chapter 2 theory research and evidence based practice

• Request new password
• Create a new account

Research Methods for Nurses and Midwives: Theory and Practice

Student resources, chapter 2: evidence-based practice.

Quizzes give you the chance to test your knowledge through multiple choice questions, short answers, matching activities and other revision tools.

1. Discuss the importance of focussing a problem into a sharply defined clinical question.

A focussed question provides a greater opportunity to search, locate and retrieve information that is relevant. The clearer the question the more useful the answer.

An example of a focussed question might be:

P  Primary Care patients for specific long term condition

I  Information leaflets

C No information leaflets

O  Patient empowerment

2. All new research should be based on evidence drawn from previous research. Explain what is involved in efficient literature searching and how the hierarchy of evidence can be used to classify different types of research.

Efficient literature searching involves focussing a question, using a PICO.  Using key words & synonyms as search terms.  Could also identify type of study – systematic review, RCT etc.  Searching relevant databases ensures that the right type of information is located e.g.  Medline for diagnosis etc.  Qualitative for nursing.

Systematic reviews provide the best answers to sharply define clinical questions and are most useful to inform potential research as they are rigorously developed and include up to date information about the nature of the topic and how best it might be researched.  If a review is not available then it is advisable to follow the hierarchy downwards in the search.

The hierarchy is so called because the types of evidence each layer yields systematic review being the most robust and opinion being the least.

3. Explain the features of a randomised controlled trial (RCT).

See the consort guidelines on Randomised controlled trials: http://www.consort-statement.org/media/default/downloads/CONSORT%202010%... . Use the online version to check what features of an RCT have been included: explanations and examples of each feature are on the e version.

4. Explain the ways in which researchers can minimise bias in an RCT.

There are many types of bias. See Chapter 7 Box 7.3 for a full list.

5. Identify three types of qualitative methods and provide brief explanations of each.

See Chapter 9 for the three most commonly used qualitative methods.

6. What is the particular value of qualitative research to patient care?

Qualitative studies are useful for underpinning further, quantitative research as well as in their own right. Using a qualitative approach could address questions such as ‘what are the influences/barriers to patient empowerment in primary care consultations?’  They could also look at the patients’ experiences which should give practitioners a valuable insight from the participants’ perspective as to what the issues are, as opposed to being surveyed using predetermined questions.

Want to create or adapt books like this? Learn more about how Pressbooks supports open publishing practices.

Module 2 Chapter 2: The Link Between Theory, Research, and Social Justice

Theory has been mentioned several times in Chapter 1 discussions. In this chapter, we explore the relationship between theory and research, paying particular attention to how theory and research relate to promoting social justice.

In this chapter you will read about:

• Why theory matters to social work
• How theory and research relate to social justice

The Significance of Theory

It is helpful to begin with thinking about what theory  is. Theory is defined as a belief, idea, or set of principles that explain something—the set of principles may be organized in a complex manner or may be quite simple in nature. Theories are not facts; they are conjectures and predictions that need to be tested for their goodness-of-fit with reality. A scientific theory is an explanation supported by empirical evidence. Therefore, scientific theory is based on careful, reasonable examination of facts, and theories are tested and confirmed for their ability to explain and predict the phenomena of interest.

Theory is central to the development of social work interventions, as it determines the nature of our solutions to identified problems. Consider an example whereby programmatic and social policy responses might be influenced by the way that a problem like teen pregnancy is defined and the theories about the problem. In Table 2-1 you can see different definitions or theories of the problem on the left, and the logical responses on the right. In many cases, the boxes on the right can also be supplemented with content from other boxes addressing other problem definitions or theories.

Table 2-1. Analysis of teen pregnancy: How defining a problem determines responses

Hopefully, through this example, you can see how the way we define a problem and our theories about its causes determines the types of solutions we develop. Solutions are also dependent on whether they are feasible, practical, reasonable, ethical, culturally appropriate, and politically acceptable.

