EASTERN MENNONITE UNIVERSITY Department of Nursing RESEARCH PROBLEMS, RESEARCH QUESTIONS, AND HYPOTHESES

1 EASTERN MENNONITE UNIVERSITY Department of Nursing RESEARCH PROBLEMS, RESEARCH QUESTIONS, AND HYPOTHESES I. The Research Problem A. Sources of Research Problems 1. Clinical Experience 2. Nursing Literature 3. Theories "deductive process" 4. Ideas from external Sources, eg., brainstorming, class 5. Social Issues B. Development and Refinement of Research Problems (guides the design) 1. Quantitative research - problem process goes from broad to a very specific final problem statement. 2. Qualitative research - problem also needs refinement, but in many cases it remains fairly broad C. Significance, researchability, & feasibility of research problems 1. Is research problem significant to nursing? a. Is it important? Have practical applications? b. Can findings potentially improve nursing practice? c. Is it possible that knowledge produced will benefit clients, nurses, or the broader community? d. Will knowledge make a difference that matters? e. Findings contribute to nursing theory? 2. Is it researchable? a. Problems of moral or ethical nature are not researchable. Can explore nurses attitudes related to euthanasia but cannot do a study to determine whether euthanasia is right or wrong 3. Is it feasible? a. Time b. Availability of subjects c. Cooperation d. Facilities, equipment, resources e. Researcher experience f. Ethical considerations II. Communicating the Research Problem A. Statement of the research purpose or goal QUALITATIVE OR QUANTITATIVE 1. Statements of purpose are often more broad so many researchers include several specific questions as well 2. Declarative form is often used in statement of purpose 3. Statement of purpose should connote objectivity

2 4. Qualitative questions often use verbs such as explore, describe, understand, discover, or develop 5. Verbs in the purpose statement often include goal, objective, intent, or aim. QUANTITATIVE 1. Should identify the key study variables and their possible relationships and the problem of interest. 2. Some suggest interrogative form - simple & direct III. The Research Hypothesis - Quantitative Studies Only A tentative prediction or explanation of the relationship between two or more variables. A. Hypothesis translates the problem statement into a precise, unambiguous prediction of expected outcomes. B. The hypothesis is subjected to empirical testing C. Hypotheses may or may not follow directly from a theoretical framework. D. Theories are tested via hypotheses Null is used for statistical testing E. Characteristics of hypotheses 1. Must have relational term in describing variables; ie. more than, less than, greater than, different from, related to, associated with 2. Based on sound justifiable rationales (theory, logical reasoning, personal experience) Dependent variable: the outcome variable of interest; acted upon or caused by independent variable Independent variable: the variable that is manipulated; cause of dependent variable F. Wording of the hypothesis 1. State relationship between independent and dependent variables 2. Simple (or univariate) hypothesis: relationship between single independent and dependent variable 3. Complex (or multivariate) hypothesis: one that predicts a relationship between two or more dependent or independent variables 4. Directional hypothesis: specifies the expected direction of the relationship between two variables 5. Nondirectional hypothesis: does not stipulate the direction of the relationship 6. Research hypothesis is a statement of relationships, whereas a statistical or null hypothesis state there is no relationship. The null hypothesis is always used for statistical testing. G. Hypothesis Testing 1. Testing of the hypotheses constitutes the heart of empirical or experimental studies. a. hypotheses are not proven!!!!!!!! b. hypotheses are supported (accepted) or rejected!!!!!!!! 2. Descriptive or exploratory research proceeds without a formally stated hypothesis. a. phenomenology - this approach aims to provide an opportunity for the human experience to be revealed without preconceived restrictions -> clear hypothesis inappropriate

3 THEORETICAL AND CONCEPTUAL FRAMEWORKS I. Theoretical Frameworks for Nursing Research A. Definition & Purpose of Theories 1. Theories are abstract generalizations that represent a systematic explanation of the relationships among phenomena. a. Provide principles for explaining, predicting, and controlling phenomena. 2. Good research builds on existing knowledge. Theories are useful in guiding and organizing the search for knowledge. a. The purpose of theories is to help explain events - the what and the why. b. Theories sharpen reality, they are not reality. c. Overall purpose of theory is to make scientific findings meaningful, generalizable, and interpretable. B. Characteristics of Theories 1. Concepts are the basic ingredients of a theory. a. Concepts are labels for ideas. b. Theories describe relationships among concepts - these are called statements or propositions. Typical terms are, "is associated with", "varies directly with", or "is contingent on". 2. Theories include a well-formulated deductive system of abstract formal statements. 3. Humans do not discover theories, they create and invent them. They must be congruent with the reality of the world around us and existing knowledge. 4. Theories are tentative in nature - they cannot be proven or confirmed. Rather they are supported. Hypotheses are deduced from theories and are tested; theories are not tested. C. Conceptual Frameworks and Models 1. Conceptual Frameworks or Conceptual Schemes a. Deal with concepts - organize around a common theme. b. Differ from theories, are not deductive c. Propositions are not as clearly stated as in theory 2. Models - also use concepts, but use minimal words. Are different from conceptual frameworks in that they use more visual or symbolic representations. 3. Schematic Models (Diagram or Conceptual Map) - Represents a phenomenon figuratively. Uses concepts. "Diagram of ideas" 4. Statistical Models express the magnitude of relationships among variables D. Conceptual Frameworks used by Nurse Researchers 1. Nurse Models, eg., Johnson, King, Neuman 2. Models from other human science disciplines. E. Critiquing Theoretical Frameworks 1. Was a framework used? 2. Is the theory/framework adequately described? 3. Does the hypothesis or research question naturally flow from the theory/conceptual framework? 4. Are the results tied back into the theory? 5. If framework is not consistent with the results, look first at the study - was the framework

