Doing a Research Project in Nursing and Midwifery

A Basic Guide to Research Using the Literature Review Methodology

Carroll Siu, Huguette Comerasamy, Carroll Siu, Huguette Comerasamy

• Publisher: SAGE Publications Ltd
• Year: 2013
• ISBN:
  9781446289860
• Edition: 1
• Topic: Medicine
• Subtopic: Nursing

Due to ethical issues surrounding data collection in the field of healthcare, students are no longer able to undertake their own empirical research. This book is written for nursing and midwifery students completing a research project based on reviewing published literature and using secondary data. It de-mystifies the concept of literature review methodology and supports students writing up their dissertation, thesis or work-based learning project.

The book provides step-by-step guidance on:

- Identifying a research problem

- Qualitative and quantitative research design

- Literature searching

- Ethical considerations

- Analysis of secondary data

- Writing your dissertation

Through its discussion of non-empirical methods, the book also prepares students for future empirical research by providing examples of best practice in healthcare research. The book is essential reading for undergraduates and postgraduates who want to succeed in their nursing or midwifery research project.

ONE

Introduction to Research Concepts and Terminologies

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Aim and objectives

The aim of this chapter is to introduce important research concepts and terminologies. By the end of the chapter you will be able to:

• Understand why research is important
• Understand the differences between qualitative and quantitative research
• Differentiate between non-empirical versus empirical research
• Appreciate the role of literature review methodology in non-empirical research
• Outline the steps in the research process for a project using the literature review methodology.

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1.1 Introduction

Research in nursing and midwifery is relatively ‘young’ compared to other disciplines, such as medicine. Nurses and midwives have trod a stony path in the process of professionalization, but we have come a long way in embracing the arts and science duality of our profession. Nurses and midwives have the skill, knowledge and self-awareness to maintain the high standards of our work. These high standards can only be achieved through the use of evidence-based practice. In order to continue to reap the rewards of our accomplishment, nurses and midwives need to understand the importance of research.

Formal research has always been carried out by researchers, but it has been advocated that students in nursing and midwifery need to carry out research projects as part of their curriculum. Before embarking on their research projects, it is vital that students begin by examining the following three themes:

• The meaning of research
• Sources of knowledge
• The purpose of research.

The rest of this section will be devoted to an exploration of these themes. There will be student activities interspersed within the text. For those activities that require you to read and reflect on passages extracted from journals, we would suggest that you use a reflective framework that you are familiar with, such as Gibbs’ (1988), Johns’ (2004), Kolb’s (1984), Schön’s (1991) and Bradbury-Jones et al.’s (2009) reflective models.

1.1.1 The meaning of the word ‘research’

In most academic texts, research is defined as an empirical inquiry, which needs to be conducted in a systematic and logical manner (Burns and Grove, 2003; Parahoo, 2006). However, the word ‘re-search’ also implies revisiting or re-examining a topic of interest. The ultimate aim of research is to add to the body of knowledge about a topic. It has a cumulative effect; as more research is done, the greater is that body of knowledge on that or any topic. As a student, you can play an important role in this cumulative process of generating knowledge from research.

Knowledge from a philosophical standpoint is about a person’s journey to gain familiarity, awareness or understanding of a subject through study or experience. The converse of this is the lack of knowledge and the impoverishment of insight that can lead to stupidity and selfishness (Grayling, 2002). This school of thought emphasizes an individual’s need to perceive and discover so as to learn. We would like to involve you, the student, in this journey of discovery and perception. However, a lot of students we have met find that the start of this journey is made problematical by their misunderstanding of what research really is. It is therefore important to clarify some of these misunderstandings, as the subject of research is replete with jargon.

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STUDENT ACTIVITY 1.1

Brainstorm the word ‘research’ and produce a mind-map. If you are not familiar with mind-maps, we would suggest that you refer to Tony Buzan at www.buzanworld.com/Mind_Maps.htm and see Buzan (2002).

Keep this mind-map because you will be referring to it in this chapter.

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1.1.2 Sources of knowledge

The aim of research is to generate knowledge and we have defined knowledge as being gained from study and experience. In nursing and midwifery, knowledge is traditionally regarded as scientific knowledge, i.e. it is reliable and unchallenged (Chalmers, 2004). However, more recent thinking suggests that practice-based nursing/midwifery research is ‘an art’ (Morse, 1994; Denzin and Lincoln, 2005) because the creative work of practitioners generates research that is in search of both knowledge and truth. However, knowledge and truth are tentative as these concepts are both value- and culture-laden (Crotty, 2003). Therefore, there needs to be a differentiation between knowledge that is ‘general’ and that which is ‘particular’, in order to understand what is true and how it is gained.

