsychol, BSc (Hons), RNMH, Dip EdProfessor of Heathcare Research, School of Nursing and Midwifery, University of Dundee, Dundee, UK

Sinead KeeneyPhD, MRes, BA (Hons), PGCHEP, FHEASenior Research Fellow, Institute of Nursing and Health Research, School of Nursing, University of Ulster, Ulster, UK

Bridie KentPhD, BSc (Hons), PG Cert HE, RNT, RNProfessor in Leadership in Nursing, Plymouth University, Plymouth, UK

Sarah E. KeyesPhD, BA (Hons)Research Fellow, Interdisciplinary Social Science in Health, School of Health in Social Science, University of Edinburgh, Edinburgh, UK

Anne LaceyDPhil. MSc, BSc Hons, RGN, RNT, DipN(Lond)Formerly Diocesan Health Coordinator, Diocese of Madi and West Nile, Arua, Uganda

Judith LathleanDPhil (Oxon), MA, BSc (Econ) (Hons)Professor of Health Research, Faculty of Health Sciences, University of Southampton, Southampton, UK

Tony LongPhD, MA, BSc (Hons), RNT, SRN, RSCNProfessor of Child and Family Health, School of Nursing, University of Salford, Salford, UK

Susie MacfarlaneBSc (Hons), GCertHigherEdeLearning Educational Developer, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia

Brendan McCormackDPhil (Oxon), BSc (Hons), FEANS, PGCEA, RMN, RGNProfessor and Head of the Division of Nursing, School of Health Sciences, Queen Margaret University, Edinburgh, UK

Hugh McKennaCBE, PhD, BSc (Hons), RMN, RGN, RNT, DipN(Lond), AdvDipEd, FFN, RCSI, FEANS, FRCN, FAANPro-Vice Chancellor, Research & Innovation, University of Ulster, Ulster, UK

Julienne MeyerPhD, MSc, BSc, Cert Ed (FE), RN, RNTProfessor of Nursing, Care for Older People; Executive Director: My Home Life programme, City University London, London, UK

Andrea E. NelsonPhD, BSc (Hons), RGNHead of School and Professor of Wound Healing, School of Healthcare, University of Leeds, Leeds, UK

Anne Marie RaffertyCBE, DPhil (Oxon), MPhil, BSc, RN, FRCN, FAAN, FQNI, FKC, LLD (Hon)Professor of Nursing Policy & Director of Academic Outreach, Florence Nightingale School of Nursing and Midwifery, King’s College London, London, UK

Janice RattrayPhD, MN, Cert Ed, RGN, SCMReader in Acute and Critical Care Nursing, School of Nursing and Midwifery, University of Dundee, Dundee, UK

Jan ReedPhD, BA, Cert EdEmeritus Professor, Northumbria University, Newcastle upon Tyne, UK

Angie ReesMA, BA (Hons), DPS, FHEA, MCLIPUniversity Teacher and Information Specialist, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK

Jo Rycroft-MalonePhD, MSc, BSc (Hons), RNProfessor of Implementation Research and Head of School, Bangor University, Gwynedd, UK

Sarah SalwayPhD, MSc, BSc (Hons) (Oxon)Senior Research Fellow, NIHR School for Public Health Research, School of Health & Related Research (ScHARR), University of Sheffield, Sheffield, UK

Janey SpeersEdD, MA, BSc (Hons), RMN, RGNSenior Lecturer, Mental Health Nursing, Institute of Health and Social Care Studies, St Martin, Guernsey, Channel Islands

Julie TaylorPhD, MSc, BSc (Hons), RN, FRCNProfessor of Child Protection, Child Protection Research Centre, University of Edinburgh, Edinburgh, UK

Angela TodPhD, MSc, MMedSci, BA (Hons), RNProfessor of Clinical Nursing Practice Research, University of Manchester, Manchester, UK

David TorgersonPhD, MScProfessor and Director, York Health Trials Unit, Centre for Health Economics, University of York, York, UK

Annie ToppingPhD, PGCE, BSc (Hons), RGNAssistant Executive Director of Nursing – Nurse Education, Hamad Medical Corporation, Qatar and Visiting Professor of Nursing, University of Huddersfield, Huddersfield, UK

Joanne TurnbullPhD, MSc, PCAP, BScSenior Research Fellow, Faculty of Health Sciences, University of Southampton, Southampton, UK

Stephen J. WaltersPhD, MSc, PGCE, BSc (Hons), CStatReader in Medical Statistics, School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK

Introduction to the 7th Edition

Since the 6th edition of The Research Process in Nursing was published in 2010, there have been some significant developments in nursing research in the United Kingdom. A framework for Clinical Academic Careers in nursing has been implemented across the United Kingdom creating for the first time the opportunity for nurses to progress through masters preparation, doctoral and postdoctoral research fellowships whilst combining research activity with clinical practice. At the same time, the pace of change in nursing research has been rapid, with a broader range of research approaches and methods being used to answer research questions arising from nursing practice. Finally, the drive to ensure that research evidence is used to inform practice has continued to gain momentum in both policy and in the everyday work of practising nurses. Patients expect to receive high-quality health care informed by the very best evidence. Nursing research is central to this endeavour.