4 F. Literature Review appropriate? Was the study carried out appropriately? 1. Research articles often begin with an abstract. 2. The literature review is usually at the beginning of the article. 3. Data bases are used to find the body of literature that needs to be reviewed. a. Web information - problem is there is often no referee to maintain quality. b. CINAHL - most likely to yield important nursing periodical sources. c. Most recent indexes should be searched first. d. Other indexes such as Medline, Psychological and Sociological Abstracts also list research literature pertinent to nursing. 4. Sources should be primary rather than secondary. 5. Opinions should not be used in a literature review; occasionally an expert's opinion may be cited. 6. Language should be objective and tentative (eg., support, accept). 7. Studies that support and disagree should be included. 8. The primary purpose of the literature review is to show that the intended study has been built on previous work. The researcher will try and "fill in the knowledge gap" will the current study. The researcher writing the literature review should give the "state of the art" in the area of research that is intended. 9. The main function of the literature review is to demonstrate the need for the intended study and to provide the context for the study (research question). I. Purposes and Dimensions of Research Design QUANTITATIVE RESEARCH DESIGN Research design refers to the researcher's overall plan for obtaining answers to the research questions and for testing the research hypothesis. A. Research design involves decisions about the following: 1. Will there be an intervention? 2. What type of comparisons will be made? 3. How will extraneous variables be controlled? 4. When & how many times will data be collected? 5. In what setting will the study take place? 6. What information will be communicated to study participants? II. Experimental research Design A. In experiments the researcher is an active agent. B. Characteristics of True Experiments. 1. Manipulation - the experimenter does something to at least some of the subjects in the study. 2. Control - the experimenter introduces one or more controls over the experimental situation. a) control group - group of subjects whose performance on the dependent variable is used as a basis for evaluating the experimental group (group that received the independent variable) 3. Randomization - the experimenter assigns subjects to a control or experimental group on a random basis. a. randomization: every subject has an equal chance of being included in any group b. Avoids systematic bias: provides equalization with respect to infinite number of variable (sex, education, etc)

5 C. Basic Designs 1. After-only (post test only) - pre-experimental 2. Pretest-post test (before-after) 3. Factorial - allows for manipulation of two or more variables a. Main effect - results from manipulated variable b. Interaction effects - effects from treatment methods c. Independent variables are called factors and each factor must have two or more levels D. Crossover Design (Repeated Measures Design) 1. The same subjects are subjected to more than one treatment - subjects are own control 2. Are true experiments only if subjects are randomly assigned to different order of treatment 3. What is major problem with this design? 4. Strong design but not always possible F. Advantages of true Experiments "True experiments represent the most powerful method available to scientists for testing hypothesis of cause-and-effect variables". 1. Causal relationships can be inferred. Criteria for cause and effect include: -- cause must precede event in time -- must be empirical relationship between cause & effect - if wanted to study stress response, what would be a good cause & effect question? -- cause & effect cannot be explained by third variable (eg. Why would you not use smokers to test your hypothesis that phenacetin containing drugs contributes to bladder cancer? (smoking believed to contribute o bladder CA as well). 2. Control How? Manipulation, comparison, randomization rules out extraneous variables F. Disadvantages of true experiments 1. Number of interesting variables cannot manipulate, ie. health history, age, gender 2. Ethical considerations prohibit manipulation 3. Experimentation is impractical 4. Hawthorne Effect - subjects act differently when in experiment 5. Controlled - doesn't always reflect reality III. Quasi-Experimental Research A. Must involve manipulation of independent variable B. Lack either randomization or control-group -> weakens ability to make causal inferences. C. Attempts are made to include other controls to compensate for lack of control group or randomization D. Quasi-Experimental Designs 1. Nonequivalent Control Group-Before-After - a group is chosen as a comparison, but there is no random assignment to groups. What is the weakness? 2. Time Series Designs a. Information collected over an extended period of time - allows for some control for non-related events to affect independent variable b. No control group or randomization c. Often use before-after comparison

