Developing a Healthcare Research Proposal

An Interactive Student Guide

Maxine Offredy, Peter Vickers

• Publisher: Wiley-Blackwell
• Year: 2013
• ISBN:
  9781118693247
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing

Are you new to research and daunted by the idea of constructing your own research proposal? Then this is the book you need!

This book and accompanying web resource will answer all your questions about healthcare research by introducing you to the concepts, theories and practicalities surrounding it. The aim of both the book and the web resource is to help you to write a good healthcare research proposal – which is the starting point for any would-be student researcher.

The book takes a look at the theory of research, the core of the topic, but also provides practical help and advice along the way. It takes the reader through the stages of the research process from developing the question to communicating the findings, demystifying the process on the way. The web resource works alongside the book, supplementing and expanding on the chapters, giving you the ability to prepare your very own research proposal.

• Explains key concepts in a clear, easy to understand way
• Includes activities and scenarios for you to work through which will also increase your understanding of research and research proposals
• Easily navigable web resource ( www.researchproposalsforhealthprofessionals.com )
• Both book and website are arranged in the same order in which you would develop and write a research proposal
• Website includes downloadable research proposal template to complete step-by-step as you work through the book and web resource

1

Research and Allied Concepts

Introduction

This book is designed to develop your appreciation of some of the key features of research methodologies and approaches. By completing the exercises in this book, you will gain a better knowledge and understanding of the research processes involved. From the outset we should state that this book is for healthcare professionals and students who are new to research and, therefore, we have assumed that you have no prior knowledge of research. Consequently, we have avoided using unnecessary jargon that may confuse you and make it difficult for you to feel confident about undertaking your own research proposal. After all, that is the most interesting and important part of your involvement with ‘research’.

To begin with, this chapter offers some definitions and discussions about:

• research;
• clinical audit;
• comparison of clinical audit and research;
• clinical effectiveness; and
• evidence-based practice.

The discussions in this chapter are put into context and discussed within the current healthcare climate. The chapter concludes with activities relating to practice for you to undertake. These, and the activities in the other chapters, will help you to understand fully the content of the chapters by your undertaking something related to them.

What is research?

Let us start at the very beginning and discuss what we mean by ‘research’.

The word ‘research’ is frequently used in everyday conversations, but has different meanings according to the context in which it is used. This chapter specifically relates to research undertaken within a healthcare context. In healthcare we are always looking for answers to questions that are related to the health and well-being of our patients/clients. For example, we may wish to find answers to questions such as:

• What are patients’ perspectives concerning a new type of treatment?
• How does the effectiveness of one type of wound dressing compare with that of another?
• How do healthcare professionals feel about working in a multi-disciplinary team?

And so on.

So, from what you have just read, you can see that research begins with a question. Now, you may think that we know the answers to some of these questions – and you may be right – but unless we subject these answers to a scientific process, then our knowledge and understanding could be said to be intuitive at best, and at worst quite possibly be based on guesswork and hunches.

The role of research, therefore, is to provide a systematic framework for obtaining answers to questions by studying and gathering the evidence in a scientific manner. In other words, the process of arriving at an answer to a question in the context of healthcare research has to follow certain rules. These rules are set out in different philosophies which underpin the type of research that is being undertaken. By following these rules our research can be judged by others to be objective, valid and reliable – three important tests of how good a piece of research is. So, to simplify: research is a way of thinking about a problem in a systematic and scientific way. We call this way of thinking about a problem a research process.

We can now take a few moments to look at the stages of the research process (see Table 1.1). As you can see from Table 1.1, the process of undertaking research involves eight stages which we need to work through when preparing a research proposal and doing the research study itself. These eight stages are:

1. Conceptual – conceiving your proposed study (chapters 1 and 2).

2. Question/hypothesis formulation – how you set about determining the question or hypothesis that will need to be answered or proved/disproved by the research (chapter 3).

3. The formulation of aims and objectives – these are very important because they follow the determining of the research question or hypothesis, and they let you set out what you hope to achieve with your research study within the context of the research question or hypothesis (chapter 3).

4. The planning and design of the research study – this is where you ask (and answer) the questions: Why are we doing this research? How are we going to do it? Where are we going to do it? You will need to make a number of decisions about how you are going to set about answering your research question or proving/disproving your hypothesis (chapter 5).

5. Collecting data – this stage consists of your collecting the data for your research study in order to achieve your aims and objectives as well as answer your research question or prove/disprove your hypothesis (chapter 8).

6. Analysing your data – this is the part of the study where you start to make sense of the data you have collected. Analysing your data will allow you to answer your research question or prove/disprove your hypothesis. However, this is not the end of your research; the next stage, presenting your research findings, is an important part of any research study (chapter 9).

7. Presenting your results and findings – this is the stage in which you organise your findings in such a way that they are clear, interesting, accessible, understandable and relevant to others who may read the report of your research study (chapter 10).

8. Disseminating your results – this is the final stage of your research when you send your results to all relevant and interested people/organisations, by writing papers and/or presenting them at conferences (chapter 10).

You may have come across some words that are new to you in this list, but do not worry, as you work through this book and the accompanying web program, you will become familiar with all these terms, and many others, and understand them and their significance to the process of undertaking and reading research studies. If you think of research as being a foreign language, then, just as you have to learn a new vocabulary and grammar, and their contexts, so it is with learning about research. Research has its own vocabulary and ‘grammar’ (methodology and philosophy) and you have to learn these within the context of a research study. Similarly, just as it is better and much easier to learn a foreign language when you are living with it – for example, living in the country where the language you are studying is spoken – so you will learn about research and understand it much better and far more easily if you are learning it in a ‘live’ situation – when doing some research. This is the reason for encouraging and helping you to write a research proposal (whether for an actual research study or as a virtual project) as you work through the accompanying web program.

