Introduction to

Nursing
Research in an
Evidence-Based
Practice Environment
 Introduction

• Nursing research has experienced

remarkable growth in the past three
decades, providing nurses with a growing
evidence base from which to practice.

• Yet many questions endure and much

remains to be done to incorporate research
innovations into nursing practice.
• Studies with humans involve two sets of people: those
who do the research and those who provide the
information. In a quantitative study, the people being
studied are called subjects or study participants. In
a qualitative study, the individuals cooperating in the
study are called informants, key informants, or
study participants. Collectively, both in qualitative and
quantitative studies, study participants comprise the
sample.

• The person who conducts a study is the researcher or

investigator. Studies are often undertaken by several
people. When a study is done by a team, the person
directing the study is the principal investigator (PI).
Two or three researchers collaborating equally are co-
 Historical
Landmarks in
Nursing Research
 Definition

• Research is systematic inquiry that uses disciplined

methods to answer questions or solve problems.- The
ultimate goal of research is to develop, refine, and
expand knowledge.
 Definitions

• Nursing research is systematic inquiry designed to develop trustworthy

evidence about issues of importance to the nursing profession, including
nursing practice, education, administration, and informatics.

• Clinical nursing research, that is, research designed to guide nursing

practice and to improve the health and quality of life of nurses’ clients.
 The Importance of Research in
Nursing

• Although there is not a consensus about what types of “evidence” are appropriate

for EBP, there is general agreement that research findings from rigorous studies

provide especially strong evidence for informing nurses’ decisions and actions.

• Nurses are accepting the need to base specific nursing actions and decisions on

research evidence indicating that the actions are clinically appropriate, cost-

effective, and result in positive outcomes for clients.

 The Consumer–Producer Continuum
in Nursing Research

• Nurses are adopting an evidence-based practice (EBP) that

incorporates research findings into their clinical decisions.
Knowledge of nursing research enhances the professional
practice of both

• consumers of research (who read and evaluate studies)

• and producers of research (who design and undertake studies).

Current and Future Directions for Nursing Research

• Nursing research continues to develop at a rapid pace and will

undoubtedly flourish in the 21st century.

• Funding continues to grow—for example, The National Institute of Nursing

Research (NINR), funding in fiscal year 2010 was more than $140 million.

• Broadly speaking, the priority for future nursing research will be the
promotion of excellence in nursing science.
Current and Future Directions for
Nursing Research

Continued focus on EBP. Greater emphasis on systematic reviews

Expanded local research in healthcare settings.

Strengthening of interdisciplinary collaboration.

Expanded dissemination of research findings Increasing the visibility

of nursing research
 Sources of
Knowledge

Clinical Experience, Trial and Error, and

Intuition

• Clinical experience is a familiar, functional

source of knowledge. The ability to
generalize, to recognize regularities, and
to make predictions is an important
characteristic of the human mind.
 Sources of
Knowledge
Logical Reasoning

Solutions to some problems are developed by logical

thought processes.

Inductive reasoning is the process of developing

generalizations from specific observations.

For example, a nurse may observe the anxious behavior of

(specific) hospitalized children and conclude that (in
general) children’s separation from their parents is
stressful.
 Sources of Knowledge

• Deductive reasoning is the process of developing specific predictions from general

principles.

• For example, if we assume that separation anxiety occurs in hospitalized children (in
general), then we might predict that (specific) children in a hospital whose parents do
not room-in will manifest symptoms of stress.
 Sources of Knowledge

• Assembled Information

• For example, rates of caesarean deliveries or infection rates.

• Cost data—information on the costs associated with certain procedures, policies

• Quality improvement and risk data, such as medication error reports, can be used to
assess the need for practice changes
 Sources of Knowledge

• Disciplined Research

Carefully synthesized findings from rigorous research are at the pinnacle of most evidence
hierarchies.
 Purposes of Nursing
Research

• Identification and Description

• Qualitative researchers sometimes study phenomena about which little is known. In

some cases, so little is known that the phenomenon has yet to be clearly identified or
named or has been inadequately defined.

• The in-depth, probing nature of qualitative research is well suited to the task of
answering such questions as, “What is this phenomenon?” and “What is its name?”
 Purposes Of Nursing
Research

• Exploration

• Exploratory research begins with a phenomenon of interest, but rather than simply observing and
describing it, exploratory research investigates the full nature of the phenomenon.

• For example, a descriptive quantitative study of patients’ preoperative stress might document the
degree of stress patients feel before surgery and the percentage of patients who are stressed. An
exploratory study might ask: What factors diminish or increase a patient’s stress?

• Qualitative methods are especially useful for exploring the full nature of a little-understood
phenomenon.
 Purposes of
Nursing Research
• Explanation

• The goals of explanatory research are to understand the

underpinnings of natural phenomena and to explain
systematic relationships among them.

• Explanatory research attempts to offer understanding of

the underlying causes or full nature of a phenomenon.

• In quantitative research, theories or prior findings are used

deductively to generate hypothesized explanations that are
then tested empirically.
 Purposes of Nursing Research

Prediction and Control

• Many phenomena defy explanation, yet it is frequently possible to make predictions and to control phenomena based on research
findings, even in the absence of complete understanding.

• For example, research has shown that the incidence of Down syndrome in infants increases with the age of the mother. We can
predict that a woman aged 40 years is at higher risk of bearing a child with Down syndrome
Thank you
Overview And Steps Of
Quantitative Study

Copyright © 2017 Wolters Kluwer Health | Lippincott Williams & Wilkins

 Phase 1: The
Conceptual Phase

• Early steps in a quantitative study

typically have a strong conceptual
or intellectual element.
 Step 1: Formulating
and Delimiting the
Problem

• Quantitative researchers begin by identifying an interesting,

significant research problem and formulating research questions.

• In developing research questions, nurse researchers must attend

to

• Substantive Issues

• Theoretical Issues

• Clinical Issues

• Methodologic Issues

• Ethical Issues
 Step 2: Reviewing the Related Literature

• Quantitative research is typically conducted in the context of previous

knowledge. To contribute new evidence, quantitative researchers strive to
understand existing evidence.

• A thorough literature review provides a foundation on which to base new

evidence and usually is conducted before data are collected. For clinical
problems, it may also be necessary to learn the “status quo” of current
procedures, and to review existing practice guidelines or protocols.
 Step 3: Undertaking Clinical Fieldwork

• Unless the research problem originated in a clinical setting, researchers embarking on a clinical
nursing study benefit from spending time in clinical settings, discussing the problem with clinicians
and administrators, and observing current practices.

• Clinical fieldwork can provide perspectives on recent clinical trends, current diagnostic procedures,
and relevant healthcare-delivery models; it can also help researchers better understand clients
and the settings in which care is provided. Such fieldwork can also be valuable in gaining access to
an appropriate site or in developing methodologic strategies. For example, in the course of clinical
fieldwork researchers might discover the need for research assistants who are bilingual.
 Step 4: Defining the Framework and
Developing Conceptual Definitions

• Theory identify regularities in the relationships among variables.

When quantitative research is performed within the context of a
theoretical framework, the findings may have broader
significance and utility.

• Researchers should have a conceptual rationale and conceptual

definitions of key variables.
 Step 5: Formulating Hypotheses

• A hypothesis is a statement of the researcher’s expectations

or predictions about relationships among study variables.
The research question identifies the study concepts and asks
how the concepts might be related; a hypothesis is the
predicted answer.
 Phase 2: The
Design and
Planning Phase
• In the second major phase of a quantitative study,
researchers make decisions about the methods
they will use to address the research question.

• Researchers usually have considerable flexibility

in designing a study, and they make many
decisions. These methodologic decisions have
crucial implications for the integrity of the
resulting evidence.
 Step 6: Selecting a
Research Design

• The research design is the overall plan for

obtaining answers to the research questions.

• Research designs indicate how often data will

be collected, what types of comparisons will be
made, and where the study will take place.

• The research design is the architectural

backbone of the study.
 Step 7: Developing
Protocols for the
Intervention
• In experimental research, researchers actively intervene,
which means that participants are exposed to different
treatment conditions.

• An intervention protocol for the study must be

developed, specifying exactly what the
treatment/intervention would entail (e.g., who would
administer it, how frequently, over how long a period the
treatment would last, and so on) and what the
alternative condition would be.
 Step 8: Identifying the Population
to be Studied

• Quantitative researchers need to clarify the group to whom

study results can be generalized—that is, they must identify
the population to be studied. A population is all the
individuals or objects with common, defining characteristics.
 Step 9: Designing the Sampling Plan

• Researchers collect data from a sample, which is a subset of the population.

• Using samples is more practical than collecting data from an entire population

In a quantitative study, a sample’s adequacy is assessed by its size and

representativeness.

• The quality of the sample depends on how typical, or representative, the sample is of
the population.

• The sampling plan specifies how the sample will be selected and recruited, and how
many subjects there will be.
 Step 10: Specifying Methods to
Measure
Research Variables
• Quantitative researchers must develop or borrow methods
to measure the research variables accurately.

• The primary methods of data collection are self-reports (e.g.,

interviews), observations (e.g., observing the sleep–wake
state of infants), and biophysiological measurements.
 Step 11: Developing
Methods to Safeguard
Human/Animal Rights

• Most nursing research involves humans, and so

procedures need to be developed to ensure that
the study adheres to ethical principles.

• Each aspect of the study plan needs to be

scrutinized to determine whether the rights of
participants have been adequately protected. A
formal presentation to an ethics committee is
often required.
 Step 12: Reviewing and Finalizing
the Research Plan
• Before collecting their data, researchers often take steps to ensure that plans will
work smoothly. For example, they may evaluate the readability of written materials
to determine if participants with low reading skills can comprehend them, or they
may pretest their measuring instruments to see if they work well.

• Normally, researchers also have their research plan critiqued by peers, consultants,
or other reviewers before implementing it. Researchers seeking financial support
submit a proposal to a funding source, and reviewers usually suggest improvements.
 Phase 3: The
Empirical
Phase

• The empirical phase of

quantitative studies involves
collecting data and preparing
the data for analysis.

• Data collection typically requires

many weeks, or even months, of
work.
 Step 13: Collecting the Data

• The actual collection of data in quantitative studies often proceeds according

to a preestablished plan. The plan specifies where and when the data will be
gathered, procedures for describing the study to participants, and methods
for recording information.

• Technological advances have expanded possibilities for automating data

collection.
 Step 14: Preparing the Data for
Analysis

• One such step is coding, which is the process of translating

verbal data into numeric form.

• For example, patients’ responses to a question about their

gender might be coded “1” for female and “2” for male (or vice
versa). Another preliminary step involves entering the data onto
computer files for analysis.
 Phase 4: The
Analytic Phase

• Quantitative data are not reported in raw form

(i.e., as a mass of numbers). They are subjected
to Quantitative data are not reported in raw
form (i.e., as a mass of numbers). They are
subjected to analysis and interpretation, which
occurs in the fourth major phase of a project
 Step 15: Analyzing the Data

• Quantitative researchers analyze their data through statistical

analyses, which include simple procedures (e.g., computing an
average) as well as ones that are complex. Some analytic methods
are computationally formidable, but the underlying logic of
statistical tests is fairly easy to grasp. Computers have eliminated
the need to get bogged down with mathematic operations
 Step 16: Interpreting the Results

• Interpretation involves making sense of study results and examining

their implications. Researchers attempt to explain the findings in
light of prior evidence, theory, and their own clinical experience—
and in light of the adequacy of the methods, they used in the study.
Interpretation also involves envisioning how the new evidence can
best be used in clinical practice, and what further research is needed.
 Phase 5: The
Disseminatio
n Phase
• Researchers’ responsibilities
are not completed, however,
until study results are
disseminated.
 Step 17: Communicating the Findings

• A study cannot contribute evidence to nursing practice if the results are not shared.
Another—and often final—task of a study, therefore, is the preparation of a research
report that summarizes the study.

• Research reports can take various forms: dissertations, journal articles, conference
presentations, and so on. Journal articles—reports appearing in such professional
journals as Nursing Research—usually are the most useful because they are available
to a broad, international audience. We discuss journal articles later in this chapter.
 Step 18: Utilizing the Findings in
Practice

• Ideally, the concluding step of a high-quality study is to plan

for the use of the evidence in practice settings.
• Please open your book and discuss the major steps of
Qualitative
Thank you
Research
Problems,
Research
Questions, and
Hypotheses
• At the end of this session, you will be able to:

 Define hypothesis
 Discuss the purposes of hypotheses
 Differentiate the types of hypotheses –Null, Research (Directional and Non-
Directional)
 Identify the characteristics of a workable hypothesis
 Critique hypotheses and research questions in a journal article
 A research problem

• Research problem
• An enigmatic, perplexing, or troubling condition
• Problem statement
• A statement articulating the research problem and indicating the
need for a study

• The purpose of research is to “solve” the problem—or to

contribute to its solution—by generating relevant evidence.
 Sources of Research Problems

• Experience and clinical fieldwork

• Nursing literature

• Quality improvement initiatives

• Social issues

• External suggestions

• Patient involvement
 Developing and Refining Research Problems

• Selecting a broad topic area (e.g., patient compliance, caregiver

stress)
• Narrowing the topic—asking questions to help focus the inquiry
Examples:
• What is going on with…?
• What factors contribute to…?
• What are the consequences of . . . ?
• What is the meaning of . . . ?
 Developing and Refining Research Problems

• Beginning researchers often develop problems that are too broad in scope
or too complex for their level of methodologic expertise.

• As researchers move from general topics to more specific researchable

problems, multiple potential problems can emerge.

• You might ask:

• What accounts for the discrepancy?

• How can I improve the situation?

 Evaluating Research Problems

Significance of the problem

Researchability of the problem

Feasibility of addressing the problem (e.g., time,

resources, ethics, cooperation of others)

Interest to the researcher

 Evaluating Research Problems

• Significance of the problem:

Evidence from the study should have potential to contribute meaningfully to
nursing practice. Within the existing body of evidence, the new study should
involve an original inquiry, but it could also be a replication to answer previously
asked questions with greater rigor or with different types of people
• Ask
• Is the problem important to nursing and its clients?
• Will patient carebenefit from the evidence?
• Will the findings challenge (or lend support to) untested assumptions?
• If the answer to all these questions is “no,” then the problem should be
abandoned.
 Evaluating Research Problems

• Researchability of the problem: Not all problems are amenable to

research inquiry. Study variables should be focused, and
measurement tools is well defined
 Evaluating Research Problems

Feasibility of addressing the problem

• Time:. The scope of the problem should be sufficiently restricted so that there will be enough time for the various steps

• Availability of Study Participants.

• Cooperation of Others. In institutional settings (e.g., hospitals), access to clients, personnel, or records requires authorization. Most
healthcare organizations require approval of proposed studies.

• Facilities and Equipment. Availability of space, office equipment, and research support

• staff may also need to be considered.

• Money. Personnel costs, Supplies, Equipment

• Researcher Experience. The problem should be chosen from a field about which you have some prior knowledge or experience.

• Ethical Considerations. A research problem may be unfeasible if an investigation of the problem would pose unfair or unethical demands
on participants.
 Evaluating Research Problems

• Interest to the researcher:

• Genuine fascination with the chosen research problem is an important
prerequisite to a successful study
 Problem Statements

• Should identify the nature, context, and significance of the problem being addressed

• Should identify the consequences of the problem

• Should fill knowledge gaps

• Should be broad enough to include central concerns

• Should be narrow enough to serve as a guide to study design

• Should propose a solution to the stated problem

 Statement of Purpose—Quantitative Studies

• Identifies key study variables

• worded declaratively (Statement)

• Sometimes use the words aim, goal, intent, or objective are used instead, as in “The aim of this study was.
Identifies possible relationships among variables

• Indicates the population of interest Suggests, through use of verbs, the nature of the inquiry (e.g., to test…,
to compare…, to evaluate… to investigate… to assess… to evaluate…to examine… to identify… to
determine…to find out the relationship )
 Statement of Purpose—Qualitative Studies

• Identifies the central phenomenon

• Indicates the research tradition (e.g., grounded theory, ethnography)
• Indicates the group, community, or setting of interest
• Suggests, through use of verbs, the nature of the inquiry (e.g., to describe…, to discover…, to
explore…to understand…. ,to develop… or ,to generate.)
• Statements of purpose in qualitative studies may “encode” the tradition of inquiry, not only
through the researcher’s choice of verbs but also through the use of “buzzwords” associated
with those traditions.

• Grounded theory: Processes, social structures, social interactions

• Phenomenological studies: experience, lived experience, meaning, essence
• Ethnographic studies: culture, roles, lifeways, cultural behavior
Research questions
 Research questions

• Research questions are the specific queries researchers want to

answer in addressing the problem.

• Research questions guide the types of data to collect in a study.

• Researchers who make specific predictions about answers to

research questions pose hypotheses that are then tested.
 Research Questions

• Are sometimes direct rewordings of statements of purpose,

worded as questions
• Are sometimes used to clarify or lend specificity to the purpose
statement
• In quantitative studies, pose queries about the relationships
among variables
 Examples of Research questions

• In the third stage of labor, what is the effect of cord cutting within the
first three minutes on placenta separation?

• Do the elderly diagnosed with dementia experience pain?

1.Does the administration of pain medication at time of surgical incision

reduce the need for pain medication twenty-four hours after surgery?

2.What are maternal factors associated with obesity in toddlers?

3.To what extent do integrated computerized nursing records across

points of care improve patient outcomes?
 Research Questions #2

• In qualitative studies, pose queries linked to the research

tradition:
• Grounded theory: process questions
• Phenomenology: meaning questions
• Ethnography: cultural description questions
Hypothesis
 Hypothesis

• A hypothesis is a statement of the researcher’s expectations

or predictions about relationships among study variables.

• The research question identifies the study concepts and asks

how the concepts might be related; a hypothesis is the
predicted answer.
 Hypothesis

• States a prediction
• Must always involve at least two variables
• Must suggest a predicted relationship between the independent
variable and the dependent variable
• Must contain terms that indicate a relationship (e.g., more than,
different from, associated with)
 Simple versus Complex Hypotheses

• Simple hypothesis
• Expresses a predicted relationship between one independent variable and one dependent variable
 (bivariate).

o “Birth weight is lower among infants of alcoholic mothers than among infants of nonalcoholic mothers.”
o “The greater the degree of sleep deprivation, the higher the anxiety level of intensive care unit patients.”

• Complex hypothesis
• States a predicted relationship between two or more independent variables and/or two or more dependent
variables
• Daily weight loss is greater for adults who follow a reduced calorie diet and exercise daily than for those who
do not follow a reduced calorie diet and do not exercise daily
Directional versus Nondirectional Hypotheses

• Directional hypothesis
• Predicts the direction of a relationship
• “The level of job mobility is different for psychiatric nurse
practitioners than for medical-surgical nurse practitioners.”
• Nondirectional hypothesis
• Predicts the existence of a relationship, not its direction
• “There is a negative relationship between denial and reports of anxiety
among post myocardial infarction patients.”
  Non- directional Hypothesis:
•“There is a change in anxiety levels of preoperative patients
after listening to a relaxation tape.”
 Directional Hypothesis:
•“The anxiety levels of preoperative patients are lower after
listening to a relaxation tape.”
 Correlational Studies

 Research Question

•“Is there a correlation between anxiety levels and mid term examination
scores of baccalaureate Nursing students?”
 Hypothesis:

•“There is a negative correlation between anxiety levels and mid term

examination scores of baccalaureate Nursing students.”
 Restate each one as a directional hypothesis

• a. Tactile stimulation is associated with comparable physiologic arousal as verbal stimulation

among infants with congenital heart disease.

• b. The risk of hypoglycemia in term newborns is related to the infant’s birth weight.

• c. The use of isotonic sodium chloride solution before endotracheal suctioning is related to
oxygen saturation.

• d. Fluid balance is related to degree of success in weaning older adults from mechanical
ventilation.

• e. Nurses administer the same amount of narcotic analgesics to male and female patients.
 Research versus Null Hypotheses

• Research hypothesis
• States the actual prediction of a relationship
• Statistical or null hypothesis
 No relationship between variables or no difference exist between groups or
correlation between variables.
•H0: “There is no difference between two drugs, on average”
 Research Hypotheses (H1): States the expected relationship between variables
•H1: “The new drug is better that the current drug , on average”
 Criteria for Hypotheses
 Should be written in a declarative sentence in a present sentence

 Non- directional Hypothesis:

•“There is a change in anxiety levels of preoperative patients after listening to a relaxation tape.”
 Directional Hypothesis:

•“ The anxiety levels of preoperative patients are lower after listening to a relaxation tape.”
•
“ There is a positive relationship between the number of times children have been
hospitalized and their fear of hospitalization”
 Criteria for Hypotheses

 Should contain the population The population should be similar to the problem
statement.
 women who are about to undergo a hysterectomy”
 “hysterectomy patients”
 Should contain the variables
 “anxiety levels are lower for preoperative CABG patients who have practiced
relaxation exercise than for CABG patients who have not practiced relaxation
exercise.”
 Criteria for Hypotheses

 Empirically Testable
 Ability to obtain empirical data should have been determined while framing the research
problem. A hypothesis that cannot be empirically tested has no scientific merit.
 Ethical and value issues are two areas that are inappropriate for hypothesis testing because
data cannot be obtained that can be empirically verified

o “Nurse practitioners are better health care providers than doctors”

o “Nurse practitioners spend more time teaching their clients about preventive health care
practices than do physicians ”
Criteria for Hypotheses
 Research Question

“Is there a correlation between anxiety levels and mid

term examination scores of baccalaureate Nursing
students?”
 Hypothesis:

“There is a negative correlation between anxiety levels

and mid term examination scores of baccalaureate
Nursing students.”
 Guidelines for Critiquing Hypotheses and Research Question

 Does the study contain a hypothesis or hypotheses?

 Is each hypothesis clearly worded and concise?

 Is the hypothesis written in a declarative sentence?

 Is each hypothesis directly tied to the study problem?

 If there is a clearly identified study framework, is each hypothesis derived from

this framework?
Does each hypothesis contain the population and at least two variables

 Is each hypothesis stated as a directional research hypothesis? If not, is the

rationale given for the type of hypothesis that is stated?

 Is it apparent that each hypothesis can be empirically tested?

 Does each hypothesis contain only one prediction?

Thank you
Developing a Theoretical/Conceptual
Framework

NUR505: Advanced Nursing Research and Evidence-based Practice

November, 2024
 OBJECTIVES
1. Types of framework
2. Terms used in TFW/CFW

3. Purposes of Conceptual Framework

4. Construction of a Conceptual Frame Work
5. Difference between CFW & TFW

6. Selection of relevant theoretical framework for their study.

 INTRODUCTION
• Nursing research and nursing practice should be theory based

• When research is guided by a theoretical framework, the

theory guides the research process from the beginning to the
end
• From the identification of the research problem to the
formulation of the study conclusions.
• A framework is the abstract, logical structure of meaning that
guides the development of the study and enables the
researcher to link the findings to nursing’s body of knowledge.
 INTRODUCTION
• Frameworks are used in both quantitative and qualitative
research.
• In quantitative studies, the framework is a testable theory
that may emerge from a conceptual model or may be
developed inductively from published research or clinical
observations.
• In qualitative research, the framework is a philosophy or
world view and it is considered as an outcome of the study.
 TYPES OF FRAMEWORK
• Theoretical framework (TFW) is based on the established
theories that exist, wherein the theorists have already made
organization of concepts and explained the relationship
between the concepts.
• Conceptual framework (CFW) is the ideas, understandings
and research findings that provide both the foundation on
which and the background within which, research will be
done. Less formal attempt at organizing phenomenon than
theories and loosely structured.
 GENERAL TERMS
• Concepts: are the building blocks of a theory. A concept is a
word, picture or mental idea of a phenomenon that symbolize
some aspect of reality. A concept may be concrete, such as the
human heart, or may be very abstract, such as pain, love,
anxiety.
• Constructs: is the term used to indicate a phenomenon that
cannot be directly observed but must be inferred by certain
indicators of the phenomenon. Examples of constructs are
wellness, mental health, self-esteem and assertiveness.
 GENERAL TERMS
• Variables: Concepts used in quantitative studies are called
variables. Variables are central building blocks of quantitative
studies. Eg. Effectiveness of Structured Teaching Programme
(STP) on level of knowledge about HIV. STP and level of
knowledge are variables.
• Theory is an integrated set of defined concepts and
statements that present a view of a phenomenon and can be
used to describe, explain, predict and control that
phenomenon. It offers a systematic explanation about the
relationships among phenomena. e.g bacteria cause disease
 GENERAL TERMS
• Models are symbolic representation of concepts or
phenomena that presents certain perspectives or points of view
about nature or function or both. It concepts are linked among
them through the use of boxes, arrows, or other symbols.
 ELEMENTS/ COMPONENT OF THEORY
1. Concept & Definition: A concept is a term that abstractly
describes, and clarify phenomenon. E.g. anxiety.
Terms related to concept: Construct and Variable
Discrete: categories or classes of phenomenon (gender,
marital status)
Continuous: Dimensions or gradation (pain, marital conflict)
Construct emotional response Abstract: (Transport, CVD,
Competency, Relationship)
Concept anxiety

Variables palmar sweating

Concrete : Wheel chair, MI &
Stroke, NG tube insertion,
Divorce
 ELEMENTS OF THEORY
Variable
1. More concrete and specific than a concept, the term
is defined so that it is measurable
2. Concepts used in quantitative studies are called
variables
3. Variables are central building blocks of quantitative
studies
 ELEMENTS OF THEORY
2. Statements: Statement express claims that are
important to the theory
• Existence statement: declares that a given
relationship between concepts occur.
• Relational statement: declares the type of
relationship that exists among variables.
 ELEMENTS OF THEORY
3. Conceptual map: It is a strategy for expressing a
theory. It is a map graphically shows the
interrelationship of the concepts and statements
• It is developed to explain which concepts contribute
to partially cause an outcome.
• It includes all of the major concepts in a theory
• The concepts are linked by arrows expressing the
proposed linkages between concepts.
 PURPOSES OF CFW
1. Overall purpose is to make research findings meaningful and
generalizable

2. To allow researchers to knit together observations and facts

into an orderly scheme
3. To explain why we are doing a project in a particular way.
4. To understand and use the ideas of others who have done
similar things.
 PURPOSES OF CFW
5. CFW act like maps that give coherence to empirical inquiry.
6. A visual or symbolic representation of a theory or conceptual
framework often helps to express abstract ideals in a concise
and readily understandable form.