6 E. Advantages of Quasi-Experiments -> Practical, feasible & generalizable to some extent F. Disadvantage of Quasi-Experiments -> can't make cause & effect inferences as readily as with true experiments and several alternative explanations are possible for results - almost always there is at least one plausible rival explanation. IV. Nonexperimental Research Used where it is either unethical or impossible to manipulate the independent variable. Also used to study naturalistic environments. A. Types of Nonexperimental Research 1. Ex post facto (correlational research)- done after the fact a. What is the problem with inferring cause & effect? Unable to manipulate independent variable. b. Can not equate groups. c. Correlation does not prove causation. e. Two types of ex post facto designs that attempt to elucidate causal relationships are retrospective and prospective. 1. Retrospective studies attempt to link a phenomenon in the present to a phenomenon in the past. 2. Prospective studies start with the examination of a presumed cause and go forward. f. Because unable to manipulate independent variable or randomly assign, cannot equate groups. 2. Descriptive Research Purpose: Observe, explore, and describe situation 3. Case-control enhanced if samples can be shown to be similar in relation to extraneous variable B. Disadvantages of Nonexperimental Research ->cannot reveal causal relationships and there may be problems due to self-selection (page 190) C. Advantages of Nonexperimental Research 1. Efficient and effective means of collecting data 2. High in realism. V. Types of Research Design: The time dimension A. Appropriate situations to design study with multiple points of data collection 1. Time-related processes - phenomena that evolve over time. eg., healing, growth 2. Time-sequenced phenomena - when temporal sequence is important. eg., infertility and depression 3. Comparative purposes - Have changes occurred over time? eg., studying trends 4. Enhancement of research control - Collect data at multiple points to enhance interpretability of results. B. Cross Sectional - involves collection of data at one point in time. Describe phenomenon or relationship among phenomena at one point in time. Eg., survey two or more groups and compare responses. 1. Advantage -> practical, economical, & easy to manage 2. Disadvantage -> frequently there are several alternative explanations for any observed differences

7 C. Longitudinal Designs 1. Trend - Samples (different people) are drawn from the same population over time with respect to the same phenomenon. 2. Panel - The same subjects are used to supply data at two or more points in time. a. Difficult & expensive to manage b. Attrition is the most serious problem. 3. Follow-up studies - determine the development of subjects who received a particular treatment 4. Main value of longitudinal studies -> show trends over time and the temporal sequencing of phenomena (an essential criterion for causality. VI. Additional types of research A Needs Assessments 1. Collects data to determine needs of group, community, or organization 2. Key informants are used B. Meta Analysis 1. Treats the findings of one single research study as a single piece of data. 2. Combines findings on topics using statistical models and analysis 3. Important tool in theory development and research utilization VII. Techniques of Research Control Need to control for extraneous variables - variables that have an irrelevant association with the dependent variable. Control is concerned with holding constant possible influences on the dependent variable so that the true relationship between the independent and dependent variables can be understood. A. Controlling external factors 1. Minimize situational contaminants -> achieve constancy of conditions 2. Environmental control 3. Time control 4. Control by constancy of information and treatment B. Controlling Intrinsic Factors (Intrinsic factors that subjects bring to the experiment Example, age, sex, health condition.) 1. Randomization a. Most effective method to control subject characteristics -> equalize groups with respect to the extraneous variables b. Controls for all extraneous variation 2. Homogeneity a. Use subjects homogenous with respect to the variables that are considered extraneous -> extraneous articles are not allowed to vary b. Method of control is simple & adds considerable control, but only be generalized to type of subjects who participated in the study 3. Matching a. Use information about subject characteristics in relation to extraneous variables to form comparison groups b. Problem is the researcher needs to know all important extraneous variables in advance. In addition, after 2 or 3 variables, it is often impossible to match adequately 5. Statistical Control (analysis of covariance) Statistically removes the effect of extraneous variables on the dependent variable

8 C. Evaluation of methods to control extraneous variables 1. Randomization is the most effective approach 2. The 4 alternatives discussed above have one disadvantage in common -> the researcher must know or predict in advance the relevant extraneous variable VIII. Characteristics of a Good design A. Statistical conclusion validity (low with small samples-stronger with larger samples) -statistical power is the ability of the design to detect true relationships among variables, p. 198). If the differences in groups being compared are large, statistical results will be clearer, increasing power (p. 198). B. Internal validity refers to the extent to which it is possible to make an inference that the independent variable is truly influencing the dependent variable C. "Are you measuring what you say you are measuring? "Competing explanations for result are referred to as threats to internal validity. Are there competing explanations for the results? 1. History - refers to the occurrence of events that take place concurrently with the independent variable and can affect the dependent variable. Not a threat in true experiments. 2. Selection - encompasses biases resulting from preexisting differences between groups *How does one prevent this? randomization 3. Maturation - refers to any change that occurs as a function of time (eg. growth, fatigue) 4. Mortality - differential loss of subjects from comparison groups. Loss may be important in relation to important variables. C. Internal Validity and Research Design -> quasi-experimental & ex post facto designs are especially susceptible to threats of internal validity Major threats to experimental studies are mortality and constancy of conditions The aim of good research is to rule out competing explanations D. External Validity 1. Refers to the generalizability of the research findings to other settings or samples. Will it work somewhere else? a. Was the sampling design adequate? Does it reflect the make up of the population? b. Various subject characteristics, characteristics of the environment or research situation affect external validity (eg., researchers and subjects act different when in a study) c. If use tight control to maximize internal validity, then it becomes so artificial can't generalize d. In nursing studies external validity is typically weak important to replicate findings

