Nurse Researcher最新文献

Background: Nurse researchers are constantly seeking novel methods of maintaining philosophical congruence while advancing their knowledge of the human condition using paradigmatically diverse means.

Aim: To provide an overview of the research philosophies underpinning the mixed methods grounded theory (MM-GT) methodology, illustrate its optimal use and introduce a quality-appraisal tool being developed with reference to extant literature.

Discussion: The utility of MM-GT has been effectively demonstrated in the nursing and health literature. Yet, there are examples of how it has been under-used and sub-optimally applied. This article includes a two-phase MM-GT study protocol guided by a pragmatic research philosophy and best practice recommendations that aims to explain neonatal nurses' professional quality of life.

Conclusion: Optimal use of MM-GT's five essential components - purposive sampling, constant comparative methods with iterative coding and analysis, theoretical saturation, memoing and theory development - combine to produce high-quality, defensible research outputs and new nursing theory.

Implications for practice: Research outputs, such as publication and presentation, expounding the multifactorial influences affecting neonatal nurses' professional quality of life will not only benefit the neonatal nursing community but also contribute to the corpus of nursing and midwifery research and enhance the health, well-being and retention of nurses and midwives more broadly.

Background: The statistical shortcomings of null hypothesis significance testing (NHST) are well documented, yet it continues to be the default paradigm in quantitative healthcare research. This is due partly to unfamiliarity with Bayesian statistics.

Aim: To highlight some of the theoretical and practical benefits of using Bayesian analysis.

Discussion: A growing body of literature demonstrates that Bayesian analysis offers statistical and practical benefits that are unavailable to researchers who rely solely on NHST. Bayesian analysis uses prior information in the inference process. It tests a hypothesis and yields the probability of that hypothesis, conditional on the observed data; in contrast, NHST checks observed data - and more extreme unobserved data - against a hypothesis and yields the long-term probability of the data based on repeated hypothetical experiments. Bayesian analysis provides quantification of the evidence for the null and alternative hypothesis, whereas NHST does not provide evidence for the null hypothesis. Bayesian analysis allows for multiplicity of testing without corrections, whereas NHST multiplicity requires corrections. Finally, it allows sequential data collection with variable stopping, whereas NHST sequential designs require specialised statistical approaches.

Conclusion: The Bayesian approach provides statistical, practical and ethical advantages over NHST.

Implications for practice: The quantification of uncertainty provided by Bayesian analysis - particularly Bayesian parameter estimation - should better inform evidence-based clinical decision-making. Bayesian analysis provides researchers with the freedom to analyse data in real time with optimal stopping when the data is persuasive and continuing when data is weak, thereby ensuring better use of the researcher's time and resources.

Background: Safety measurement tools have traditionally examined safety climate and culture from the perspective of healthcare professionals. A small number of studies have used tools to measure patients' perceptions of safety.

Aim: To develop and check the validity of a questionnaire, the King's Patient Safety Measure (KPSM), that assesses how patients perceive their safety when receiving acute care.

Discussion: A cross-sectional survey of 158 patients was undertaken that was constructed to establish the validity and reliability of a 13-item questionnaire. A general linear model statistically tested how patients perceived the safety of their care and whether those views were associated with covariates that included characteristics such as age, gender, ethnic identity, socio-economic factors, how long they stayed in hospital and the way they were admitted to hospital.

Conclusion: The KPSM is a validated tool consisting of a single factor that is internally consistent.

Implications for practice: The KPSM is appropriate for and potentially applicable to a diverse range of patients and could act as an early warning tool.

Background: Interviewing is a vital and common method of collecting data in qualitative research. The interview is usually recorded and a written transcription is created from the recording. The transcription document is then analysed by reading and re-reading to fracture the data and develop initial codes, as in grounded theory methodology. However, this method has disadvantages.

Aim: To report on how the authors used the process of generating initial codes during their analysis in a research study.

Discussion: The authors compare the rigour and efficiency of generating initial codes from reading written transcripts with generating initial codes from listening to recordings. The most notable difference between the two methods is the length of time needed to transcribe the recording before coding can start. The authors discuss the lessons they learned from their pragmatic decision to expedite initial coding by listening to rather than reading the interview data.

Conclusion: Grounded theory requires concurrent data generation and analysis. Audio analysis is efficient in developing initial codes from interview recordings.

Implications for practice: Nurse researchers can use the audio method of analysing interview data.