7. A CFW is a diagram that depicts the variables in the research

and the relationship among them.
8. The diagram should be accompanied by a written description
of approximately six to ten sentences that explains the
diagram.
 CONSTRUCTION OF A CFW
Steps of constructing a conceptual Frame work

I. Selecting and defining the concepts.

II. Developing statements relating to the concepts.
III. Expressing the statements to hierarchical fashion

IV. Developing a conceptual map that expresses the

framework
 CONSTRUCTION OF A CFW
I. Selecting and defining the concepts:
 Concepts are selected for a framework on the basis of their
relevant to the phenomenon of concern.
 Every variable included in the study should be a reflection of
a concept included in the framework.
 Each concepts included in a framework needs to be
conceptually defined.
 CONSTRUCTION OF A CFW
II. Developing statements relating to the concepts:
 It is to link all the concepts through relational statement.

The process is
 Select a portion of a theory that discusses the relationship
between or among two or three concepts.
 Write down a single sentence from the theory that seems to
be a relational statement.
 CONSTRUCTION OF A CFW
III. Expressing the statements to hierarchical fashion
 First arrange the concepts on the page in sequence of
occurrence (or casual linkage) from left to right, with the
concepts reflecting the outcomes located on the far right.
abstract construct can be placed in a frame of box, sets of
closely interrelated concepts can be linked by enclosing them
in a frame or circle.

Contd…
 CONSTRUCTION OF A CFW
III. Expressing the statements to hierarchical fashion
 Second, using arrows, link the concepts in a way consistent
with the diagrammatic statements you have preciously
developed. For some studies at some point on the map. The
path of relationships may diverge, so that there are then two or
more paths of concepts. The paths may converge at a later
point. Every concept should be linked to at least one other
concept.
Contd…
 CONSTRUCTION OF A CFW
III. Expressing the statements to hierarchical fashion
Third, examine the map for completeness by asking yourself the
following questions
a) Are all the concepts that are included in the study on the map?
b) Are all the concepts on the map defined ?
c) Does the map clearly portray the phenomenon?
d) Does the map accurately reflect all the statements ?
e) Is there a statement for each of the linkages portrayed by the
map ? - Is the sequence accurate ?
f) Continue to revise you conceptual map until you achieve some
degree of consensus with people you have consulted and you
feel a sense of rightness about it.
 CONSTRUCTION OF A CFW
IV. Developing a conceptual map that expresses the
Framework:
 Conceptual maps are initiated early in the development of the
framework, but refinement of the map will probably be one
of the last steps accomplished. Before the map can be
completed, the following information must be available.
- A clear problem and purpose statement
-The concepts of interest, including conceptual definitions
Contd…
 CONSTRUCTION OF A CFW
IV. Developing a conceptual map that expresses the
Framework:
 Results of an integrative review of the theoretical and
empirical literature
 Relational statements linking the concept, expressed literally
and diagrammatically.
 Identification and analysis of existing theories that address
the relationships of interest.
 Identification of existing conceptual models congruent with
the developing framework.
 Linking of proposed relationship with hypotheses, questions,
or objectives (hierarchical statement sets).
 CONSTRUCTION OF A CFW
• The factors influencing enrollment in a prenatal education
program.
• After reviewing the literature, discussing the problem with colleagues,
and developing ideas from our own experiences, and prepare a
conceptual scheme.
• It allow us to study a number of research questions and to place those
problems in perspective. E.g. The availability of social supports
declines, obstacles to participation in a prenatal education program
increase.
• Hypothesis: “Single pregnant women are less likely to participate in a
prenatal education program than married pregnant women,”
 CONSTRUCTION OF A CFW

Negative Factors
Positive Factors
Age/ Maturity Lack of social support

Wantedness/
Practical impediments
intendedness Enrollment in prenatal
(cost, accessibility)
of pregnancy educational program

Maternal/
Paternal Competing time
education level demand

Fig. The factors influencing prenatal education program

 DIFFERENCE BETWEEN TFW & CFW

TFW CFW

Based on one existing theory Researcher constructs a CFW to be

used in the proposed research
study.
A proposition from the CFW may link concepts selected
selected theory will be tested from several theories, from
in any study based on that previous research results, or from
particular theory the researcher’s own experience

Deals with one or more Researcher relates the concepts in

specific, concrete concepts a logical manner Contd…
 DIFFERENCE BETWEEN TFW & CFW
TFW CFW

Theoretical It is a less-well developed than a TFW but

definitions as per may serve as the impetus for the
particular theorist is formulation of a theory. The concrete
used. findings are linked to the abstract ideas of
the theory or proposed by the researcher in
the CFW
Conceptual model of The model is first formulated. The
the theorist is taken researcher develop propositions and gives
as such. operational definitions and develops
hypotheses.
 STATEMENT OF THE PROBLEM

• E.g. A study to assess the effect of Stress

management interventional package on stress,
coping and burden on care givers of critically
ill traumatic brain injury patients hospitalized
in critical care units at selected Hospital.
 OPERATIONAL DEFINITIONS
• Stress: it refers to real or interpreted or perceived threat to the
physiological or psychological and/or bodily response of the care giver of
the traumatic brain injury patient in relation to caring as measured by Leven
Stein et al in his tool Perceived stress questionnaire (1993).
• Coping: it implies adjusting, adopting or meeting a demand, it involves
cognitive, emotive and behavioral efforts to deal with, reduce or tolerate
excess demand internal or external as measured by Derek Rogers in his tool
Coping style questionnaire (1993)
• Burden: it refers to the presence of problems, difficulties and adverse
elements which affect the life of care givers in the family as measured by
Zarit et al in his tool Zarit burden interview (1983).
Contd…
 OPERATIONAL DEFINITIONS
• Effectiveness: refers to the extent of specific intervention strategies
adopted by the researcher have achieved the desired result as expressed in
decreased numerical /scores of level of stress and burden, and increasing
numerical terms/ scores of adaptive coping strategies utilized.
• Stress management interventional package (SMIP): A series of teaching
and learning activities between the investigator and the care givers that help
them to remove or modify the extent of the stressors which will be educated
in the interventional programme.
• Care giver: refers to the significant person who is staying in the hospital
along with patient.
Schematic representation of the theoretical
framework of the study
(based on Ludwig Von Bertalanffy, 1968)
 ENVIRONMENT

INPUT PROCESS OUTPUT

Development of SMIP comprising of 6

Decreased scores
sessions such as:
of stress and
TBI care Client burden level and
PRE-TEST
givers background increased scores of
subjects Age, sex, Stress management interventional
Assessment of
coping level after
package (SMIP) the SMIP
involved in religion marital client’s stress,
the patient status, coping and
1. Introduction to TBI, its S/S and burden level
care occupational adverse effects on families and using the
status, Importance of care giver’s role. standardized
Residence, scales
educational 2. Concept of stress, its S/S and warning No changes
signs of care giver’s stress noted in the
status etc stress, coping
3. Methods of handling stressors and and burden
stress management strategies level after the
SMIP
4. Concept of coping, its categories and
its components.

5. Concept of burden, its categories and

its components.
Included in the study
6. Behavioral approaches & coping
Not included in study styles

POST TEST

Feedback
(Fig. : Schematic representation of the theoretical framework of the study (based on Ludwig Von Bertalanf,ly 1968)
 TFW OF THE STUDY
• The theoretical framework for this study is based on general systems theory
with input, process, output and feedback as introduced by Ludwig Von
Bertalanffy (1968).
• A system is a group of elements that interact with one another in order to
achieve the goal. An individual is a system as he or she receives input from
the environment, this input when processed provides an output.
• All the living systems are open and in that there is continual exchange of
matter, energy and information.
• The system is cyclical in nature and will be continuous as long as the four
parts (input, process, output and feedback) keep interacting, if there is a
change in any parts, there will be change in all the parts, feedback from within
the system or from the environment provides information which helps the
system to determine whether it is meeting its goals or not.
 TFW OF THE STUDY

• Input: It consists of information, material or energy that will

enter the system. In the present study TBI care giver is a
system with input from itself and acquired from the
environment. These inputs include care giver background such
as age, sex, occupation, religion, income, marital status,
domicile and educational status.
 TFW OF THE STUDY
• Process: After the input is absorbed into the system, it is
processed in a way useful to the system, here it refers to
administration of interventional sessions through a teaching
programme to achieve the desired output and to increase the
knowledge about the various techniques that will be adopted
to be relieved from stress and helps to enhance better coping
skills and reduce the burden level.
 TFW OF THE STUDY
• Output: output from a system is energy, matter of information
that is disposed of by the system as a result of its process. In
the present study it refers to the knowledge gained by the TBI
care giver regarding the stress, coping and burden
management techniques, which can be assessed by the pre-test
and post- test of stress, coping and burden level scores.
 TFW OF THE STUDY
• Feedback: It is the process that enables a system to regulate
itself and provide information about the system’s output and
its feedback as input. Accordingly, the decreased stress and
burden scores and increased coping scores obtained by the
care givers in post-test indicates that teaching programme on
stress, coping and burden management is effective in
increasing the level of coping in the TBI care givers.
 CONCLUSION
• Nurses have used theories from nursing and from other
disciplines when conducting nursing research.
• TFW or CFW guides the steps in the research process and is
the mechanism through which a generalizable body of
knowledge is developed.
• To identify a suitable TFW, it is wise to confer with people
who may be familiar with a broad range of theoretical
perspectives.
 REFERENCES
Polit, D. R & Beck, C. T (2021). Nursing Research Generating
and Assessing Evidence for Nursing Practice. (11th ED.).
Philadelphia: Lippincott.
Gray, J. R., Grove, S. K., & Sutherland, S. (2017). Burns and
Grove’s the practice of nursing research-E-book: Appraisal,
synthesis, and generation of evidence. (8th Ed.). Elsevier
Health Sciences.

Meleis, A.I. (1997). Theoretical Nursing: Development and

Progress. (3rd ED.). Philadelphia: Lippincott.
Literature
Reviews:
Finding and
Critiquing
Evidence
 Objectives

• At the end of this session, you will be able to:

 Explain the purposes for the literature review

 Differentiate between primary and secondary sources in research literature
 Discuss print and electronic resources that may be used in locating literature
references
 Conduct a literature search on the topic selected for writing research proposal
 Extract pertinent information from literature sources
 Purposes of a Literature Review

• Identification of a research problem

• Orientation to what is known/not known

• Determination of gaps or inconsistencies in a body of research

• Determination of a need to replicate a study

• Identification of clinical interventions that need to be tested

• Identification of relevant conceptual frameworks for a research problem

• Identification of suitable designs and data collection methods

• Identification of experts who could be used as consultants on a project

• Assistance in interpreting findings and developing implications

 Purpose of literature review Content Length
A review in a research report. Provide readers with an overview of existing 2 to 4 double-spaced
evidence and contribute to the argument for the pages
new study.

A review in a proposal confirms the need for new research and reflect according to proposal
expertise on the topic in a very succinct fashion. guidelines but is often
just one or two pages.

A review in a thesis or dissertation include a thorough, critical literature review. An 15 to 25 pages long
entire chapter may be devoted to the review.

Free-standing literature reviews Include reviews that critically appraise and 15 to 25 pages long
summarize a body of research, sometimes for a
course or for an EBP project. (systematic
reviews)
 Literature
Sources

• Primary source
• Secondary source
 Types of Information for a Research Review

• Primary Source research reports: descriptions of studies written by

original investigator(s) /researchers and frequently found in journal articles
• As a novice researcher, try to begin your search with the most recent
primary sources.
• Read the abstract or summary of the study to determine if the source
should be read in depth.
• These primary sources will frequently contain references citations for
earlier research reports that may be relevant to the proposed study.
 Types of Information for a Research Review

• Secondary source research documents are descriptions of studies prepared

by someone other than the original researcher. Literature reviews, for
example, are secondary sources.
• The beginning researcher (novice researcher) may be tempted to rely on
secondary sources.
• Secondary sources may provide valuable insight into the material. But it is (the
original) the primary source that should be read, when possible.
• There is always a danger that the author of a secondary source may
misinterpret information or leave out important information that might be
valuable to the reader.
Steps of Literature Review
 Major Steps and Strategies in Doing a
Literature Review

• The Primary Question for the literature review is the same as the actual research question for the new
study . Ex: What factors affect nurses’ effective management of pain in hospitalized children?

Problem statement: Many children are hospitalized annually and many hospitalized children experience high levels of pain. Although effective analgesic
and nonpharmacologic methods of controlling children’s pain exist, and although there are reliable methods of assessing children’s pain, it has been found that nurses
do not always manage children’s pain adeptly. What factors associated with the nurses or their practice settings are associated with effective management of
hospitalized children’s pain?

Secondary Questions as well because you will need to develop an argument (a rationale) for the new
study in the problem statement
• What types and levels of pain do hospitalized children experience?

• How can pain in hospitalized children be reliably assessed and what are effective treatments?

• How knowledgeable are nurses about pain assessment and pain management strategies for children?

• What are the barriers to effective pain management for hospitalized children?
Formulating a
Search Strategy
 Formulating a Search Strategy

• Searching for references in bibliographic databases.

• Ancestry Approach, involves using citations from relevant studies to track down

earlier research on the same topic (the “ancestors”).

• Descendancy approach, is to find a pivotal early study and to search forward in

citation indexes to find more recent studies (“descendants”) that cited the key study.

• Grey literature, which refers to studies with more limited distribution, such as

conference papers, unpublished reports,

 Formulating a Search Strategy

• limit your search to studies conducted within a in time frame (e.g., within the past

15 years).

• exclude studies with certain types of participants. For instance, in our example of

a literature search about nurses’ characteristics and treatment of children’s pain,

we might want to exclude studies on neonates.

• limit your search based on how your key variables are defined. For instance, in our
example, you may (or may not) wish to exclude studies in which the focus was on nurses’ attitudes

toward children’s pain.

 Develop a Search Strategy

Create a set of search terms or phrases

• Expand your search words with synonyms, antonyms, and other relevant
words. e.g., Pregnancy, birth, labor, childbirth, delivery, daytime, night,
day, time factors

• In databases, add terms such as study, research, measurement, statistics,

randomized, validity, and narrative to retrieve research studies.
• Group similar terms together with brackets and the word OR e.g.,
[Hypertension OR "high blood pressure" OR "pre-eclampsia"] AND
[Pregnancy] AND [Management].

• Because AND is a limiting term, another alternative may provide the

convenience of clicking on a "combine" option and choosing the
correct connection. If the big list of results is obtained, activate the
"limit" feature is to narrow down the search.
 Formulating a Search Strategy

• Searching Bibliographic Databases

• keywords, rather than needing to enter a term that is exactly the same as a Medical subject

heading (Mesh Browser) in the database.

 Formulating a Search Strategy

• General Database Search Features

• Boolean operators to expand or delimit a search. Three widely used Boolean operators are

• AND, OR, and NOT (usually in all caps).

1. The operator AND delimits a search. If we searched for pain AND children, the software would retrieve

only records that have both terms.

2. The operator OR expands the search: pain OR children could be used in a search to retrieve records with

either term.

3. Finally, NOT narrows a search: pain NOT children would retrieve all records with pain that did not

include the term children.

 Formulating a Search Strategy

• Wildcard and truncation symbols

• A truncation symbol (often an asterisk, *) expands a search term to include all forms of a root word. For

• example, a search for child* would instruct the computer to search for any word that begins with “child”
such as children, childhood, or childrearing.

• Wildcard symbols (often a question mark or asterisk) inserted into the middle of a search term permits a
search for alternative spellings.

• behavio?r would retrieve records with either behavior or behaviour.

• wom?n would retrieve records with either woman or women.

• Moreover, not every database (including PubMed) allows wildcard codes in the middle of a search term.

• Quotation marks often can be used to ensure that the words are searched only in
combination, as in “blood pressure.”
Databases
 Key Electronic Databases for Nurse
Researchers

• Two especially useful electronic databases for nurse researchers are CINAHL and
MEDLINE

• CINAHL (Cumulative Index to Nursing and Allied Health Literature )

• CINAHL is an important electronic database: It covers references to virtually all English-language nursing and
allied health journals, as well as to books, dissertations, and selected conference proceedings in nursing and
allied health fields.

• MEDLINE (Medical Literature On-Line)

• The MEDLINE Database The MEDLINE database was developed by the U.S. National Library of Medicine
(NLM), and is widely recognized as the premier source for bibliographic coverage of the biomedical
literature.
 Key Electronic Databases for Nurse
Researchers
Other potentially useful bibliographic databases for nurses include:
• British Nursing Index
• Cochrane Database of Systematic Reviews
• Dissertation Abstracts online
• EMBASE (the Excerpta Medica database)
• HaPI (Health and Psychosocial Instruments database)
• Health Source: Nursing/Academic Edition
• ISI Web of Knowledge
• Nursing and Allied Health Source (ProQuest)
• PsycINFO (Psychology Information)
• Scopus
 Screening and Gathering
References
One screen is a practical one: Is the reference accessible?

A second screen is relevance, which you can usually infer by

reading the abstract.
Third Screening criterion may be the study’s methodologic
quality.
Online retrieval of full text articles has increasingly become
possible.
Literature Review
Protocols
 Literature Review Protocols

• Protocols are a means of recording various aspects of a study

systematically, including the full citation, theoretical foundations,
methodologic features, findings, and conclusions.

• you can decide what elements are important to record consistently

across studies to help you organize and analyze information

• If you developed a coding scheme, you can use the codes to record
information about study variables rather than writing out their names
 Collect the obtained materials

• Don’t forget to note the title, source, and other important information
about the source; you will need it for your references.

• Digital Object Identifier (DOI) within the citation of the article in the
reference list. A DOI is a unique number assigned to each article to
provide a persistent link to its location on the internet.

• American Psychological Association (APA) recommends that DOIs be

included for both print and electronic sources when they are available.
Literature Review
Matrices
 Literature Review Matrices

• two-dimensional matrices to organize information, because matrices directly

support a thematic analysis.

• three types of matrix are useful:

• A Methodologic Matrix, which organizes information to answer: How have

researchers studied this research question?

• Results Matrices, which address: What have researchers found?

• An Evaluation Matrix, to answer: How much confidence do we have in the evidence?

 Literature Review Matrices
for example, is for recording information for studies that examined nurses’ education in relation to
responses to children’s pain.
Evaluating a Body
of Research
 Evaluating a Body of Research

• Assess the quality of evidence in each study so that you could draw
conclusions about the overall body of evidence.

• In systematic reviews, methodologic quality often plays a role in

selecting studies.

• The advantage of combining information in one matrix is that

methodologic features and assessments about those features are in a
single table.
Writing Literature
Review
 Content of the Written Literature Review

• A written research review should provide readers with an

objective, organized synthesis of evidence.

• The review should cover all the study variables and discuss the
population.
 Writing a Literature Review

• Organizing the Review Organization is crucial in a written review.

Having an outline helps to structure the flow of presentation.

• If the review is complex, a written outline is recommended; a

mental outline may suffice for simpler reviews.

•
 Style of a Research Review

• Students preparing their first written research review often face stylistic challenges.

• The literature should be summarized in your own words. The review should
demonstrate that you have considered the cumulative worth of the body of research.

• The review should be objective, to the extent possible. Studies that are at odds with
your hypotheses should not be omitted . The review should point out both
consistencies & contradictions & offer possible explanation for inconsistencies

• If the review is conducted for a new study, this critical summary should demonstrate
the need for the research and should clarify the basis for any hypotheses
• In preparing a written review, it is important to organize
materials logically, preferably using an outline. The written
review should not be a succession of quotes or abstracts.

• The reviewers’ role is to describe study findings, the

dependability of the evidence, evidence gaps, and (in the
context of a new study) contributions that the new study
would make.
 Style of a Research Review

Linking words are important:

• If you are grouping together writers with similar opinions,

you may use words like similarly, in addition, also, and again.

• If there is disagreement, use linkers like however, on the

other hand, conversely, nevertheless
Steps of Literature Review
 Guidelines for Critiquing the Literature Review

• Is the literature review comprehensive?

• Is the literature review concise?
• Are all sources relevant to the study topic?
• Are sources critically appraised?
• Are both classic and current sources included?
• Are paraphrases or direct quotes used most often?
• Are both supporting and opposing theory and research presented?
• Are most of the references primary sources?
Thank you
 Quantitative Research Design

NUR505: Advanced Nursing Research and Evidence-based Practice

November, 2024
Learning Objectives
• Discuss types of quantitative research designs

• Discuss types of qualitative research designs

• Identify the threats to internal and external validity related to research

design

• Differentiate between true, quasi and pre experimental designs

• Analyze nonexperimental/observational research

• Critique the design of qualitative/quantitative research studies

 Causality

• Many research questions, however, are about causes and effects:

• Does a telephone therapy intervention (I) for patients diagnosed

with prostate cancer (P) cause improvements in their decision-
making skills (O)? (Therapy question)

• Do birth weights less than 1,500 grams (I) cause developmental

delays (O) in children (P)? (Prognosis question)

• Does a high-carbohydrate diet (I) cause dementia (O) in the

elderly (P)? (Etiology/harm question)
 Causality

• Causes of health-related phenomena usually are not

deterministic but rather are probabilistic—that is, the
causes increase the probability that an effect will occur.

• For example, there is ample evidence that smoking is a

cause of lung cancer, but not everyone who smokes
develops lung cancer, and not everyone with lung cancer
has a history of smoking.
 The Counterfactual Model

• a counterfactual is what would have happened to

the same people exposed to a causal factor if they
simultaneously were not exposed to the causal
factor.

• An effect represents the difference between what

actually did happen with the exposure and what
would have happened without it.
 Criteria for Causality

1. Temporal: A cause must precede an effect in time. If we test the hypothesis that smoking
causes lung cancer, we need to show that cancer occurred after smoking commenced.

2. Relationship: There must be an empirical relationship between the presumed cause and
the presumed effect. In our example, we must show an association between smoking and
cancer—that is, that a higher percentage of smokers than nonsmokers get lung cancer.

3. No confounders: The relationship cannot be explained as being caused by a third

variable. Suppose that smokers tended also to live in urban environments. There would
then be a possibility that the relationship between smoking and lung cancer reflects an
underlying causal connection between the environment and lung cancer.
 Criteria for Causality

1. Coherence : having similar evidence from multiple sources

2. Consistency : having similar levels of statistical relationship in several

studies.

3. Biologic plausibility :evidence from laboratory or basic physiologic

studies that a causal pathway is credible.

 Criteria for Causality

• Cause and effect: aspertame causes fetal abnormalities

1. Temporal: it would be necessary to demonstrate that the abnormalities did
not develop before the mothers’ exposure to aspertame.

2. Empirical relationship: an association between aspertame consumption

and fetal abnormalities

3. No confounders: the relationship cannot be explained as being caused by

a third variable
Experimental Research Design
Experimental Design #1
 Experimental Design #1

• A basic distinction in quantitative research design is between

experimental and nonexperimental research. In an experiment (or
randomized controlled trial, RCT), researchers are active agents,
not passive observers.

• Controlled experiments are considered the GOLD STANDARD

for yielding reliable evidence about causes and effects.
 Manipulation

• Doing something to study participants

• Experimenter manipulates the independent variable by

administering a treatment (intervention) to some subjects and
withholding it from others, or by administering some other
treatment
Experimental Design #1

• Experiment (randomized control trial)

• Gold standard
• Manipulation:
• Control
• Randomization
Experimental Design #1
Features for a True Experimental Design

Randomization
Control

Manipulation
the independent, or experimental variable (e.g.,
intervention, therapies, treatment) is controlled
by researcher
 Manipulation

• Doing something to study participants

• Experimenter manipulates the independent variable by

administering a treatment (intervention) to some subjects and
withholding it from others, or by administering some other
treatment
Example
• For example, suppose we hypothesized that gentle massage is an effective
pain relief strategy for nursing home residents.