Theory, Research, and Social Justice

Theory is integral to research and research is integral to theory. Theory guides the development of many research questions and research helps generate new theories, as well as determining whether support for theories exists. What is important to remember is that theory is not fact: it is a belief about how things work; theory is a belief or “best guess” that awaits the support of empirical evidence.

“The best theories are those that have been substantiated or validated in the real world by research studies” (Dudley, 2011, p. 6).

Countless theories exist, and some are more well-developed and well-defined than others. More mature theories have had more time and effort devoted to supporting research, newer theories may be more tentative as supporting evidence is being developed. Theories are sometimes disproven and need to be scrapped completely or heavily overhauled as new research evidence emerges. And, exploratory research leads to the birth of new theories as new phenomena and questions arise, or as practitioners discover ways that existing theory does not fit reality.

Examples of theories and theoretical models with which you may have become familiar in other coursework are developed, tested, and applied in research from multiple disciplines, including social work. You may be familiar with the concepts of multidisciplinary  and interdisciplinary  practice, research and theory, but you also might be interested to learn the concept of transdisciplinary  research and theory. The social work profession engages in all three, as described in Figure 2-1.

Figure 2-1. Comparison of multidisciplinary, interdisciplinary, and transdisciplinary as concepts

An example of transdisciplinarity is demonstrated in motivational interviewing. The principles and practice of motivational interviewing skills transcends disciplines—it is relevant and effective regardless of a practitioner’s discipline and regardless of which discipline is conducting research that provides supporting evidence. An example of interdisciplinarity is when social workers, nurses, pediatricians, occupational therapists, respiratory therapists, and physical therapists work together to create a system for reducing infants’ and young children’s environmental exposure to heavy metal contamination in their home, childcare, recreational, food and water (e.g., lead and mercury). An example of multidisciplinarity is when a pediatrician, nurse, occupational therapist, social worker, and physical therapist each deliver discipline-specific services to children with intellectual disabilities.

Here are examples of theories that you may have encountered or eventually will encounter in your career:

• behavioral theory
• cognitive theory
• conflict theory
• contact theory (groups)
• critical race theory
• developmental theory (families)
• developmental theory (individuals)
• feminist theory
• health beliefs model
• information processing theory
• learning theory
• lifecourse or lifespan theory
• neurobiology theories
• organizational theory
• psychoanalytic theory
• role theory
• social capital model
• social ecological theory
• social learning theory
• social network theory
• stress vulnerability model
• systems theory
• theory of reasoned action/planned behavior
• transtheoretical model of behavior change

Social work practitioners generate new theories in the field all the time, but these theories are rarely documented or systematicallyl tested. Applying systematic research methods to test these practice-generated theories can help expand the social work knowledge base. Well-developed theories must be testable through the application of research methods. Furthermore, they both supplement and complement other theories that have the support of strong evidence behind them. In addition to these points, for theories to be relevant to social work, they need to:

• have practice implications at one or more level of intervention—suggest principles of action;
• be responsive to human diversity;
• contribute to the promotion of social justice (Dudley, 2011).

Social Justice and The Grand Challenges for Social Work .  In 2016, the American Academy of Social Work & Social Welfare (AASWSW) rolled out a set of 12 initiatives, challenging the social work profession to develop strategies for having a significant impact on a broad set of problems challenging the nation: “their introduction truly has the potential to be a defining moment in the history of our profession” (Williams, 2016, p. 67). The Grand Challenges directly relate to content presented in the Preamble to the Code of Ethics of the National Association of Social Workers (2017):

The primary mission of the social work profession is to enhance human well-being and help meet the basic human needs of all people, with particular attention to the needs and empowerment of people who are vulnerable, oppressed, and living in poverty. A historic and defining feature of social work is the profession’s dual focus on individual well-being in a social context and the well-being of society. Fundamental to social work is attention to the environmental forces that create, contribute to, and address problems in living (p. 1).

The ambitious Grand Challenges ( http://aaswsw.org/grand-challenges-initiative/12-challenges/ ) call for a synthesis of research and evidence generating endeavors, social work education, and social work practice (at all levels), with promoting social justice and transforming society at the forefront of attention. None of the Grand Challenges can be achieved without collaboration between social work researchers, practitioners, key stakeholders/constituents, policy makers, and members of other professions and disciplines (see Table 2-2). Each of the papers published under the 12 umbrella challenges not only reviews evidence related to the challenge, but also identifies a research and action agenda for promoting change and achieving the stated challenge goals.

