This book is designed to help you develop skills that will allow you to read, evalu- ate, and use nursing studies (i.e., to become skillful consumers and users of nurs- ing research). In each chapter of this book, we present information relating to the methods used by nurse researchers and provide specific guidance in several ways.
First, interspersed throughout the chapters, we offer tips on what you can expect to
find in actual research articles with regard to the content in the chapter, identified by the icon . These include special “how-to-tell” tips that help you find concepts discussed in this book in research reports. These tips are identified with this icon:
. Second, we include guidelines for critiquing those aspects of a study covered in each chapter. Each set of critiquing guidelines is included in the Toolkit section
on the accompanying CD-ROM so that you can “fill in” answers on a com- puter, or adapt questions to suit your needs. The questions in Box 1.1 are designed to assist you in using the information in this chapter in an overall preliminary assessment of a research report. And third, we offer opportunities to apply your newly acquired skills. The critical thinking activities at the end of each chapter guide you through appraisals of real research examples (some of which are pre- sented in their entirety in the appendix) of both qualitative and quantitative stud- ies. These activities also challenge you to think about how the findings from these studies could be used in nursing practice.
1. How relevant is the research problem to the actual practice of nursing? Does the study focus on a topic that is considered a priority area for nursing research?
2. Is the research quantitative or qualitative?
3. What is the underlying purpose (or purposes) of the study—identification, description, exploration, prediction/control, or explanation? Does the purpose correspond to an EBP focus such as treatment, diagnosis, prognosis, harm and etiology, or meaning?
4. What might be some clinical implications of this research? To what type of people and settings is the research most relevant? If the findings are accurate, how might the results of this study be used by me?
BOX 1.1 QUESTIONS FOR A PRELIMINARY OVERVIEW OF A RESEARCH REPORT
Each chapter of this book presents brief descriptions of actual studies conducted by nurse researchers, focusing on key terms and concepts discussed in the chapters. The descriptions are followed by some questions to guide critical thinking. A review of the full journal articles would prove useful for learning more about study methods and findings.
EXAMPLE 1 ■ Quantitative Research Study
Depression and anxiety in women with breast cancer and their partners (Badger et al., 2007).
R E S E A R C H E X A M P L E S A N D C R I T I C A L T H I N K I N G A C T I V I T I E S
Study Purpose
The purpose of the study was to evaluate the effectiveness of telephone-delivered psychosocial interventions in decreasing depression and anxiety in women with breast cancer and their partners.
Study Methods
A total of 96 women with breast cancer and their partners were recruited to participate in the study. Two different, but complementary, interventions were implemented using a telephone delivery method. The 6-week telephone interpersonal counseling intervention (TIP-C) combined cancer education with interpersonal counseling that targeted the social support behavior of both cancer survivors and their partners. The other 6-week telephone intervention focused on self-managed exercise (EX). Study participants were allocated, based on a lottery- type system, to either one of the two interventions or to a control group that received neither treatment but that got printed information and brief weekly calls (CON). All study participants, including partners, were interviewed before the study began, and then 6 weeks and 10 weeks later. The interviews included scales that measured levels of depression and anxiety.
Key Findings
The analysis suggested that anxiety was reduced, for both the women and their partners, in both the TIP-C and EX intervention groups but not in the control group. Depression decreased over time in all three groups.
Conclusions
Badger and colleagues concluded that both telephone-delivered interventions were effective in improving psychological quality of life when compared with nonreceipt of either intervention.
CRITICAL THINKING SUGGESTIONS*:
*See the Student Resource CD-ROM for a discussion of these questions.
1. Answers the questions from Box 1.1 regarding this study.
2. Also consider the following targeted questions, which may assist you in assessing aspects of the study’s merit:
a. Why do you think the researchers decided to have a third group that did not get either intervention?
b. Why do you think the control group participants received brief weekly phone calls?
c. Could this study have been undertaken as a qualitative study? Why or why not?
EXAMPLE 2 ■ Qualitative Research Study
Living with risk: Mothering a child with food-induced anaphylaxis (Gillespie et al., 2007).
Study Purpose
The purpose of this study was to develop a narrative description of the underlying meaning of mothers’ lived experience of parenting a child with food-induced anaphylaxis (FIA).
Study Methods
Six mothers of children 6 to 12 years of age who were considered at risk for FIA were recruited to participate in the study. The number and type of food allergies varied, but peanut was the
most common. Two in-depth interviews, each lasting 11⁄2to 2 hours, were conducted with each mother in her own home. The interviews, which were audiotaped and then transcribed, focused on what it was like for the mothers to have a child with a life-threatening food allergy.
Key Findings
“Living with risk” was identified as the essence of the mothers’ experience, and was supported by five themes: (1) living with fear; (2) worrying about well-being; (3) looking for control;
(4) relying on resources; and (5) it is hard, but it is not. Each theme was supported with rich narrative descriptions from the in-depth interviews.
Conclusions
The researchers concluded that the themes describing mothers’ fears and concerns would be useful in assisting nurses to meet families’ education and support needs related to FIA.
CRITICAL THINKING SUGGESTIONS:
1. Answer the questions in Box 1.1 regarding this study.
2. Also consider the following targeted questions, which may assist you in assessing aspects of the study’s merit:
a. Why do you think that the researchers audiotaped and transcribed their in-depth inter- views with study participants?
b. Do you think it would have been appropriate for the researchers to conduct this study using quantitative research methods? Why or why not?
EXAMPLE 3 ■ Quantitative Research in Appendix A
1. Read the abstract and the introduction from Howell and colleagues’ (2007) study (“Anxiety, anger, and blood pressure in children”) in Appendix A of this book, and then answer the relevant questions in Box 1.1.
2. Also consider the following targeted questions, which may further sharpen your critical thinking skills and assist you in assessing aspects of the study’s merit:
a. What gap in the existing research was the study designed to fill?
b. Would you describe this study as applied or basic, based on information provided in the abstract?
c. Could this study have been undertaken as a qualitative study? Why or why not?
d. Who helped to pay for this research? (This information appears at the end of the report).
EXAMPLE 4 ■ Qualitative Research in Appendix B
1. Read the abstract and the introduction from Beck’s (2006) study (“Anniversary of Birth Trauma”) in Appendix B of this book and then answer the questions in Box 1.1.
2. Also consider the following targeted questions, which may further sharpen your critical thinking skills and assist you in assessing aspects of the study’s merit:
a. What gap in the existing research was the study designed to fill?
b. Was Beck’s study conducted within the positivisit paradigm or the naturalistic para- digm? Provide a rationale for your choice.