• The independent variable, receipt of gentle massage, can be manipulated by

giving some patients the massage intervention and withholding it from others.
We would then compare pain levels (the dependent variable) in the two
groups to see if differences in receipt of the intervention resulted in differences
in average pain levels.
Manipulation

• Intervention protocols
The full nature of the intervention must be delineated in formal protocols

 What is the intervention, and how does it differ from usual methods of care?

 What specific procedures are to be used with those receiving the intervention?

 What is the dosage or intensity of the intervention?

 Over how long a period will the intervention be administered, how frequently will it be
administered, and when will the treatment begin (e.g., 2 hours after surgery)?

 Who will administer the intervention? What are their credentials, and what type of special
training will they receive?
 Manipulation

• Tailored interventions/patient-centered interventions (PCIs)

 The purpose of PCIs is to enhance treatment efficacy by taking people’s

characteristics or needs into account. In tailored interventions, each person
receives an intervention customized to certain characteristics, such as
demographic characteristics (e.g., gender), cognitive factors (e.g., reading
level), or affective factors (e.g., motivation).

 There is some evidence that tailored interventions are more effective than
standardized interventions
A social science tradition use the term “group” or
“condition” (e.g., the experimental group or the control
condition), but medical researchers often use the term
“arm,” as in the intervention arm or the control arm of
the study.
Manipulation: The Control Condition

The term control group refers to a group of participants

whose performance on an outcome is used to evaluate
that of the treatment group on the same outcome.
Experimental Design #1

Features for a True Experimental Design

The researcher introduces controls- over the experimental

situation, including devising an approximation of a
counterfactual
Control
Usually indicates a comparison or a
control group usually indicates a group that
does not receive the experimental treatment.
To measure the effective as the
experimental treatment *strict criteria *

The comparison group usually

Manipulation receives the “normal” or routine
intervention. The

the independent, or experimental variable (e.g.,

intervention, therapies, treatment) is controlled
by researcher
 Manipulation: The Control Condition

• Researchers can expose the control group to various

conditions:
• No treatment
if we wanted to evaluate the effectiveness of a nursing intervention
for hospital patients, we would NOT devise an RCT in which
patients in the control group received no nursing care at all.
 Manipulation: The Control Condition

• An alternative intervention

for example, participants could receive two different types of

distraction as alternative therapies for pain.
 Manipulation: The Control Condition
• Placebo

A placebo or pseudo intervention presumed to have no therapeutic value . for

example, in studies of the effectiveness of drugs, some patients get the
experimental drug and others get an innocuous substance such as injecting plain
normal saline to control group.
 Manipulation: The Control Condition

• Standard treatment
• The usual/ routine care for patients.
• This is the most typical control condition in nursing studies.
•
 Manipulation: The Control Condition
• Different doses or intensities of treatment
• Where in all participants get some type of intervention, but the
experimental group gets an intervention that is richer, more intense,
or longer to analyze dose-response effects
 Manipulation: The Control Condition
• Wait list
• Wait-list control group, with delayed treatment; the control group eventually
receives the full experimental intervention, after all research outcomes are
assessed.
• Attention control group when they want to rule out the possibility that intervention
effects are caused by the special attention
Manipulation: The Control Condition
• Some researchers combine two or more comparison strategies. For example, they

• might test two alternative treatments (option 1) against a placebo (option 3). The
use of multiple comparison groups is often attractive but adds to the cost and
complexity of the study.
 Randomization Procedures

• Randomization (also called random assignment or random allocation)

involves assigning participants to treatment conditions at random.

• Random means that everyone has an equal chance of being assigned

to any group.

• If people are placed in groups randomly, there is no systematic bias in

the groups with respect to preintervention attributes that could affect
outcome variables.
 Experimental Design #1

Features for a True Experimental Design

The researcher introduces controls- over the
experimental situation, including devising an
approximation of a counterfactual
Randomization
Control
each member of the population has
Usually indicates a comparison or
an equal chance of being selected to
a control group usually indicates a
participate in the research study group that does not receive the
sampling frame * experimental treatment. To
measure the effective as the
experimental treatment *strict
Random Assignment Of Cases criteria * The comparison group usually
ensures that each subject has an receives the “normal” or
equal chance of being placed into Manipulation routine intervention. The

any of the groups in an

experimental study. the independent, or experimental variable (e.g.,
intervention, therapies, treatment) is controlled
by researcher
Randomization Procedures

Involves placing subjects into treatment conditions at random

Approximates the ideal—but impossible—counterfactual of having

the same people in multiple treatment groups simultaneously

Basic randomization

Allocation concealment
Question #3

• Tell whether the following statement is true or false:

• Some studies involve patient-centered interventions that are

tailored to meet individual needs or characteristics.
 Answer to Question #3

• True

• Everyone in the experimental group usually gets the same intervention as

delineated in formal protocols, but some studies involve patient-centered

interventions (PCIs) that are tailored to meet individual needs or

characteristics.
 Basic Randomization

• A Table Of Random Numbers

To randomize.

• Find a random starting point, close your eyes and let your finger fall at some
point on the table.

• Move in any direction from that point

• The allocation process should be truly random.

• Strict adherence to the randomization schedule.

 Small Table of Random Digits

• E.g., Total sample of 15 children. Recruit three group , five will be

randomly assigned to each group.
Example for Random Assignment Procedure
 Randomization

• Computerized resources are available for free on the Internet to help

with randomization.
Randomization Variants

• Stratified randomization

• Permuted block randomization

• Urn randomization

• Randomized consent

• Partial randomization

• Cluster randomization
 Randomization Variants

• Stratified randomization, in which randomization occurs separately for distinct subgroups (e.g., males and females)
283

• Permuted block randomization, in which people are allocated to groups in small blocks to ensure a balanced
distribution in each block

• Urn randomization, in which group balance is continuously monitored and the allocation probability is adjusted when
an imbalance occurs (i.e., the probability of assignment becomes higher for the treatment condition with fewer
participants) •

• Randomized consent, in which randomization occurs prior to obtaining informed consent (also called a Zelen design)

• Partial randomization, in which only people without a strong treatment preference are randomized—sometimes
referred to as partially randomized patient

• preference (PRPP)

• Cluster randomization, which involves randomly assigning clusters of people (e.g., hospital wards) to different
treatment groups
 Randomization Variants

• Random assignment should involve allocation concealment that prevents those

who enrol participants from knowing upcoming assignments. Allocation
concealment is intended to prevent biases that could stem from knowledge of
allocations before assignments actually occur.
 Randomization Variants

• Allocation Concealment:

• prevents those who enroll participants from knowing upcoming assignments.

• prevent biases that could stem from knowledge of allocations before

assignments actually occur.

• sequentially numbered, opaque sealed envelopes (SNOSE) containing

assignment information.
 Randomization Variants

• The timing of randomization is also important.

• Study eligibility—whether a person meets the criteria for inclusion—should be

ascertained before randomization.

• Randomization should occur as closely as possible to the start of the intervention

to maximize the likelihood that all randomized people will actually receive the
condition to which they have been assigned
 Randomization Variants

• Stratified randomization

• In most cases, randomization involves the random assignment of individuals to different conditions.
An alternative is cluster randomization, which involves randomly assigning clusters of people to
different treatment groups

• This approach also reduces the risk of contamination of treatments, that is, the co-mingling of
people in the groups, which could cloud the results if they exchange information.

• For example, if a researcher stratified on the basis of gender

 Go to web site

Consort Flow Chart

Randomization Variants

• Permuted block randomization

• Randomization occurs for blocks of participants

• for example, 6 or 8 at a time.

 Randomization Variants

• Randomized consent

• randomized consent or a Zelen design.

• Study participants some-times have a preference about which condition they want.

• If randomization occurs after informed consent people who are not assigned to their preferred
condition may opt out of the study.

• Zelen proposed a simple solution: randomize first and then obtain consent, thus eliminating
the possibility that the consent process will generate preferences.

• If the control group condition is standard care, control group members may not even be asked
for their consent, as they would not be getting anything different.
 Randomization Variants

• Partially randomized patient preference (PRPP)

• Where in all participants are asked preferences about treatment

conditions. Only those without a strong preference are randomized

 Blinding or Masking

• Participants often want to be helpful and also want to present

themselves in a positive light.

• A procedure called blinding (or masking) is used in some RCTs to

prevent biases stemming from awareness.
 Blinding or Masking

• Blinding involves concealing information from participants, data collectors,

careproviders, intervention agents, or data analysts to enhance objectivity and
minimize expectation bias. Blinding typically involves disguising or withholding
information about participants’ status in the study (e.g., whether they are in the
experimental or control group), but can also involve withholding information about
study hypotheses, baseline performance on outcomes, or preliminary study results.
 Blinding or Masking

• Performance bias
• Performance bias refers to systematic differences in the care provided to members of
different groups of participants, apart from an intervention that is the focus of the
inquiry.

• Those delivering an intervention might treat participants in groups differently, apart

from the intervention itself.

• Blinding of participants, and blinding agents delivering treatments, is used to avoid

performance bias.
 Blinding or Masking

• Detection bias (or ascertainment)

• concerns systematic differences between groups in how outcome variables

are measured, verified, or recorded, is addressed by blinding those who
collect the outcome data or, in some cases, those who analyze them.
 Blinding or Masking

• When blinding is not used, the study is an open study, in contrast to a closed study that
results from masking. When blinding is used with only one group of people (e.g., study
participants), it is sometimes described as a single-blind study.

• When it is possible to mask with two groups (e.g., those delivering an intervention and
those receiving it), it is sometimes called double-blind. However, recent guidelines have
recommended that researchers not use these terms without explicitly stating which groups
were blinded because the term “double blind” has been used to refer to many different
combinations of blinded groups (Moher et al., 2010).
 Blinding or Masking

• Open study/closed study

• Single-blind studies
• When blinding is used with only one group of people (e.g., study participants), it is

sometimes described as a single-blind study.

• Double-blind studies
• When it is possible to mask with two groups (e.g., those delivering an intervention
and those receiving it), it is sometimes called
Experimental Designs #2

• Symbolic representation of a pretest–posttest experimental

design:
R O1 X O2
R O1 O2

R = Randomization
O = An observation or measurement
X = An intervention
 Specific Experimental Designs

• Basic experimental designs

• After-only (posttest-only) design

• Before–after (pretest–posttest) design

• Factorial design

• Crossover (repeated measures) design

 Experimental Designs #3

• Posttest-Only Control Group Design (or after-only design)

because data on the dependent variable are collected only once—after

randomization and completion of the intervention.

(a) Participants are randomly assigned to groups

R X O1 (experimental group)

(b) the experimental group receives the experimental treatment, and the comparison group R O1 (control group)

receives the routine treatment or no treatment, and

(c) a posttest is given to both groups.

 Experimental Designs #3

• Factorial design

• Two or more variables are manipulated simultaneously

• Test both main effects and interaction effects

• example

• 1. Does auditory stimulation have a more beneficial effect on premature infants’ development than
tactile stimulation, or vice versa?

• 2. Is the duration of stimulation (independent of type) related to infant development?

• 3. Is auditory stimulation most effective when linked to a certain dose and tactile stimulation most
effective when coupled with a different dose?
crossover design
• Counterbalancing

• For example, if a crossover design were used to compare the effects of

auditory and tactile stimulation on infant development, some infants
would be randomly assigned to receive auditory stimulation first, and
others would be assigned to receive tactile stimulation first.

• When there are three or more conditions to which participants will be

exposed, the procedure of counterbalancing can be used to rule out
ordering effects.
 Experimental Designs #3

• Crossover design
• Carry-over effects
• When people are exposed to two different treatments or conditions, they may be
influenced in the second condition by their experience in the first condition.
• As one example, drug studies rarely use a crossover design because drug B administered
after drug A is not necessarily the same treatment as drug B administered before drug A.

• Washout period (i.e., a period of no treatment exposure).

Strengths and Limitations of Experiments

• Strengths

• Yield strong evidence about intervention effectiveness

• Greater corroboration

• Limitations

• Constraints of experimental approach

• Artificiality

• Hawthorne effect
 Quantitative Research Design

NUR505: Advanced Nursing Research and Evidence-based Practice

November, 2024
Quasi-experimental Research Design
Quasi-experiments
• Quasi-experiments, often called controlled trials without randomization in
the medical literature, involve an intervention but they lack randomization,
the signature of a true experiment. Some quasi-experiments even lack a
control group.
• The signature of a quasi-experimental design, then, is an intervention in
the absence of randomization.
Quasi-Experimental and Preexperimental Designs

Nonequivalent control group pretest–posttest design (quasi-experimental)

O1 X O2
O1 O2

Nonequivalent control group posttest-only design (preexperimental)

X O1
O1

One group pretest–posttest design (preexperimental)

O1 X O2
Quasi-Experimental Designs

• Time series design

• Nonequivalent control group before–after

design
O1 O2 O3 O4 X O5 O6 O7 O8
Other Quasi-Experimental Designs
• Quasi-experimental dose-response analysis

• Quasi-experimental (nonrandomized) arms of a PRPP randomization

design
Partially Randomized Patient Preference (PRPP)

• Quasi-experimental (nonrandomized) arms of a PRPP randomization design

The two randomized groups are part of the true experiment, but the two groups
who get their preference are part of a quasi -experiment.
Strengths and Limitations of Quasi-Experiments

• Practical.

• Introduce some research control when full experimental rigor is not possible.

Limitations
The cause-and-effect inferences are less compelling
Nonexperimental/Observational Research
Nonexperimental/Observational Research
• Descriptive research

• When researchers do not intervene by manipulating the independent variable,

the study is nonexperimental, or, in the medical literature, observational.

• Correlational Cause-Probing Research

• a relationship or association between two variables, that is, a tendency for

variation in one variable to be related to variation in another.
• In experiments, researchers have direct control over the
independent variable. In correlational research, on the other hand,
investigators do not control the independent variable, which often
has already occurred.

• Although correlational studies are inherently weaker than

experimental studies in elucidating cause-and-effect relationships,
different designs offer different degrees of supportive evidence.
• Cross-sectional designs involve collecting data
at one point in time

• longitudinal designs involve data collection two

or more times over an extended period..

 Designs of Correlational Studies

• Retrospective (case-control) design

• A phenomenon existing in the present is linked to phenomena that occurred in the past.

• the researcher begins with the dependent variable (the effect) and then examines whether it
is correlated with one or more previously occurring independent variables (potential causes).

• Most early studies of the smoking–lung cancer link used a retrospective case-control
design, in which researchers began with a group of people who had lung cancer (cases) and
another group who did not (controls).

• Retrospective studies are often cross-sectional, with data on both the dependent and
independent variables collected at a single point in time. In such studies, data for the
independent variable are based on recollection (retrospection).
 Designs of Correlational Studies

• Prospective (cohort) designs

• In correlational studies with a prospective design (called a cohort design in medical
circles), researchers start with a presumed cause and then go forward in time to the
presumed effect. For example, we might want to test the hypothesis that rubella during
pregnancy (the independent variable) is related to birth defects (the dependent variable).

• Also, prospective designs require large samples if the outcome of interest is rare, as in the
example of malformations associated with maternal rubella

• Some prospective studies are exploratory. Researchers sometimes measure a wide range
of possible “causes” at one point in time and then examine an outcome of interest at a
later point (e.g., length of stay in hospital).
 Designs of Correlational Studies

• Prospective (cohort) designs

 Designs of Correlational Studies

Natural Experiments
• Researchers are sometimes able to study the outcomes of a natural
experiment in which a group exposed to a phenomenon with potential
health consequences is compared with a nonexposed group.

• Natural experiments are nonexperimental because the researcher does

not intervene, but they are called “natural experiments” if people are
affected essentially at random. For example, the psychological well-
being of people living in a community struck with a natural disaster
 Descriptive Research

• Descriptive Correlational Studies S

• simply describe relationships than to comprehend causal pathways. Many research

problems are cast in noncausal terms.

• example, whether men are less likely than women to bond with their newborn infants, not
whether a particular configuration of sex chromosomes caused differences in parental
attachment.

• Unlike other types of correlational research such as the cigarette smoking and lung
cancer investigations—the aim of descriptive correlational research is to describe
relationships among variables rather than to support inferences of causality.
 Descriptive Research

• Univariate Descriptive Studies

• The aim of some descriptive studies is to describe the frequency of occurrence

of a behavior or condition, rather than to study relationships. Univariate
descriptive studies are not necessarily focused on only one variable. For
example, a researcher might be interested in women’s experiences during
menopause.
 Descriptive Research

Prevalence studies

• Prevalence studies are done to estimate the prevalence rate of some condition
(e.g., a disease or a behavior, such as smoking) at a particular point in time.
 Incidence studies

• Incidence studies estimate the frequency of developing

new cases. Longitudinal designs are needed to estimate
incidence because the researcher must first establish who
is at risk of becoming a new case—that is, who is free of
the condition at the outset.
Thank you
 College of Health & Sport Sciences
Nursing Department

Chapter 2
Evidence-Based Nursing:
Translating Research Evidence into Practice
PG.
 Objectives
By the end of the lecture, student will be able to:
1.Define the key concepts of Evidence-Based Practice (EBP).
2.Describe the hierarchy of evidence and apply it to clinical decision-making.
3.Demonstrate the ability to follow the steps of the evidence-based practice
process
4.Formulate clinical questions using the PICO(T/S) framework and identify
relevant evidence sources.
5.Recognize the different models of EBP and explain the Iowa model of EBP.
6.Identify common barriers to apply EBP.
7.Understand the role of nurses as key contributors to the implementation of
EBP
 Key Concepts in Evidence-Based Nursing

Research Utilization (RU):

The use of findings from a study or set of studies in a practical
application that is unrelated to the original research.

Ex. A study on early mobilization in post-operative patients may not

have been initially focused on ICU patients. However, findings from
this study could be used to support early mobilization protocols in
critically ill patients to reduce ICU-acquired weakness.
 Key Concepts in Evidence-Based Nursing

Knowledge Translation (KT):

The process of moving research evidence into clinical practice,
ensuring that findings are accessible and effectively applied.

Ex. Evidence suggests that nurse-led protocols for sepsis screening

improve early recognition. Translating this evidence into daily nursing
practice involves developing sepsis screening tools, training ICU staff,
and integrating them into electronic health records (EHR).
 Key Concepts in Evidence-Based Nursing

Evidence-Based Practice (EBP):

The integration of best research evidence with clinical expertise and
patient values. EBP refers to making clinical decisions based on the best
possible evidence, particularly focusing on high-quality research
studies.

Ex. Turning and Repositioning ICU Patients to Prevent Pressure

Ulcers: Evidence-based guidelines recommend turning and repositioning
critically ill patients every 2 hours to prevent the development of pressure
ulcers.
 Key Concepts in Evidence-Based Nursing

Evidence-Based Practice (EBP):

Best Evidence:
•The best evidence comes from rigorous, well-conducted studies,
such as RCTs, meta-analyses, and systematic reviews. It helps guide
clinical decisions for optimal patient care.

Ex. A meta-analysis shows that prone positioning improves oxygenation and

reduces mortality in patients with severe ARDS. Based on this evidence, many ICUs
have adopted prone positioning as a standard intervention.
 Key Concepts in Evidence-Based Nursing

Evidence-Based Practice (EBP):

Patient Values and Preferences:
•EBP also considers patient values and preferences, ensuring care is
aligned with what matters most to the patient.

Ex. Respecting a Patient’s Preference for Limited Sedation: A critically ill patient on
mechanical ventilation might express a preference for light or minimal sedation to
remain more aware of their surroundings. Nurses, in collaboration with the care
team, can respect this preference by adjusting the sedation levels, balancing patient
comfort with safety, and regularly involving the patient in decisions about their care.
 Key Concepts in Evidence-Based Nursing

Evidence-Based Practice (EBP):

Clinical Expertise and Experiential Evidence:
•Clinical expertise involves the experience, skill, and judgment that nurses
and other healthcare professionals bring to practice.

Ex. Recognizing Early Signs of Sepsis in a Patient: An experienced ICU nurse may
notice early, subtle signs of sepsis in a patient, such as a slight increase in heart
rate, altered mental status, or changes in skin color, before lab results or vital signs
clearly indicate infection. Based on their clinical expertise, the nurse quickly alerts
the healthcare team, leading to early intervention, such as administering antibiotics,
which can significantly improve patient outcomes.
Evidence Hierarchy: Levels of Evidence
Evidence Hierarchy: Levels of Evidence
 Evidence Hierarchy: Levels of Evidence

Systematic Review (Level I -

Highest Level of Evidence):
•A comprehensive, methodical process of
reviewing all available studies on a
specific topic to determine the best
evidence. Unlike traditional literature
reviews, which may be selective and
subjective, a systematic review follows a
strict protocol to minimize bias and
ensure that the findings are reliable and
comprehensive.
 Evidence Hierarchy: Levels of Evidence

Meta-Analysis (Level I - Highest

Level of Evidence):
• A statistical technique that combines the
results of multiple quantitative studies into a
single, comprehensive summary. The key
feature of meta-analysis is that it treats the
findings of each individual study as data
points rather than individual patient
outcomes.
 Evidence Hierarchy: Levels of Evidence

Single Randomized
Controlled Trial (RCT) (Level
II):
• An experimental study where
participants are randomly assigned to
groups to test the effect of an
intervention
 Evidence Hierarchy: Levels of Evidence

Single Non-Randomized Trial

(Quasi-Experiment - (Level
III):
• An intervention study without
randomization, often used when
randomization is impractical.
 Evidence Hierarchy: Levels of Evidence

Single Prospective Cohort

Study (Level IV):
• A study where a group of individuals
is followed over time to assess the
development of outcomes based on
exposures.
 Evidence Hierarchy: Levels of Evidence

Single Case-Control Study

(Level V):
• A retrospective study comparing
patients with a condition (cases) to
those without (controls) to identify
risk factors.
 Evidence Hierarchy: Levels of Evidence

Single Cross-Sectional
Study (e.g., Survey - Level
VI):
• Observational research conducted
at one point in time to describe
relationships or characteristics.
 Evidence Hierarchy: Levels of Evidence

Single In-Depth Qualitative

Study (Level VII):
• Research that explores individuals'
experiences or perceptions using
methods like interviews or focus
groups.
 Evidence Hierarchy: Levels of Evidence

Expert Opinion, Case

Reports, etc. (Lowest
Level- Level VIII):
• These include opinions from clinical
experts, case studies, or descriptive
reports, often used when higher
levels of evidence are unavailable.
 Major steps in EBP

0. Cultivate a spirit of inquiry within an evidence-based practice (EBP)

culture and environment
1. Asking clinical questions that can be answered with research evidence
2. Searching for and retrieving relevant evidence
3. Appraising the evidence
4. Integrating the evidence with your own clinical expertise, patient
preferences, and local context
5. Assessing the effectiveness of the decision, intervention, or advice
6. Disseminate the outcomes of the EBP decision or change.
 Major steps in EBP

0- Cultivate a spirit of inquiry within an evidence-based practice (EBP)

culture and environment
• Encourage a questioning attitude: Nurses are motivated to challenge current practices
and ask, "Is there a better way?”
• Institutional support: The organization’s mission, policies, and evaluations should
prioritize EBP to create a supportive environment.
• Mentorship: EBP mentors guide clinicians, helping them build skills and overcome barriers
to implementing evidence-based changes.
• Access to resources: Provide tools like research databases, EBP rounds, and ongoing
education to support evidence-based practice.
• Recognition: Regularly acknowledge individuals and teams who successfully apply EBP to
foster continued engagement.
 Major steps in EBP

1. Asking clinical questions that can be answered with research

evidence
Most guidelines for EBP use the acronyms PIO or PICO to help practitioners develop
well-worded questions that facilitate a search for evidence. In the most basic PIO form,
the clinical question is worded to identify three components:
2. P: the population or patients (What are the characteristics of the patients or people?)
3. I: the intervention, influence, or exposure (What are the interventions or therapies of
interest? or, What are the potentially harmful influences/exposures of concern?)
4. C: the comparison component may be needed, when the intervention or influence of
interest is contrasted with a specific alternative.
5. O: the outcomes (What are the outcomes or consequences in which we are interested?)
Other components may be relevant, such as a time frame in which an intervention might be appropriate (adding a “T” for
 Major steps in EBP

1. Asking clinical questions that can be answered with research

evidence
EX. Does using a nurse-led mobility protocol improve recovery time in critically ill ICU
patients?
P (Patient/Population): The patient or population you are interested in studying.
This could be a specific group of patients, a certain condition, or a demographic.
I (Intervention): The intervention or treatment you're considering for the patient or
population.
C (Comparison): The alternative to the intervention, such as a different treatment,
no treatment, or a placebo. Not all questions need a comparison.
O (Outcome): The desired outcome or effect of the intervention. This could include
 Major steps in EBP

1. Asking clinical questions that can be answered with research

evidence
EX. In ICU patients at risk for pressure ulcers, does the use of foam dressing,
compared to standard gauze, reduce the incidence of pressure ulcers over a 4-week
period in an adult ICU setting?
P (Patient/Population): ICU patients at risk for pressure ulcers
I (Intervention): Use of foam dressing.
C (Comparison): Standard gauze.
O (Outcome): Reduction in the incidence of pressure ulcers.
T (Time): Over a 4-week period
S (Setting): Adult ICU setting
 Major steps in EBP

1. Asking clinical questions that can be answered with research

evidence
EX. Does using a nurse-led mobility protocol improve recovery time in critically ill ICU
patients?
P (Patient/Population): The patient or population you are interested in studying.
This could be a specific group of patients, a certain condition, or a demographic.
I (Intervention): The intervention or treatment you're considering for the patient or
population.
C (Comparison): The alternative to the intervention, such as a different treatment,
no treatment, or a placebo. Not all questions need a comparison.
O (Outcome): The desired outcome or effect of the intervention. This could include
 Major steps in EBP
1. Asking clinical questions that can be
answered with research evidence

A) Treatment/Intervention:
Ex: In ICU patients with sepsis, what is the effect
of early fluid resuscitation on survival rates?
Ex: In ICU patients with ARDS (Acute Respiratory
Distress Syndrome), what is the effect of low tidal
volume ventilation, in comparison to standard
ventilation, on mortality rates?
 Major steps in EBP
1. Asking clinical questions that can be
answered with research evidence

B) Diagnosis/Assessment:
Ex: For ICU patients at risk of pressure ulcers, does
the use of a skin assessment tool (e.g., Braden
Scale) yield accurate diagnostic information about
the risk of developing pressure ulcers?
Ex: For critically ill patients in the ICU, does the
Braden Scale yield more accurate assessment
information about pressure ulcer risk than the
Norton Scale?
 Major steps in EBP
1. Asking clinical questions that can be
answered with research evidence

C) Prognosis:
Ex: For ICU patients who have experienced cardiac
arrest, does prolonged mechanical ventilation
increase the risk of long-term cognitive
impairment?
Ex: For patients with septic shock, does the
presence of chronic kidney disease, relative to no
kidney disease, increase the risk of ICU mortality?
 Major steps in EBP
1. Asking clinical questions that can be
answered with research evidence

D) Causation/Etiology/Harm:
Ex: Does long-term use of high-dose
corticosteroids increase the risk of infection in ICU
patients?
Ex: Does early use of parenteral nutrition increase
the risk of infection, compared to enteral nutrition,
in critically ill patients in the ICU?
 Major steps in EBP
1. Asking clinical questions that can be
answered with research evidence

E) Meaning or Process:
Ex: What is it like for ICU nurses to experience
moral distress while providing end-of-life care for
critically ill patients?
Ex: What is the process by which family members
of ICU patients cope with the decision-making
process regarding life-sustaining treatment?
 Activity

Formulating PICO(T/S) Questions

Select a topic and formulate a clear clinical question

using PICO(T/S) components.