Table 2-2. 12 Grand Challenges for Social Work

Theory and its related research is presented in the literature of social work and other disciplines. Being able to locate the relevant literature is an important skill for social work professionals and researchers to master. The next chapter introduces some basic principles about identifying literature that informs us about theory and the research that leads to the development of new theories and the testing of existing theories.

Using Data to Support Social Justice Advocac y

It is one thing to collect data, statistics, and information about the dimensions of a social problem; it is another to apply those data, statistics, and information in action to promote social change around an identified social justice cause. Advocacy is one tool or role important to the social work profession since its earliest days. Data and empirical evidence should routinely support social workers’ social justice advocacy efforts at the micro level—when working with specific client systems (case advocacy). Social justice advocacy also is a macro-level practice (cause advocacy), one that often involves the use of data to raise awareness about a cause, establish change goals, and evaluate the impact of change efforts. Consider, for example, the impact of data on social justice advocacy related to opioid misuse and addiction across the United States. Data regarding the sharp, upward trend in opioid-related deaths have had a powerful impact on public awareness, having captivated the attention of mass media outlets. These are data from the Centers for Disease Control and Prevention (CDC) for the period 1999 to 2016 (see Figure 2-2). The death rate from opioid overdose increased remarkably in the most recent years depicted, including heroin, natural and semisynthetic (morphine, codeine, hydrocodone, oxycodone), and synthetic opioids (fentanyl, fentanyl analogs, tramadol); the rate declined somewhat for deaths related to methadone, a highly controlled prescription medication used to treat opioid addiction (Hedegaard, Warner, & Miniño, 2017). In 2016 the overdose death rate was more than triple the 1999 rate and surpassed all other causes of death (including homicide and automobile crashes) for persons aged 50 or younger (Vestal, 2018). The good news is that the rates dropped significantly across 14 states during 2017 as new policy approaches were implemented—including more widespread use and access to naloxone (an opioid overdose reversal drug). The bad news is that the opioid overdose death rates increased significantly across 5 states and the District of Columbia as fentanyl and related drugs became integrated into the illicit drug supply: “Nationally, the death toll is still rising” (Vestal, 2018, p. 1). The Ohio Department of Health, with Ohio being one of the 5 states with more than a 30% increase in opioid overdose deaths, now recommends that naloxone be used more widely in overdose situations, whether or not opioids are known to be involved.

Figure 2-2. Opioid drug overdose death rate trends 1999-2016, by opioid category

Having data of this sort available to argue the urgency of a cause is of tremendous value. Imagine the potential impact of data on social issues such as child maltreatment, intimate partner violence, human trafficking, and death by suicide. Imagine also the potential impact of data concerning disparities in health, incarceration, mental and traumatic stress disorders, and educational or employment achievement across members of different racial/ethnic, age, economic, and national origin groups. This type of evidence has the potential to be a powerful element in the practice of social justice advocacy.

Follow links below to specific AASWSW Grand Challenges and consider the ways that research evidence is being used to advocate for at least one of the following social justice causes:

• Health Equity: Eradicating Health Inequalities for Future Generations
• From Mass Incarceration to Smart Decarceration
• Safe Children: Reducing Severe and Fatal Maltreatment
• Ending Gender Based Violence: A Grand Challenge for Social Work
• Prevention of Schizophrenia and Severe Mental Illness
• Increasing Productive Engagement in Later Life
• Strengthening the Social Responses to the Human Impacts of Environmental Change

Social Work 3401 Coursebook Copyright © by Dr. Audrey Begun is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License , except where otherwise noted.

Share This Book

An official website of the United States government

The .gov means it’s official. Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

The site is secure. The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

• Publications
• Account settings

Preview improvements coming to the PMC website in October 2024. Learn More or Try it out now .

