Nursing Research: Principles, Process and Issues

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As the four studies were conducted in different countries, the nurse’s cultures, values, beliefs about management and prevention of PUs may be different from the experience and knowledge of the nurses in the United Kingdom (UK). Therefore, one will be cautious while applying the findings to the healthcare settings in the UK as there may be differences in the PU treatment guidelines, protocols and policies. The International Council for Nurses (ICN) emphasis on the need for nurses to apply the evidence from clinical literatures which have an informed basis for their clinical decisions (ICN, 2012). Adoption of evidence-based practice (EBP) by the nurses is vital because they are directly involved in the management and treatment of PUs as part of a multidisciplinary team approach in various healthcare settings (Lehane et al., 2018). However, King Funds(2018) argues thatalthough the guidelines and research evidence are used in the management of PU’s in the UK, the quality of the treatment provided by individual nurses varies. As a result, there is a need to explore the attitude and knowledge of nurses on prevention and treatment, as well as the barriers which impact on the nurse’s management of PUs. National Institute for Health and Care Excellence (NICE, 2018) guideline emphasised on transparent treatment, quality improvement and outcome measurement. The guideline enables the nurses to improve healthcare and reduce inequalities in health treatment by effective adoption of evidence-based practice (EBP). Hence, the effective application of EBP in healthcare management is crucial in reducing avoidable PUs and promoting patient safety. This is important as research findings aids improvement of policies and practices in nursing, and research evidences help to reduce the rate and risk of PU development in patients and provides the necessary support needed for the treatment ( Lehane et al., 2018). Creswell J. W. (2014). Research design: Qualitative, quantitative and mixed methods approaches (4th ed.). Thousand Oaks, CA: Sage. [ Google Scholar] Frowe I. (2001). Language and educational research. Journal of Philosophy of Education, 35, 175–186. [ Google Scholar]

There are numerous databases to apply the search strategy to, for relevance of nursing research, CINAHL and MEDLINE have been chosen for their credibility, and range of sources (Figure 4) (Booth et al., 2016). LoBiondo-Wood G., Haber J. (2014). Nursing research, methods and critical appraisal for evidence-based practice (8th ed.). St. Louis, MI: Mosby. [ Google Scholar]

About the contributors

Finlay L. (2006). “Rigour,”“ethical integrity” or “artistry”? Reflexively reviewing criteria for evaluating qualitative research. British Journal of Occupational Therapy, 69, 319–326. [ Google Scholar] Miles M. B., Huberman A. M., Saldana J. (2014). Qualitative data analysis: A methods sourcebook (3rd ed.). Thousand Oaks, CA: Sage. [ Google Scholar] Caelli K., Ray L., Mill J. (2003). “Clear as mud”: Toward greater clarity in generic qualitative research. International Journal of Qualitative Methods, 2( 2), 1–23. [ Google Scholar] Consent was gained from the University, prior to the research commencing. As such, the research will have been reviewed by the University in line with the Ethical Research Standards (WHO, 2011). The researchers kept all data anonymised in line with the protection of human rights, protecting confidentiality and anonymity (Lo-Biondo Wood and Haber, 2017).

Kingdon C. (2005). Reflexivity: Not just a qualitative methodological research tool. British Journal of Midwifery, 13, 622–627. [ Google Scholar] Holloway I. (2005). Qualitative research in health care. Berkshire, UK: Open University Press. [ Google Scholar] There is a myriad of qualitative approaches to research. Yet, the researcher may be confronted with a question or a topic that belongs within the qualitative paradigm but does not correspond neatly with approaches that are well documented and clearly delineated. Within the literature, various terms have been used to describe research that does not fit within a traditional qualitative approach. Thorne, Kirkham, and MacDonald-Emes (1997) define “interpretive description” as a “noncategorical” qualitative research approach (p. 169). Merriam (1998) refers to this type of research as “basic or generic qualitative research” (p. 20) and Sandelowski (2000, p. 335, 2010) explores what she calls “basic or fundamental qualitative description.” Exploratory research is the umbrella term used by Brink and Wood (2001) to describe all description qualitative research and suggest it “is a Level 1 research endeavor” (p. 85), and Savin-Baden and Howell Major (2013) refer to a pragmatic qualitative approach. This interchangeable use of terms creates ambiguity and confusion in relation to qualitative description research as a methodology in its own right. Reference to “interpretive” as described by Thorne et al. (1997) can cause confusion with phenomenology, for example, and Savin-Baden and Howell Major’s (2013) use of a “pragmatic qualitative approach” might suggest that if all else fails, the researcher should adopt a pragmatic approach.