9 I. Design and Planning of Qualitative Studies QUALITATIVE DESIGNS AND APPROACHES A. The study design typically evolves during the project - often referred to as an emergent design. The researcher designs a plan but may deviate from the plan if necessary to collect better data. 1. Identification of possible sites that may provide fruitful data and then choosing of specific sites. 2. Identification of "gatekeepers" who can provide access to important sources of data. 3. Determine time available for the study, considering time and financial constraints. 4. Identification of equipment that could be used in the field in data collection (recording equipment, lap top computers, etc) 5. Determine assistants may need, if any, to complete the project (interviewers, transcriptionists) B. Qualitative Design Features 1. Nonexperimental designs - do not manipulate an independent variable 2. Typically do not compare groups - may see comparisons emerging from data. 3. May be cross-sectional (one data collection point per participant) or longitudinal (multiple data collection points over a period of time to observe the evolution of some phenomenon) 4. May observe the evolution of some phenomenon (prospective) or look for antecedents to some phenomenon (retrospective) in trying to better understand the phenomenon. Qualitative researchers do not use the terms prospective and retrospective. 5. Almost always collect data in real-world, naturalistic settings. May study a phenomenon in a variety of contexts. C. Phases in a Qualitative Inquiry 1. Orientation and Overview - researcher doesn't know what is known - try to get a handle on what is salient about the phenomenon of interest. 2. Focused exploration - More focused scrutiny and in-depth exploration of those aspects of the phenomenon that are judged to be salient. Who the participants (subjects) will be and the questions that will be asked were shaped in the first phase. 3. Confirmation and closure - Researcher makes sure findings are trustworthy. II. Qualitative Research Traditions A. Anthropologic Traditions Anthropology is concerned with the study of human cultures. 1. Ethnoscience (cognitive anthropology) - focuses on the cognitive world of a culture, with particular emphasis on semantic rules and shared meanings that shape behavior. 2. Ethnography - the primary research tradition in anthropology and provides a framework for studying the meanings, patterns and experiences of a cultural group in a holistic fashion. a. macro ethnography - study of a broadly defined culture b. micro ethnography - study of a narrowly defined culture c. Aim of the ethnographer is to learn from members of a group (not to study it) Emic perspective - the ways members of a culture envision their world Etic perspective - outsider's interpretation of a culture Ethnographers try to reveal tacit knowledge. This is information that is so deeply embedded in cultural experiences that members do not talk about it or may not even be aware of it. d. Types of information sought - cultural behavior, cultural artifacts, and cultural speech.

10 e. Researchers use a variety of sources - interviews, records, charts, observation, physical evidence. f. Product of ethnographic research is rich holistic descriptions. g. Ethnonursing research as described by Madeline Leininger is the study and analysis of local or indigenous people's viewpoints, beliefs, and practices about nursing care behavior and processes of designated cultures. B. Psychological Traditions 1. Ethology - study of human behavior as it evolves in its natural context. 2. Ecological psychology - attempts to explain the interdependence of humans and their environmental context. 3. Hermeneutics - closely related to phenomenology; focuses on meaning, how socially and historically conditioned individuals interpret their world within their own context. 4. Phenomenology - roots in philosophy as well as psychology. Rooted in the philosophical traditions of Husserl and Heidegger. It is concerned with the lived experiences of humans. Phenomenologists believe that lived experience gives meaning to each person's perception of a particular phenomenon. a. Focus of phenomenology is what people experience in relation to some phenomenon and how they interpret those experiences. b. Goal of phenomenology is to describe lived experience and the perceptions to which it gives rise. c. Four aspects of lived experience that are of interest are lived space or spatiality, lived body or corpeality, lived time or temporality, and lived human relation or relationality. d. Being-in-the-world (or embodiment) acknowledges that people have physical ties to the world - they interact with the world through their senses and are conscious through their interaction with the world. e. Research methodology usually involves in-depth conversations - researcher is a full participant but does not lead the participants. Number of participants is limited (~5) Methodologies often include the following: Bracketing - the researcher holds in abeyance preconceived ideas and opinions so the data can be confronted in true form. Intuiting - occurs when the researcher remains open to the meanings attributed to the phenomenon by those who have experienced it. Analysis - make sense of the meaning of the phenomenon (coding, etc.) Description- researcher comes to understand the phenomenon so he/she can describe it. C. Sociological Traditions 1. Ethnomethodology - seeks to discover how people make sense of their everyday activities and interpret their social worlds so as to behave in socially acceptable ways. 3. Historical Research a tradition that systematically collects and critically evaluates data relating to past occurrences. 4. Grounded Theory - seeks to describe and understand the key social, psychological and structural processes that occur in a social setting. Developed by Glaser and Strauss (symbolic interactionists) in the 1960s. The primary purpose is to generate comprehensive explanations of phenomena that are grounded in reality. a. Methodology - data collection, data analysis, and sampling of study participants may occur spontaneously. Data comes from many sources. Sample size ~ 25-50. b. Constant comparison is used to develop and refine categories. As new data is elicited it is compared to current categories and as new categories emerge, they are compared to previous data. c. Grounded theory research usually results in a conceptual model or theory.