 Major steps in EBP

2. Searching for and retrieving relevant evidence

Nurse can conduct such a search in three well-known databases: Cochrane
Library, PubMed, and CINAHL
1. Cochrane Library: Cochrane Reviews | Cochrane Library -
How to use the Cochrane Library | Cochrane Library
2. PubMed: PubMed - Help - PubMed
3. CINAHL (Cumulative Index to Nursing and Allied Health Literature):
CINAHL Databases - Basic Searching Tutorial - CINAHL Help Sheet
 Cochrane Library
Search Strategy -
Boolean operators

1. AND
 Purpose: The AND operator
narrows the search by ensuring
that all the keywords you
specify are present in the
results.
 Usage: It is used to combine
different terms that must
appear in the same record.
Ex. ICU AND Sepsis
 Cochrane Library
Search Strategy -
Boolean operators

2. OR
 Purpose: The OR operator
broadens the search by
returning results that include at
least one of the terms
specified.
 Usage: It is helpful when you
want to search for different
terms that mean the same
thing or are related.
Ex. Cardiac OR Heart AND
Disease
 Cochrane Library
Search Strategy -
Boolean operators

3. NOT
 Purpose: The NOT operator
excludes a term from the
search results.
 Usage: This is useful when you
want to filter out certain
irrelevant topics.
Ex. ICU AND Sepsis NOT Post-
operative
 Cochrane Library
Search Strategy -
Boolean operators

4- Quotation Marks " "

- Purpose: Quotation marks are
used to search for exact phrases.
When terms are in quotes, the
database will only return results
where the exact phrase appears.
Ex. “Intensive Care Units” AND
“Pain Management”
 Cochrane Library
Search Strategy -
Boolean operators

5- Parentheses ( )
- Purpose: Parentheses are used
to group terms and control the
order of the search logic,
especially when combining
multiple operators.
Ex. ("ventilator-associated
pneumonia" OR "VAP") AND
("ICU" OR "intensive care unit")
AND ("prevention" OR "nursing
interventions")
 Cochrane Library
Search Strategy -
Boolean operators

6- Wildcards (*)
- Purpose: A wildcard symbol
(usually an asterisk, * or
sometimes a ?) allows you
to search for multiple
variations of a root word. It’s
useful for finding different
forms of a word.
Ex. Nurs* AND "Critical Care"
 Cochrane Library
Search Strategy -
Boolean operators

7- NEXT & NEAR

Ex. "ICU" NEAR "Mechanical Ex. "ICU" NEXT "Mechanical Ex. "ICU" AND "Mechanical Ventila
 Cochrane Library
Search Strategy -
Boolean operators

Examples

Proposed Title: "Effectiveness of Early

Goal-Directed Therapy in Sepsis
Management“

Searching using Boolean operators:

("early goal-directed therapy" OR "EGDT")
AND ("sepsis" OR "septic shock") AND
("effectiveness" OR "mortality" OR "patient
outcomes")
 Cochrane Library
Search Strategy -
Boolean operators

Examples

Proposed Title: "Comparison of Non-

Invasive and Invasive Ventilation on
Mortality in Acute Respiratory Failure“

Searching using Boolean operators:

("non-invasive ventilation" OR "NIV") AND
("invasive ventilation" OR "mechanical
ventilation") AND ("acute respiratory
failure" OR "ARDS") AND ("mortality" OR
"patient outcomes")
 Cochrane Library
Search Strategy -
Boolean operators

Examples

Proposed Title: "The Impact of Early

Defibrillation on Survival in Out-of-Hospital
Cardiac Arrest“

Searching using Boolean operators:

("early defibrillation" OR "defibrillation")
AND ("out-of-hospital cardiac arrest" OR
"OHCA") AND ("survival rates" OR
"mortality")
 PubMed Library
Search Strategy -
Boolean operators

• Searching By Medical Subject

Headings-MsEH - MeSH Browser

 PubMed Library
Search Strategy -
Boolean operators

The Boolean operators used for

searching in PubMed and the Cochrane

Library are the same, as both databases

support standard Boolean logic.

PubMed Library
Search Strategy -
Boolean operators
 PubMed Library
Search Strategy -
Boolean operators

Proposed Title: "Effectiveness of Early

Goal-Directed Therapy in Sepsis
Management“

Searching using Boolean operators:

("early goal-directed therapy" OR "EGDT")
AND ("sepsis" OR "septic shock") AND
("effectiveness" OR "mortality" OR "patient
outcomes")
 Major steps in EBP

3. Appraising the evidence

3. Appraising the evidence
 Major steps in EBP

3. Appraising the evidence “Evaluating Study Quality”

Critical Appraisal Skills Programme (CASP): It is a widely used program
that provides checklists and tools to help individuals systematically
evaluate the quality and relevance of research evidence in healthcare
and other fields. The CASP checklists are designed to appraise different
types of studies, such as randomized controlled trials, cohort studies,
case-control studies, and qualitative research.
CASP Checklists - Critical Appraisal Skills Programme
Activity

Appraising an evidence

• Select a research article related to a critical care nursing

intervention

• Answer the questions for appraising evidence

 Major steps in EBP

4. Integrating the Evidence with Your Own Clinical Expertise, Patient

Preferences, and Local Context
After appraising the evidence, the next step is to integrate the findings with
your own clinical expertise, the patient's preferences, and the local context
in which care is being provided.
Ex.
Clinical Expertise: As an ICU nurse, you understand that early mobilization reduces ICU-
acquired weakness but requires careful patient assessment to ensure safety.
Patient Preferences: Patients or families may worry about risks (e.g., pain, instability).
Educating them on benefits like preventing complications can help align preferences with
evidence-based care.
Local Context: Feasibility depends on staffing, equipment (e.g., mobility aids), and hospital
policies. Limited resources may require simpler interventions like passive exercises or sitting up
in bed.
 Major steps in EBP

5. Assessing the Effectiveness of the Decision, Intervention, or Advice

The final step involves evaluating the effectiveness of the

intervention or decision based on the evidence and
monitoring the outcomes in real-time.
1. Evaluating the Outcomes of the Intervention: Measure Success, Use Metrics,
Monitor Real-Time Results.
2. Evaluating the Evidence-Based Practice (EBP) Process:
•Ask Reflective Questions:
• Am I consistently formulating clear, answerable clinical questions?
• Am I effectively searching for and appraising the best evidence?
• Did the chosen intervention align well with patient preferences and local context?
•Self-Assessment: Evaluate your strengths and areas for improvement in applying
EBP principles.
 Major steps in EBP

6. Disseminate the outcomes of the EBP decision or change

• For ensuring that knowledge and improvements in patient care are
shared across the healthcare community.
• Dissemination ensures that the benefits of EBP changes are not
limited to one setting.
• By sharing knowledge, clinicians, patients, and organizations can
continuously improve practices, leading to better healthcare
outcomes on a larger scale.
 Major steps in EBP

6. Disseminate the outcomes of the EBP decision or change

(Strategies)
• Podium/Oral Presentations
• Poster Presentations
• Community Meetings
• Hospital/Organizational and Professional Committee Meetings
• Journal Clubs
• Published Articles
Models for Evidence-Based Practice
 Iowa Model of Evidence-

Based Practice to Promote

Quality Care
 Barriers to Using Research in Nursing Practice

1. Quality and nature of the research: Lack of clear clinical

applicability, Conflicting Evidence, Limited access to high-quality
research.
2. Characteristics of nurses: Lack of knowledge or skills, Time
constraints, Resistance to change
3. Organizational factors: Lack of administrative support, Resource
limitations, Workplace culture
 Nurses’ Role in Using Research Evidence

1. Read widely and critically.

2. Attend professional conferences.

3. Learn to expect on evidence that a procedure is effective.

4. Become involved in a journal club.

5. Pursue and participate in RU/EBP projects.

 References

Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2015). Evidence-
based practice for nurses and healthcare professionals: Model and guidelines.
Sigma Theta Tau International.
Godshall, M. (2020). Fast facts for evidence-based practice in nursing: Implementing
EBP in a nutshell (2nd ed.). Springer Publishing Company.
McKenna, L., & Copnell, B. (2020). Fundamentals of nursing and midwifery research:
A practical guide for evidence-based practice (2nd ed.). Routledge, Taylor &
Francis.
Melnyk, B. M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing &
healthcare: A guide to best practice (4th ed.) Wolters Kluwer Health.
Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing
Thank You
Sampling in Quantitative
Research
Learning Objectives
• Define population and sample.

• Distinguish between target and accessible population.

• Discuss and non-probability sampling procedures.

• Compare four methods of probability sampling.

• Compare three methods of non-probability sampling.

Question #1
• Tell whether the following statement is true or false:

• The aggregate of cases in which a researcher is interested

is called a sample.
Answer to Question #1
• False
• The aggregate of cases in which a researcher is interested
is called a population. A sample is selection of a portion of
the population to represent the entire population.
Sampling plan
• Quantitative researchers seek to select samples that will
allow them to achieve statistical conclusion validity and to
generalize their results.

• a sampling plan that specifies in advance how

participants are to be selected and how many to include.
Basic Sampling Concepts in
Quantitative Studies #1

• Population: the aggregate of cases in which a researcher is interested.

E.g.,
All male patients who had cardiac surgery in bahrain.
All women with irritable bowel syndrome in sydney
All children in Canada with cystic fibrosis.
 Basic Sampling Concepts in
Quantitative Studies #1
• Target population: the aggregate of cases about which the researcher would
like to generalize

• Accessible population: the aggregate of cases that conform to designated

criteria and that are accessible for a study

• A target population might consist of all diabetic people in the United States, but
the accessible population might consist of all diabetic people at SMC.

• Researchers usually sample from an accessible population and hope to

generalize to a target population.
 Basic Sampling Concepts in
Quantitative Studies #2
• Eligibility criteria/inclusive criteria: criteria that specify population
characteristics
•Cost
•Practical constraints
•People’s ability to participate
•Design considerations
•Exclusion criteria
 Basic Sampling Concepts in
Quantitative Studies #3
• Samples and Sampling
•Sampling: selection of a portion of the population (a sample) to represent the entire
population
•Element: basic population unit about which information is collected
•Sample: a subset of population elements
•Representative sample
A representative sample

• A representative sample is one whose key characteristics closely

approximate those of the population.

• If the population in a study of blood donors is 50% male and 50% female,
then a representative sample would have a similar gender distribution. If the
sample is not representative of the population, the study’s external validity
(and construct validity) is at risk.
• Greater confidence can be placed in the representativeness of probability samples.
Question #2
• Tell whether the following statement is true or false:
• Researchers usually sample from the target population.
Answer to Question #2
• False
• Researchers usually sample from the accessible population
but should identify the target population to which they want
to generalize their results.
Answer to Question #3
• True
• Probability sampling involves random selection of elements.
 Basic Sampling Concepts in
Quantitative Studies #4
• Staged sample: samples are sometimes selected in multiple phases
• Sampling bias: the systematic over- or underrepresentation of segments of
the population on key variables
• Sampling bias refers to the systematic over- or underrepresentation of a population segment
on a characteristic relevant to the research question.

• As an example of consciously biased selection, suppose we were investigating patients’

responsiveness to nurses’ touch and decide to recruit the first 50 patients meeting eligibility
criteria. We decide, however, to omit Mr. Z from the sample because he has been hostile to
nursing staff. Mrs. X, who has just lost a spouse, is also bypassed.

• These decisions to exclude certain people do not reflect bona fide eligibility criteria. This can
lead to bias because responsiveness to nurses’ touch (the outcome variable) may be affected by
patients’ feelings about nurses or their emotional state.
Non-Probability Sampling
Question #3
• Tell whether the following statement is true or false:
• Probability sampling involves random selection of elements.
 Simple Random Sampling
• Simple random sampling is the most basic probability sampling design.

• In simple random sampling, researchers establish a sampling frame, the

technical name for the list of elements from which the sample will be chosen.

• Once a sampling frame has been developed, elements are numbered

consecutively.

• A table of random numbers

• computer-generated list of random numbers would then be used to draw a

sample of the desired size.
Coin flipping Toss Lottery Method

Random Number Table

 Simple Random Sampling

• Developing a sampling frame, numbering all elements, and selecting

elements are time-consuming chores, particularly if the population is
large.

• Although there is no guarantee that a random sample will be

representative, random selection ensures that differences in the
attributes of the sample and the population are purely a function of
chance.
 Stratified Random Sampling

• In stratified random sampling, the population is first divided into two or

more strata.

• Stratified sampling designs subdivide the population into homogeneous

subsets (e.g., based on gender or illness severity categories) from
which an appropriate number of elements are selected at random.
 Stratified Random Sampling

• 25 men (numbers 1 through 25) and 25 women (numbers 26

through 50).

• Using gender as the stratifying variable, we could guarantee a

sample of 10 men and 10 women by randomly sampling 10
numbers from the first half of the list and 10 from the second half.
 Stratified Random Sampling

• We might select participants in proportion to the size of the stratum in the population,

using proportionate stratified sampling.

• If the population was students in a nursing school that had 10% African American,

10% Hispanic, 10% Asian, and 70% white students, then a proportionate stratified

sample of 100 students, with race/ethnicity as the stratifying variable, would consist

of 10, 10, 10, and 70 students from the respective strata.

 Stratified Random Sampling
• For this reason, researchers may use disproportionate sampling
when comparisons are sought between strata of greatly unequal size.

• Stratified random sampling enables researchers to sharpen the

representativeness of their samples.

• When it is desirable to obtain reliable information about subpopulations

whose memberships are small, stratification provides a means of
including a sufficient number of cases in the sample by oversampling
for that stratum.
 Stratified Random Sampling
• For this reason, researchers may use disproportionate sampling when
comparisons are sought between strata of greatly unequal size.
• Stratified random sampling enables researchers to sharpen the
representativeness of their samples.
• When it is desirable to obtain reliable information about subpopulations
whose memberships are small, stratification provides a means of including
a sufficient number of cases in the sample by oversampling for that
stratum.
 Multistage/ Cluster Sampling
• Largescale surveys—especially ones
involving personal interviews—almost
never use simple or stratified random
sampling; they usually rely on
multistage sampling, beginning with
clusters.

• Cluster sampling involves selecting

broad groups (clusters) rather than
selecting individuals, and is typically the
first stage of a multistage approach.

• Clusters can be selected either by simple

or stratified methods. For instance, in
selecting clusters of nursing schools, it
may be advisable to stratify on program
type.
Systematic Sampling
 Systematic Sampling
• Systematic sampling involves selecting every kth case from a list )
sampling frame(, such as every 10th person on a patient list or
every 25th person on a student roster.

• Required sample size (n).

• The size of the population (N).

• By dividing N by n, the sampling interval width (k) is established.

• The sampling interval is the standard distance between sampled

elements.
Identify the starting point by simple random sampling
 Evaluation of Probability Sampling
• Probability sampling is the best method of obtaining representative samples.

• If all the elements in a population have an equal probability of being selected, then the
resulting sample is likely to do a good job of representing the population.

• Probability sampling allows researchers to estimate the magnitude of sampling error.

• Sampling error refers to differences between population values (such as the average
age of the population) and sample values (such as the average age of the sample).

• The great drawback of probability sampling is its impracticality.

Non-Probability Sampling
Convenience Sampling
• Convenience sampling entails using the most conveniently available
people as participants.

• A faculty member who distributes questionnaires to nursing students

in a class is using a convenience sample.

• A nurse is working at SMC and collecting data from H words at SMC

• Convenience samples do not necessarily comprise individuals known

to the researchers.
Snowball sampling
• Snowball sampling (also called network sampling or chain sampling) is a variant of
convenience sampling. With this approach, early sample members (called seeds) are asked to
refer other people who meet the eligibility criteria.

• This sampling method is often used when the population is people with characteristics who
might otherwise be difficult to identify (e.g., people who are afraid of hospitals).

• Snowballing begins with a few eligible participants and then continues on the basis of
participant referrals.
Quota Sampling
• A quota sample is one in which the researcher identifies
population strata and determines how many participants are
needed from each stratum.

• In this example, the convenience sample over-represents

women and under-represents men.

• We can, however, establish “quotas” so that the sample

includes the appropriate number of cases from both strata.
Consecutive Sampling
• Consecutive sampling involves recruiting all of the people from an accessible
population who meet the eligibility criteria over a specific time interval, or for
a specified sample size.

• For example, in a study of ventilator-associated pneumonia in ICU patients, if

the accessible population were patients in an ICU of a specific hospital, a
consecutive sample might consist of all eligible patients admitted to that ICU
over a 6-month period. Or it might be the first 250 eligible patients admitted
to the ICU, if 250 were the targeted sample size.
Consecutive Sampling
• Consecutive samples can be selected either for a retrospective or
prospective time period. For example, the sample could include every
patient who visited a diabetic clinic in the previous 30 days. Or, it could
include all of the patients who will enroll in the clinic in the next 30 days.
 Evaluation of Nonprobability
Sampling
• Nonprobability samples are rarely representative of the population.

• When every element in the population does not have a chance of being included in the
sample, it is likely that some segment of it will be systematically under-represented.

• When there is sampling bias, there is a chance that the results could be misleading,
and efforts to generalize to a broader population could be misguided.

• Nonprobability samples will continue to predominate, however, because of their

practicality
Sample Size in Quantitative Studies
• Power analysis

• Estimate sample size

• Large samples preferred to small samples

• Sample size basics

• Factors affecting sample size /requirements in quantitative research

• Effect size

• Homogeneity of the population

• Cooperation and attrition

• Subgroup analyses
Sample Size in Quantitative
Studies
Sample Size in Quantitative
Studies
• Power analysis

• Estimate sample size

• Large samples preferred to small samples

• Sample size basics

• Factors affecting sample size /requirements in quantitative research

• Effect size

• Homogeneity of the population

• Cooperation and attrition

• Subgroup analyses
Factors affecting sample size /requirements in quantitative research

• Power analysis builds on the concept of an effect size, which expresses the strength

of relationships among research variables. If there is reason to expect that the

independent and dependent variables will be strongly related, then a relatively small

sample may be adequate to reveal the relationship statistically.

• When there is no a priori reason for believing that relationships will be strong, then

small samples are risky.

Factors affecting sample size /requirements in quantitative research

• Homogeneity of the Population

• If the population is relatively homogeneous, a small sample may be adequate.

The greater the variability, the greater is the risk that a small sample will not
adequately capture the full range of variation.
Factors affecting sample size /requirements in quantitative research

• Cooperation and Attrition

• In most studies, not everyone invited to participate in a study agrees to do so.

Therefore, in developing a sampling plan, it is good to begin with a realistic,

evidence-based estimate of the percentage of people likely to cooperate. Thus,

if your targeted sample size is 200 but you expect a 50% refusal rate, you

would have to recruit 400 or so eligible people.

 Factors affecting sample size /requirements in quantitative research

• Subgroup Analyses

• Subgroup Analyses Researchers sometimes wish to test hypotheses

not only for an entire population, but also for subgroups. When a

sample is divided to test for subgroup effects, the sample must be

large enough to support analyses with such divisions of the sample.

Factors affecting sample size /requirements in quantitative
research

• Subgroup Analyses

• For example, we might be interested in assessing whether a structured

exercise program is effective in improving infants’ motor skills. After

testing the general hypothesis with a sample of infants, we might wish

to test whether the intervention is more effective for certain infants (e.g.,

low-birth-weight versus normal-birth-weight infants).

Implementing a Quantitative Sampling Plan
• Steps in sampling

• Identify the population

• Specify the eligibility criteria

• Specify the sampling plan

• Recruit the sample

• Sample recruitment

• Screening instrument

• Generalizing from samples

A screening instrument
• During the recruitment phase, it may be necessary to

develop a screening instrument, which is a brief interview

or form that allows researchers to determine whether a

prospective participant meets all eligibility criteria for the

study.
Critical Appraisal of Sampling Plans #1
• Sampling Plan

• Construct

• Internal factors

• External factors

• Statistical conclusion validity

 Critical Appraisal of Sampling Plans #1

• You should consider two issues in your critique of a study’s sampling plan. The first is whether the
researcher adequately described the sampling strategy.
• Ideally, research reports should include a description of the following:

• The type of sampling approach used (e.g., convenience, simple random)

• The study population and eligibility criteria for sample selection
• The number of participants and a rationale for the sample size, including whether a power analysis was
performed
• A description of the main characteristics of sample members (e.g., age, gender, medical condition, and so
forth) and, ideally, of the population
• The number and characteristics of potential participants who declined to participate in the study
 Critical Appraisal of Sampling Plans #2
• Sampling plan should be scrutinized with respect to
• Approach used
• Study population and eligibility criteria
• Number of participants and rationale for sample size
• Inclusion of power analysis
• Description of main characteristics of sample
• Number and characteristics of participants who declined
participation/dropped out
Thank you
 Chapter 14

Data Collection in
Quantitative Research
Learning Objectives
• Discuss the Data Collection Plan

• Discuss types of data collection methods

• Structured Self-report Instruments
• Structured Observation
• Bio-physiologic Measures
Data-Collection Methods

3
 Question #1

• Tell whether the following statement is true or false:

• For unstructured data, researchers use formal data collection

instruments that place constraints on those collecting data and
those providing them.
 Answer to Question #1
• False

• For structured data, not unstructured data, researchers use formal data
collection instruments that place constraints on those collecting data and
those providing them.
 Developing a Data Collection Plan
• Identifying data needs In quantitative studies, researchers may need data for the following purposes:
1. Testing hypotheses or addressing research questions. Researchers must include one or more measures of all key
variables.
2. Describing sample characteristics. Information should be gathered about major demographic (age, gender, race
or ethnicity, and education (or income). and health characteristics (severity, treatments, time since Diagnosis) of
the sample.
3. Controlling confounding variables. for analysis of covariance, variables that are statistically controlled must be
measured.
4. Analyzing potential biases. Collect data that help the researcher to identify potential biases (selection or attrition
biases).
5. Understanding subgroup effects. answer research questions for key subgroups of participants
6. Interpreting results. Researchers should try to anticipate alternative results.
7. Assessing treatment fidelity. monitor treatment fidelity and to assess whether the intended treatment was actually
received.
8. Assessing costs.
9. Obtaining administrative information.
 Developing a Data Collection Plan
• Selecting types of measures: The decisions must also be guided by ethical considerations, cost constraints,
availability of assistants to help with data collection. Data collection is often the costliest and most time-consuming portion of a
study.