Background: Questionnaires are perhaps the most widely used measuring tools in nursing research, as many studies conducted by nurses focus on understanding the underlying complex factors that are amenable to questionnaires. However, most questionnaires used in nursing research continue to display inadequate evidence of validity under the traditional methods while ignoring the modern Rasch techniques with better proofs of objective measurement.

Aim: To draw researchers' attention to the recurrent limitations of the classical approach to questionnaire design and to suggest advanced psychometric analysis exemplified in Rasch methodology as a more appropriate alternative.

Discussion: For questionnaire data to be suitable for statistical analysis, transparent demonstration of mathematical assumptions embodied in the questionnaire is compulsory. The failure to engage contemporary measurement models in designing good questionnaires raises concerns about researchers' awareness of the application and usefulness of the evidence generated by the modern approach. This paper illustrates with examples the problems inherent in the traditional or classical test theory and advanced dimensionality and category functioning as requisite psychometric properties of a questionnaire. It also outlines several diagnostic parameters that proponents of Rasch techniques recommend for testing.

Conclusion: Traditional methods of assessing and analysing a questionnaire's psychometric properties are no longer tenable because the modern Rasch approach offers exemplary proofs of questionnaire validity rooted in objective measurement theories.

Implications for practice: Nurse researchers using questionnaires for clinical decisions and education purposes should apply the fundamental principles of objective measurements demonstrated in Rasch theory.

Background: Mobile phones are familiar to most nurses, but the applications available for voice recording and transfer of audio files in research may not be.

Aim: To provide an overview of a pilot study which trialled the use of mobile phones, WhatsApp and phone interviews as a safe and reliable means of collecting data.

Discussion: A pilot study was designed to test the use of: mobile phones as a safe and reliable way to record audio diaries as research data; WhatsApp to transmit the audio files; and phone interviews to explore them. Undertaking the pilot demonstrated that the tools proposed for collecting data were useable and acceptable to the target population and that the researcher's guidance for doing so was satisfactory.

Conclusion: New technologies enable innovation but trialling them for useability is important. Confidentiality and consent need to be carefully managed when using WhatsApp to ensure a study is compliant with data protection regulations.

Implications for practice: Collection of research data digitally and remotely has become increasingly mainstream and relied on during the COVID 19 pandemic. The methods discussed in this article provide solutions for timely data collection that are particularly useful when the researcher is geographically distant from participants. The 'in the moment' reflective nature of the audio diaries could also be applicable to non-research settings - for example, as a method of assisting ongoing professional development and/or collection of reflective accounts.

Background: Societal use of digital technology rapidly increased during the COVID-19 pandemic. Face-to-face services converted to online provision where possible. This affected many nurse researchers.

Aim: To explore conducting research interviews online with children and young people (CYP) about sensitive topics.

Discussion: This article considers digital inclusion, as well as ethical issues surrounding safety, support and consent, along with choosing tools for collecting data. It also presents a discussion of physical proximity in qualitative interviews with this population and its role in data quality. The authors investigate benefits in the context of researchers' personal experiences. They acknowledge the disadvantages of conducting interviews online and discuss ways to mitigate these.

Conclusion: The advantages for researchers include cost-effectiveness, time-efficiency and greater geographical reach of participants. However, CYP's perspectives are unknown and the specific ethical issues of using this method with CYP need careful consideration.

Implications for practice: More research is needed to examine virtual interviews from the perspectives of CYP as participants. Virtual acquisition of consent and assent should be investigated to standardise good research practices.

Background: Using a structured process to develop a self-administered questionnaire provides a robust tool for collecting data that enhances the credibility of the results. Describing this process mitigates any complexity and confusion for the nurse researcher which can be generated by many sources of information that either lack detail or have complex statistical approaches.

Aim: To discuss the development of a self-administered questionnaire with a focus on face, content, construct validity and reliability testing.

Discussion: Adopting a well-established, sequential, five-step approach ensures that important concepts of questionnaire development are addressed: assessing existing tools and qualitative data, if available; drafting of the questionnaire with consideration for question styles, comprehension, acquiescent bias and face validity; expert panel review to establish content validity and inter-rater reliability; pilot testing to assess construct validity; and exploratory factor analysis to establish reliability testing. This approach results in a robust and credible tool for collecting data.

Conclusion: This article provides nurse researchers with a structured process for developing self-administered questionnaires.

Implications for practice: Investing time and effort to assess a newly developed questionnaire for validity and reliability and consider question styles, comprehension and acquiescent bias results in an improved and strengthened tool for collecting data. This in turn enhances the quality and credibility of a study's findings.