As editors, we have felt it necessary to ensure that this well-established research text reflects these developments in nursing research. In compiling the 7th edition of The Research Process in Nursing, we have made some changes to the content of the book, although the overall structure remains unchanged. There are two completely new chapters, one on the use of digital technologies in research and the second examining future trends in nursing research, and five chapters on established topics have been prepared by new authors. The remaining chapters have been revised and updated to ensure that the reader is provided with the very latest information on research processes and methods. In order to engage readers, we have included for the first time a number of reflection activities in each chapter which encourage the reader to think more broadly about what they have read and apply their learning to practice. In addition, we have extended the resources available on the web site associated with the book (www.wiley.com/go/gerrish/research), enabling readers to complement their studies by accessing the many web resources that are available in the field of health care research and highlighting work being undertaken by some of the chapter authors.

We, the editors, have been privileged to continue to work with chapter authors who are leaders of nursing research and other disciplines across the United Kingdom and also in Australia and Canada. We are indebted to our team of authors for their wide-ranging and authoritative contributions to the research methodology literature. We have continued to target the book at novice researchers, be they pre-registration students or those embarking on a postgraduate research degree, but the book should also be of value to many who are further on in their research careers. We have encouraged authors to write in an accessible style, but not to shrink away from complex debates and technical issues.

The book is structured into six sections.

Section 1, Setting the Scene, deals with the background issues of nursing research in the current policy context in the United Kingdom, the nature of the research process and ethics. Two chapters encouraging inclusive approaches to the research process are also included in this section. The chapter on user involvement has been rewritten by new authors and the chapter on research in a multi-ethnic society has been substantially updated. A new and innovative chapter on technologies in research has been included in this edition to reflect the increasing use of a range of digital technologies at different stages of the research process. Readers new to the context in which nursing research is taking place will find themselves orientated to the subject by this section and, we hope, enthused to engage with an activity that has the potential to change and improve the provision of health care.

Section 2, Preparing the Ground, includes chapters that take the reader through the essential steps that are necessary before a research project can begin. The chapters outlining how research evidence can be accessed and appraised in order to inform research have been updated, especially in terms of the use of technologies to assist in these processes. Subsequent chapters guide the reader through the process of developing a research proposal and subsequently planning and managing the research project. Regulatory frameworks governing research in the United Kingdom have continued to evolve, and the chapter on this issue has been revised to reflect these changes.

Section 3, Choosing the Right Approach, is the longest section and in many ways the heart of the book. It starts by providing an introduction to the philosophical debates underlying the different research approaches available to nurses and is followed by a chapter on sampling that has been prepared by new authors. The remainder of this section presents 14 research approaches used in nursing research and explores each of them in detail. Whereas these qualitative and quantitative approaches were included in the previous edition, they have each been revised to reflect recent developments, with the chapters on practitioner research and mixed methods prepared by new authors, thus providing a fresh perspective. In addition to commonly used approaches such as surveys, systematic reviews and grounded theory, the inclusion of other approaches such as practitioner research and realist synthesis represents new ways of thinking about doing research. They are commended to the reader as possible ways into difficult-to-research areas, particularly those related closely to nursing practice.

Section 4, Collecting Data, and Section 5, Making Sense of Data, are both practical sections dealing with the skills required in data collection and analysis. Here the emphasis is upon research tools, such as interviewing and statistical analysis, common to many different research approaches.

Section 6, Putting Research into Practice, concludes the book by taking the reader through the process of disseminating research findings and getting them implemented into policy and practice. As well as addressing active researchers, these chapters will be of use to nurses who, though not wanting to engage themselves in research, want to incorporate it into their professional lives through evidence-based practice. The final chapter is new to this edition and introduces the reader to current trends in nursing research which will be important for nurse researchers to consider in the future.

Although the book is designed in a logical fashion, as outlined above, each chapter is also intended to be complete in itself. Many readers will dip in and out of different sections as necessary. For this reason, we have included cross-references wherever possible to other chapters that might be helpful and have provided key point summaries at the beginning of each chapter. We have also compiled a glossary of research terms to help the reader with new language with which they may be unfamiliar.

