Nursing Research: Research Designs

Nursing Research

Research Designs

Unit 3

Horace Williams

Nursing Review

Image summary: A photograph shows a nurse in a white lab coat, focused on writing notes in a notebook.

Instructional Objectives

- Specific.

- Measurable.

- Achievable.

- Rewarding.

- Timely.

Image summary: An illustration of a man in a blue suit and glasses, looking thoughtful while holding a pen, as if planning or writing out objectives.

At the end of this interactive session, students will be able to:

- Explain at least three types of quantitative designs according to Flanagan and Beck 2024, and Nieswiadomy 2012 and 2018.

- Describe at least four forms of qualitative designs as cited by Gray, Grove and Cipher 2026, and Nieswiadomy 2012 and 2018.

- Discuss the development and construction of a research proposal.

Quantitative Research Designs

Image summary: An illustration showing two people at a table with two identical-looking coffee cups, accompanying the text 'The need for blind experiments'. This visual suggests a setup for a blind taste test or a controlled experiment to avoid bias.

Quantitative Research

- Quantitative research is concerned with objectivity, tight controls over the research situation, and the ability to generalize findings.

- In the past, nurse researchers have primarily conducted quantitative research.

- Quantitative research has been the traditional scientific approach used by many of the other disciplines.

Steps in Quantitative Research

- Identify the problem.

- Determine the purpose.

- Review the literature.

- Develop a theoretical or conceptual framework.

- Identify the study assumptions.

- Acknowledge the study limitations.

- Formulate the study hypotheses, variables, or research questions.

Quantitative Research Designs

The research design of a study spells out the strategies that researchers adopt to answer their questions and test their hypotheses.

There are three basic types of quantitative research designs:

- Experimental.

- Quasi-experimental.

- Non-experimental.

Experimental Designs – Randomized Control Trials (R.C.T)

- Early scientists learned that complexities occurring in nature often made it difficult to understand relationships through pure observation.

- This problem was addressed by isolating phenomena and controlling the conditions under which they occurred.

- These experimental procedures have been profitably adopted by researchers interested in human physiology and behaviour.

Characteristics of True Experiments

A true experimental design or R.C.T is characterized by the following properties:

- Intervention or manipulation means the experimenter does something to some participants by manipulating the independent variable.

- Control means the experimenter introduces controls into the study, including devising a good approximation of a counterfactual, which is usually a control group that does not receive the intervention or the full intervention.

- Randomization means the experimenter assigns participants to a control or experimental condition on a random basis.

Intervention/Manipulation

- By introducing an intervention or treatment, experimenters consciously vary and manipulate the independent variable and then observe its effect on the outcome.

- To illustrate, suppose we were investigating the effect of physical exertion on mood in healthy young adults.

- One experimental design for this research problem is a pretest-posttest design, which involves observation of the outcome, in this case mood, at two points in time: before and after the intervention.

- Participants in the experimental group undergo a physically demanding exercise routine, whereas those in the control group undergo a sedentary activity.

- This design permits us to examine what changes in mood were caused by the exertion because only some people were subjected to it, providing an important comparison.

- In this example, we met the first criterion of a true experiment by varying physical exertion, the independent variable.

Control

- The term control group refers to a group of participants whose performance on an outcome variable is used to evaluate the performance of the experimental group, which is the group getting the intervention, on the same outcome.

- A control group used for comparative purposes represents a proxy for the ideal counterfactual, also known as the control group condition.

Randomization

- Experimental designs also involve placing participants in groups at random.

- Through randomization, or random assignment, every participant has an equal chance of being included in any group.

- If people are randomly assigned, there is no systematic bias in the groups with regard to attributes that may affect the dependent variable.

Random Assignment

- Randomly assigned groups are expected to be comparable, on average, with respect to an infinite number of biologic, psychological, and social traits at the outset of the study.

- Group differences in outcomes observed after randomization can therefore be inferred as being caused by the treatment.

- Random assignment can be accomplished by flipping a coin or pulling names from a hat.