11 D. Research with Ideological Perspectives 1. Critical Theory 2. Feminist Research 3. Participatory Action Research IV. Critiquing criteria for qualitative designs. I. Examining Specific Types of research SPECIFIC TYPES OF RESEARCH A. Phases of Clinical Trials Phase I Initial development of drug or therapy (dose, strength, safety, tolerance) Phase II Goals include: to see if the treatment holds promise, the feasibility of launching a large study, and looking for possible side effects. (usually quasi or experimental design) Phase III RCT or randomized clinical trial. This is reported in the literature. Should include a large, heterogeneous sample from multiple geographically diverse sites. Phase IV Monitoring the long term effects of the treatment or intervention. B. Surveys 1. Nonexperimental (no intervention) 2. Self-report 3. Methods of data collection - face-to-face interviews, telephone interviews, and mailed surveys 4. Often superficial - more appropriate for extensive than intensive analysis C. Evaluation Research 1. Design can be experimental, quasi-experimental, non-experimental or can be crosssectional, longitudinal or mixed design 2. Types a. Process analysis or implementation analysis used to evaluate new programs or procedures b. Outcome analysis (net effect) want to show a causal connection between an intervention and an outcome c. Cost-benefit analysis determines whether the monetary benefits of an intervention/program outweigh the costs. D. Outcomes Research Documents the effectiveness of health care services E. Case Studies 1. In-depth investigation of a person, group, institution, or other social unit. 2. Researcher is passive observer 3. If engaging in a single-subject experiment usually use a time series approach 4. Provide in-depth information 5. Drawback - lack of ability to generalize F. Secondary Analysis Uses data from previous studies to explore new phenomena, relationships or to test new hypotheses G. Methodologic Research - "research of research methods" 1. Investigations of the methods of obtaining, organizing, & analyzing data 2. Concentrates on developing an accurate, serviceable, and trustworthy instrument that cab be used by other researchers & evaluate success of the instrument

12 II. Integration of Qualitative and Quantitative Approaches (Mixed Method) A. Rationale for integrated designs 1. Complementarity - uses words and numbers, strength of one diminishes weakness of the other 2. Enhanced theoretical insight - gives alternate ways of viewing the world 3. Incrementality - progress in knowledge development is incremental; qualitative adds indepth knowledge and quantitative adds broader knowledge 4. Enhanced validity - when two approaches support findings it strengthens results 5. Creating new frontiers - If an integrated study results in findings that are inconsistent, it provides a springboard for new learning as the discrepancy is explored. B. Applications of Integrated Designs 1. Instrumentation - many nurse researchers are using the results of qualitative studies to develop instruments for quantitative studies. 2. Illustration - qualitative data can help clarify quantitative results within a study. C. Understanding Relationships and Causal Processes 1. Qualitative data can give insight into why variables are related in a quantitative study. Go beyond researcher's "best guess". 2. Help clarify and give shape to quantitative findings. D. Theory building, testing and refinement Multiple methods provide greater support for or disconfirmation of a theory E. Integration Strategies 1. Embedding qualitative approaches within a survey 2. Embedding quantitative approaches into field work. F. Qualitative and quantitative studies can be combined in experimental research. Qualitative data is especially helpful when complex interventions are being evaluated. I. Sampling Concepts SAMPLING PLANS A. "A population is the entire aggregation of cases that meets a designated set of criteria". 1. Eligibility criteria - criteria are the characteristics that delimit the population of interest. 2. Target population - entire population in which researcher is interested. 3. Accessible population - cases that conform to eligibility criteria and are accessible B. Sampling- process of selecting a portion of the population to represent the entire population 1. The overriding consideration in assessing a sample is its representativeness. 2. There is never a guarantee that a sample is representative. 3. Researchers operate under conditions in which error is possible - their role is to minimize or control errors as much as possible 4. Strata may be identified & used in the sampling selection process to enhance representativeness of the sample 5. Rationale for sampling a. More economical & efficient b. Not necessary to gain data from entire population - it s "almost always possible to obtain a reasonably accurate understanding of the phenomenon under investigation by securing information from a sample". c. Problem is sampling bias - "the over-representation or under-representation of some segment of the population in terms of characteristics relevant to the research question. d. To assess risk of sampling bias, readers of research reports must consider the degree to which a population is heterogeneous with respect to key variables. e. Want to generalize to the population