Table 1.1 Stages of research.

Stage 1	What?
Conceptual		This involves thinking, reading, theorising, rethinking and discussing your ideas with colleagues and experts in the field or in your area of interest.
Stage 2
Question/hypothesis formulation		At this point, you would be reading the related literature to (i) get an idea of what has been done and how it has been done; (ii) assess the results of the research and gaps in the literature; and (iii) formulate your question/hypothesis which will provide direction for the research. (A hypothesis is a tentative statement to explain observations or facts and which requires experimental investigation for verification.)
Stage 3
Formulate aims and objectives		Aims are statements of what the research sets out to achieve. In other words, what do you want to find out? Objectives are a set of specific statements pertaining to the aim of the research and must fulfil the requirements of the aim. Aims and objectives are therefore interrelated and the latter can be seen as being more detailed information about the aims. They are the intellectual activities that the researcher will perform throughout the research process.
Stage 4	How? Whom? Where?
Design and planning		The researcher must make a number of decisions about how to go about doing the research. These methodological decisions have implications for the validity and credibility of the study findings. If the methods used to collect and analyse the data are flawed, then the conclusions will be flawed also and doubtful. At this stage of the research process, you will be involved in: • Selecting the research design: i.e. the overall plan, how to get answers to the question being studied and how to handle some of the difficulties encountered in the study. • Thinking about a theoretical framework: you may wish to use a theoretical framework to structure and analyse the research. • Identifying the population to be studied. • Selecting measures for the research variables: i.e. defining the research variables and clarifying exactly what each means. • Designing the sampling plan: decide on your sample and how you will collect data, bearing in mind time and cost, and level of skill required. Sampling procedures include probability sampling and non-probability sampling (these are discussed later in the book). • Deciding on location. • Finalising and reviewing the research plan: showing your research plan to colleagues to get constructive criticism. The research plan is sometimes referred to as the research proposal. • Ethical considerations: you will need to discuss this with your R&D lead (or their equivalent) to ascertain what other approval may be required. Approval must be obtained before data collection. • Pilot study, if appropriate.
Stage 5	How?
Empirical stage – data collection		This involves the collection of the data and approaches used to answer the research question/hypothesis. More than one method may be used; the commonest are interviews and questionnaires.
Stage 6 Analytic stage	How?	This is the process of systematically explaining the data so that their meaning, structure and relationships are clearly articulated. The analysis will depend on whether the approach used is quantitative or qualitative. The key point is that the information gathered will be transformed so that it provides useful information and lets you reach conclusions. Qualitative data involve integration and synthesis of narrative data, whereas quantitative data are analysed through statistical procedures to describe, summarise and compare data. Whatever approach you use, the analysis must be carried out in relation to the research problem.
Stage 7 Presentation of results/findings	How?	You should put a lot of thought into how you present your results or findings. For example, consider whether figures or graphs are the best way to bring out your data and whether these will help the reader follow what you have found. Tables are also useful for presenting information as they can provide a complete picture for the reader.
Stage 8 Dissemination	How?	Results of data are of little use if they are not communicated to others. Ideally, the final step of a first-class study is to plan for its utilisation in practice.

The other thing to point out about the list on pages 2–4 and Table 1.1 is that all these stages are covered fully in this book by being assigned a whole chapter so that we can introduce you to the eight stages and help you to understand them as you work though the book and accompanying web program.

At this stage, it is important to stress that the research proposal is essential to the whole process of undertaking research because it encapsulates everything that we need to go through in order to undertake a research study. Consequently, the better the proposal, the better and easier is the process of undertaking a research study. It is this process of absorbing information, knowledge and understanding in its natural and ‘live’ context that is the rationale for this book and web program, both of which are focused on helping you to prepare a research proposal.

The next section discusses the ‘audit’ and explains the differences between research and audit.

What is clinical audit?

Many healthcare students undertaking a project as part of their degree programme, or other academic studies – and indeed many qualified healthcare professionals who wish to look at a problem in their own practice – are uncertain if their work will be classified as research or as an audit, as the two activities are closely related. For example, they both:

• involve questions relating to quality of care;
• can be done prospectively (looking forward) or retrospectively (looking back);
• use:

– sampling,

– questionnaires,

– the analysis of findings;

• are usually professionally led.

Nevertheless, audit and research are very different processes.

The National Institute for Health and Clinical Excellence (2002: 1) defines an audit as a:

‘quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria ...

Table of contents

• Cover
• Contents
• Dedication
• Title Page
• Copyright
• Preface
• Introduction
• 1 Research and Allied Concepts
• 2 Philosophical Assumptions
• 3 The Research Proposal: Developing the Research Question
• 4 The Research Proposal: Searching and Reviewing the Literature
• 5 The Research Proposal:Research Design
• 6 The Research Proposal:Ethics in Research
• 7 The Research Proposal: Selecting Participants
• 8 The Research Proposal: Collecting Data
• 9 The Research Proposal: Analysing Data
• 10 The Research Proposal: Communicating Research Findings
• 11 The Research Proposal: Current Research Issues in Healthcare
• Index