- Researchers typically either use computers to perform the randomization or rely on a table of random numbers, which is a table displaying hundreds of digits arranged in random order.

Experimental and Control Conditions

- In designing experiments, researchers make many decisions about what the experimental and control conditions entail, and these decisions can affect the results.

- To give a view of sufficient intensity and duration that affects the outcome of the intervention, a fair test, researchers need to design one that might reasonably be expected.

- Researchers describe the intervention in formal protocols that stipulate exactly what the treatment is for those in the experimental group.

The control group condition, which is the counterfactual, must also be carefully conceptualized.

Researchers have choices about what to use as the control condition, and the decision affects the interpretation of the findings.

Among the possibilities for the control condition are the following:

- One option is no intervention, meaning the control group gets no treatment at all.

- Usual care refers to the standard or normal procedures used to treat patients.

- An alternative treatment may be used, such as music versus massage.

- A placebo, or pseudo-intervention, is presumed to have no therapeutic value; this is also called an attention control condition, where the control group receives attention but not the active ingredients of the intervention.

- A lower dose or intensity of treatment, or only parts of the treatment.

- Delayed treatment, that is, control group members are wait-listed and exposed to the experimental treatment at a later point.

QUASI-Experimental Designs

- Called trials without randomization in the medical literature, these also involve an intervention; however, quasi-experimental designs lack randomization, which is the signature of a true experiment.

- Some quasi-experiments even lack a control group.

- The signature of a quasi-experimental design, then, is an intervention in the absence of randomization.

Non-experimental Studies

- Many research questions, including cause-probing ones, cannot be addressed with an R.C.T or quasi-experimental design.

- For example, take this prognosis question: Do birth weights under 7 pounds cause developmental delays in children? Clearly, we cannot manipulate birth weight, which is the independent variable.

- Babies' weights are not subject to research control, nor are they random.

Non-Experimental Designs

- When researchers do not intervene by controlling the independent variable, the study is non-experimental, or, in the medical literature, observational.

- There are various reasons for doing a non-experimental study, including situations in which the independent variable inherently cannot be manipulated, such as prognosis questions, or in which it would be unethical to manipulate the independent variable, such as some aetiology questions.

- Experimental designs are also not appropriate for descriptive questions.

Types of NON-Experimental/OBSERVATIONAL Studies

- Correlational studies describe an interrelationship or association between two variables, which is a tendency for variation in one variable to be related to variation in another, such as people's height and weight.

- Correlations can be detected through statistical analyses.

- Retrospective correlational studies occur when an effect or outcome observed in the present is linked to a potential cause occurring in the past.

- For example, in retrospective lung cancer research, researchers begin with some people who have lung cancer and others who do not and then look for differences in antecedent behaviours or conditions, such as smoking habits.

- Prospective design, which refers to observational studies with a cohort design, starts with a presumed cause and then goes forward to the presumed effect.

- For example, in prospective lung cancer studies, researchers start with a cohort of adults that includes smokers and nonsmokers, and then later compare the two groups in terms of lung cancer incidence.

Descriptive Designs

- The purpose of descriptive studies is to observe, describe, and document aspects of a situation.

- For example, an investigator may wish to determine the percentage of teenagers who engage in risky behaviour, such as drug use and unsafe sex, which refers to the prevalence of such behaviours.

- Descriptive correlational research means that researchers seek to describe relationships among variables, without attempting to infer causal connections.

- For example, researchers might be interested in describing the relationship between fatigue and psychological distress in patients with H.I.V.

- Because the intent in these situations is not to explain or to understand the underlying causes of the variables of interest, a descriptive non-experimental design is appropriate.

Cross-Sectional Designs

- In cross-sectional designs, data are collected at one point in time, or multiple times in a short time period, such as one and two hours postoperatively.

- Cross-sectional designs are appropriate for describing phenomena at a fixed point.

- For example, a researcher might study whether psychological symptoms in menopausal women are correlated contemporaneously with physiologic symptoms.