• Selecting and developing instruments: researchers should determine if there are instruments available for
measuring study variables Additional factors that may affect your decisions in selecting an instrument are as follows:

1. Resources. Resource constraints sometimes prevent the use of the highest-quality measures.

2. Availability and familiarity. consider how readily available or accessible various instruments are.

3. Population appropriateness. Instruments must be chosen with the characteristics of the target population in mind.

4. Norms and comparisons. Norms indicate the “normal” values on the measure for a specified population

5. Administration issues. sometimes requires the skills of a professions.

6. Reputation. seek the advice of knowledgeable people, preferably ones with personal, direct experience using the instruments.
 Developing a Data Collection Plan
• Pretesting the data collection package is to see how much time it takes to administer the entire instrument
package. Pretests can serve many other purposes, including the following:

• Identifying parts of the instrument package that are difficult for participants to read or under- stand or that may have been
misinterpreted

• Identifying questions that participants find objectionable or offensive

• Assessing whether the sequencing of questions or instruments is sensible

• Evaluating training needs for data collectors

• Determining if the measures yield data with sufficient variability

• Developing data collection forms and procedures. It is prudent to design forms that are attractively
formatted, legible, and inviting to use, especially if they are to be used by participants themselves. Care should also be taken to
design forms to ensure confidentiality.
Question #2
• Tell whether the following statement is true or false:

• Open-ended questions permit respondents to reply in

narrative fashion.
Answer to Question #2
• True
• Open-ended questions permit respondents to reply in
narrative fashion, whereas closed-ended (or fixed-
alternative) questions offer response alternatives from which
respondents must choose.
Structured Self-Report Instruments
 Structured Self-Report Instruments

• Interview schedules: when questions are asked orally in face-to-face

or telephone interviews.

• Questionnaires or an SAQ (self-administered

questionnaire): when respondents complete the instrument themselves,
either in a paper-and-pencil format or on a computer.
Questionnaires

Interview schedules
Closed-ended questions Open-ended questions
Difficult to construct Easy to construct
Easy to analyze Difficult to analyze
To gain descriptive information researchers need the analysis of open-ended items is more
only tabulate the number of responses to each difficult and time-consuming. Researchers
alternative. essentially transform open-ended responses to
fixed categories in a post hoc fashion so that
tabulations can be made
Respondents can answer more closed- than open- Participants may be less willing to compose
ended questions in a given amount of written responses than to check off a response
Time. alternative
Drawback of closed-ended questions is the risk Open-ended questions
of failing to include key responses. Such allow for a richer and fuller perspective on a
omissions can lead to inadequate understanding topic, if respondents are verbally expressive and
of the issues or to outright bias if respondents cooperative. Some of this richness may be lost
choose an alternative that misrepresents their when researchers tabulate answers
position.
Closed-ended items is that they tend to be Open-ended questions give freedom to
superficial. Some people object to being forced respondents and, therefore, offer the possibility
to choose from response options that do not of spontaneity and elaboration.
reflect their opinions well.
 Open- and Closed-Ended Questions
• Open-ended questions allow people to respond in their own words, in narrative
fashion

• Questionnaires/interviews (“What was your biggest challenge after your surgery?”)

• Closed-ended answers may range from a simple yes or no to complex expressions of

opinion or behavior
 Closed-Ended Questions
• Dichotomous (Yes , No)
• Multiple choice
• Rank order
• Forced choice
• Rating
• Checklists
• Visual analog scales
Require respondents to make a choice
between two response alternatives.

Offer three or more response

alternatives.

Ask respondents to rank target

concepts along a continuum

Require respondents to choose between

two statements that represent polar
positions or characteristics

ask respondents to evaluate something

along an ordered dimension.
Question #3
• Which type of closed-ended questions have several
questions with the same response format?

A. Forced choice

B. Rating

C. Checklist

D. Visual analog scale

 Answer to Question #3
• C

• Forced-choice questions require respondents to choose between two competing

positions; rating questions ask respondents to make judgments along a bipolar
dimension; checklists have several questions with the same response format;
and visual analog scales (VASs) are continually used to measure subjective
experiences.
 Composite Scales and Other Structured Self-Reports

• Likert scale
• Summated rating scale
• Series of statements about a phenomenon
• Indicate degree of agreement or disagreement
• Total score is computed by summing item scores, each of which is scored for
the intensity and direction of favorability
 Composite Scales and Other Structured Self-Reports
• Cognitive and neuropsychological tests

• Intelligence: evaluate a person’s global ability to perceive relationships and solve problems
• Aptitude: measure a person’s potential for achievement
 Other Types of Structured Self-Reports:
Semantic Differentials
• Measuring attitudes

• Bipolar rating scales (Semantic Differential)

• Indicate reactions toward a phenomenon

• Measure
• Evaluative
• Activity
• Potency
 Other Types of Structured Self-Reports: Q Sort

• Participants are presented with a set of cards on which words or phrases are
written

• Sort a set of card statements into piles

• Specified criteria
• Measure
• Attitude
• Personality
• Psychological traits
Other Types of Structured Self-Reports: Vignettes

• Brief descriptions of the event

• Asked to react to events

• Assess respondents’
• Perceptions
• Hypothetical behaviors
• Decisions
Question #4
• Tell whether the following statement is true or false:

• Interviews are less costly and time-consuming than

questionnaires.
Answer to Question #4
• False

• Questionnaires are less costly and time-consuming than

interviews.
 Questionnaires Vs. Interviews #1
• Interviews
• Questionnaires
• Higher response rate
• Less costly
• Wider variety of people e.g.
• Possibility of anonymity children and illiterate

• No risk of interviewer bias • Clarity

• Depth of questioning
• Less missing information
• More supplementary data
 Designing Structured Self-Reports
• Related constructs should be clustered into separate modules or areas of questioning.

• The schedule should begin with questions that are interesting, motivating, and not too
sensitive.

• Well arranged to minimize bias.

• The introduction usually takes the form of an accompanying cover letter. It should be
carefully constructed because it is the first point of contact with potential respondents.

• a revised version of the instrument can be pretested. The pretest should be administered
to a small sample of individuals (usually 10 to 20) who are like actual participants.
 Tips for Wording Questions
• Clarity. Questions should be worded clearly and unambiguously.

• Ability of respondents to give information. Researchers need to consider whether

respondents can be expected to understand the question or are qualified to provide
meaningful information.

• Bias. Questions should be worded in a manner that will minimize the risk of response
biases.

• Sensitivity. Researchers should strive to be courteous, considerate, and sensitive to

respondents’ circumstances, especially when asking questions of a private nature.
 Tips for Wording Questions
• Avoid leading questions that suggest a particular answer. A question such as, “Do you
agree that nurse-midwives play an indispensable role in the health team?” is not
neutral.

• Avoid jargon or technical terms (e.g., edema) if lay terms (e.g., swelling) are equally
appropriate.

• State a range of alternatives within the question itself when possible. For instance, the
question, “Do you prefer to get up early in the morning on weekends?” is more
suggestive of the “right” answer than “Do you prefer to get up early in the morning or to
sleep late on weekends?”
 Tips for Wording Questions
• For questions that deal with controversial topics or socially unacceptable behavior (e.g.,
excessive drinking), closed-ended questions may be preferred.

• Impersonal wording of questions is sometimes useful in encouraging honesty. For

example,

• (1) “I am dissatisfied with the nursing care I received during my hospitalization,

• (2) “The quality of nursing care in this hospital is unsatisfactory.”

A respondent might feel more comfortable admitting dissatisfaction with nursing care in
the less personally worded second question.
 Tips for Preparing Response Options
• Response options should cover all significant alternatives. respondents should feel comfortable with the
available options. As a precaution, researchers often have as a response option a phrase such as “Other—
please specify.”

• Alternatives should be mutually exclusive. 30 years or younger <30 years

30-50 years 30- <50 years
50 years or older. 50 years and more

• Response options should be ordered rationally. Options often can be placed in order of decreasing or
increasing favorability, agreement, or intensity (e.g., strongly agree, agree…)

• Response options should be brief. One sentence or phrase for each option is usually sufficient to express a
concept. Response alternatives should be about equal in length.
 Tips for Formatting an Instrument
• Do not compress questions into too small a space.

• Set off the response options from the question or stem. Response alternatives are often aligned vertically In
questionnaires, respondents can be asked either to circle their answer or to check the appropriate box.

• Give care to formatting filter questions, which route respondents through different sets of questions
depending on the responses. In interview schedules, skip patterns instruct interviewers to skip to a specific
question for a given response (e.g., SKIP TO Q10). In SAQs, skip instructions can be confusing. It is often
better to put questions appropriate to a subset of respondents apart from the main series of questions, as
illustrated in Box 13.1, part B. An important advantage of CAPI, CATI, audio-CASI, and Internet surveys is
that skip patterns are built into the computer program, leaving no room for human error.
 Collecting Interview Data

• Interviewers for large survey organizations receive general

training in addition to specific training for each study.

• A primary task of interviewers is to put respondents at ease

so that they will feel comfortable in expressing their views

honestly.
 Collecting Interview Data
• Interviewers should always be punctual (if an appointment has been
made), courteous, and friendly.

• Interviewers should strive to appear unbiased and to create an

atmosphere that encourages candor.

• All opinions of respondents should be accepted as natural; interviewers

should not express surprise, disapproval, or even approval.
 Guidelines for Collecting Interview Data
• With a structured interview schedule, interviewers should follow question wording precisely.

• Interviewers should not offer spontaneous explanations of what questions mean. Repetition
of a question is usually adequate to dispel misunderstandings, especially if the instrument
has been pretested.

• Interviewers should not read questions mechanically. A natural, conversational tone is

essential in building rapport.

• Interviewers record answers to closed-ended items by checking or circling the appropriate

alternative, but responses to open-ended questions must be written out in full.

• Interviewers should not paraphrase or summarize respondents’ replies.

 Guidelines for Collecting Interview Data

• Some may say, “I don’t know” to avoid giving their opinions on sensitive topics or to
stall while they think over the question. In such cases, the interviewers’ job is to
probe to encourage a more complete response to open-ended questions by a
nondirective supplementary question, such as, “How is that?”.

• The purpose of a probe is to elicit more useful information than respondents

volunteered initially.

• A probe can take many forms; sometimes it involves repeating the question, and
sometimes it is a long pause
 Guidelines for telephone interviews

• Guidelines for telephone interviews are essentially the same as

those for face-to-face interviews, but additional effort usually is

required to build rapport over the telephone.

• Questionnaire Distribution Methods

• In-person distribution

• Mail distribution

• Internet surveys
 In-Person Distribution
• Advantages:
• Maximizes completed questionnaires
• Allows for immediate questions and clarifications

• Settings:
• Educational environments
• Clinical situations
 Individual Distribution
• Benefits:
• Positive impact on response rates
• Cost-effective in clinical settings
• Efficiency:
• High response rates possible through personal contact
 Collecting Data through the Mail
• Advantages:
• Cost-effective for broad populations
• Reaches geographically dispersed respondents
• Challenges:
• Typically low response rates
• Risk of bias with lower response rates
 Internet Surveys
• Cost-Effectiveness:
• Economical method for distribution
• Access to specific interest groups
• Distribution Methods:
• Email attachments
• Web-based forms
• Interactive Features:
• Respondents can receive feedback on their answers
• Enhanced motivation to participate
• Data Analysis:
• Directly amenable to analysis
Evaluation of Structured Self-Reports
• Structured questions can be carefully worded and rigorously pretested.

• Structured self-reports are susceptible to the risk of various response biases.

• Respondents may give biased answers in reaction to the interviewers’ behavior or

appearance.

• Social desirability response bias the tendency of some individuals to misrepresent

themselves by giving answers that are congruent with prevailing social values.

• Extreme responses reflecting consistent selection of extreme alternatives

• Acquiescence response set, some people have been found to agree with statements
regardless of content.
STRUCTURED
OBSERVATION
STRUCTURED OBSERVATION
• Structured observation is used to record behaviors, actions,
and events.

• Structured observation involves using formal instruments and

protocols that specify what to observe, how long to observe it,
and how to record information.

• The challenge of structured observation lies in formulating a

system for accurately recording observations.
STRUCTURED OBSERVATION
• Methods of Recording Structured Observations
Researchers recording structured observations typically
use either a checklist or a rating scale
 Specific types of closed ended quistions
• Checklist include several questions
with the same response format.
 Specific types of closed ended quistions
• Visual analog scale

are used to measure subjective experiences, such as pain,

fatigue, and dyspnea.
 Specific types of closed ended quistions

Visual analog scale

The VAS is a straight line, the end anchors of which are labeled as the extreme limits of the
sensation or feeling being measured. People are asked to mark a point on the line
corresponding to the amount of sensation experienced. Traditionally, the VAS line is 100
mm in length, which facilitates the derivation of a score from 0 to 100 through simple

measurement of the distance from one end of the scale to the person’s mark on the line.
 Methods of Recording Structured Observations: Checklists

• Structured observation is used to record behaviours, actions, and events.

• It involves using formal instruments and protocols that specify what to

observe, how long to observe it, and how to record information.

• The challenge of structured observation lies in formulating a system for

accurately recording observations.
 Sampling for Structured Observation: Sampling

• Time sampling involves the specification of the duration and

frequency of observational periods and intersession intervals.

• Event sampling selects integral behaviors or events of a special type

for observation.
 Evaluation of Structured Observation: Biases

• Enhancement of contrast effect observers distort observations in the direction of dividing content
into clear- cut entities.

• Central tendency extreme events are distorted toward a middle ground.

• Halo effect is the tendency of observers to be influenced by one characteristic in judging other, unrelated
characteristics.

• Assimilatory biases observers distort observations in the direction of identity with previous inputs.

• Errors of leniency is the tendency for observers to rate everything positively.

• Errors of severity is the contrasting tendency to rate too harshly.

Bio-physiologic
measurs
 Types of biophysiologic measurs
• In vivo are performed directly in or on living organisms, measures of oxygen saturation, blood pressure, and body
temperature.

• In vitro is performed outside the organism’s body, as in the case of measuring serum potassium concentration in the
blood.

• Selecting a biophysiological measures considerations.

• Necessary equipment available?
• Difficult to secure permission?
• Will a single measure of outcome be sufficient?
• Will measures be influenced by reactivity?
• Are safety precautions familiar?
 Biomarkers: Evaluation
• Advantages

• Accurate/precise/objective

• Valid measures of variables

• Disadvantages

• Cost

• Measuring tools affect variables

• Biomarkers may be damaged

• Varying lab protocols

• Biased norm values

 Physical Performance Tests

• Patients’ abilities and skills are sometimes measured with performance tests.

• 6-mile walk test

 Implementing a Data Collection Plan
• Considerations to keep in mind when selecting research
personnel
• Experience Research staff ideally have had prior experience collecting data
• Congruency data collectors should match participants with respect to racial or
cultural background and gender.

• Appearance Data collectors should not wear anything that conveys their political,
social, or religious views.

• Personality Data collectors should be pleasant (but not effusive), sociable (but not
overly talkative), and nonjudgmental (but not unfeeling about participants’ lives).

• Training
 Data Extracted From Records
• Needed
• Trained abstractors
• Abstractors blinded to the study
• Explicated records inclusion and exclusion criteria
• Defined variables of interest
• Unambiguous guidelines
• Clear-cut rules
• Frequent accuracy checks
• Verification by random sampling
 Guidelines
• Is the selected tool is standardized
• Name of the author and year
• Name and Type of the instrument
• Details about the instrument such as no. of items, domains or sub-
categories, scoring and interpretation of the tools
• The validity and reliability (r-0.7 to 0.9) of the tools
• Check for the appropriateness of the tools related to the research questions
Thank you
 Ethical issues in Research

NUR505: Advanced Nursing Research and Evidence-based Practice

November 2024
 Learning Objectives
1. Explore the historical overview about ethical issues in Research

2. Discuss the Ethical Research Guidelines

3. Identify the functions of Institutional Review Boards

4. Formulate the Informed Consent

5. Analyze the Integrity in Research

6. Recognize the Guidelines for Nurses

 Historical Overview
• During 1942 and 1943, World War II prisoners’ wounds were
deliberately infected with bacteria. Sulfanilamide was then given to
these prisoners to determine the effectiveness of this drug. Some
subjects died, and others suffered a serious injuries.

• In1944, photographs and body measurements were taken of 112

Jewish prisoners. They were then killed, and their skeletons
defleshed. One purpose of this study was to determine if
photographs of live human beings could be used to predict skeletal
size. (Nuremberg Military Tribunals, 1949).
 Unethical Research in the United States
• One of the most widely known unethical studies was carried
out in 1932 in Macon County, Alabama, The study was titled
“Tuskegee Study of Untreated Syphilis in the Negro
Male.” of the 600 black male subjects, 399 had syphilis, and
201 did not have the disease. Subjects with active cases
were given no treatment. Even after penicillin was accepted
as the treatment of choice for syphilis in 1945, subjects were
still given no treatment.
 Historical Overview
• From 1963 to 1966, a group of children diagnosed with mental
retardation were deliberately injected with the hepatitis virus in
Willowbrook State Hospital on Staten Island, New York. The
researchers defended the project by proposing that the vast
majority of the children would acquire the infection anyway
while at Willowbrook and that it would be better for them to
acquire the disease under carefully controlled conditions.
They then tried to treat them with gamma globulin antibodies.
 Ethical Research Guidelines
• Ethics is concerned with the rules and principles of human
behaviour.

OR

• Deals with the “rightness” or “wrongness” of human behaviour.

• Founding Principles of Ethical Research

• The present ethical standards used in nursing research, and in

research conducted by other disciplines, are based on the
guidelines developed after World War II.
 Nuremberg Code (1947)
• This code seeks to ensure that several criteria for research are met,
including the following: An international effort to establish ethical
standards.

1. Potential subjects must be informed about the study.

2. The research must be for the good of society.

3. Animal research should precede research on humans, if possible.

4. An attempt must be made by the researcher to avoid injury to research

subjects.

5. The researcher must be qualified to conduct research.

6. Subjects or the researcher can stop the study if problems occur.

 The Belmont Report – 1979
Three basic ethical principles:
• Principles related to research subjects are:
1. Respect for Persons. Research subjects should have
autonomy and self-determination.
2. Beneficence. Research subjects should be protected from
harm.
3. Justice. Research subjects should receive fair treatment.
 Codes of Ethics in Nursing Research
• American Nurses Association (ANA) issued Ethical Guidelines in the Conduct,
Dissemination, and Implementation of Nursing Research (Silva, 1995).

• Revised Code of Ethics for Nurses with Interpretive Statements (ANA, 2015).

• Ethical Research Guidelines for Registered Nurses (Canadian Nurses Association, 2002).

• Most countries have developed their own professional codes.

• International Council of Nurses (ICN), however, has developed the ICN Code of Ethics
for Nurses, updated in 2012.

• Code of Professional Conduct (NHRA, 2020).

 Code of Professional Conduct (NHRA, 2020)
Duties in Clinical Trials:

• Ensure you participate in research approved by the NHRA and other appropriate research ethics committees only.

• Inform the patients clearly that they are participating in research and not receiving the standard of care or an
unapproved modality of treatment.

• Provide the potential participants with enough information about the trial to aid them in making an informed decision
about their acceptance or refusal to being enrolled into the given trial.

• Ensure all participants sign an informed consent form prior to being enrolled into the trial.

• Inform trial participants about their right to withdraw from the trial at any time without prejudice to their ongoing
health care services.

• Inform trial participants about unanticipated risks that occur during the trial and access their willingness to continue in
the trial.
 Ethical Dilemmas in Conducting Research
• There are situations in which participants’ rights and study demands are in direct conflict, posing ethical dilemmas for
researchers.

• Does a new medication prolong life in patients with AIDS?

• Are nurses equally empathic in their treatment of male and female patients in the ICU?

• What are the coping mechanisms of parents whose children have cancer?

• What is the process by which adult children adapt to the day-today stresses of caring for a parent with
Alzheimer’s disease.

During ethical dilemmas the codes of ethics have been developed to guide researchers’ efforts.
Question 1: What are the Ethical principles that
protects the study participants?
Answer:

• Beneficence- It imposes a duty on researchers to minimize harm and maximize benefits.

This principle covers multiple aspects such as A) Right to Freedom from Harm
((nonmaleficence) and Discomfort (physical, emotional, social or financial. B) Right to
Protection from Exploitation.

• Respect for Human Dignity- It includes the right to self-determination and the right to
full disclosure.

• Justice- The participants’ right to fair treatment and their right to privacy
 Procedures for protecting study participants
• Risk/Benefit Assessments

• Informed Consent and Participant Authorization

 Institutional Review Boards
• An institutional review board (IRB) is an administrative body that is established to
review and approve research that is intended to study human subjects under the auspices
of the institution with which the board is affiliated.
 Institutional Review Boards
• Human subjects are defined as “living individual(s) about whom an investigator
conducting research obtains

(1) data through intervention or interaction with the individual,

(2) identifiable private information”

• Note that the use of the term research subjects is decreasing. In today’s literature, you
may see the terms participants, respondents, and informants.
 Attributes associated with
clinical research with human subjects
(a) a proposal to develop new knowledge

(b) a plan for a protocol or intervention that is specifically defined and that may provoke
minimal physical, psychological, or emotional risk as well as the risk of confidentiality to
the participants

(c) an analysis that depends on a comparison between the participants in the study

(d) a potential benefit to society in general

(e) an intervention that can inform future practices

(f) results are to be published through a peer-reviewed process (Ogrinc et al., 2013).
 Informed Consent
(a) The principal means for ensuring that the rights of research participants are protected is
through the process of informed consent.

(b) Informed consent concerns a participant’s participation in research in which they have a
full understanding of the study before the study begins.
 Elements of Informed Consent
1. A statement that the study involves research with an explanation of the purposes of the
research

2. a description of the procedures to be implemented, and the duration of the participant’s

activities

3. A description of any foreseeable risks or discomforts

4. A description of any benefits to the subject or to others

5. A disclosure of appropriate alternative procedures that might help the participant, in the
case of a study with therapeutic interventions
 Elements of Informed Consent
6. A statement describing how the confidentiality of the participant’s records will be
maintained

7. An explanation of how unforeseeable injuries will be handled

8. An explanation of whom to contact for answers to questions relevant to the study

9. A statement that participation is voluntary and that refusal to participate or the

prerogative to withdraw
In experimental studies in which people
will receive certain treatments.

While informing the participant of

the purpose or the objectives of the
study, the researcher should
clearly present the information
and all printed material in the
participant’s language and reading
level. It is not always necessary to
describe the entire nature of the
study.

w h e n a n d w h e r e ?
 Debriefing

• Subjects have the right to be fully informed at

the conclusion of the study during debriefing,
and to be given an opportunity to withdraw
consent for their data to be included in the
study results. Debriefing involves a meeting
with research participants that ensures their
understanding of the reasons and justification
for the procedures that were used in the study.
 Description of
Unforeseeable
Risks
• No more than minimal risks are involved in the
study.

• Investigator is obligated to try to identify all

possible risks or discomforts (either physical or
psychological)

• Any invasion of privacy must also be discussed.

• One of the roles of IRBS is to assess the

adequacy of consent forms.
 Plans for
Unforeseeable
Injuries
• For research that involves more than minimal
risk, there should be an explanation of what
the participant would expect if an injury
related to the study occurs. This type of
information would include whether or not the
participant would be entitled to monetary
compensation or medical treatments. The
extent of compensation and medical treatments
should also be identified.
 Description of
Benefits
• Describe both those benefits are applicable to
participants as well as how the results could
benefit others.
• To control for biased responses, participants
are usually not told which of the comparison
products is the focus of the study.
• In nursing research, the researcher should
avoid monetary compensation, if possible.
• It is acceptable for the researcher to cover the
cost of such items as laboratory tests and
travel expenses for the participant
 • Potential subjects should be informed of any alternative procedures that
Disclosure of may be followed, such as “You may fill out the questionnaire here or take it
Appropriate home.
Alternative • The researcher tells the control group that the experimental treatment
Procedures will be available to them upon completion of the study.

• The subjects in the experimental group could also be offered this

alternative or routine treatment at the conclusion of the study.
 Description of Maintenance of Confidentiality or Anonymity
• Anonymity occurs when no one, including the researcher, can link subjects with the data they
provide. If subjects can be linked to data, the researcher has the obligation to address confidentiality.

• Confidentiality

• Involves the protection of the subjects’ identities by the researcher.

• To maintain confidentiality, data are coded, and subjects’ names and code numbers are kept in a separate
location that is accessible only to the research team.

• Confidentiality can be assured by the deletion of any identifying information that would allow subject
identification.