Throughout the book, we have adopted certain generic terms to assist readability and reduce repetition. Foremost among these is the term ‘nursing’. By this we mean to include all the professions of nursing, midwifery, health visiting and related specialisms. We hope that members of these professions will forgive our shorthand, but we have tried to ensure that examples given are taken from a wide range of health care settings. We have also used the terms ‘evidence’ and ‘evidence-based practice’ to denote the plethora of resources and implementation activities that have become so important in health care today.

This book is intended to be used primarily by nurses, midwives and health visitors, but it has much wider application to any health and social care practitioner who wishes to learn about research. Members of the allied health professions, particularly, face many of the same debates and dilemmas as nurses in developing research capacity. The contributors of the book are not all nurses but include statisticians, social scientists and information specialists.

We trust that this 7th edition of a well-established book will continue to make a valuable contribution to research capacity building in nursing and health care.

Kate Gerrish and Judith LathleanEditors to the 7th edition 2015

About the Companion Website

This book is accompanied by a companion website:

                          www.wiley.com/go/gerrish/research

The website includes:

- Interactive multiple-choice questions- Key points of each chapter- End-of-chapter web resources

Section 1Setting the Scene

Nursing research does not exist in a vacuum but is an applied discipline set in the context of a dynamic academic community and relating to a complex health care system. This section explores this context and introduces the reader to the nature of nursing research.

Chapter 1 presents the fundamental concepts of the discipline, reviews the current context of nursing research and emphasises the essential connection between nursing research and the practice of the profession. Even those who do not see themselves as active researchers should be users of the knowledge generated by research, and so need to understand much of what follows in the sections of this book. Chapter 2 takes the reader through the essential steps in the research process, each of which will be dealt with in much more depth in later sections, but with the aim of giving an overview of the entire undertaking, that is research. Recent examples from the literature are used to illustrate the varied nature of nursing research.

Research in nursing, as in health care generally, is complicated by the fact that it is involved with vulnerable human beings, and ethical principles need to be observed from the outset of any research project. Chapter 3 therefore tackles this moral obligation on the researcher, drawing out the practical implications, and setting the context for the more specific ethical regulations dealt with in Section 2.

The next two chapters, Chapters 4 and 5, deal with the need for nursing research to be inclusive in scope. User involvement in research has been advocated from within and outside the profession for more than a decade now, and Chapter 4, which has been written by new authors, argues for the full inclusion in the research process of those to whom the outcomes might apply. Chapter 5 examines research in a multi-ethnic society. Although there are many minority groups that deserve special consideration when designing nursing research, ethnicity perhaps merits particular consideration as a major factor impacting upon health care in UK society.

Chapter 6 is new to the seventh edition of the book and reflects the growth in digital technologies in recent years. This chapter introduces the reader to a range of digital technologies and considers how they can be used to support different stages of the research process.

Chapter 1Research and Development in Nursing

Kate Gerrish

Key points

Research is concerned with generating new knowledge through a process of systematic scientific enquiry, the research process.

Research in nursing can provide new insights into nursing practice, develop and improve methods of caring and test the effectiveness of care.

Whereas comparatively few nurses may undertake research, all nurses should develop research awareness and use research findings in their practice.

Evidence-based practice involves integrating the best available research evidence with professional expertise whilst also taking account of patient preferences, the patient’s state, setting and circumstances and health-care resources.

Introduction

Significant changes in health care have taken place in the three decades since the first edition of this book was published, and these changes are set to continue. Technological developments have led to improved health outcomes and at the same time have raised public expectations of health-care services. Increased life expectancy and lower birth rates mean that the population in the United Kingdom is ageing. An older population is more likely to experience complex health needs, especially in regard to chronic disease, and this places additional demands on an already pressurised health service. At the same time, the escalating cost of health care is leading to a shift from expensive resource-intensive hospital care to more services being provided in the primary and community care sectors. In response to these changes, government health policy is increasingly focused on improving the clinical and cost-effectiveness of health care while at the same time reducing the burden of ill health through active public health and health promotion strategies. These changes in the United Kingdom are reflected in other high-income countries internationally.