- Retrospective studies are usually cross-sectional, meaning that data on the independent and outcome variables are collected concurrently, such as participants' lung cancer status and smoking habits, but the independent variable usually concerns events or behaviours occurring in the past.

Longitudinal Designs

- Longitudinal designs involve collecting data multiple times over an extended period.

- Such designs are useful for studying changes over time and for establishing the sequencing of phenomena, which is a criterion for establishing causality.

- Multiple data collection points can also strengthen causal inferences, such as in a nonequivalent control group design in which collecting pretreatment data offers evidence about the initial comparability of groups.

Longitudinal Studies

- In longitudinal studies, the number of data collection points and the time intervals between them depend on the nature of the study.

- When change or development is rapid, numerous data collection points at relatively short intervals may be required to understand trends.

- By convention, however, the term longitudinal implies multiple data collection points over an extended period of time.

- A serious challenge in longitudinal studies is the loss of participants, known as attrition, over time.

- Attrition is problematic because those who drop out of the study usually differ in important respects from those who continue to participate, resulting in potential biases, the risk of faulty inferences, and concerns about the generalizability of the findings.

Qualitative Designs

Image summary: A cartoon illustration shows a person in a white lab coat holding a clipboard, while a group of people stand before them with speech bubbles, symbolizing the collection of personal stories and experiences in qualitative research.

Qualitative Research Designs

Qualitative and Quantitative Research Perspectives

- Qualitative research is concerned with the subjective meaning of an experience to an individual.

- Some people do not consider qualitative research to be scientific.

- Others view quantitative research as hard science and qualitative research as soft science.

- Still others view both research approaches as scientific.

Qualitative Research Design

- Qualitative studies use an emergent design that evolves as researchers make ongoing decisions based on what they have already learned.

- An emergent design in qualitative studies is a reflection of the researchers' desire to have the inquiry based on the realities and viewpoints of those under study, which are realities and viewpoints that are not known at the outset.

Characteristics of Qualitative Research Design

- Qualitative inquiry has been guided by different disciplines, and each has developed methods for addressing questions of interest.

- Some characteristics of qualitative research design tend to apply across disciplines.

However, in general, qualitative design:

- Is flexible and elastic, capable of adjusting to what is being learned during data collection.

- This often involves merging various data collection strategies, such as triangulation.

- It tends to be holistic, striving for an understanding of the whole, which requires researchers to become intensely involved and can necessitate a lengthy period of time.

- It benefits from ongoing data analysis to guide subsequent strategies and decisions about when data collection is done.

Qualitative Design Features

- Qualitative design features are often post hoc characterizations of what happened in the field rather than features specifically planned.

- Regarding intervention, control, and blinding, qualitative research is almost always non-experimental, although a qualitative sub-study may be embedded in an experiment.

- Qualitative researchers do not conceptualize their studies as having independent and dependent variables, and they rarely control any aspect of the people or environment under study.

Blinding in Experiments

- A blind or blinded experiment is an experiment in which information about the test is masked, or kept from the participant, to reduce or eliminate bias until after a trial outcome is known.

- If both the tester and subject are blinded, the trial is called a double-blind experiment.

- Blinding is rarely used by qualitative researchers.

Blinding

- In an experiment, if subjects in the control group know that they are receiving a placebo, the placebo effect will be reduced or eliminated, and the placebo will not serve its intended control purpose.

- Blinding is the practice of not telling subjects whether they are receiving a placebo.

Qualitative Research Goals and Comparisons

- The goal is to develop a rich understanding of a phenomenon as it exists and as it is constructed by individuals within their own context.

- Regarding comparisons, qualitative researchers typically do not plan to make group comparisons because the intent is to thoroughly describe or explain a phenomenon.

- Yet, patterns emerging in the data sometimes suggest illuminating comparisons.

Research Settings

- Qualitative researchers usually collect their data in real-world, naturalistic settings, whereas a quantitative researcher usually strives to collect data in one type of setting to maintain constancy of conditions, such as conducting all interviews in participants' homes or school settings.