• Subjects should always be assured that they are free to omit information from their responses.
 Contact Information for Questions Relevant to the Study
• Prior to receiving informed consent, it is important for researchers to identify
themselves and describe their qualifications to conduct the study.

• “I am a nursing student at _____ University and am conducting a research study as part

of the requirements for _____.”

• The researcher is obligated to be available (by phone, postal mail, or email) if

questions arise at a later time, or if subjects have questions

• Research subjects should always be given the opportunity to obtain the study results.
 Assurance of Freedom to Volunteer for or Withdraw from the Study
• All participation in nursing research must be voluntary. No form of coercion should be
involved. There must be no penalty involved for nonparticipation.

• Potential research subjects must also be informed that they may withdraw from a study
at any time, and for any reason. This is particularly important in experimental studies
in which a treatment is involved.
Documentation of
Informed Consent
 Documentation of Informed Consent

When the participant signs an IRB-approved written

Sign an IRB-approved consent form that states that the *participant has willingly
written consent given permission and is aware of the risks and benefits of
the study*.
The statement should be included on the questionnaire in
Self report questionnaire capital letter as *RETURN OF THIS QUESTIONNAIRE
WILL INDICATE YOUR CONSENT TO PARTICIPATE
IN THIS STUDY*

Assent to participate in the If the subject is a minor or is not able to give informed
study. consent because of mental or physical disability.

Assent should be documented by a legally authorized

representative, such as a child’s parent.
Who sign the assent?
 Vulnerable Populations
• Children
• Mentally or emotionally disabled people
• Severely ill or physically disabled people
• Geriatric clients
• Prisoners
• Homeless
• People with AIDS
• Unconscious
• Sedated patients.
• Assent considerations
❖An underage child or adolescent freely chooses to participate in a study
 Building Ethics into the Design of the Study
Examples of Questions for Building Ethics into a Study Design
RESEARCH DESIGN:
• Will participants get allocated fairly to different treatment groups?
• Will steps to reduce bias or enhance integrity add to the risks participants will incur?
• Will the setting for the study protect against participant discomfort?
INTERVENTION:
• Is the intervention designed to maximize good and minimize harm?
• Under what conditions might a treatment be withdrawn or altered?
SAMPLE:
• Is the population defined so as to unwittingly and unnecessarily exclude important segments of people (e.g., women or
minorities)?
• Will potential participants be recruited into the study equitably?
DATA COLLECTION:
• Will data be collected in such a way as to minimize respondent burden?
• Will procedures for ensuring confidentiality of data be adequate?
• Will data collection staff be appropriately trained to be sensitive and courteous?
REPORTING:
• Will participants’ identities be adequately protected?
 Integrity in Research
Research misconduct can occur at any stage of the research
Research misconduct project from the time of submission of the proposal to
dissemination of the findings (Bierer & Barnes, 2014)

Fierz et al. (2014) also discovered a lack of published

Misconduct (RM) examples of research misconduct (RM) in the field of nursing
science. The authors described the major forms of RM as
data fabrication, data falsification, and plagiarism.

Assent to participate in the Authorship issues relate to the criteria that qualify a person
study. to be included as an author in the publications associated
with the research. (credited to another person).

Other forms of misconduct: inappropriate management of data; publication-related

misconduct; failure to disclose conflicts of interest
 Data Fabrication, Data Falsification, and Plagiarism
• Data fabrication refers to making up data for the purpose of deception

• Data falsification refers to the willful distortion of the results of the study or the

reported collection of the data (Fierz et al., 2014).

• Plagiarism refers to the near or verbatim copying of texts or ideas without identifying

the original source of the citation (Fierz et al., 2014).

 Conflicts of Interest
• Conflicts of interest (COI) in research may occur when nurses receive payments from
companies that also sponsor their research (Lach, 2014).

• When the research is associated with the use of a company’s product, there is a risk that
this type of relationship could create a bias.

• There are situations where researchers may want to conduct a study in which their own
patients will be the subjects. In this case, the researcher must approach the research
setting as a complete stranger to use patients’ charts for data collection.
 Research Guidelines for Nurses
1. In 1968, the American Nurses Association (ANA) Research and Studies
Commission published a set of guidelines for nursing research. These guidelines,
revised in 1975 and 1985, are titled *Human Rights Guidelines for Nurses in Clinical
and Other Research*.

2. Later in 2015, the ANA published the Code of Ethics for Nurses with Interpretative
Statements. Provision 3.2 of the document on Protection of Human Participants in
Research stems from concerns related to the principles of respect for autonomy,
respect for persons, and respect for self-determination (ANA, 2015).
• The code affirms that the research nurse’s role as a patient advocate should include

assurances of the fulfillment of human rights through the process of ongoing informed

consent, continual assessment of risk versus benefit for research participants, and the

prevention of harm.
 Nurse Researcher as a Patient Advocate
1. In cases in which research nurses assist clinicians to run clinical trials, they have a
central role as patient advocates (Pick, Berry, Gilbert, & McCaul, 2013).

2. Nurses should consider protecting the interests of the patients who have agreed to be
in the studies (Pick et al., 2013).

3. Nursing advocacy entails an ethical obligation to also evaluate the participant’s

understanding of the study.
 Nurse Researcher as a Patient Advocate
4. Nurse who is in dual roles of healthcare provider and the researcher must be especially
careful of risks associated with conflicts of interest between the participant’s care and
the needs of the research intervention (Bristol & Hicks, 2014).

5. Nurses who are not a part of the research team should also familiarize themselves
with any clinical trials that are being conducted in their work setting.
 Guidelines for Critique the Ethical Aspects of a Study
• Was the study is approved by an institutional Review board?

• Were participants subjected to any physical harm, discomfort, or psychological distress?

• Did the researchers take appropriate steps to remove, prevent, or minimize harm?

• Was informed consent obtained from the subjects?

• Is there information about provisions for anonymity or confidentiality?

• Were vulnerable subjects used?

• Does it appear that subjects might have been coerced into acting as subjects?
 Guidelines for Critique the Ethical Aspects of a Study
• Was the study is approved by an institutional Review board?
• Was informed consent obtained from the subjects?
• Is there information about provisions for anonymity or confidentiality?
• Were vulnerable subjects used?
• Does it appear that subjects might have been coerced into acting as subjects?
• Is it evident that the benefits of participation in the study outweighed the risks involved?
• Were subjects provided the opportunity to ask questions about the study and told how to
contact the researcher if other questions arose?
• Were the subjects told how they could obtain the results of the study?
 College of Health & Sport Sciences
Nursing Department

Chapter 20
Qualitative Research Design
and Approaches
PG. 2024-25
 Objectives
By the end of the lecture, student will be able to:
• Define qualitative research and its purpose in studying human experiences and
social contexts.
• Identify essential features of qualitative research, such as flexibility, naturalistic
settings, and focus on participants' perspectives.
• Summarize the key traditions in qualitative research, including ethnography,
phenomenology, and grounded theory.
• Explore the purpose, methods, and applications of ethnography and
phenomenology in qualitative research.
• Apply criteria to evaluate the rigor and trustworthiness of qualitative studies in
health and sport sciences.
 Introduction to Qualitative Research

•Definition: Qualitative research involves exploring phenomena in their natural

settings, aiming to make sense of or interpret phenomena in terms of the meanings
people bring to them.
•Evolving Nature: Unlike quantitative research, qualitative research design is emergent
and adapts as the study progresses.
•Participant Viewpoints: The focus is on understanding realities and viewpoints of
participants rather than predefined hypotheses.
•Emergent Design: Allows researchers to base their inquiry on participants' realities,
which may not be known at the outset.
 Characteristics of Qualitative Research Design

•Triangulation: Combining multiple data collection strategies (e.g., interviews,

observations, and document analysis) to ensure comprehensive understanding.
•Flexibility: Adaptability to new insights and evolving contexts during data
collection.
•Holistic Approach: Striving to understand the entire phenomenon in context.
•Researcher Involvement: Researchers actively engage as primary instruments
in data collection and analysis.
•Iterative Analysis: Ongoing analysis helps refine data collection strategies
and decide when saturation is achieved.
 Qualitative Design and Planning

•Importance of Planning:
• Provides flexibility for emergent designs while avoiding constraints.
•Advanced Preparation Includes:
• Selecting a broad framework or tradition (e.g., phenomenology, ethnography).
• Identifying time ad resource constraints to ensure realistic study scope.
• Developing strategies to enhance data trustworthiness (e.g., triangulation,
member checking).
• Collecting preliminary site materials (e.g., maps, organizational charts).
• Reflecting on potential biases and their impact on the study.
 Overview of Qualitative Research Traditions

•Traditions by Discipline:
• Anthropology: Ethnography explores cultural patterns and shared
meanings.
• Psychology: Phenomenology focuses on lived experiences and
meanings.
• Sociology: Grounded Theory investigates social processes and
constructs theories based on data.
Overview of Qualitative Research Traditions
 Overview of Qualitative Research Traditions

Anthropology: Ethnography and Ethnoscience

•Ethnography studies cultural patterns and experiences holistically.

Example: Leininger (1991) conducted an ethnographic study to explore the cultural practices and

beliefs surrounding health and illness among the Gadsup people of Papua New Guinea. By immersing

herself in the community, Leininger gathered insights into how cultural values influenced healthcare

behaviors and nursing care, helping to develop the field of transcultural nursing.

•Ethnoscience (Cognitive Anthropology) focuses on the cognitive world of a culture, emphasizing semantic

rules and shared meanings that shape behavior.

Example: Hirst (2002) used ethnoscientific methods to define resident abuse as perceived by nurses in

long-term care settings, focusing on linguistic symbols and "folk terms."

 Ethnography
Core Aspects of Ethnography:
1.Definition:
1. Ethnography describes and interprets cultural behavior.
2. It combines fieldwork (learning through immersion) and a written text (communicating
insights).
2.Types of Ethnography:
1. Macroethnography: Broad cultural studies (e.g., an entire village).
2. Microethnography: Focused studies on smaller groups or specific activities (e.g., nurse-
patient interactions in an emergency room).
3.Perspectives:
1. Emic Perspective: Insider’s view; how members of a group see their world.
2. Etic Perspective: Outsider’s interpretation; the researcher’s analytical view.
Ethnography

Core Aspects of Ethnography:

4. Fieldwork:
•Involves prolonged engagement with the group being studied.
•Employs participant observation, where researchers actively participate
while observing.
5. Data Sources:
•Observations, interviews, records, artifacts, photographs, and diaries.
6. Key Informants:
•Trusted members of the group who help interpret cultural practices.
 Ethnography
Variants of Ethnography:
1.Ethnonursing Research:
Focuses on culturally specific nursing practices and care behaviors.
Example: Aga et al. (2009) studied Ethiopian family caregivers of HIV/AIDS patients,
identifying themes of nourishment, hygiene, comfort, and sacrifice.
2.Institutional Ethnography:
Explores how organizational and social processes shape experiences.
Example: Riley and Manias (2006) examined time management in operating rooms.
3. Autoethnography:
Researchers study their own culture or group.
Example: Schneider (2005) explored how mothers of adults with schizophrenia discuss
their children, using her personal experience as a mother.
 Overview of Qualitative Research Traditions

Phenomenology and Hermeneutics

•Phenomenology has roots in both philosophy and psychology, focusing on the
meaning of lived experiences of humans.
Example: Smith (2010) explored the lived experiences of individuals with chronic pain, focusing
on how they interpreted and made sense of their condition, highlighting themes of isolation and
resilience.
•Hermeneutics uses lived experiences to better understand the social, cultural, political, or
historical context, with a focus on meaning and interpretation.
Example: Johnson (2015) examined Indigenous elders' interpretations of historical trauma, using
their narratives to understand the broader social and historical impact of colonization on cultural
identity.
 Phenomenology

•Philosophical Roots: Developed by Husserl and Heidegger,

phenomenology aims to understand the essence of people’s lived
experiences.
•Essence: Refers to the core, invariant structure of a phenomenon, which
makes it what it is.
•Key Questions: "What is the essence of this phenomenon as
experienced by these people?" and "What does it mean?“
•Applications: Useful for poorly understood phenomena, such as
suffering, chronic pain, or domestic violence.
 Phenomenology

Aspects of Lived Experience

•Lived Space (Spatiality): How individuals experience their physical surroundings.
•Lived Body (Corporeality): Awareness of being in the world through the body.
•Lived Time (Temporality): The subjective experience of time.
•Lived Human Relation (Relationality): Interpersonal connections.

Data Collection and Analysis

•In-depth conversations are the primary method for data collection.
•Researchers strive to enter participants' worlds to fully understand their experiences.
•A small sample size (typically fewer than 10 participants) is common.
•Analysis often involves multiple interviews, introspective reflection, and synthesizing
participants’ perspectives.
 Phenomenology

Variants of Phenomenology:
1- Descriptive Phenomenology (Husserl)
•Goal: Describe phenomena as they are experienced.
•Key Steps:
• Bracketing: Set aside preconceived notions to approach the data without bias.
• Intuiting: Remain open to participants’ meanings.
• Analyzing: Extract and categorize essential meanings.
• Describing: Define and articulate the essence of the phenomenon.
•Example: Flinck and Paavilainen (2010) explored women’s perceptions of their violent
behavior in partnerships.
 Phenomenology

Variants of Phenomenology:
2- Interpretive Phenomenology (Hermeneutics)
•Focus: Understanding and interpreting lived experiences.
•Philosophical Basis: Rooted in Heidegger’s question, "What is being?"
•Hermeneutic Circle: Researchers understand the whole of a text by examining its parts
and vice versa.
•Bracketing: Not emphasized; researchers acknowledge their prior knowledge and
interpret through their own lens.
•Example: Ellett et al. (2009) studied fathers’ experiences with colicky infants, describing
the shared family struggle.
 Overview of Qualitative Research Traditions

Human Ethology and Ecological Psychology

•Human Ethology studies behavior as it evolves in its natural context using
observational methods.
•Example: Spiers (2006) used ethological methods to study pain-related
interactions between patients and home-care nurses.
•Ecological Psychology explores the influence of the environment on human
behavior and examines the interdependence of humans and their environmental
contexts.
•Example: Robertson et al. (2007) used an ecological framework to study Latino
construction workers’ experiences with occupational noise and hearing protection.
 Overview of Qualitative Research Traditions

Grounded Theory, Ethnomethodology, and Symbolic Interactionism

• Grounded Theory seeks to describe and understand key social psychological and structural
processes in social settings.
Brown (2018) conducted a grounded theory study to explore how nurses in intensive care units manage
emotional stress. The research identified key processes like emotional detachment, team support, and coping
mechanisms as strategies used by nurses to maintain professional resilience in high-stress environments.
• Ethnomethodology aims to discover how people make sense of everyday activities and interpret
their social worlds.
Example: Ozeki (2008) studied transcultural stress among Japanese mothers in the UK using an
ethnomethodologic approach.
• Symbolic Interactionism focuses on how people interpret social interactions and social symbols,
such as language. Semiotics, a related area, studies signs and their meanings.
Example: Giarelli (2006) conducted a semiotic analysis of editorial cartoons related to cloning and stem cell
research.
 Overview of Qualitative Research Traditions

Sociolinguistics: Discourse Analysis

• Discourse Analysis seeks to understand the rules, mechanisms, and structures

of conversations and texts. The analysis is often based on transcripts from

naturally occurring conversations.

Example: Plumridge et al. (2009) used conversation analysis to examine

partnership and collaboration between nurses and parents during children’s

vaccinations.
 Overview of Qualitative Research Traditions

Historical Research

• Historical Research systematically collects and evaluates data related to past

occurrences, relying primarily on qualitative data. Historical research methods

have been used to study various phenomena in nursing.

Example: Lewenson (1993) conducted a historical research study to examine the role of

nursing during the American Civil War. By analyzing letters, diaries, and official documents

from the 1860s, the study provided insights into the contributions of nurses and how their

efforts shaped the early development of professional nursing in the United States.
 Overview of Qualitative Research Traditions

OTHER TYPES OF QUALITATIVE RESEARCH “Case Studies”

•Definition: In-depth exploration of a single entity or a small number of entities (e.g.,

individuals, groups, organizations).
•Strengths and Limitations:
• Provides rich, detailed insights but may lack generalizability.
Data Sources in Case Studies
•Case studies use a wide range of data, such as:
• Interviews
• Observations
• Documents
• Artifacts
 Overview of Qualitative Research Traditions

OTHER TYPES OF QUALITATIVE RESEARCH “Case Studies”

Types of Case Study Designs

1- Single-case, Holistic Design:
•Focuses on a single case and examines its overall context.
•Appropriate when:
• Testing a theory: It is used as a critical case to evaluate a well-formulated theory.
• Unique or extreme cases: When the case is rare or presents extreme characteristics.
• Representative cases: When the case is a typical example of a phenomenon.
• Revelatory cases: Provides new insights into a previously inaccessible or unexplored situation.
• Longitudinal cases: Follows a single case over time to track changes.
2- Single-case, Embedded Design:
•Focuses on a single case but examines multiple units of analysis (subunits).
•Allows a more detailed understanding of sub-elements within the case.
3- Multiple-case, Holistic Design:
•Involves examining multiple cases, each in a holistic manner, focusing on the global nature of each case.
4- Multiple-case, Embedded Design:
•Examines multiple cases and includes multiple units of analysis within each case, focusing on subunits for
a deeper understanding.
 Overview of Qualitative Research Traditions

OTHER TYPES OF QUALITATIVE RESEARCH “Narrative Analysis”

Narrative analysis focuses on understanding how people make sense of their lives and
experiences by constructing stories. The core idea is that stories serve as a way for individuals
to link their inner world of desires and motivations with the external world of observable
actions. Researchers analyze both the form and content of these stories, asking questions like,
“Why was the story told that way?”
 Overview of Qualitative Research Traditions

OTHER TYPES OF QUALITATIVE RESEARCH “Narrative Analysis”

Key Structural Approaches to Narrative Analysis

1.Gee's Linguistic Approach (1996):
1. Focuses on the oral tradition and analyzes how the story is told, including:
1. Pitch, loudness, stress, and syllable length.
2. Hesitations, pauses, and sentence cohesion.
2. Stories are organized into stanzas and strophes, which are analyzed to understand how
the themes are communicated.
3. Example: Crepeau (2000) used Gee’s approach to analyze stories told by a
geropsychiatric team about a patient named Gloria during team meetings.
 Overview of Qualitative Research Traditions

OTHER TYPES OF QUALITATIVE RESEARCH “Narrative Analysis”

Key Structural Approaches to Narrative Analysis
2- Labov and Waletzky’s Social Approach (1967):
•Narratives consist of six components:
• Abstract: Summary of the story.
• Orientation: Time, place, and individuals.
• Complicating Action: Sequence of events.
• Evaluation: Significance of the action.
• Result or Resolution: What occurred at the end.
• Coda: Return to the present perspective.
•Narratives vary based on the social context in which they are told.
•Example: Montgomery et al. (2009) analyzed postpartum depression stories from 27 Canadian
women using this approach.
 Overview of Qualitative Research Traditions

OTHER TYPES OF QUALITATIVE RESEARCH “Narrative Analysis”

Key Structural Approaches to Narrative Analysis
3- Burke’s Pentadic Dramatism (1969):
•Focuses on five key elements of a story:
• Act: What was done.
• Scene: When/where it was done.
• Agent: Who did it.
• Agency: How it was done.
• Purpose: Why it was done.
•Analysis focuses on the tensions and imbalances between these elements.
•Bruner (1991) added a sixth element: "Trouble", to address imbalances in the narrative.
•Example: Beck (2006) analyzed birth trauma stories using Burke’s pentad. A key imbalance was
the act vs. agency, with women perceiving childbirth as traumatic due to how the medical staff
performed certain actions.
Research With Ideological Perspectives
 Research With Ideological Perspectives

1- Critical Theory
•Origins: Emerged from the Frankfurt School of Marxist scholars in the 1920s.
•Purpose: Critical researchers aim to critique society, identify contradictions, and promote social change. The
goal is to create awareness about societal issues and inspire action to transform them.
•Approach:
• Rejects the idea of an objective researcher.
• Focuses on action-oriented research that promotes self-reflection and sociopolitical action.
• Often involves a critique of assumptions, language, and biases in research.
• Critical ethnography is a form of critical theory, emphasizing emancipation and social change by
addressing historical, social, and political power dynamics.
•Example: Gardezi et al. (2009) conducted a critical ethnography to explore the dynamics of
communication and power between physicians and nurses in an operating room in Canada.
 Research With Ideological Perspectives

2- Feminist Research
•Focus: Gender, domination, and discrimination, especially in patriarchal societies.
•Goal: To challenge gender inequalities and address the invisibility and distortion of female experiences.
•Approaches:
• Feminist empiricism: Works within standard qualitative inquiry but focuses on more accurate
representations of women’s lives.
• Feminist standpoint research: Begins with women’s lived experiences and emphasizes the
privileged position of women’s views.
• Feminist postmodernism: Challenges the concept of absolute truth, viewing the world as multiple
narratives.
•Methods:
• In-depth, collaborative, and interactive interviews.
• Focus on ethical research that prioritizes trust and non-exploitative relationships.
Example: Van den Tillaart et al. (2009) used feminist methods to explore Canadian women’s experiences
with mental health diagnoses and their interactions with healthcare systems.
 Research With Ideological Perspectives

3- Participatory Action Research (PAR)

•Origins: Stems from the work of Kurt Lewin in the 1940s and focuses on action research.
•Purpose: PAR aims to empower marginalized groups by involving them in the research process.
The goal is not just knowledge production but also action and consciousness raising.
•Approach:
• Researchers and participants collaborate on defining the research problem, selecting
methods, analyzing data, and applying findings.
• Methods can include traditional interviews and observations but also more creative
techniques such as storytelling, sociodrama, and art to explore participants’ experiences.
•Example: Nomura et al. (2009) conducted a 5-year PAR project in Japan to empower older
adults with early dementia and their caregivers, through collaboration at individual, group, and
community levels.
Guidelines for Critiquing Qualitative Designs
 References

McKenna, L., & Copnell, B. (2020). Fundamentals of nursing and midwifery research: A

practical guide for evidence-based practice (2nd ed.). Routledge, Taylor & Francis.

Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence

for nursing practice (11th ed.). Wolters Kluwer Health.

Thank You
 College of Health & Sport Sciences
Nursing Department

Chapter 22
Data Collection in
Qualitative Research
PG. 2024-25
 Objectives
By the end of the lecture, student will be able to:
1.Define the key concepts of Evidence-Based Practice (EBP).
2.Describe the hierarchy of evidence and apply it to clinical decision-making.
3.Demonstrate the ability to follow the steps of the evidence-based practice
process
4.Formulate clinical questions using the PICO(T/S) framework and identify relevant
evidence sources.
5.Recognize the different models of EBP and explain the Iowa model of EBP.
6.Identify common barriers to apply EBP.
7.Understand the role of nurses as key contributors to the implementation of EBP
 Introduction

Adaptability: In qualitative research, data collection is often fluid and evolves as researchers

engage with participants. Researchers might need to explore unanticipated directions based on

early findings.

Creativity in Approach: A great example is Irwin and Johnson (2005), who used creative

methods like drawing and role-playing to build rapport with 6-year-old children in health

interviews. This approach helped make the participants comfortable and increased the quality of

data.

Setting Flexibility: Selecting an appropriate setting for interviews may also require thinking

outside the box, adapting to participants' needs, and overcoming environmental challenges.
 Types of Data for Qualitative Studies

Common Methods: Interviews: The primary method for collecting qualitative data,
particularly in phenomenology and grounded theory studies.
•Observation: Essential in ethnographic research and complements interviews.
•Cultural Products: Ethnographers may analyze documents, records, artifacts, and
photographs to understand the studied culture.
Role of Researchers: Phenomenologists build relationships to gain rich descriptions of
experiences.
•Grounded theorists process and analyze data to develop theoretical categories.
•Ethnographers act as participant-observers, balancing active involvement with an
outsider’s perspective.
Comparison of Data Collection Issues in Three Qualitative Traditions
 Field Issues in Qualitative Studies

a. Gaining Trust
•Trust is essential in qualitative research and often requires researchers to align with
participants’ norms and behaviors without losing professional boundaries.
•Balancing Act: Researchers must avoid aligning too closely with influential figures in the
group, as this could alienate others.
b. The Pace of Data Collection
•Data collection in qualitative research can be exhausting, especially when studying
sensitive topics (e.g., illness or domestic violence). Researchers need to pace their work,
limit interviews, and decompress through activities like exercise or discussions with
colleagues.
 Field Issues in Qualitative Studies

c. Emotional Involvement
•A challenge called "going native" arises when researchers become too emotionally attached
to participants. While empathy is essential, it is crucial to maintain objectivity, avoid
personal interventions, and instead guide participants toward appropriate resources.
d. Reflexivity
Reflexivity involves self-awareness about how a researcher’s presence, biases, and
perspectives may influence data collection and interpretation.