13 II. Nonprobability Sampling {not random} A. Convenience Sampling (accidental sampling) - uses the most conveniently available subjects in a study 1. Snowball or network sampling - Early sample members are asked to identify others who meet characteristics 2. Convenience is weakest form of sampling - no way to evaluate the biases that may be operating B. Quota Sampling - researcher identifies strata of the population & specifies the proportion of elements needed from various segments of the population (Tables 12.1 & 12.2 show examples) 1. Provides improvement over convenience sampling, but has some of the same problems. C. Purposive Sampling (Judgmental) - researcher's knowledge is used to hand pick the cases to be included in the sample D. Disadvantages of nonprobability sampling 1. Rarely representative of researcher's target population - not every element in the population has a chance of being included in the sample 2. Must be cautious about inferences and conclusions drawn from the data E. Advantages of nonprobability sampling 1. Convenience & economy III. Sample Size in Quantitative Studies A. The larger the sample the more representative of the population it is likely to be B. Power Analysis - statistical method used to determine sample size C. When expected differences between groups are large a large sample is not needed to ensure that differences will be revealed in statistical analysis D. When expected differences are small a large sample is needed to show differences in statistical analysis E. "A large sample cannot correct for a faulty sampling design". F. Must assess both the size of the sample & the method by which the sample is selected G. The ultimate criterion for assessing a sample is its representativeness. IV. Sampling in Qualitative Studies A. Logic of Qualitative Sampling - generalizability not a guiding criteria B. Types of Qualitative Sampling 1. Volunteer (convenience, snowballing) 2. Purposive or Theoretical a. Maximum variation b. Homogeneous c. Extreme/deviant case d. Typical Case e. Criterion C. Sample Size - largely a function of the purpose of the inquiry, the quality of the informants, and the type of sampling strategy used. Guiding principle is data saturation.

14 I. Data Collection and Data Sources DATA COLLECTION METHODS A. Existing Data vs New Data 1. Existing Data: a) Historical Research c) Secondary Data Analysis Advantages: Records are economical, give trends over time, response bias may be completely absent, cooperation not an issue. Disadvantages: Researcher may be unaware of bias: Selective deposit and selective survival. Incomplete records. 2. Generating New Data B. Major Types of Data for Nursing Studies 1. Self-report 2. Observation 3. Biophysiologic measures C. Key Dimensions of Data Collection Methods Structure: Data given in comparable, pre-specified ways; Naturalistic (used in field studies) Quantifiability: Collect data so can be quantified (Structured methods can usually be more easily quantified.) Qualitative data is analyzed in narrative form. Obtrusiveness: Issue is if researcher is too obtrusive the subjects will not act normally and if the subjects are unaware they are in a study, an ethical problem exists. Objectivity: Generally the goal is to be as objective as possible in making judgments. In phenomenological based research the subjective judgment of the investigator is considered a valuable component of data collection. II. Self-Report Methods Advantages: Offers direct approach to gathering info, information gathered is unattainable via other methods, and can gather retrospective data (past behaviors). Disadvantages: Validity and accuracy of reports. Validity = does it measure what it is suppose to? A. Qualitative Self-Report Unstructured: No specific questions, no specific order. Interviews tend to be conversational - used in qualitative research. Completely Unstructured Focused Interviews Diaries Focus Group Interviews Life Histories Grand Tour Questions Think Aloud Unstructured interviews are most helpful in areas where new research is being employed. Unstructured methods are time consuming and demanding of the researcher's organizational, analyzing, and interpretive skills. B. Qualitative Self Report 1. Structured Interviews and questionnaires Formal written documents (interview schedule, questionnaire, instrument) Question Forms: Closed-ended (fixed alternative) - ensures comparability of response and facilitates analysis. Advantage: Easier to administer and analyze, more efficient. Some people will not take time to answer open-ended questions. Disadvantage: More difficult to construct. Researcher may overlook or neglect some important potential responses. Information is often superficial. Open-ended Questions (semi-structured or focused):

Advantage: Allow for richer fuller perspective. Some respondents resist choosing from among alternatives that do not reflect their opinions precisely. Disadvantage: Time consuming to analyze. Instruments: Each question must be analyzed for clarity, sensitivity to the respondent's Pretest: psychological state, freedom from biases and reading level. A trial run, usually with a smaller group. The purpose is to determine if questions are clearly worded and free from major biases, and whether questions solicit the type of information envisioned. 2. Interviews versus questionnaires Interpersonal skills of the interviewer are important in interviews. Advantages of questionnaires over interviews: - Less costly, require less time & energy to administer - Allow for complete anonymity - important in surveying socially unacceptable behaviors - Reflects no bias based on an interviewer's presence (a weakness is that there is often selection bias) Strengths of interviews far outweigh questionnaires. Their advantages are: - High response rate (low response rate leads to bias) - Many people are unable to fill out questionnaires - Less prone to misinterpretation by respondents - Additional information is gained via observation. C. Scales and Other Forms of Structured Self-Reports Device designed to assign a numeric score to subjects to place them on a continuum with aspects to attributes being measured (i.e., weight). Composite Scale: Advantages: Likert (a summated rating scale) Semantic Differential (SD) Visual Analog (VA) Allows for efficient quantification of subtle gradations in the strength or intensity of individual characteristics. Can do individual & groups comparisons. Can administer verbally or in writing. Disadvantages: Response set biases. - Social desirability: Give answers consistent with current social views - Extreme Response set biases: Consistent expression of attitudes in the extreme - Other persons always answer in the middle - Acquiescence response set bias "yea-sayers" - agree regardless of content "nay-sayers" - disagree regardless of content Counterbalancing is an attempt to overcome or at least to detect this. Critiquing scales: They are time consuming. New instruments prevent comparisons across studies. Vignettes - Involve brief descriptions if events or situations to which respondents are asked to react Advantages: *Economical way to elicit information about how people might behave in situations that are difficult to observe in daily life *Possible to experimentally manipulate stimuli by randomly assigning vignettes to subjects *Can incorporate vignettes into mailed questionnaires Disadvantage: Validity of responses (self-report) - is it an accurate description of how the respondent would actually behave? Projective techniques -Stimuli are ambiguous. Pictorial, Verbal, Expressive Rationale for approach: the manner in which a person organizes and reacts to unstructured stimuli is a reflection of the person's needs motives, attitudes, values, and personality traits. Advantages: Less susceptible to faking, particularly useful to special groups. Disadvantages: Can not score objectively. Q Sorts - Subject sorts cards on which words, phrases, messages, or statements are written. Sort 15