In order to respond to these challenges, the UK government has identified a number of priorities that need to be progressed in order to provide high-quality care for patients and promote the health of the population at large. These include improving health outcomes by preventing illness as well as enhancing the quality of care provided to people with particular needs, for example, patients with common long-term conditions such as diabetes or those in need of palliative and end-of-life care (Department of Health 2012a, 2013a). In order to achieve the aspirations for enhancing quality and improving health and health outcomes, there is a need to change the way health-care professionals work and the way health services fit together and ensure that patients have access to the best available treatments. However, achieving quality in health care is a moving target. What was considered high-quality care in 1948 when the NHS was first founded is no longer considered to be the case nearly seven decades later. Knowledge about effective health-care interventions has increased by leaps and bounds, and this is certainly the case with nursing interventions.

It is essential that nurses respond proactively to the developments in nursing and health-care delivery outlined earlier in order to provide high-quality care in response to the needs of the individuals and communities with whom they work. To do this, they need up-to-date knowledge to inform their practice. Such knowledge is generated through research. This chapter introduces the concept of nursing research and considers how research contributes to the development of nursing knowledge. In recognising that nursing is a practice-based profession, the relevance of research to nursing policy and practice is examined within the context of evidence-based practice, and the responsibilities of nurses are explored in respect of research awareness, research utilisation and research activity.

Nursing Research and Development

The definition of research provided by Hockey (1984) in the first edition of this book is still pertinent today:

Research is an attempt to increase the sum of what is known, usually referred to as a ‘body of knowledge’ by the discovery of new facts or relationships through a process of systematic scientific enquiry, the research process. (Hockey 1984: 4)

Other definitions of research emphasise the importance of the knowledge generated through research being applicable beyond the research setting in which it was undertaken, that is, that it is generalisable to other similar populations or settings. The Department of Health, for example, defines research as

the attempt to derive generalisable new knowledge by addressing clearly defined questions with systematic and rigorous methods. (Department of Health 2005: 3, section 1.10)

Research is designed to investigate explicit questions. In the case of nursing research, these questions relate to professional activities and concerns that are primarily the responsibility of nurses. The International Council of Nurses’ (ICN) definition of nursing research captures these broad areas of interest that are relevant to nurse researchers:

Nursing research is a systematic enquiry that seeks to add new nursing knowledge to benefit patients, families and communities. It encompasses all aspects of health that are of interest to nursing, including promotion of health, prevention of illness, care of people of all ages during illness and recovery or towards a peaceful and dignified death. (ICN 2009)

The ICN has identified nursing research priorities in two broad areas, namely, health and illness and the delivery of care services. These priority areas are outlined in Box 1.1. In further developing the nursing research agenda, various organisations have identified priorities for specific areas of nursing practice. For example, a recent consultative exercise in the United Kingdom involving patients, carers, health-care professionals and researchers identified 12 research priorities into the prevention and management of pressure ulcers (James Lind Alliance Pressure Ulcer Partnership 2013). Box 1.2 shows that these priorities are broad ranging and cover not only aspects of nursing care but also education, service delivery, surgical interventions and patient/carer involvement.

Box 1.1 Priorities for nursing research identified by the International Council of Nurses

Health and illness

Nursing research priorities in health and illness focuses on:

health promotion

prevention of illness

control of symptoms

living with chronic conditions and enhancing quality of life

caring for clients experiencing changes in their health and illness

assessing and monitoring client problems

providing and testing nursing care interventions

measuring the outcomes of care

Delivery of care services

Nursing research priorities in delivery of care services focus on:

quality and cost-effectiveness of care

impact of nursing interventions on client outcomes

evidence-based nursing practice

community and primary health care

nursing workforce to include quality of nurses’ work life, retention and satisfaction with work

impact of health-care reform on health policy, programme planning and evaluation

impact upon equity and access to nursing care and its effects on nursing

financing of health care

ICN (2009)

Box 1.2 Top 12 pressure ulcer research priorities

How effective is repositioning in the prevention of pressure ulcers?

How effective at preventing pressure ulcers is involving patients, family and lay carers in patient care?

Does the education of health and social care staff on prevention lead to a reduction in the incidence of pressure ulcers, and, if so, which education programmes are most effective?

What is the relative effectiveness of the different types of pressure-relieving beds, mattresses, overlays, heel protectors and cushions?

What impact do different service models have on the incidence of pressure ulcers including staffing levels, continuity of care and the current organisation of nursing care in hospitals?

What are the best service models to ensure that patients with pressure ulcers receive the best treatment outcomes?

For wheelchair users sitting on a pressure ulcer, how effective is bed rest in promoting pressure ulcer healing?

How effective are wound dressings in the promotion of pressure ulcer healing?

Does regular turning of patients in bed promote healing of pressure ulcers?

Does improving diet and hydration promote pressure ulcer healing?

How effective are surgical operations to close pressure ulcers?