Example: Egerod (2009) reflected on her motives and preconceptions during interviews with
Danish physicians on ICU sedation. She systematically acknowledged how her context
shaped the construction of knowledge.
 Recording and Storing Data

a. Recording Interviews:
•Preferred Methods: Audio and video recordings ensure accuracy. Taking detailed
notes is less reliable and can distract the interviewer from active listening.
•Challenges: Background noise, interruptions (e.g., toddlers playing or a fussy baby),
and technical issues can complicate recordings.

b. Observational Notes:
•Observational data should be recorded immediately after the session, either as
detailed notes or through video recordings. These notes are essential for analysis and
interpretation.
 Recording and Storing Data

c. Grounded Theory Memos:

•Researchers in grounded theory studies write analytic memos to
document and reflect on emerging ideas and themes.

d. Data Security:
•In the field, securing data can be problematic. Researchers often carry
data physically (e.g., in a bag) until it can be safely stored. Proper
labeling of materials is essential.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

1. Unstructured Interviews
•Purpose: These interviews are conversational and exploratory, allowing participants to
share their stories with minimal interruption.
•Characteristics:
• Suitable when researchers lack preconceived notions about the topic.
• Begins with broad, open-ended questions (e.g., "What happened when you first
learned you had AIDS?").
• Subsequent questions evolve naturally based on participant responses.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

1. Unstructured Interviews
A- Phenomenological Interview Techniques (Van Manen, 1990):
• Describe the experience from the inside (feelings, emotions, mood).
• Focus on vivid or first-time examples of the experience.
• Attend to sensory details (how things looked, sounded, smelled).
B- Hermeneutic Phenomenology (Kahn, 2000):
• Ongoing Experience: Ask about daily life (e.g., "Pick a normal day and tell me what happened.").
• Past Experience: Start with reflective questions like, "What does this experience mean to you?" and
probe for detailed descriptions
Examples: Rice (2009): Studied violence among women with schizophrenia through unstructured
interviews with case managers. Initial question: "I am interested in hearing your experiences as a case
manager who works with women diagnosed with schizophrenia and live with violence."
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

1. Unstructured Interviews
C- Grounded Theory Interviews
•Purpose: To develop a theory grounded in participants' narratives.
•Characteristics:
• Initial stages involve open-ended, unstructured interviews to gather broad narratives.
• As theory emerges, questions become more focused and related to theoretical categories.
• Interviews become shorter as researchers ask targeted questions.
•Key Insight (Glaser & Strauss, 1967): Researchers initially "sit back and listen" before steering
interviews toward specific categories.
 QUALITATIVE SELF-REPORT TECHNIQUES
Types of Qualitative Self-Reports
1. Unstructured Interviews
D- Ethnographic Interviews
•Purpose: To explore cultural and social practices within a group.
•Types of Questions (Spradley, 1979):
• Descriptive Questions: Ask participants to narrate their experiences in their language (e.g.,
"How would you describe quality in your ICU work?").
• Structural Questions: Explore categories or domains of experience (e.g., "Can you describe
how you organize your shift?").
• Contrast Questions: Highlight differences in meaning (e.g., "Can you give an example of a
time when the quality of your work was not as good as usual?").
•Examples:
• Storesund and McMurray (2009): Studied nursing practices in an Australian ICU using
descriptive, structural, and contrast questions.
 QUALITATIVE SELF-REPORT TECHNIQUES
Types of Qualitative Self-Reports
1. Unstructured Interviews
E-Unstructured Internet Interviews
•Purpose: To gather qualitative data from participants who are geographically distant or prefer online
communication.
•Characteristics:
• Participants share narratives through digital communication (e.g., emails).
• Allows for detailed, reflective responses.
•Examples:
• Beck (2009): Conducted an online phenomenological study of mothers caring for children with
brachial plexus injuries. Participants were asked to describe their caregiving experiences in
detail via email.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

2. Semi-structured Interviews

Semistructured interviews strike a balance between structured and unstructured methods,

allowing researchers to cover specific topics while still encouraging participants to share

freely. This method is particularly useful when researchers have a clear idea of the areas to

explore but remain open to unexpected insights.

 QUALITATIVE SELF-REPORT TECHNIQUES
Types of Qualitative Self-Reports
2. Semi-structured Interviews
Characteristics of Semistructured Interviews
1.Planned Structure:
1. Researchers use a written topic guide to ensure that all relevant areas are addressed during
the interview.
2. Questions are typically organized in a logical sequence (e.g., chronological or general to
specific).
2.Flexibility in Response:
1. While the researcher controls the topics, participants have the freedom to provide detailed,
narrative responses.
2. Interviewers must adapt to participants’ natural flow of conversation, allowing for deeper
exploration when new insights emerge.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

2. Semi-structured Interviews
Characteristics of Semistructured Interviews
3. Use of Probes:
1. Interviewers use prompts to encourage elaboration (e.g., “What happened next?” or “How did
you feel when that occurred?”).
2. Probes ensure comprehensive and rich data collection.
4. Avoiding Close-Ended Questions:
1. Questions requiring simple “yes” or “no” answers are avoided to encourage detailed
explanations and storytelling.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

2. Semi-structured Interviews
Advantages of Semistructured Interviews
•Comprehensive Coverage: Ensures that critical topics are discussed while remaining open
to participants’ unique perspectives.
•Depth of Insight: Encourages detailed and illustrative responses, providing a richer
understanding of the phenomenon.
•Consistency: Standardization of topics ensures comparability across participants without
sacrificing flexibility.

Example of a Semistructured Interview

•Study: Arnaert et al. (2010) explored how a retreat weekend helped cancer patients' relatives
heal.
•Participants: Eight relatives who attended the retreat.
•Questions:
• "How did you experience the retreat weekend?"
• "What is your perception of the concept of healing?"
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

2. Semi-structured Interviews
Guidelines for Conducting Semistructured Interviews
1.Designing the Topic Guide:
1. Identify key areas relevant to the research objectives.
2. Organize questions logically to facilitate a natural conversational flow.
3. Include suggested probes to elicit deeper responses.
2.Conducting the Interview:
1. Begin with open-ended, general questions to build rapport.
2. Use the topic guide as a flexible framework, adapting to participants’ responses.
3. Listen attentively and probe when needed to clarify or expand on responses.
3.Analyzing Data:
1. Look for recurring themes and patterns across participants.
2. Consider both expected and unexpected insights.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

3. Focus Group Interviews
Focus group interviews involve a group of 5 or more people discussing specific topics under
the guidance of a moderator, using a pre-prepared set of questions or topics.
Characteristics:
1.Group Dynamics:
1. Group interaction fosters deeper insights as participants react to each other’s
viewpoints.
2. Homogeneity in the group (e.g., similar age or background) promotes comfort and
openness.
2.Session Logistics:
1. Optimal group size: 6–12 participants (smaller groups for sensitive topics).
2. Neutral, comfortable settings are essential.
3. Sessions are typically recorded for later analysis.
3.Moderator Role:
1. Ensures equal participation and avoids dominance by vocal members.
2. Uses a structured questioning route, moving from general to specific questions.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

3. Focus Group Interviews

Advantages:
•Efficient collection of multiple perspectives.
•Stimulates richer expressions of opinion.
Challenges:
•Some participants may hesitate to express themselves in a group.
•Group dynamics may lead to “groupthink.”
Example:
•Wu et al. (2010): Conducted focus groups with Chinese children (aged 7–18) with leukemia
to study cancer-related fatigue. A sample question was, “Could you describe what it feels like
to be tired and lacking in energy?”
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

4. Joint Interviews

Joint interviews involve two or more intimately connected individuals (e.g., couples, family
members) to understand relational dynamics or shared experiences.
Characteristics:
1.Participants:
1. Respondents are intimately related, unlike focus groups with unrelated members.
2. Can provide insights into relational dynamics.
2.Format:
1. May use unstructured or semistructured formats.
2. Usually supplements individual interviews to explore topics not discussed in front of
the other party.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

4. Joint Interviews

Advantages:
•Captures interaction dynamics.
•Offers a shared perspective on events or phenomena.
Challenges:
•Respondents may withhold critical information in the presence of others.
Example:
•Chang & Mu (2008): Conducted joint interviews with ten married couples in Taiwan to
explore family stress during ovarian hyperstimulation treatment. Questions included, “Tell me
how you felt during your/your wife’s admission to the hospital?”
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

5. Life Histories
A method where participants narrate their life experiences, often in chronological order, to
provide insights into cultural or social patterns.
Characteristics:
1.Process:
1. May take months to collect.
2. Researchers provide minimal guidance, focusing on participants' narrations.
2.Additional Data Sources:
1. Observation, interviews with family/friends, letters, or photographs often supplement
life histories.
Example:
•Patching & Lawler (2009): Used a life history approach to study recovery experiences of 20
women with eating disorders.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

6. Oral Histories
Oral histories collect personal recollections of events, focusing on themes rather than
individual experiences, to connect personal stories with broader social contexts.
Characteristics:
1.Focus:
1. Investigates specific historical events or experiences.
2. Can involve multiple participants or repeated interviews with one person.
2.Approach:
1. Typically uses unstructured interviews.
2. Often used in feminist and historical research.
Example:
•Dunlop et al. (2009): Examined the oral histories of Canadian nurses providing anesthesia in
the early 20th century.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

7. Critical Incidents
The critical incidents technique focuses on specific, observable episodes of behavior that had
a significant positive or negative impact on an outcome.
Characteristics:
1.Specificity:
1. Focuses on detailed accounts of specific incidents.
2. Participants act as “expert witnesses” of their experiences.
2.Scope:
1. Multiple incidents are collected from a smaller number of participants.
Advantages:
•Focused data collection targeting key behaviors or events.
Example:
•Donohue & Endacott (2010): Investigated nurses’ perceptions of managing patient
deterioration in acute wards using the critical incidents technique.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

8. Diaries and Journals
Personal diaries provide an intimate and detailed description of everyday life. They can be
unstructured (e.g., writing daily thoughts) or semi-structured (e.g., focusing on specific
experiences like sleep patterns or appetite).
•Advantages:
Offers insights into ongoing experiences. Audio-recorded diaries can help participants with
lower literacy skills.
•Limitations:
Requires high participant cooperation and is limited to those with adequate literacy skills.
•Example:
• Egerod and Christenson (2009): Analyzed 25 patient diaries maintained by critical
care nurses in Denmark. The analysis identified three stages of the ICU experience:
crisis, turning point, and normalization.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

9. Think-Aloud Method
Collects data on cognitive processes such as decision-making and problem-solving by having
participants verbalize their thoughts during tasks. Can be used in naturalistic or simulated
settings.
Advantages:
Helps analyze real-time decision-making sequences in context.
Limitations:
Participants may alter behavior when verbalizing thoughts, and follow-up interviews may be
necessary for clarification.
Example: Hoffman et al. (2009): Compared novice and expert nurses in their use of cues for
making clinical decisions about postoperative ICU care.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

10. Photo Elicitation Interviews

Involves interviews guided by photographic images to stimulate discussion. Images can be

researcher-provided, participant-owned, or participant-created (e.g., photovoice).
Advantages:
Breaks down barriers between researchers and participants and provides cultural insights.
Limitations:
Using participant-provided photos limits the researcher’s ability to frame questions.
Example: Fleury et al. (2009): Hispanic women took photographs of resources for engaging
in physical activity using disposable cameras to explore cultural and contextual influences.
 QUALITATIVE SELF-REPORT TECHNIQUES

Types of Qualitative Self-Reports

11. Self-Report Narratives on the Internet

Gathers narrative data online through structured/semi-structured interviews, chat rooms, or

blogs. Existing unsolicited messages can also be analyzed.
Advantages:
Cost-effective, geographically inclusive, and reaches remote populations.
Limitations:
Ethical concerns, authenticity issues, and methodological challenges.
Example: Hall and Irvine (2009): Analyzed email messages from 40 mothers participating in
a Canadian online support group for mothers of infants and toddlers.
 Gathering Qualitative Self-Report Data

I) Preparing for the Interview

Purpose: To ensure the interview is purposeful and aligned with participants’ worldviews.

Key Steps:
✓ Develop broad or initial questions thoughtfully.
✓ Understand the vocabulary, culture, or nuances of the group studied.
✓ Conduct practice interviews.
✓ Plan sensitive questions for later in the interview.
✓ Decide on how to present yourself (e.g., as a nurse, researcher, or learner).
✓ Choose an appropriate interview setting, allowing participants to decide where possible
(e.g., home, office, or remote).
✓ Use new technologies like video conferencing for accessibility and added visual context.

Example: Sevean et al. (2009): Used hour-long video interviews to study patients’ and families’
experiences with telehealth in rural northern Canada.
 Gathering Qualitative Self-Report Data

II) Conducting the Interview

Key Practices:
✓ Prepare respondents with small talk and ease their stage fright, especially when recording.
✓ Build trust and rapport through concern, interest, and nonverbal communication.
✓ Be a good listener, avoid interruptions, and adapt follow-up questions based on respondents’
narratives.
✓ Manage strong emotions with care and be prepared for potential crises or distractions.
✓ Positively close the interview with open-ended questions (e.g., "Is there anything else you'd
like to share?").

Challenges:
✓ Recording failures, interruptions, and emotional disclosures.
✓ Potentially rescheduling interviews due to interruptions or sensitive circumstances.
 Gathering Qualitative Self-Report Data

III) Post-Interview Procedures

Steps for Quality Assurance:

✓ Review recordings promptly for audibility and completeness.
✓ Take immediate notes to preserve reliability.
✓ Critique personal interviewing style for improvement.
✓ Ensure rigorous transcription by experienced transcribers, with checks for accuracy.
✓ Support transcribers when handling emotionally charged interviews.

Key Consideration:
✓ Maintaining the integrity of the data by capturing nuances such as pauses, laughter, and
speech volume.
 Unstructured Observation

Unstructured observation involves collecting observational data with minimal pre-structuring, aiming to
understand behaviors and experiences as they naturally occur. It is often used to complement self-reported
data in qualitative research, offering insights into behaviors within their naturalistic context.
Key Features
1.Participant Observation:
1. Researchers engage in the activities of the group being studied.
2. Observation occurs within the sociocultural and political contexts relevant to participants.
3. Prolonged, immersive interaction is typical.
Example: Rasmussen et al. (2010) studied breast cancer survivors at a rehabilitation center, observing their
physical and social interactions.
2- Nonparticipant Observation:
1. Observers do not actively participate in group activities.
2. Focuses on recording behaviors from an outsider's perspective.
Example: Martinsen et al. (2009) observed assisted feeding of spinal cord injury patients to understand
"sensitive cooperation."
 Unstructured Observation

Observer-Participant Roles in Participant Observation

1. Leininger and McFarland’s Four Phases:

1. Phase 1: Observation and active listening to gain a broad view.

2. Phase 2: Observation with limited participation to enhance understanding.

3. Phase 3: Active participation combined with observation for deeper insights.

4. Phase 4: Reflection and reconfirmation of findings with informants.

 Unstructured Observation

Observer-Participant Roles in Participant Observation

2- Junker’s Continuum:
•Complete Participant: Fully integrated into the group, identity as a researcher is
concealed.
•Participant as Observer: Active participation with transparency about the research role.
•Observer as Participant: Limited participation while primarily observing.
•Complete Observer: Observes from the outside with no group interaction.

Example: Dupuis-Blanchard et al. (2009) studied social engagement among seniors by

observing their environment and engaging in low-key participation during events.
 Unstructured Observation

Advantages
1.Captures natural behaviors and interactions.
2.Provides context-rich data.
3.Facilitates understanding of cultural assumptions and group dynamics.
Challenges
1.Role Balance: Managing dual roles as a participant and observer can be complex.
2.Access and Trust: Establishing rapport and gaining trust within the group is critical.
3.Ethical Concerns: Concealed observation may raise ethical issues.
4.Time-Consuming: Requires prolonged engagement and reflection.
Guidelines for Critiquing Unstructured Data Collection Methods
 References

McKenna, L., & Copnell, B. (2020). Fundamentals of nursing and midwifery research: A

practical guide for evidence-based practice (2nd ed.). Routledge, Taylor & Francis.

Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence

for nursing practice (11th ed.). Wolters Kluwer Health.

Thank You
 College of Health & Sport Sciences
Nursing Department

Chapter 23
Qualitative Data Analysis
PG. 2024-25
 Objectives
By the end of the lecture, student will be able to:
1. Understand of the fundamental principles of qualitative data management, including the
importance of organizing, categorizing, and storing qualitative data effectively.
2. Explore various strategies and tools for organizing qualitative data, such as coding, categorization,
and indexing, to make data accessible and manageable for analysis.
3. Learn how to identify and organize emerging themes and categories in qualitative data, helping to
facilitate the analysis process and ensure coherence in findings.
4. Apply various qualitative data analysis methods (e.g., thematic analysis, grounded theory, and
phenomenological analysis)
5. Understand the importance of reflexivity and creativity in the interpretation of qualitative data
6. Learn to critically evaluate qualitative studies by assessing the rigor, validity, and ethical
considerations of data collection, analysis, and interpretation processes.
 Introduction

Qualitative analysis aims to organize data, provide structure, and extract meaning to
understand the phenomena under study. Unlike quantitative methods, qualitative analysis
integrates data collection and analysis processes.

Key Challenges:
1.Lack of Universal Rules:
1. No standardized procedures for analysis.
2. Difficulty in explaining or replicating analytical processes.
2.Labor-Intensive Workload:
1. Requires scrutinizing large volumes of narrative data through repeated readings.
2. Balancing depth of insight with conciseness when presenting findings.

Process Overview:
1.Active Engagement:
1. Iterative and reflective engagement with data to uncover patterns, themes, and meanings.
2. A blend of conjecture and verification, guided by creativity and sensitivity.
2.Data Reduction:
1. Identifying key themes while retaining the richness and authenticity of data.
2. Ensuring evidentiary value in reporting findings.
 Qualitative Data Management And Organization

I) Transcribing Qualitative Data

Effective transcription is foundational for qualitative data analysis. Key considerations include:
1. Accuracy and Verbatim Reflection:
1. Verbatim transcription is essential, capturing all speech elements such as pauses,
intonation, and nonlinguistic utterances.
2. Common transcription errors include:
1. Deliberate Alterations: Intentional "tidying" like omitting profanities or verbal fillers.
2. Accidental Alterations: Misinterpretation of words or punctuation that changes
meaning.
3. Unavoidable Alterations: Omissions of nonverbal cues, such as body language or
tone, due to format limitations.
 Qualitative Data Management And Organization

I) Transcribing Qualitative Data

2. Training and Feedback:
Researchers must collaborate with transcriptionists to establish:
1.Conventions for inaudible sections.
2.Guidelines for emotional or complex material.
3.Notation preferences for clarity and consistency.
 Qualitative Data Management And Organization

II) Developing a Category Scheme

This stage involves organizing data into manageable units for analysis:
1. Data Organization
•Objective: To reduce large sets of data into smaller, manageable units.
•Method: Classify and index data in a way that key parts can be
retrieved without needing to reread everything.
 Qualitative Data Management And Organization

II) Developing a Category Scheme

2. Developing a Category Scheme
•Preliminary Scheme: Sometimes researchers develop an initial template before data
collection, but more often the scheme is developed after analyzing the data.
•Categories: These are based on concepts identified in the data. The process involves:
• Close reading of the data to identify clusters and underlying concepts.
• Detail and specificity: Categories can range from concrete to abstract,
depending on the goals of the research.
 Qualitative Data Management And Organization

II) Developing a Category Scheme

3. Descriptive Categories
•Concrete Focus: In descriptive studies, the categories tend to be
specific and concrete, often focusing on actions, events, or experiences.
Example: Perry and colleagues (2008) identified categories like barriers
and motivators for women in a walking program. Barriers were further
divided into subcategories such as balancing family, chronic illness, and
routine disruptions.
 Qualitative Data Management And Organization

II) Developing a Category Scheme

4. Conceptual Categories
•Abstract Focus: In studies aiming to develop a theory, categories are more conceptual and
abstract.
•Method: Researchers segment the data, compare segments for similarities and differences, and
try to discern meanings behind those phenomena. This involves asking:
• What is this?
• What is going on?
• What does it stand for?
•Example: Beck (2006) created a coding scheme with abstract categories to analyze data from
interviews about birth trauma anniversaries. One category labeled “plagued with distressing
thoughts and emotions” was used to code data describing feelings of dread.
 Qualitative Data Management And Organization

II) Developing a Category Scheme

5. Labeling Categories

•Importance of Labels: Labels should be clear, sufficiently descriptive,

and sometimes provocative to capture the essence of the category.

•Process: Abstract concepts are identified and labeled, forming the

foundation for the category scheme.

 Qualitative Data Management And Organization

III) Coding Qualitative Data

A process that involves reading and re-reading the data to ensure it
accurately corresponds to the developed categories.
1. Initial Coding Process
•Reading the Data: Once the category scheme is developed, the researcher reads through the
entire data set and assigns codes corresponding to the categories.
•Challenges:
• Ambiguity: Sometimes it's hard to determine the best code for a piece of data.
• Understanding: The underlying meaning of some segments may not be immediately clear
and could require multiple readings.
•Nuances: It often takes two or three readings to fully capture the nuances of the material.
 Qualitative Data Management And Organization

III) Coding Qualitative Data

2. Emerging Categories
•Incomplete Categories: As the researcher codes, new categories may emerge that
weren’t part of the initial template.
•Revisiting Previous Data: If a new category is discovered, it’s important not to
assume it was absent from the material that has already been coded. The researcher
must go back and recheck the previously coded data to ensure it fits into the new
category.
•Complexity of Adjustments: While making changes midway can be frustrating, it's
crucial to build a comprehensive and accurate category system.
 Qualitative Data Management And Organization

III) Coding Qualitative Data

3. Non-Linear Data Structure
•Multitopic Segments: In narrative data, such as interview transcripts,
segments of text often address multiple categories. A single paragraph
may touch on several themes or concepts.
•Example: In Beck’s (2006) study on the anniversary of birth trauma, a
segment of an interview might contain elements that correspond to
three or four different codes.
 Qualitative Data Management And Organization

III) Coding Qualitative Data

4. Ensuring Coding Consistency
•Single-Coder Approach: It is sometimes recommended that a single
person codes the entire data set to ensure consistency.
•Inter-Coder Reliability: At least part of the data should be coded by
two or more people early in the process to check for consistency, which
helps enhance coding reliability.
Qualitative Data Management And Organization
 Qualitative Data Management And Organization

IV) Manual Methods of Organizing Qualitative Data

Although computer software for managing qualitative data has become
more prevalent, traditional manual methods are still sometimes used,
especially in smaller-scale studies or when researchers prefer a hands-
on approach.
 Qualitative Data Management And Organization

IV) Manual Methods of Organizing Qualitative Data

1. Color-Coding with Paper Clips or Post-It Notes
•Simple Category Systems: This method is useful when the category system is simple and
manageable. Researchers use different colored paper clips or Post-It Notes to code specific
sections of text.
•Example:
• Blue clips for text related to loss of fertility.
• Red clips for text about menopausal side effects.
• Yellow clips for aging-related concerns.
•Process: Once all text is marked with appropriate colored clips or notes, researchers can pull
out all the sections with a certain color to focus on one specific issue or category.
 Qualitative Data Management And Organization

IV) Manual Methods of Organizing Qualitative Data

2. File Card System (Phenomenological Research)

•Physical Organization: In phenomenological research, researchers often use a file

card system. Significant statements from interviews or narratives are written on

individual file cards.

•Sorting by Themes: The file cards are sorted into piles representing different themes,

making it easy to review material related to each theme. Different colored cards may

be used for data from different participants.