according to a particular dimension. Advantage: Versatile, requirement for certain number of cards in a pile eliminates some of the biases of Likert Scales. Disadvantages: Time consuming, requiring certain number of cards in a pile is artificial, can't do by mail. 16 III. Observational Methods Nurses are in an excellent position to observe relatively unobtrusively. Researcher defines observational unit. Observer Concealment: refers to researcher's openness in admitting to subject that they are part of a study Reactivity: Behavioral distortions due to observation Advantages: Can measure broad range of phenomena, extremely versatile, and researcher can vary degree of structure. A. Unstructured Observation Methods Commonly used in field studies. Collective descriptive data that is analyzed qualitatively. Researcher guided by questions but not constrained by them. Participant Observation: Advantages: Offers source of data and a basis for understanding what the data mean. B. Gathering and Recording Data Single positions: observing in a single location Multiple positions: moving around site to observe behaviors from different locations Mobile positioning: follow person throughout a given activity or period Log: Daily record of events and conversations Field Notes: May include a log, but are broader, more analytic and interpretive. C. Structured Observational Methods Involves specifying behaviors or events for observation and the preparation of record-keeping forms. Category system - need to decide if want to observe particular behaviors or all behaviors within a specific domain. - Must explicitly define the behaviors and characteristics to be observed. (This requires that some inferences must be made.) Checklists Rating Scales Observational Sampling - obtain representative behaviors Time sampling: Time frames selected for observation Event Sampling: Integral behaviors or prescribed events are chosen for observation. Advantages: Used whenever people cannot be expected to adequately describe their own behaviors (ie., unaware of own behavior, embarrassed, or emotionally laden, not capable of articulating their actions) Disadvantages: Ethical difficulties, reactivity, lack of consent, vulnerability of observational data to distortions and biases. Interferences with objective observations: - emotions, prejudices, attitudes of observer - personal commitment and interest may color interpretation - May observe what expect to observe - Hasty decisions without adequate data collection can result in erroneous conclusions D. Evaluation of Unstructured Observations Advantages: Offer deeper richer understanding of human behaviors and social situations

17 IV. Flexible (Critics of quantitative approaches say they are too mechanistic and superficial to render a meaningful account of the intricate nature of human behavior). Useful for in-depth study that allows conceptualization of important variables that can lead to a hypothesis. Disadvantages: Observer bias and influence, emotional involvement of researcher, researcher may develop myopic view. Are highly dependent on the observational and interpersonal skills of the researcher. Note: More structured observational methods are bettered suited to testing of hypothesis. Valid measures for targeted variables. Equipment available to nurses at low or no cost. Disadvantages: Measuring may affect variable trying to measure, artifacts may interfere with measures, the high interaction among biophysiologic systems may complicate results and energy must often be applied to the organism when taking measurements. In evaluating research methods always ask: IS the data collection strategy appropriate to the research question? The choice of how to measure must be linked to how the variable is conceptualized in the research problem. Implementing Data Collection Plan - Who will collect data? - Will they introduce any bias? - Can they produce data that are accurate and believable? - Circumstances under which data is collected is important: degree of privacy, non-judgmental atmosphere - Anything about the way data was collected that could have introduced bias? Was data collected to minimize distortion or bias? MEASUREMENT AND DATA QUALITY I. Measurement & Assessment of Quantitative Data Ideal data collection procedures are credible, accurate, unbiased, and sensitive in measuring the concept of interest. A. Measurement Consists of rules for assigning numbers to objects to represent qualities or attributes - quantification is intimately associated with measurement. Does it always measure the variable {phenomenon} consistently? 1. Numbers must be assigned to objects according to rules. 2. Numeric values must be linked to reality. 3. Almost all measures are fallible. 4. Advantages of measurement a. Removes guess work b. Because rules are explicit, information tends to be objective c. Able to obtain reasonably precise information d. Constitutes a language of communication "numbers are less vague than words" 5. Errors of measurement a. No tool is infallible - even the best tools have a certain margin of error Obtained score = True score + Error b. Extraneous factors result in the discrepancies between true & obtained scores and result in distortions 1. Situational Contaminants - reactivity, environnemental conditions etc. 2. Response-set biases - ie., socially acceptable responses, extreme response sets 3. Transitory personal factors - ie., fatigue, hunger, mood. 4. Administration variations - Inconsistent data collection among subjects 5. Instrument clarity - poor directions -> misunderstanding 6. Item Sampling - errors as a result of sampling of items used to measure