• Advanced Search
• Journal List
• Lippincott Open Access

Evidence-Based Practice and Nursing Research

Evidence-based practice is now widely recognized as the key to improving healthcare quality and patient outcomes. Although the purposes of nursing research (conducting research to generate new knowledge) and evidence-based nursing practice (utilizing best evidence as basis of nursing practice) seem quite different, an increasing number of research studies have been conducted with the goal of translating evidence effectively into practice. Clearly, evidence from research (effective innovation) must be accompanied by effective implementation, and an enabling context to achieve significant outcomes.

As mentioned by Professor Rita Pickler, “nursing science needs to encompass all manner of research, from discovery to translation, from bench to bedside, from mechanistic to holistic” ( Pickler, 2018 ). I feel that The Journal of Nursing Research must provide an open forum for all kind of research in order to help bridge the gap between research-generated evidence and clinical nursing practice and education.

In this issue, an article by professor Ying-Ju Chang and colleagues at National Cheng Kung University presents an evidence-based practice curriculum for undergraduate nursing students developed using an action research-based model. This “evidence-based practice curriculum” spans all four academic years, integrates coursework and practicums, and sets different learning objectives for students at different grade levels. Also in this issue, Yang et al. apply a revised standard care procedure to increase the ability of critical care nurses to verify the placement of nasogastric tubes. After appraising the evidence, the authors conclude that the aspirate pH test is the most reliable and economical method for verifying nasogastric tube placement at the bedside. They subsequently develop a revised standard care procedure and a checklist for auditing the procedure, conduct education for nurses, and examine the effectiveness of the revised procedure.

I hope that these two studies help us all better appreciate that, in addition to innovation and new breakthrough discoveries, curriculum development and evidence-based quality improvement projects, though may not seem so novel, are also important areas of nursing research. Translating evidence into practice is sound science and merits more research.

Cite this article as: Chien, L. Y. (2019). Evidence-based practice and nursing research. The Journal of Nursing Research, 27 (4), e29. https://doi.org/10.1097/jnr.0000000000000346

• Pickler R. H. (2018). Honoring the past, pursuing the future . Nursing Research , 67 ( 1 ), 1–2. 10.1097/NNR.0000000000000255 [ PubMed ] [ CrossRef ] [ Google Scholar ]

• Sign Up for Free Sign Up

Chapter 2: Theory, Research, and Evidence-Based Practice

Description.

• nursing 101
• fundamentals of nursing
• theory research and evidence based practice
• nursing 101: fundamentals of nursing

Resource summary

• Instinctitive knowledge
• Scientific knowledge
• Authoritative knowledge
• Traditional knowledge
• A nurse interviews and examines a new patient diagnosed with prehypertension to formulate a care plan.
• A nurse draws from personal experiences of being a patient to establish a therapeutic relationship with a patient.
• A nurse searches the Internet to find the latest treatments for type 2 diabetes
• A nurse uses spiritual training to draw strength when counseling a patient who is in hospice for an inoperable brain tumor.
• A nurse follows the protocol for assessing postoperative patients in the ICU.
• A nursing student studies anatomy and physiology of the body systems to understand the disease states of assigned patients.
• Madeline Leininger
• Jean Watson
• Dorothy E. Johnson
• Betty Newman
• A system is a set of individual elements that rarely interact with each other.
• The whole system is always greater than its parts.
• Boundaries separate systems from each other and their environments.
• A change in one subsystem will not affect other subsystems.
• To survive, open systems maintain balance through feedback.
• A closed system allows input from and to the environment.
• Environment
• Prescriptive theory
• Descriptive theory
• Developmental theory
• General systems theory
• The subject
• The instrument
• Descriptive research
• Correlational research
• Quasi-experienced research
• Experimental research
• Ethnography
• Grounded thory
• Phenomenology

Question 10

• Comparison to another similar treatment
• Clearly defined, focused literature review
• Specific identification of the desired outcome
• Explicit descriptions of the population of interest

Question 11

• The currently used turning schedule
• Turning clients more frequently
• Preventing skin bread down
• Clients who have experienced a stroke

