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Understanding Nursing Research: Building an Evidence-Based Practice PDF

547 Pages·2014·8.644 MB·English
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YOU’VE JUST PURCHASED MORE THAN A TEXTBOOK! Evolve Student Resources for Grove: Understanding Nursing Research: Building an Evidence-Based Practice, 6th Edition, include the following: (cid:129) Review Questions (cid:129) Research Article Library (cid:129) Appraisal Exercises (cid:129) Key Points Activate the complete learning experience that comes with each textbook purchase by registering at http://evolve.elsevier.com/Grove/understanding/ REGISTER TODAY! You can now purchase Elsevier products on Evolve! Go to evolve.elsevier.com/html/shop-promo.html to search and browse for products. CONTENTS 1 Introduction to Nursing Research and Evidence-Based Practice, 1 2 Introduction to Quantitative Research, 31 3 Introduction to Qualitative Research, 66 4 Examining Ethics in Nursing Research, 93 5 Research Problems, Purposes, and Hypotheses, 129 6 Understanding and Critically Appraising the Literature Review, 162 7 Understanding Theory and Research Frameworks, 189 8 Clarifying Quantitative Research Designs, 210 9 Examining Populations and Samples in Research, 248 10 Clarifying Measurement and Data Collection in Quantitative Research, 281 11 Understanding Statistics in Research, 317 12 Critical Appraisal of Quantitative and Qualitative Research for Nursing Practice, 361 13 Building an Evidence-Based Nursing Practice, 414 14 Outcomes Research, 466 Glossary, 500 Index, 515 This page intentionally left blank 6th Edition Understanding Nursing Research Building an Evidence-Based Practice Susan K. Grove, PhD, RN, ANP-BC, GNP-BC Professor Emerita College of Nursing The University of Texas at Arlington Arlington, Texas; Adult Nurse Practitioner Family Practice Grand Prairie, Texas Jennifer R. Gray, PhD, RN, FAAN George W. and Hazel M. Jay Professor, College of Nursing Associate Dean, College of Nursing The University of Texas at Arlington Arlington, Texas Nancy Burns, PhD, RN, FCN, FAAN Professor Emerita College of Nursing The University of Texas at Arlington Arlington, Texas; Faith Community Nurse St. Matthew Cumberland Presbyterian Church Burleson, Texas 3251RiverportLane St.Louis,Missouri63043 UNDERSTANDINGNURSINGRESEARCH:BUILDING ANEVIDENCE-BASEDPRACTICE,EDITIONSIX ISBN:978-1-4557-7060-1 Copyright©2015,2011,2007,2003,1999,1995bySaunders,animprintofElsevierInc. Allrightsreserved.Nopartofthispublicationmaybereproducedortransmittedinanyformorbyanymeans, electronicormechanical,includingphotocopying,recording,oranyinformationstorageandretrievalsystem, withoutpermissioninwritingfromthepublisher.Detailsonhowtoseekpermission,furtherinformationaboutthe Publisher’spermissionspoliciesandourarrangementswithorganizationssuchastheCopyrightClearance CenterandtheCopyrightLicensingAgency,canbefoundatourwebsite:www.elsevier.com/permissions. ThisbookandtheindividualcontributionscontainedinitareprotectedundercopyrightbythePublisher (otherthanasmaybenotedherein). Notices Knowledgeandbestpracticeinthisfieldareconstantlychanging.Asnewresearchandexperiencebroadenour understanding,changesinresearchmethods,professionalpractices,ormedicaltreatmentmaybecome necessary. Practitionersandresearchersmustalwaysrelyontheirownexperienceandknowledgeinevaluating andusinganyinformation,methods,compounds,orexperimentsdescribedherein.Inusingsuch informationormethodstheyshouldbemindfuloftheirownsafetyandthesafetyofothers,including partiesforwhomtheyhaveaprofessionalresponsibility. Withrespecttoanydrugorpharmaceuticalproductsidentified,readersareadvisedtocheckthe mostcurrentinformationprovided(i)onproceduresfeaturedor(ii)bythemanufacturerofeachproducttobe administered,toverifytherecommendeddoseorformula,themethodanddurationofadministration,and contraindications.Itistheresponsibilityofpractitioners,relyingontheirownexperienceandknowledge oftheirpatients,tomakediagnoses,todeterminedosagesandthebesttreatmentforeachindividualpatient,and totakeallappropriatesafetyprecautions. Tothefullestextentofthelaw,neitherthePublishernortheauthors,contributors,oreditors,assumeany liabilityforanyinjuryand/ordamagetopersonsorpropertyasamatterofproductsliability,negligence orotherwise,orfromanyuseoroperationofanymethods,products,instructions,orideascontainedin thematerialherein. InternationalStandardBookNumber:978-1-4557-7060-1 ExecutiveContentStrategist:LeeHenderson ContentDevelopmentManager:BillieSharp ContentDevelopmentSpecialist:CharleneKetchum PublishingServicesManager:DeborahL.Vogel ProjectManager:BridgetHealy DesignDirection:MaggieReid PrintedinChina Lastdigitistheprintnumber: 9 8 7 6 5 4 3 2 1 CONTRIBUTOR AND REVIEWERS CONTRIBUTOR Tamara Kear, PhD, RN, CNS, CNN AssistantProfessorof Nursing DianeDoran,RN, PhD, FCAHS VillanovaUniversity Professor Emerita Villanova,Pennsylvania LawrenceS.Bloomberg Facultyof Nursing Universityof Toronto SharonKitchie,PhD, RN Toronto, Ontario AdjunctInstructor Revised Chapter 14 Keuka College Keuka Park, NewYork REVIEWERS Madelaine Lawrence,PhD, RN Lisa D. Brodersen,EdD, MA, RN Associate Professor Professor, Coordinatorof InstitutionalResearch Universityof NorthCarolina atWilmington and Effectiveness Wilmington, NorthCarolina Allen College Waterloo, Iowa