18 attribute B. Reliability of Measuring Instruments The degree of consistency with which the instrument measures the attribute. Can be equated with stability, consistency or dependability of a measuring tool. 1. Stability - Refers to the extent to which the same scores are obtained when the instrument is used with the same subjects twice. a. Test re-test reliability b. Reliability Coefficient =.00 to 1.00 Satisfactory = >70;.85 -.95 preferable. Is a measurement of how small the differences are between the scores on the same test taken more than once. c. "Test-retest reliability provides estimates of the stability at a measure over time. Stability indexes are most appropriate for relatively enduring characteristics, such as personality and abilities". 2. Internal consistency or homogeneity exists to the extent that all the subparts of an instrument are measuring the same characteristic. a. Split-half technique splits questions (odd versus even) and computes a reliability coefficient b. Chronbach's alpha or coefficient alpha gives an estimate for all possible ways of dividing the measure into halves. 3. Equivalence - this approach to estimating reliability involves different observers or raters using an instrument to measure the same phenomena. 4. Interpretation of reliability coefficients - Instruments with low reliability interfere with adequate hypothesis testing. Homogeneity results in lower reliability coefficients. C. Validity of Measuring Instruments "Validity refers to the degree to which an instrument measures what it is supposed to be measuring" (p. 249). An instrument that is not reliable cannot possibly be valid. An instrument can be reliable without being valid. 1. Content validity - is concerned with the sampling adequacy of the content being measured. Are the right questions asked to cover the content area? Content validity index. 2. Criterion - Related Validity - researcher seeks to establish the relationship between the scores on the instrument and some external criterion. a. Predictive validity - ability of an instrument to differentiate between the performance or behaviors of people on some future criterion. b. Concurrent validity - ability of an instrument to distinguish people who differ in their present status on some criterion. 3. Construct Validity - What construct is the instrument actually measuring? Logical analysis and the testing of relationships (empirical) predicted on the basis of theory are utilized. Researcher must be able to make predictions. a. Known-groups techniques - the attribute is measured in two groups that are expected to be different in relation to the critical attribute. b. Factor analysis - identifying clusters of related variables 4. Interpretation of Validity - Like reliability, not "all or nothing", it is a question of degree. The question is, is the instrument valid for this population? Validity coefficients are computed by using mathematical formulas that correlate the scores on the instrument with scores on the criterion variable. Range.00-1.00. D. Sensitivity and Specificity Important evaluative tool in quantitative instruments. Sensitivity: yields the true positives Specificity: rate of yielding true negatives II. Assessment of Qualitative Data

19 Lincoln and Guba offer four criteria for establishing trustworthiness of qualitative data: credibility, transferability, and confirmability. A. Credibility - "validity in quantitative" Involves two aspects: carrying out the investigation in such a way that the believability of the findings is enhanced and taking steps to demonstrate credibility. Methods to use: 1. Prolonged engagement -invest significant time in data collection, test for misinformation and distortions, and build trust with informants. 2. Persistent observation - researcher focuses on the characteristics or aspects of a situation or conversation related to the phenomenon being studied. 3. Triangulation - use multiple referents a. Data triangulation - use of multiple data sources b. Investigator triangulation - use of multiple individuals to collect, analyze, interpret a single set of data. c. Theory triangulation - use of multiple perspectives to interpret a single set of data d. Method triangulation - use of multiple methods to address a research problem 4. External checks - Debriefing with peers, debriefing with informants (member checks). 5. Searching for disconfirming evidence - look for negative cases. 6. Researcher credibility Researcher's training, qualifications, experience. Any connection to the population being studied? B. Dependability - stability of data over time and conditions. "Reliability in quantitative" a. Step-wise replication - two teams of researchers that conduct independent inquiries and then compare results. b. Inquiry audit - External reviewer scrutinizes documents (also related to data confirmability) C. Confirmability - Are data objective and neutral as agreed upon by independent persons? Researchers must leave an audit trail that allows an independent auditor to review the data and come to conclusions. Important to leave a decision trail. D. Transferability - "generalization of results", thick description", rich and thorough description" I. Qualitative Analysis - Introduction ANALYSIS OF QUALITATIVE DATA A. Qualitative Analysis: General Considerations 1. Purpose of data analysis is to impose order on a large body of information so it can be synthesize, interpreted, and communicated in a research report. 2. Because of the sheer volume of data, analysis is time consuming. B. Analysis styles 1. Template analysis style - researcher applies an analysis guide to narrative data. The template undergoes revision during analysis. A template may list typical behaviors, expressions, etc. Used by ethnographers. 2. Editing analysis style - Researcher reads data searching for meaningful segments to help understand a phenomenon. Often used in grounded theory. 3. Immersion/crystallization analysis style - Researcher is totally immersed in the data, reflects on it, which results in an intuitive crystallization of the data. C. Qualitative analysis process 1. Comprehending - try to make sense of the data, "what is going on?"