Footnotes

World Medical Association Declaration of Helsinki (2014) ‘Ethical Principles for Medical Research Involving Human Subjects’, Jahrbuch für Wissenschaft, 18(1), pp.1-10. Cluett E. R., Bluff R. (2006). Principles and practice of research in Midwifery (2nd ed.). London: Bailliere Tindall. [ Google Scholar]

The research process contains multiple components, the first is devising a research question; identifying what is to be researched and formulating a focused question (Parahoo, 2014). The question forms the foundation of the research and offers the idea which will be examined (Lo-Biondo Wood and Haber, 2017). For example:Harvey, M. and Land, L. (2017) Research methods for nurses and midwives. Los Angeles: Sage Publications. Process maps are diagrams that set out each step of what is presently happening to detect problems in the system. Solutions to the problem can be identified using driver diagrams. Subsequently, it is necessary to consider how trainees will know whether a change resulted in an improvement. This means that baseline data must be collected. This may be done retrospectively. Petkovic, J., Duench, S., Welch, V., Rader, T., Jennings, A., Forster, A. and Tugwell, P. (2018) ‘Potential harms associated with routine collection of patient sociodemographic information: A rapid review’, Health Expectations, 22(1), pp.114-129. A systematic review will be completed of Rylance et al’s. (2017) quantitative research into ‘mental health students feeling prepared to assess physical health’, using CEBMa’s (2014), critical appraisal tool.

Kalowes, P., Messina, V. and Li, M. (2016) ‘Five-Layered Soft Silicone Foam Dressing to Prevent Pressure Ulcers in the Intensive Care Unit’, American Journal of Critical Care, 25(6), pp.108-119. Doody O., Noonan M. (2013). Preparing and conducting interviews to collect data. Nurse Researcher, 20( 5), 28–32. [ PubMed] [ Google Scholar] Guest G., Bunce A., Johnson L. (2006). How many interviews are enough? An experiment with data saturation and variability. Field Methods, 18, 59–82. [ Google Scholar]

Ryan-Nicholls D., Will I. C. (2009). Rigour in qualitative research: Mechanisms for control. Nurse Researcher, 16, 70–83. [ PubMed] [ Google Scholar] Lee, V. (2018) ‘Beyond seeking informed consent: Upholding ethical values within the research proposal’, Oncology Nursing Journal, 28(3), pp.222-227. For nurses to be successful evidence-based practitioner’s, critical and analytical ability is vital when completing a systematic review (Ellis, 2016). This ensures limitations and strengths have been explored, strengths should outweigh the limitations to provide credible research (Coughlan et al., 2013). This reflects the systematic review aims of summarising the best available evidence (Pearson et al., 2009). The second qualitative research conducted by Carlsson and Gunningberg (2017) has two clearly stated objectives. The initial objective was to identify and describe different ways in which nurses understand unavoidable PUs in late palliative care. Then the second objective was to explore the expediency of the different levels of understanding the unavoidable PUs. The recruited participants were 8 nurses and 7 healthcare assistants (HCA) who work in various nursing homes and specialist palliative inpatient care units in Sweden. A purposeful sampling was also used f or recruiting the participants. The data was collected using a semi-structured interview which lasted between 20-45 minutes per participant. The interviews were tape-recorded and the data was transcribed and analysed using the phenomenological analysis steps. The study was approved by the regional ethical review board. The result of the study shows that the entire participant agreed that prevention of PUs in End of Life (EoL) care is worthwhile and that not all PUs in dying patients can be prevented and this reflects the topic that was reviewed. Pearson, A., Field, J. and Jordan, Z. (2009). Evidence-Based Clinical Practice in Nursing and Health Care: Assimilating Research, experience and Expertise.