RobinMoyers, PhD, RN-BC Nurse Educator SaraL. Clutter,PhD, RN Carl Vinson VA Medical Center Associate Professorof Nursing Dublin,Georgia Waynesburg University Waynesburg, Pennsylvania SueE. Odom,DSN, RN Professorof Nursing Clayton StateUniversity JacalynP. Dougherty,PhD, RN Morrow, Georgia Nursing ResearchConsultant JP DoughertyLLC Teresa M.O’Neill, PhD, APRN, RNC Aurora, Colorado Professor Our Ladyof HolyCrossCollege JoanneT.Ehrmin, RN, COA-CNS, PhD, New Orleans, Louisiana MSN,BSN Professor Sandra L. Siedlecki, PhD, RN, CNS Universityof Toledo, Collegeof Nursing Senior Nurse Scientist Toledo, Ohio ClevelandClinic Cleveland,Ohio BetsyFrank,PhD, RN, ANEF Professor Emerita SharonSouter, PhD,RN,CNE Indiana State UniversityCollege ofNursing Dean andProfessor Health,and Human Services Universityof Mary HardinBaylor Terre Haute,Indiana Belton, Texas v vi CONTRIBUTOR AND REVIEWERS Molly J.Walker, PhD,RN,CNS, CNE Fatma A.Youssef, RN, DNSc, MPH Professor ProfessorEmerita AngeloState University MarymountUniversity San Angelo, Texas Schoolof HealthProfessions Arlington, Virginia CynthiaWard, DNP, RN-BC,CMSRN, ACNS-BC Surgical ClinicalNurse Specialist Carilion RoanokeMemorialHospital Roanoke, Virginia AngelaWood, PhD,RN,Certified High-Risk PrenatalNurse Associate Professor and Chair Department of Nursing Carson-Newman University Jefferson City, Tennessee To all nurses who change the lives of patients through applying the best research evidence. —Susan, Jennifer, and Nancy To my husband Jay Suggs who has provided me endless love and support during my development of research textbooks over the last 30 years. —Susan To my husband Randy Gray who is my love and my cheerleader. —Jennifer To my husband Jerry who has supported all of my academic endeavors through 58 years of marriage. —Nancy PREFACE Researchisamajorforceinnursing,andtheevidencegeneratedfromresearchisconstantlychang- ing practice, education, and health policy. Our aim in developing this essentials research text, Understanding Nursing Research: Building an Evidence-Based Practice, is to create an excitement about research in undergraduate students. The text emphasizes the importance of baccalaureate-educated nurses being able to read, critically appraise, and synthesize research so this evidence can be used to make changes in practice. A major goal of professional nursing andhealthcareisthedeliveryofevidence-basedcare.Bymakingnursingresearchanintegralpart ofbaccalaureateeducation,wehopetofacilitatethemovementofresearchintothemainstreamof nursing.Wealsohopethistextincreasesstudentawarenessoftheknowledgethathasbeengen- eratedthroughnursingresearchandthatthisknowledgeisrelevanttotheirpractice.Onlythrough researchcannursingtrulyberecognizedasaprofessionwithdocumentedeffectiveoutcomesfor the patient, family, nurse provider, and healthcare system. Because of this expanded focus on evidence-basedpractice(EBP),wehavesubtitledthiseditionBuildinganEvidence-BasedPractice. DevelopingasixtheditionofUnderstandingNursingResearchhasprovideduswithanoppor- tunity to clarify and refine the essential content for an undergraduate research text. The text is designed to assist undergraduate students in overcoming the barriers they frequently encounter in understanding the language used in nursing research. The revisions in this edition are based on our own experiences with the text and input from dedicated reviewers, inquisitive students, andsupportivefacultyfromacrossthecountrywhoprovideduswithmanyhelpfulsuggestions. Chapter 1, Introduction to Nursing Research and Evidence-Based Practice, introduces the reader to nursing research, the history of research, and the significance of research evidence for nursingpractice.Thischapterhasbeenrevisedtoincludethemostrelevanttypesofresearchsyn- thesisbeingconductedinnursing—systematicreview,meta-analysis,meta-synthesis,andmixed- methods systematic review. The discussion of research methodologies and their importance in generating an evidence-based practice for nursing has been updated and expanded to include the exploratory-descriptive qualitative research method. A discussion of the Quality and Safety EducationforNursing(QSEN)competenciesandtheirlinktoresearchhasbeenincludedinthis edition.SelectedQSENcompetenciesarelinkedtothefindingsfromstudiespresentedasexamples throughout thetext toincrease students’understanding ofthe importancein deliveringquality, safe health caretopatientsand families. Chapter2,IntroductiontoQuantitativeResearch,presentsthestepsofthequantitativeresearch processinaconcise,clearmannerandintroducesstudentstothefocusandfindingsofquantitative studies. Extensive, recentexamplesof descriptive, correlational, quasi-experimental, and experi- mentalstudies areprovided, which reflect the qualityof currentnursing research. Chapter 3, Introduction to Qualitative Research, describes five approaches to qualitative researchandthephilosophiesuponwhichtheyarebased.Theseapproachesincludephenomenol- ogy, grounded theory, ethnography, exploratory-descriptive qualitative, and historical research. Data collection and analysis methods specific to qualitative research are discussed. Guidelines forreadingandcriticallyappraisingqualitativestudiesareexplainedusingexamplesofpublished studies. viii

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