How effective are topical skin care products and skin care regimes at preventing pressure ulcers?

James Lind Alliance Pressure Ulcer Partnership (2013)

Research in the field of nursing education is also important, for unless nurses are prepared appropriately for their role, they will not be able to respond to the needs of patients, families and communities. Some examples of priorities for research in nursing education are identified in Box 1.3.

Box 1.3 Priorities for research in nursing education

Education–practice linkages

Education models focused on delivery of team-based patient-centred care to diverse patient populations in a variety of clinical settings

Education–practice partnerships designed to relate innovative teaching models to quality patient care outcomes

New curriculum models related to inter-professional education and practice

Knowledge acquisition

The effectiveness of various creative teaching–learning approaches to foster development of clinical reasoning in patient care contexts

Teaching–learning approaches that relate knowledge acquisition and evidence-based practice to the patient’s actual care experience

Technology in nursing education

The effectiveness of emerging technologies in the teaching of nursing decision-making skills

The relationship between simulated learning experience, programme outcomes and graduate nurse competencies

Adapted from National League for Nursing (2012)

Most nursing research investigates contemporary issues; however, some studies may take a historical perspective in order to examine the development of nursing by studying documentary sources and other artefacts. Rafferty (2010) points out that studying what happened in the past can contribute to our understanding of the contemporary problems we face and give insight into human behaviours and the forces influencing social change.

The questions that nursing research may address vary in terms of their focus. Over 30 years ago, Crow (1982) identified four approaches that research could take; these remain pertinent today:

Research that will provide new insights into nursing practice

Research that will deepen an understanding of the concepts central to nursing care

Research that is concerned with the development of new and improved methods of caring

Research that is designed to test the effectiveness of care

Reflection activity

Think about your own area of nursing practice. What priority areas for nursing research can you identify? You may be aware of aspects of your own practice that are underpinned by research, but there may be other areas of practice that require further research. The list of research priorities identified by the ICN (Box 1.1) may help you to think more broadly about areas for research. From the list you have compiled, identify the area that you think is the most important to research.

Nursing research does not necessarily need to be undertaken by nurses. Indeed, sociologists and psychologists undertook some important early studies into nursing practice and nurse education from the 1950s to 1970s. However, research expertise amongst nurses has developed considerably in the past 40 years, to the extent that research examining nursing practice is most likely to be undertaken by nurses themselves or nurses collaborating with other disciplines.

Likewise, nurses who engage in research may not confine their area of enquiry to nursing research. The growing emphasis on multidisciplinary, multi-agency working means that nurse researchers may choose to examine questions that extend beyond the scope of nursing into other areas of health and social care. Nurse researchers may find themselves working in multidisciplinary teams including statisticians, health economists, psychologists, sociologists and other health professionals, working on research areas such as rehabilitation that encompass a wide range of disciplines. Nurse researchers work appropriately in a number of university departments such as social science and health services research as well as in departments of nursing and midwifery.

Whereas the generation of new knowledge is valuable in its own right, the application and utilisation of knowledge gained through research are essential to a practice-based profession such as nursing. This latter activity is known as ‘development’ and may take the form of practice or service development. Thus, research and development (‘R&D’) go hand in hand.

R&D can be divided into three types of activity:

Basic research

is original, experimental or theoretical work, primarily for the purpose of obtaining new knowledge rather than focusing on the specific use of the findings. For example, biomedical laboratory-based research falls within this category.

Applied research

is also original investigation with a view to obtaining new knowledge, but it is undertaken primarily for practical purposes. Much nursing research falls within this category and is undertaken with the intention of generating knowledge that can be used to inform nursing practice and can involve both clinical and non-clinical methods.

Development

activity involves the systematic use of knowledge obtained through research and/or practical experience for the purpose of producing new or improved products, processes, systems or services.

Development activity that focuses on the use of knowledge generated through research can take different forms. The most common activities include clinical audit, practice development and service evaluation (see Box 1.4). Like research, these activities often employ systematic methods to address questions arising from practice. Research, however, is undertaken with the explicit purpose of generating new knowledge that has applicability beyond the immediate setting. By contrast, clinical audit, practice development and service evaluation are primarily concerned with generating information that can inform local decision-making (Health Research Authority 2013). Yet, the boundaries between some forms of research, for example, action research (see Chapter 23) and practice development and evaluation research (see Chapter 22) and service evaluation, are often blurred (Gerrish & Mawson 2005). It is, however, important to be able to differentiate between these activities as they require very different approval processes before the work can begin (see Chapter 11).

Box 1.4 Definitions of research, clinical audit and practice development

Research