Nurse Researcher最新文献

Background: The use of photo-elicitation interviews (PEIs) has increased in popularity across a range of disciplines including healthcare. Although qualitative researchers have embraced PEIs as a creative way to explore people's experiences of their lives and environments, the methodological and practical aspects of using photographs have received little attention in the literature.

Aim: To discuss the use of PEI techniques, including sourcing and using photographs.

Discussion: The authors discuss definitions of photo-elicitation, and explore the value of and difference between using photographs taken by the researcher and those taken by participants. They consider methodological issues in the context of a small-scale focus group study that used PEIs to explore young women's conceptualisations of teenage and older motherhood.

Conclusion: Using photographs in research is far more complex than providing participants with cameras or presenting them with photographs. Researchers must be aware of the potential bias in the choice, selection and sequencing of photographs, as well as the methodological considerations associated with PEIs.

Implications for practice: This article highlights the value of using photographs in qualitative research and presents some of the methodological issues that nurse researchers need to consider when designing and conducting research using photographs.

Background: Vignettes are regularly used in nursing research and education to explore complex clinical situations. However, paper-based vignettes lack clinical realism and do not fully recreate the pressures, sights and sounds of clinical settings, limiting their usefulness when studying complex decision-making processes.

Aim: To discuss the approach taken by the authors in developing and implementing audiovisual vignettes to collect data remotely in a qualitative study.

Discussion: The authors describe how they created audiovisual vignettes for a qualitative 'Think Aloud' study exploring how critical care nurses decide whether to restrain agitated patients with varying degrees of psychomotor agitation. They discuss the practicalities of filming, editing and hosting, as well as the theoretical and clinical background that informed the creation of the vignettes.

Conclusion: Audiovisual vignettes are a cost- and time-effective way of remotely exploring decision-making in challenging environments. This innovative method assists in studying decision-making under simulated clinical pressures and captures data about how people make complex decisions.

Implications for practice: Audiovisual vignettes are an innovative tool for collecting data and could also be used in educational settings and offer the opportunity to explore complex clinical decision making remotely. Clinical accuracy is essential for immersing participants and simulating an environment and its pressures. The method could be further enhanced by making vignettes responsive to participants' decisions.

Background: The assessment and monitoring of health conditions using remote or online delivery is an emerging interest in healthcare systems globally but is not routinely used in mental health research. There is a growing need to offer remotely delivered appointments in mental health research. There is a lack of practical guidance about how nurse researchers can undertake remote research appointments ethically and safely, while maintaining the scientific integrity of the research.

Aim: To provide mental health nurse researchers with information about important issues to consider when assessing the appropriateness of remotely delivered research and methods to support the development of a supportive research relationship.

Discussion: The practice guidance and checklist include issues a nurse researcher should consider when assessing suitability and eligibility for remotely delivered research visits, such as ethical considerations and arrangements, safety, communication, and identifying participants requiring further support. This article addresses processes to follow for assessing mental capacity, obtaining informed consent and collaboratively completing research measures.

Conclusion: Remotely delivered research appointments could be acceptable and efficient ways to obtain informed consent and collect data. Additional checks need to be in place to identify and escalate concerns about safeguarding or risks.

Implications for practice: Practical guidance for mental health nurse researchers when determining the appropriateness of remote research visits for participants, and an adaptable checklist for undertaking remote research appointments are outlined.

Background: Realist evaluation is increasingly used in healthcare research, and theories can provide plausible explanations of why interventions work or do not work in certain circumstances such as the effect of the opt-out hepatitis C virus (HCV) testing policy in English prisons.

Aim: To present the process of constructing the middle-range theories (MRTs) developed as part of an evaluation of hepatitis C test uptake in an English prison as a resource for researchers using realist evaluation.

