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2738_FM_i-xiv 07/12/12 10:33 AM Page i Reading, Understanding, and Applying Nursing Research 2738_FM_i-xiv 07/12/12 10:33 AM Page ii Online Resource Center DavisPlus is your online source for a wealth of learning resources and teaching tools, as well as electronic and mobile versions of our products. Visit davisplus.fadavis.com StudentS InStructorS Unlimited free access. Upon Adoption. Sign up today to see what’s Password-protected library of available for your title. title-specific, online course content. Taber’s online resources are now available across many of the DavisPlus resource pages. Look for this icon to find Taber’s resources! explore more online resources from f.a.davis www.drugGuide.com www.Tabers.com www.LabdxTest.com The complete Davis’s Drug The power of Taber’s® Cyclo- The complete database for Guide for Nurses® database pedic Medical Dictionary Davis’s Comprehensive with over 1,100 monographs on the web. Find more than Handbook of Laboratory on the web. 60,000 terms, 1,000 images, and Diagnostic Tests with and more. Nursing Implications online. Access hundreds of detailed monographs. www.fadavis.com 2738_FM_i-xiv 07/12/12 10:33 AM Page iii Reading, Understanding, and Applying Nursing Research F O U RT H E D I T I O N JAMES A. FAIN, PhD, RN, BC-ADM, FAAN Dean and Professor University of Massachusetts Dartmouth College of Nursing North Dartmouth, Massachusetts 2738_FM_i-xiv 07/12/12 10:33 AM Page iv F. A. Davis Company 1915 Arch Street Philadelphia, PA 19103 www.fadavis.com Copyright © 2013 by F. A. Davis Company Copyright © 1999, 2004, 2009, by F. A. Davis Company. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the publisher. Printed in the United States of America Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1 Publisher, Nursing: Joanne Patzek DaCunha, RN, MSN Director of Content Development: Darlene D. Pedersen Project Editor: Echo Gerhart Electronic Project Editor: Tyler Baber Design and Illustration Manager: Carolyn O’Brien As new scientific information becomes available through basic and clinical research, recom- mended treatments and drug therapies undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up-to-date, and in accord with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check product information (package inserts) for changes and new information regarding dose and contraindications before administering any drug. Caution is especially urged when using new or infrequently ordered drugs. Library of Congress Cataloging-in-Publication Data Proudly sourced and uploaded by [StormRG] Fain, James A., 1953- Kickass Torrents | TPB | ET | h33t Reading, understanding, and applying nursing research: a text and workbook / James A. Fain.—4th ed. p.; cm. Includes bibliographical references and index. ISBN 0-8036-2738-3 (alk. paper) 1.Nursing—Research. I. Title. [DNLM: 1. Nursing Research—methods. WY 20.5 F162r 2003] RT81.5.F35 2003 610.73072—dc21 2003046170 Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F. A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Transactional Reporting Service is: 978-0-8036-2783-3/13 0 + $.25. 2738_FM_i-xiv 07/12/12 10:33 AM Page v To Linda and our children, Lauren, Jillian, and Timothy 2738_FM_i-xiv 07/12/12 10:33 AM Page vi 2738_FM_i-xiv 07/12/12 10:33 AM Page vii P R E FA C E Research plays an integral part in determining the roles and responsi- bilities of nurses. Involvement in research can range from conducting an independent research study to critically appraising the research literature. Enhancing knowledge of research and practicing research skills can help nurses increase their appreciation of how research influences the quality of patient care. This fourth edition of Reading, Understanding, and Applying Nursing Researchhas been updated while retaining all important features of previous editions. With students now being more sophisticated in the use of technology and inclined to use it, the fourth edition allows students to use the CD with computer ease and Web accessibility to help increase recognition and understanding of the research process. The book continues to be directed toward undergraduate students, RNs returning to school, and practicing nurses. This edition continues to emphasize how to read research reports, evaluate them critically, and apply findings to practice by providing more examples of nursing research throughout the book. Steps of the research process are illustrated with excerpts from studies that have been published in nursing literature. The fourth edition continues to organize content into three parts. Part 1, Nature of Research and the Research Process, presents the im- portance of nursing research. In addition, several documents present suggested research activities for nurses. The idea that data obtained through sound research methods provide the necessary foundation for best practices (evidence-based nursing) is likewise introduced in Part 1. Part 2, Planning a Research Study, discusses specific aspects of the research process, providing students with information they need to understand inductive and deductive reasoning, along with the for- mation of research questions and hypotheses from a conceptual model or theoretical framework. Part 3, Utilization of Nursing Research, introduces suggested strategies for evaluating and critiquing research reports along with guidelines for utilization of research findings. Specific objectives of this edition are to provide students with (1) an understanding of the steps of the research process, (2) a sound ethical knowledge base, (3) the skill to critically evaluate a problem and purpose statement, (4) the knowledge of what specific statistical procedures can be used to answer various research questions and/or hypotheses, (5) the knowledge of randomized clinical trials as a methodological “gold stan- dard” and why use of other types of design is so often necessary in nursing research, and (6) a sense of confidence in their ability to read research reports. In addition, an Instructor’s Guide is provided, which includes vii 2738_FM_i-xiv 07/12/12 10:33 AM Page viii viii Preface a chapter corresponding to each chapter in the book, with answers to review, multiple-choice, and critical-thinking questions. Finally, an additional test bank of multiple-choice questions and answers is provided. As with previous editions, student learning objectives are presented at the beginning of every chapter, along with a glossary of terms, and a summary of key ideas is presented at the end of every chapter. A popular feature in previous editions focused on the presentation of excerpts from published research reports. Updated examples of published research from actual journal articles are included in each chapter to help students improve their skills in reading and understanding research reports. The quality of patient care depends largely on the quality of nursing research. The ability to understand components of the research process and to integrate scientific knowledge with practice to make informed judgments and valid clinical decisions is critical. Reading, Understand- ing, and Applying Nursing Researchprovides the skills necessary to help students understand what researchers are trying to communicate in published research reports. As consumers of nursing research, the emphasis is on assisting students to understand and evaluate the research reports being discussed. Reading, Understanding, and Applying Nursing Re- search provides a clear and practical presentation of these skills. —James A. Fain 2738_FM_i-xiv 07/12/12 10:33 AM Page ix R E V I E W E R S Janet G. Alexander, EdD, MSN, RN, CNE Professor & Director, Accelerated Second-Degree BSN Program Samford University, Ida V. Moffett School of Nursing Birmingham, Alabama Maureen C. Creegan, BSN, MA, EdM, EdD, RN Professor of Nursing Dominican College Orangeburg, New York Mary Isaacson, PhD, RN Assistant Professor of Nursing Augustana College Sioux Falls, South Dakota Valerie Lunsford, RN, BSN, MSN, PhD Professor Goldfarb School of Nursing at Barnes Jewish College Saint Louis, Missouri Lynx Carlton McClellan, RN, DSN Clinical Associate Professor University of Alabama in Huntsville Huntsville, Alabama Chris M. Wood, OP, RN, PhD, GNP Associate Professor Goshen College Department of Nursing Goshen, Indiana ix