 Qualitative Data Management And Organization

IV) Manual Methods of Organizing Qualitative Data

3. Conceptual Files
•File Folder System: In this method, researchers create a separate physical file for
each category or concept. Each file contains excerpts from the data that correspond to
that category.
•Process:
• Initial Reading: Researchers read through the entire dataset, marking relevant
sections with codes in the margins.
• Cutting the Data: After coding, the data is physically cut up into excerpts
corresponding to each category. These are then filed in the appropriate folder.
 Qualitative Data Management And Organization

IV) Manual Methods of Organizing Qualitative Data

4. Challenges
Multiple Codes: If a section of text corresponds to multiple categories, researchers must create
multiple copies of that excerpt, each labeled with a different code.
Contextual Understanding: The cut-up excerpts should be accompanied by enough context to
understand their meaning (e.g., surrounding material that helps explain the excerpt).
Administrative Information: Each excerpt should include relevant administrative information
(e.g., participant ID number) to track its source and retrieve additional data if necessary.
 Qualitative Data Management And Organization

V) Computer Programs for Managing Qualitative Data (CAQDAS)

Computer-assisted qualitative data analysis software (CAQDAS) has become essential
in managing qualitative data, offering numerous benefits over traditional manual
methods. These tools allow researchers to manage and analyze large volumes of text-
based data more efficiently, without the need for physically cutting up narrative
materials. While software can aid in coding, organizing, and retrieving data, it does not
perform the actual coding or provide analysis on its own—these tasks still require
critical thinking from the researcher.
 Qualitative Data Management And Organization

V) Computer Programs for Managing Qualitative Data (CAQDAS)

Main Types of CAQDAS
CAQDAS can be categorized into several types, each with specific functions:
1.Text Retrievers
1. These programs help researchers locate specific text or terms within a dataset or
document. They serve as search engines for qualitative data, enabling quick access to
relevant sections of text.
2.Code-and-Retrieve Software
1. These packages allow researchers to code text and later retrieve all the relevant excerpts
associated with specific codes. The coding process remains with the researcher, but the
software streamlines the process of sorting and retrieving data based on predefined
codes.
 Qualitative Data Management And Organization

V) Computer Programs for Managing Qualitative Data (CAQDAS)

Main Types of CAQDAS
3. Theory Building Software
•This is the most commonly used type of CAQDAS. It helps researchers build theories by
enabling them to:
• Examine relationships between concepts.
• Develop hierarchies of codes.
• Create diagrams and visual representations.
• Construct hyperlinks to build non-hierarchical networks.
•Examples of theory-building software include:
• ATLAS/TI
• HyperRESEARCH
• MaxQDA
• NVivo8 (from Qualitative Solutions and Research [QSR]), which combines features from
two earlier packages (NVivo2 and NUD*IST 6) to help researchers identify patterns and
analyze relationships within their data.
 Qualitative Data Management And Organization

V) Computer Programs for Managing Qualitative Data (CAQDAS)

Main Types of CAQDAS
4. Concept Mapping Software
Concept mapping software is used to create diagrams that represent knowledge by
illustrating concepts and the relationships between them. Unlike theory-building
software, concept mapping programs allow for more advanced and visual
representations.
•An example of concept mapping software is CmapTools (CmapTools | Cmap), which
is available at no cost for educational and non-profit organizations.
 Qualitative Data Management And Organization

V) Computer Programs for Managing Qualitative Data (CAQDAS)

Main Types of CAQDAS
Data Conversion/Collection Software
•This type of software converts audio into text, such as voice recognition programs that
transcribe spoken language into written text. This is particularly useful for transcribing audio
recordings of interviews.
•Voice Recognition Software: Requires training for recognizing a specific speaker's voice. The
software is trained by having the transcriptionist speak into the system for several hours to
improve accuracy. However, the software does not automatically handle punctuation and often
requires manual corrections.
•Despite the time-saving potential of voice recognition, some challenges exist, including misinterpretation of
homonyms and the need for subsequent editing to correct errors (e.g., confusion between "hear" and "here,"
or "to" and "too").
 Qualitative Data Management And Organization

V) Computer Programs for Managing Qualitative Data (CAQDAS)

Advantages:
•Efficiency: CAQDAS saves time and effort by automating the retrieval and organization of data.
•Advanced Analysis: Researchers can perform more complex analysis, such as exploring
relationships between concepts, creating diagrams, and identifying patterns across large
datasets.
•Flexibility: CAQDAS allows for easy modifications, such as re-coding data or adjusting the
category system, without the labor-intensive process of physically re-sorting files.
•Storage and Accessibility: Digital data is easier to store and retrieve, and researchers can
easily access and analyze large amounts of data.
 Qualitative Data Management And Organization

V) Computer Programs for Managing Qualitative Data (CAQDAS)

Disadvantages:
•Loss of Proximity to Data: Some researchers argue that using software can make the
research process feel more mechanical and less intuitive, distancing them from a close
engagement with the data.
•Potential Over-reliance on Technology: Critics worry that researchers may rely too
heavily on the software for analysis, forgetting that the tool can only assist in the
process, not replace critical thinking and interpretation.
 Qualitative Data Analytic Procedures

Reductionism vs. Constructionism:

Reductionist Approach: Qualitative data management involves reducing large datasets into smaller,
manageable units.
Constructionist Approach: Analysis involves constructing meaning by grouping data into patterns or
categories.
Thematic Analysis:
•Themes: Themes are abstract entities that unify meanings from the data. They are central to understanding
experiences and can be identified through principles like similarity (finding commonalities) and contrast
(highlighting differences).
•Thematic analysis requires both across-case and within-case analyses to ensure a comprehensive
understanding of experiences. It also necessitates recognizing how themes may vary between participants or
contexts.
Qualitative Data Analytic Procedures
Dynamic and Iterative Process:

• The process of identifying themes is iterative, meaning that researchers refine

their themes as they revisit the data. New insights or refinements often emerge
as the analysis progresses.

• Researchers may abandon initial concepts if they no longer fit with the data. An
example is the abandonment of the "dance" metaphor in a study of family
caregivers, as it no longer represented the complexity of interactions between
caregivers and patients.
 Qualitative Data Analytic Procedures

Tools for Analyzing and Displaying Data:

• Charting and Visualization: Tools like flowcharts, timelines, and two-dimensional

matrices help display the relationships and evolution of themes and data points over time.

• Timelines: Useful for studies involving dynamic experiences, such as the decision-making
process, to illustrate key moments and factors influencing decisions.

• Matrices: These can help organize data by participants or themes, and spreadsheets are
often used for sorting and analysis.
 Qualitative Data Analytic Procedures

Refining Themes and Patterns:

• Identifying themes and categories is rarely linear and often involves constant iteration.
Researchers must revisit their data with the emerging themes in mind and refine them
based on new insights.

• The process may also include abandoning early conceptualizations that no longer seem
to fit as the analysis progresses.

Use of Metaphors:

• Metaphors can serve as an analytic strategy, offering deeper insights into human
experience. However, they should be used cautiously to avoid oversimplification or
distortion of complex phenomena.
 Qualitative Data Analytic Procedures

Validation:

• Validation ensures that the themes accurately represent participants' perspectives.

Researchers may use investigator triangulation, where multiple researchers
collaborate to minimize biases.

• Quasi-statistics, such as frequency counts of recurring themes, can also help

validate findings, though they differ from statistical frequencies in survey studies.

Final Integration:

• The final step in qualitative analysis is weaving themes into an integrated whole. This stage requires
creativity and intellectual rigor to ensure that the data forms a coherent, overarching structure (e.g.,
theory or integrated description).
 Qualitative Data Analytic Procedures

Qualitative Content Analysis:

1. Content analysis involves breaking down data into smaller units, coding them, and grouping
them based on shared concepts.
2. Clustering and dendrograms are used to represent results visually, illustrating relationships
among units at various levels of abstraction.

Ethnographic Analysis:

• Ethnographers analyze patterns in behavior and thoughts from the very beginning of their
fieldwork. They use tools like maps, flowcharts, and matrices to illustrate and crystallize
the data.

• Spradley’s 12-step sequence is a well-known method for ethnographic data analysis,

emphasizing the role of language and cultural symbols in shaping meaning.
 Qualitative Data Analytic Procedures
Ethnographic Analysis:
• Spradley’s 12-steps:
1. Locating an informant
2. Interviewing an informant
3. Making an ethnographic record
4. Asking descriptive questions
5. Analyzing ethnographic interviews
6. Making a domain analysis
7. Asking structural questions
8. Making a taxonomic analysis
9. Asking contrast questions
10. Making a componential analysis
11. Discovering cultural themes
12. Writing the ethnography
 Qualitative Data Analytic Procedures

Phenomenological Analysis :

Many qualitative analysts use what might be called “fracturing” strategies that break
down the data and rearrange them into categories that facilitate comparisons across
cases (e.g., grounded theory researchers).

Phenomenologists often prefer holistic, “contextualizing” strategies that involve

interpreting the narrative data within the context of a “whole text.” Three frequently
used methods for descriptive phenomenology are the methods of Colaizzi (1978),
Giorgi (1985), and Van Kaam (1966), all of whom are from the Duquesne school of
phenomenology, based on Husserl’s philosophy.
 Qualitative Data Analytic Procedures
Phenomenological Analysis :
 Qualitative Data Analytic Procedures
Phenomenological Analysis :
 Qualitative Data Analytic Procedures
Grounded Theory Analysis:

Grounded theory methods emerged in the 1960s in

connection with Glaser and Strauss’s (1967) research
program on dying in hospitals. The two co-originators
eventually split and developed divergent schools of thought,
which have been called the “Glaserian” and “Straussian”
versions of grounded theory (Walker & Myrick, 2006).
 Qualitative Data Analytic Procedures
Grounded Theory Analysis:
 Qualitative Data Analytic Procedures
Focus Group Data Analysis:

Transcription Challenges:
•Technical Issues: Focus group interviews are often difficult to transcribe due to
issues such as uneven voice volumes, multiple people speaking at once, and the
challenge of identifying who is speaking in audio recordings. Video recordings may
help identify speakers, but often, researchers rely on detailed field notes to track
who said what.
•Emotional Content: Transcription should capture not only verbal content but also
the emotional tone or body language that can provide further context. For instance,
non-verbal cues like gestures or facial expressions can significantly alter the
interpretation of the spoken words.
 Qualitative Data Analytic Procedures
Focus Group Data Analysis:

Analysis at Different Levels:

•Group-Level Analysis: Some researchers advocate for focusing on
the group as a whole, interpreting data from the collective dynamics
of the group. This is grounded in the belief that interactions between
participants, influenced by group dynamics, provide insights that
cannot be isolated to individual responses.
 Qualitative Data Analytic Procedures
Focus Group Data Analysis:

Analysis at Different Levels:

Individual-Level Analysis: Others argue that individual responses
within the group provide important insights that should be analyzed
separately, especially when considering personal experiences, beliefs,
or behaviors that may not be fully captured in the group context.
 Qualitative Data Analytic Procedures
Focus Group Data Analysis:

Analysis at Different Levels:

Combination Approach: Some researchers, like Carey and Smith
(1994), suggest a third approach, analyzing both individual responses
and group-level dynamics. This includes identifying when an
individual's response aligns with or contrasts the majority viewpoint in
the group, thereby offering a richer understanding of both personal
and collective perspectives.
 Qualitative Data Analytic Procedures
Focus Group Data Analysis:

Field Notes and Contextual Analysis:

•Integrating Field Notes: Detailed field notes (such as participant behaviors, emotions, and
non-verbal cues) should be integrated with verbatim transcripts to provide a comprehensive
view of the focus group interaction. For example, a participant’s seemingly casual remark, “It
was no big deal,” can gain additional meaning when field notes indicate it was said
sarcastically with eyes cast downward.
•Contextualizing Responses: It's important to consider not just the content of the responses
but also the context in which they were made—when and why particular themes or issues
emerge during the group discussions.
 Qualitative Data Analytic Procedures
Focus Group Data Analysis:
Identifying Themes and Patterns:
•Emergence of Themes: Analysts must determine whether a specific issue raised in a focus
group constitutes a recurring theme or is merely the strong viewpoint of a few individuals.
Identifying themes that appear across different groups can provide stronger evidence for their
relevance to the research.
•Salience and Spontaneity: Themes that are spontaneously mentioned by multiple
participants at different points in the session may be especially significant. Such issues may
represent core concerns or key factors for the group.
•Interpreting Group Differences: When analyzing multiple focus groups, researchers should
explore why differences in responses arise—whether these differences are due to participant
characteristics or group processes that influence the discussion.
 Qualitative Data Analytic Procedures
Focus Group Data Analysis:
Quantitative Methods as an Adjunct to Qualitative Analysis:
Software for Analysis: Some analysts employ qualitative data analysis software to enhance
their ability to detect patterns, frequencies, and relationships within the data. For example,
they may look for similarities or differences between groups, examine how much each
participant contributes to the conversation, or assess how often certain themes arise.
Sociogram Analysis: A sociogram can be used to visually map the flow of conversation and
interpersonal relationships within the focus group. This tool helps to understand the
dynamics of who speaks to whom and how the conversation develops, shedding light on the
structure of interactions.
 Interpretation of Qualitative Findings

1. Immersion and Closeness to Data:

•Iterative Process: Researchers engage with the data multiple times, re-reading and
categorizing it, and continuously refining the emerging themes. This cyclical process
allows the data to be understood more deeply.
•Incubation: This term refers to the process of “living” with the data. Researchers
need time to understand the deeper meanings within the data, discern essential
patterns, and ultimately draw legitimate, insightful conclusions. It is important that
researchers give themselves enough time for reflection and contemplation, as
insights often emerge after a period of immersion.
 Interpretation of Qualitative Findings

2. Reflexivity:

•Self-awareness: A critical component of qualitative interpretation is the researchers'

ability to reflect on their own perspectives and biases. This is known as reflexivity,

where researchers examine how their worldview, assumptions, and experiences

might influence the interpretation of data. Reflexivity ensures that interpretations

are more robust and less likely to be influenced by unconscious biases.

 Interpretation of Qualitative Findings

Creativity in Interpretation:

•Generating Insights: Creativity is central to interpreting qualitative data.

Researchers often use creative thinking to uncover deeper meanings within the data,

moving beyond surface-level observations to develop novel theories or frameworks.

As Chandler mentions, achieving insight requires time and incubation, where new

ideas slowly percolate and eventually lead to the "aha" moments that clarify the data.
 Interpretation of Qualitative Findings
Validation of Interpretations:
•Self-scrutiny and Peer Review: Qualitative researchers must scrutinize their
interpretations carefully and invite peer feedback to ensure their conclusions are
credible. This process of validation involves not just reviewing the data but also
considering alternative explanations or theories that might challenge the initial
interpretation.
•Alternative Explanations: Researchers should consider different perspectives or
counterarguments that may question or modify their conclusions. For example,
James et al. (2009) highlighted that their study's preliminary interpretations were re-
evaluated using counterarguments based on alternative theories, which helped
refine the analysis.
 Interpretation of Qualitative Findings

5. Transferability and Practical Application:

•Implications for Practice and Research: When drawing conclusions, qualitative

researchers need to consider how the findings might apply to other contexts

(transferability) and how they can inform future research or nursing practice. While

qualitative research is often context-specific, thoughtful consideration of its broader

implications can help guide future investigations or inform evidence-based practice

in the field.
Guidelines for Critiquing Qualitative Analyses and Interpretations
 References

McKenna, L., & Copnell, B. (2020). Fundamentals of nursing and midwifery research: A

practical guide for evidence-based practice (2nd ed.). Routledge, Taylor & Francis.

Polit, D. F., & Beck, C. T. (2021). Nursing research: Generating and assessing evidence

for nursing practice (11th ed.). Wolters Kluwer Health.

Thank You
College of Health and Sport Sciences
NURSING DEPARTMENT
Measurement and
Data Quality
Question #1
• Tell whether the following statement is true or false:
• Measurement involves assigning numbers to objects to
represent the amount of an attribute.
Answer to Question #1
• True
• Measurement involves assigning numbers to objects to
represent the amount of an attribute, using a specified set of
rules. Researchers strive to develop or use measurements
whose rules are isomorphic with reality.
Measurement defintion
• The assignment of numbers to represent the amount of an
attribute present in an object or person, using specific rules
• Rules are necessary to promote consistency and
interpretability
• Advantages
• Removes guesswork
• Provides precise information
• Less vague than words
Theories of Measurement
• Psychometrics is a branch of psychology concerned with the
theory and methods of psychological measurement.
• Two theories
• Classical test theory (CTT)
• Item response theory (IRT)
Errors of Measurement
• Obtained score = True score + Error
• Obtained score: an actual data value for a participant
• True score: value that would be obtained for a hypothetical
perfect measure attribute
• Error of measurement: represents measurement
inaccuracies
Factors That Contribute to Errors
of Measurement
• Situational contaminants
• Transitory personal factors
• Response-set biases
• Administration variations
• Instrument clarity
• Item sampling
 Factors That Contribute to Errors of 9

Measurement

• Situational contaminants:

Scores can be affected by the condition and participants’ awareness of observers.

Environmental factors such as temperature, lighting, and time of day

• Transitory personal factors:

The score can be influenced by such personal states e.g., fatigue or mood. Factors
directly affect anxiety and cooperation.

• Response-set biases:

Relatively enduring characteristics of people can interfere with accurate

measurements, such as social desirability or acquiescence.
Factors That Contribute to Errors of 10

Measurement

• Administration variations:

Alteration in the methods of collection data from one person to the next can
result in score variations unrelated to variations in the target attribute e.g.,
physiologic measures are taken before feeding & after feeding, and errors
occur.

• Instrument clarity :

If the directions on an instrument are poorly understood questions in self-

reporting

• Item sampling :

Errors can be introduced because of the sampling of items used in the

measure.
Major Types of Measures
• Generic
• Specific
• Static
• Adaptive
• Reflective scales
• Formative indexes
Measurement Taxonomy
• Four measurement property domains
• Cross-sectional domains
• Reliability
• Validity
• Longitudinal measurement domains
• Reliability of change scores
• Responsiveness
 Measurement Taxonomy
Four measurement property domains

The Longitudinal
measurement Cross-sectional The
quality of domains properties
measurem Domains used for
ents decades by
capturing psychometr
changes Reliability of
Reliability icians
over time change scores

Responsiveness Validity
Measurement and Statistics
• Correlation coefficients
• Correlation coefficients indicate direction and magnitude of
relationships between variables.
• Pearson's r
• Range:
• From −1.00 (perfect negative correlation)
• Through 0.00 (no correlation)
• To +1.00 (perfect positive correlation)
Reliability #1

• Consistency—the absence of variation in measuring a stable

attribute for an individual
• Reliability assessments involve computing a reliability
coefficient
• Most reliability coefficients are based on correlation
coefficients.
Question #2
• Tell whether the following statement is true or false:
• Reliability coefficients usually range from .00 to 1.00, with
higher values reflecting less reliability.
Answer to Question #2
• False
• Reliability coefficients usually range from .00 to 1.00, with
higher values reflecting greater reliability, not less reliability.
 Stability

The stability of an instrument is the extent to which similar

scores are obtained on separate occasions.
Reliability #2
• Replication approaches
• Test–retest reliability: administration of the same
measure to the same people on two occasions
• Interrater reliability: measurements by two or more
observers or raters using the same instrument or
measurements by the same observer or rater on two or
more occasions
• Parallel test reliability: measurements of the same
attribute using alternate versions of the same instrument,
with the same people
 Stability Reliability
• Test–retest reliability: administration of the same
measure to the same people on two occasions

Researchers administer the same measure to a sample twice

and then compare the scores.

The comparison is performed objectively by computing a

reliability coefficient, which is an index of the magnitude of the
test’s reliability.
Stability Reliability

• To check the instrument’s stability, we administer the scale

2 weeks apart to 10 people.

Stability Reliability
• Test–retest reliability
The test–retest method is easy, and can be used with self-report,
observational, and physiologic measures. Yet, this approach has
certain disadvantages. One issue is that many traits do change over
time, independently of the measure’s stability.

Attitudes, knowledge, perceptions, and so on can be modified by

experiences between testings. Test– retest procedures confound
changes from measurement error with true changes in the attribute.
Stability Reliability
• Test–retest reliability

In the second administration will be influenced by their memory of

initial responses, regardless of the actual values the second day. Such

memory interference results in spuriously high reliability coefficients

 Equivalence

Equivalence with concerns the degree to which two or more

independent observers or coders agree about scoring.

If there is a high level of agreement, then the assumption is

that measurement errors have been minimized. Nurse
researchers are especially likely to use this approach with
observational measures
 Equivalence
Interrater (or interobserver) reliability can be assessed by:

Consensus measures of interrater reliability for

observational coding involve having two or more trained
observers watching an event simultaneously, and
independently recording data.

The data are then used to compute an index of agreement

between observers.
 Equivalence
Interrater (or interobserver) reliability can be assessed by:
 Equivalence
Interrater (or interobserver) reliability can be assessed by:

A widely used statistic in this situation is Cohen’s kappa,

which adjusts for chance agreements. a value of

.60 is minimally acceptable, and that values of .75

or higher are very good.

The intraclass correlation coefficient (ICC) can also be used

to assess interrater reliability
 Equivalence
Interpretation of Reliability Coefficients

Coefficients in the vicinity of .70 may be adequate but coefficients of .80

or greater are highly desirable. ideally should

be .90 or better.

e.g., ICC= 0.89 is acceptable

❖ Can be improved by making instrument longer (adding items)

Reliability Coefficient (R)
• Represent the proportion of true variability to obtained
variability:
R= VT
Vo
• Should be at least .70; .80 preferable
• Can be improved by making instrument longer (adding
items)
• Are lower in homogeneous than in heterogeneous samples
Internal Consistency
• The extent to which all the instrument’s items are measuring the
same attribute
• Evaluated by administering the instrument on one occasion
• Appropriate for most multi-item instruments
• Most widely used evaluation method is the coefficient alpha or (or
Cronbach’s alpha)
• An instrument may be said to be internally consistent or
homogeneous to the extent that its items measure the same trait.
E.g., all the item are measuring anxiety nothing else e.g., self-
awarness
Measurement Error
• Unless a reliability coefficient is 1.0 (virtually never
happens), measurement error is present.
• Used to estimate the range within which the true score lies
• Standard error of measurement (SEM)
• Limits of agreement (LOA)
• Measurement error is routinely estimated for multi-item
measures developed with item response theory (IRT)
methods.
Validity
Validity
• The degree to which an instrument measures what it is
supposed to measure (resilience)
• Four aspects of validity
• Face validity
• Content validity
• Criterion-related validity
• Construct validity
 Face Validity
• Refers to whether the instrument looks as though it is
measuring the appropriate construct
• Based on judgment, no objective criteria for assessment
• It might be easier to persuade people (expert) to participate
in a study if the instruments have face validity, for example.
Content Validity
• The degree to which an instrument has an appropriate
sample of items for the construct being measured
• Relevance
• Comprehensiveness
• Balance
• Evaluated by expert evaluation, via the content validity index
(CVI)
• Please read page 337 and Discuss ICV-I and S-CVI
Content Validity
Content validity concerns the degree to which an instrument has an
appropriate sample of items for the construct being measured and adequately
covers the construct domain.

For cognitive measures, the content validity question is, how representative
are the test questions of the universe of questions on this topic?

Researchers designing a new instrument should begin with a thorough

conceptualization of the construct so the instrument can capture the full
content domain.
 Content Validity
There are no completely objective methods of ensuring adequate content

coverage on an instrument, but it is common to use a panel of experts to

evaluate the content validity of new instruments.

Criterion Validity #1
• The degree to which the instrument correlates with an external
criterion or “gold standard”
• Focal measures
• Expense, efficiency, risk and discomfort, criterion unavailable,
and prediction

Once a criterion is selected, a criterion-related validity coefficient

can be computed by correlating scores on the instrument and the
criterion.
The correlation coefficient of .83 indicates that the professionalism scale correlates
Criterion Validity #2
• Two types of criterion-related validity
• Predictive validity: the instrument’s ability to distinguish
people whose performance differs on a future criterion

• Concurrent validity: the instrument’s ability to distinguish

individuals who differ on a present criterion
Criterion Validity #1
Construct Validity
• Concerned with the questions
• What is this instrument really measuring?
• Does it adequately measure the construct of interest?
Methods of Assessing Construct
Validity
• Hypothesis-testing validity

• Convergent validity

• Known-groups validity

• Divergent validity (discriminant validity)

• Multitrait–multimethod matrix method (MTMM)

• Structural validity

• Cross-cultural validity
 Factor Analysis
• Another approach to construct validation uses a statistical
procedure called factor analysis.

• Factor analysis is a method for identifying clusters of related

variables—that is, dimensions underlying a broad construct.

• Each dimension, or factor, represents a relatively unitary attribute.

The procedure is used to identify and group together different
items measuring an underlying attribute.
 Factor Analysis
• Exploratory Factor Analysis

• Factor analysis disentangles complex interrelationships among

items and identifies items that “go together” as unified concepts.

• assumes no a priori hypotheses about dimensionality of a set of

items.

• confirmatory factor analysis—uses more complex modeling and

estimation procedures, as described later.
 Measurement Taxonomy
Four measurement property domains

The Longitudinal
measurement Cross-sectional The
quality of domains properties
measurem Domains
used for
ents decades by
capturing psychometr
changes Reliability of
Reliability icians
over time change scores

Responsiveness Validity
Reliability of Change Scores
• Change score: represents the amount of change between
two scores
• Difference score: the difference between the randomized
groups at posttest
• Smallest detectable change (SDC): a change in scores that
is beyond measurement error
• Reliable change index (RCI): assesses the clinical
significance of improvement during a psychotherapeutic
intervention
Responsiveness
• The ability of a measure to detect change over time in a
construct that has changed, commensurate with the amount
of change that has occurred
• Whether a change score is truly capturing a real change in
the construct
Question #3
• Tell whether the following statement is true or false:

• Reliability is the degree to which an instrument measures

what it is supposed to measure.
Answer to Question #3
• False

• Validity is the degree to which an instrument measures what

it is supposed to measure. Reliability is the degree of
consistency or accuracy with which an instrument measures
an attribute.
Critiquing Data Quality in
Quantitative Studies
• Can I trust the data in this study?

• Are the measurements of key constructs reliable and valid,

and are change scores reliable and responsive?
Psychometric Assessment
• Gather evidence

• Validity

• Reliability

• Other assessment criteria

Thank you