Discussion: MRTs are propositions that can explain a particular behaviour or outcome. In this evaluation, the MRTs emerged from a realist evaluation, a theory-driven approach for understanding what interventions work, in what circumstances and how. The mixed-methods data collected during the realist evaluation and the sociological theory of prisonisation were used to create the MRTs. Combining prisonisation with the qualitative data illustrates how healthcare interventions may be viewed by people in prison who may have adopted either the 'deprivation' or 'importation' processes of adaptation to cope with their incarceration. Their views may affect the acceptance of HCV tests.

Conclusion: The development of MRTs is a creative and iterative process, requiring an in-depth understanding of the data collected and the subject area. MRTs permit us to see relationships among phenomena that might otherwise seem disconnected, thereby aiding the development of more efficacious interventions.

Implications for practice: The MRT developed presents an evidence base for selecting interventions to increase the uptake of HCV tests in prisons. This paper explains how a MRT was developed and how HCV test uptake in prisons can be explained using a sociological theory.

Background: Dismantling structural racism challenges nurses to consider the extent to which issues of inclusion, diversity and race are operationalised in day-to-day professional practice. This includes nurse education. To be truly effective, any examination of teaching content in nurse education needs to be investigated through document analysis plus observation in the classroom. However, tools to ensure consistency between these methods of collecting data are limited.

Aim: To design a structured tool for collecting data by analysing teaching materials and observing teaching on pressure injuries and people with darker skin tones.

Discussion: This novel approach of using a single tool provides a unique opportunity to explore teaching materials and what is actually taught in the classroom. The data collected can assist with comparative analysis, enabling an in-depth view of curriculum content.

Conclusion: The nuanced and subtle data gathered using the complementarity of analysis between teaching materials and teaching observations in the exemplar tool presented created a unique data set for examination.

Implications for practice: This tool has broad applications for nurse researchers, particularly for examining topics that are often perceived to be sensitive, such as race and skin tone. It can be used for in-depth scrutiny of classroom teaching, to develop and influence curriculum content and team discussions, and in larger studies exploring nurse education content.

Background: Measurement error must always be considered when planning a research project and interpreting its results. The accuracy of some data collected during a study can often be confidently assured, but more than one measurement or observer is needed to assess exposure and outcomes status in cases where clinical measurement is prone to measurement error. Little attention is paid in nursing research to misclassification and measurement error. Bias is often discussed in nursing research education, but not its potential consequences or measures that can be taken to improve the study's quality.

Aim: To present examples of random measurement error - misclassification of a binary outcome - in a continuous exposure and outcomes variable, to address this gap in nurses' research training.

Discussion: The article discusses the relationship between exposure and outcome in the absence and presence of measurement error using risk (relative risk) and association using correlation. It provides methods to estimate the true value of these measures of risk and association, when only given the clinical measurements with errors.

Conclusion: If the assumption of random error holds, attenuation of risk or association towards the null will occur.

Implications for practice: Understanding the effect of measurement error including misclassification will enable researchers to interpret the results of their studies, and to take into consideration this potential error when planning and conducting a study.

Background: A study aimed at reducing the time spent on the phone obtaining insurance preauthorisation in a neurosurgical clinic was successfully completed. However, the researchers were unable to reject the null hypothesis because of a combination of chronological bias and the Hawthorne effect.

Aim: To increase nurse researchers' awareness of the potential to introduce a chronological bias as a confounder in clinical research and suggest potential alternative approaches to study design.

Discussion: The researcher shared the study's purpose, design and outcome measure with the participants before collecting the baseline data. This enabled the participants to alter their practice before the intervention was implemented (a chronological bias) and change their behaviour surrounding the outcome (the Hawthorne effect).

Conclusion: The use of the Delphi method became a catalyst for change before the collection of baseline data, the combination of chronological bias and the Hawthorne effect affecting the study's results.

Implications for practice: Nurse researchers seeking to improve practice should collect baseline data before informing participants and consider the risks and benefits of blinding (concealment) surrounding the outcome.