- Qualitative researchers may deliberately strive to study phenomena in a variety of natural contexts, especially in ethnographic research.

Causality and Qualitative Research

- In attempting to not only describe but also to explain phenomena, qualitative researchers who undertake in-depth studies will inevitably reveal patterns and processes suggesting causal interpretations.

- These interpretations can be and often are subjected to more systematic testing using more controlled methods of inquiry.

Qualitative Research Traditions

- Although some features are shared by many qualitative research designs, there is a wide variety of approaches.

These include:

- Ethnography is a type of qualitative inquiry that involves the description and interpretation of a culture and cultural behaviour.

- Culture refers to the way a group of people live, which includes the patterns of human activity and the symbolic structures, such as values and norms, that give such activity significance.

Ethnographies and Phenomenology

- Ethnographies typically involve extensive fieldwork, which is the process by which the ethnographer comes to understand a culture.

- Because culture is, in itself, not visible or tangible, it must be inferred from the words, actions, and products of members of a group and then constructed through ethnographic writing.

- Phenomenology is rooted in a philosophical tradition developed by philosophers Husserl and Heidegger; it is an approach to exploring and understanding peopleoods everyday life experiences.

Phenomenology

- Phenomenological researchers ask: What is the essence of this phenomenon as experienced by these people, and what does it mean to them?

- Phenomenologists assume there is an essence, an essential structure, that can be understood in much the same way that ethnographers assume that cultures exist.

- Phenomenologists investigate subjective phenomena in the belief that critical truths about reality are grounded in people's lived experiences.

Phenomenology and Grounded Theory

- The topics appropriate to phenomenology are fundamental to the life experiences of humans, such as the meaning of suffering or the quality of life with chronic pain.

- Grounded Theory has contributed to the development of many theories of phenomena relevant to nurses.

- Grounded theory was developed in the 1960s by two sociologists, Glaser and Strauss, whose theoretical roots were in symbolic interaction, which focuses on the manner in which people make sense of social interactions.

Qualitative Research Traditions

- Grounded theory tries to account for people's actions from the perspective of those involved.

- Grounded theory researchers seek to understand the actions by first discovering the main concern or problem, and then the behaviour that is designed to address it.

- The manner in which people resolve this main concern is called the core variable.

- Historical Research is one other qualitative tradition that springs from the discipline of history.

Historical Research

- Historical research is the systematic collection and critical evaluation of data relating to past occurrences.

- Historical research relies primarily on qualitative narrative data but can sometimes involve statistical analysis of quantitative data.

- Nurses use historical research methods to examine a wide range of phenomena in both the recent and more distant past.

- Historical research should not be confused with a review of the literature about historical events.

- Like other types of research, historical inquiry has as its goal discovering new knowledge, not summarizing existing knowledge.

Other Types of Qualitative Research

- Case studies are in-depth investigations of a single entity or a small number of entities.

- The entity may be an individual, family, institution, community, or other social unit.

- Case study researchers attempt to analyze and understand issues that are important to the history, development, or circumstances of the entity under study.

- One way to think of a case study is to consider what is at center stage; the case itself is central.

- The focus of case studies is typically on understanding why an individual thinks, behaves, or develops in a particular manner rather than what his or her status or actions are.

- Probing research of this type often requires detailed study over a considerable period.

- Data are often collected that relate not only to the person's present state but also to past experiences and situations relevant to the problem being examined.

Narrative Analyses

- This approach focuses on story as the object of inquiry, to understand how individuals make sense of events in their lives.

- The underlying premise of narrative research is that people most effectively make sense of their world, and communicate these meanings, by constructing and narrating stories.

- Individuals construct stories when they wish to understand specific events and situations that require linking an inner world of desire to an external world of observable actions.

- Analyzing stories opens up forms of telling about experience and is more than just content.

- Narrative analysts ask, "Why did the story get told that way?"

Building A Research Proposal

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- We will go through an outline.