Question 12

• Theoretic frameworks guide physiologic nursing care.
• Theoretic frameworks advance nursing knowledge an practice.
• Theoretic frameworks guide psychosocial nursing care
• Theoretic frameworks advance the ethical aspects of practice

Question 13

• Health care systems theory
• Unitary man theory
• Maslow's theory
• Freud's theory

Question 14

• A Delphi study
• Qualitative research
• Quantitative research
• Methodologic survey

Question 15

• Nursing care now incorporates research studies into client care
• Nurses now have to part in research
• Nursing care now uses EBP as a means of ensuring quality care
• Nurses now spend time looking up the best way to give nursing care

Question 16

• Quantify outcomes related to patients
• Generate knowledge to guide practice
• Determine outcomes for patients
• Prevent further disease and death

Question 17

• Qualitative data
• Nursing process
• Quantitative data
• Nursing theory

Question 18

Question 19.

• Nursing is an art
• Nursing is a therapeutic, interpersonal, and goal oriented process
• Human are in a constant relationships with stressors in the environment
• Meeting the personal needs of the client within the environment

Question 20

• A foundation for nursing skills and care.
• A group of interrelated objects that follow a pattern
• An explanation of nursing and nursing practice
• A set of phenomena and related abstractions

Question 21

• Humans are in a constant relationship with stressors in the environment
• Nursing is a therapeutic, interpersonal and goal-oriented process

Question 22

• Florence Nightingale
• Sister Callista Roy
• Dorothea Orem

Question 23

Question 24.

• Nursing research helps improves ways to promote and maintain health
• Nursing research explains ongoing medical studies to clients, and asks for participation
• Nursing research involves client in their care while hospitalized
• Nursing research draws conclusions about the quality of client care

Question 25

• Lilian Wald
• Dorethea Dix
• Clara Barton

Question 26

• Explaining how the particular characteristics of the Vietnam War affected the roles of nurses
• Understanding how a new client copes with a new diagnosis of Alzheimer's disease
• Attempting to understand non-English speaking immigrant's experiences of being hospital clients
• Describing the health maintenance activities that are practiced by homeless, intravenous drug users

Question 27

• Going through the informed consent process with the client
• Giving the client the opportunity to ask questions about the study
• Meeting with the hospital's institutional review board (IRB)
• Obtaining the client's signature on a permission document

Question 28

• Adaptation theory

Question 29

• The client must directly and personally benefit from the research
• All interventions must benefit all clients
• Clients must grant informed consent if they are to participate
• Descriptive studies are more ethical than experimental studies

Question 30

• Formulating clinical question
• Searching the literature
• Appraising evidence
• Evaluating practice change

Question 31

• Review of the literature
• Conclusions

Question 32

• Quasi-experimental research

Question 33

• Select literature relevant to the problem.
• Determine a source appropriate to collect data
• Evaluate the number of ways to collect data
• Obtain a list of possible outcomes

Want to create your own Quizzes for free with GoConqr? Learn more .

Ace Your Fundamentals of Nursing, 9th Ed., Taylor, Lynn, Bartlett Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Registered Nurse (RN) Students

With picmonic, facts become pictures. we've taken what the science shows - image mnemonics work - but we've boosted the effectiveness by building and associating memorable characters, interesting audio stories, and built-in quizzing. whether you're studying for your classes or getting ready for a big exam, we're here to help., fundamentals of nursing, 9th ed., taylor, lynn, bartlett | registered nurse (rn) school study aid, ace your registered nurse (rn) classes & exams with picmonic:, over 1,870,000 students use picmonic’s picture mnemonics to improve knowledge, retention, and exam performance..

Choose the #1 Registered Nurse (RN) student study app.

Picmonic for registered nurse (rn) covers information that is relevant to your entire registered nurse (rn) education. whether you’re studying for your classes or getting ready to conquer your nclex®-rn, hesi, ati, teas test, kaplan exams , we’re here to help., works better than traditional registered nurse (rn) flashcards., research shows that students who use picmonic see a 331% improvement in memory retention and a 50% improvement in test scores., it's worth every penny.