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STUDENT ACTIVITY 1.2

Please read the extract below from Oberle and Allen (2001: 148):

In attempting to define ‘advanced practice’, we argue that nursing as such is teleological or goal directed with those goals being defined by the patient or client in interaction with the nurse. In helping the patient meet identified goals, the nurse requires two kinds of knowledge – general and particular. General includes theory (know why), pattern recognition (know what), and practical knowledge (know how). Particular (know who) is personal knowledge about the patient. The advanced practice nurse, by virtue of graduate education, is able to move beyond the familiar and experientially learned. He or she makes a deliberate attempt to situate self in dialectic between general and particular knowledge in such a way that the interplay opens possibilities. Knowing when a particular action would be most helpful is defined as practical wisdom. We argue that a highly developed sense of practical wisdom is the hallmark of advanced practice.

Now reflect on your own practice, taking note of the following:

Think of an advanced-level nurse or midwife you have worked with in the past who has helped a female client achieve her goal by knowing what, how and why about that client in addition to being aware of her own (i.e. the nurse’s or midwife’s) values, beliefs and culture.

• Is this advanced-level nurse or midwife utilizing her knowledge of the client’s signs and symptoms to come to a diagnosis?
• Is she utilizing her social skills of communication in gaining a rapport with the client and/or her family?
• Is she helping the client and/or family by providing adequate treatment, care and advice, which is value-free and accepting of the client’s choice?

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In the example above, the advanced-level nurse or midwife used a combination of general and particular knowledge. General knowledge is the understanding of what, how and why, acquired through education. The ultimate goal is the formulation of that general knowledge into concepts and theories; this is where research findings play an important role as a cornerstone of theory building.

Particular knowledge, on the other hand, is the understanding of self. This self-awareness is gained from being in touch with oneself, so as to be in touch with others. The move from general to particular knowledge requires experience, as the student learns from observations made in the real world. The process of making sense of one’s experience occurs through reflection. Reflective practice is something that has been considered by many authors, such as Boud, Keogh and Walker (1985), Gibbs (1988), Schön (1991) and Johns (2004), and it provides the vital link between theory and practice.

To complete the discussion of sources of knowledge, one must appreciate that general knowledge and particular knowledge are on either end of a continuum. Figure 1.1 highlights the crucial position of research in the generation of knowledge in practice-based professions. The message we want to get across to you is that research forms the foundation on which future knowledge is based.

1.1.3 Purpose of research

Research generates knowledge and ultimately theory. However, there is good and bad research and in Chapter 5 we will be revisiting the process of critiquing research. This is a valuable skill that is part of the process of literature review research methodology. From now on, our discussion of research relates to ‘good’ or worthwhile research.

The purpose of research can be broadly put into these two categories. It can be used to:

• solve a problem; and/or
• illuminate a topic.

Figure 1.1

Knowledge continuum

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STUDENT ACTIVITY 1.3

Referring back to your mind-map of the meaning of research in Student Activity 1.1, can you see if your idea of research related to either of the above categories?

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In our experience of facilitating students in their research, some have felt ‘frustrated’ as their chosen topic and process of research did not provide an immediate answer or a solution to the problem. This is not uncommon; it is human nature to seek spontaneous gratification. However, it is important to remember what we said earlier about knowledge being cumulative. If several pieces of research provide multiple perspectives on a problem, the total effect of illumination on a topic will ultimately point to an answer or a solution. This answer or solution may be the evidence needed to solve the problem and to justify action.

‘Evidence-based healthcare’ is a term that has been used more frequently in the last decade or so in the UK, and it is the backbone of quality assurance. Research is an irrefutable source of evidence to justify healthcare delivery (Brown, 2009). As practitioners, educationalists, managers and researchers, we need to be able to provide a rationale for our decisions and the actions we take. The consumers are our main stakeholders, but the benefits of our decisions and actions can be more far-reaching.

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STUDENT ACTIVITY 1.4

Read the following four scenarios and determine the stakeholders concerned:

1. A podiatrist treated a diabetic foot with a new dressing used as part of a clinical trial devised by a pharmaceutical company.
2. A group of nurse teachers utilized a recently published method of visual collage with students to help develop reflective practice.
3. The director of public services based his decision on allocating funds to the development of a screening tool for domestic violence by referring to research done by a joint team of social workers and representatives from a crime prevention agency.
4. Two researchers from opposite sides of the world published their work on gene therapy in a well-known journal.

Discuss and compare y...

Table of contents

• Cover Page
• Title Page
• Copyright
• Dedication
• Contents
• List of Tables
• List of Figures
• Authors
• Preface
• Acknowledgements
• 1 Introduction to Research Concepts and Terminologies
• 2 Identifying the Research Problem
• 3 Research Design: Comprehensive Literature Review as a Research Methodology
• 4 Collecting Data by Searching and Sampling the Literature and Other Secondary Data Sources
• 5 Ethical Considerations when Critiquing Literature-Based Data
• 6 Analysis and Synthesis of Literature-Based Data
• 7 Presentation and Discussion of Findings
• 8 Writing Your Research Report
• References
• Index