I need your help in finding two academic quantitative articles in correlation to my research question which is Does oversight, accountability, and transparency of leader cause more positive experience? Then do a critique for both articles.
The important point that I need to finish this assignment tomorrow night, kindly could anyone help me on this issue?
Related to this task, I have a critique form and table 17.1 on page 359-361 I should follow and answered the questions.
There is an example on 482.
Kindly see the attached files
Thank you in advance for your understanding and collaboration
LWBK437-FM_i-x.qxd 30/10/2009 08:45 AM Page i Aptara THIRD EDITION Canadian Essentials of
CARMEN G. LOISELLE, PhD, RN
Associate Professor and Director of Oncology Nursing
School of Nursing, Faculty of Medicine
Lady Davis Institute and Centre for Nursing Research
Jewish General Hospital
Canada JOANNE PROFETTO-McGRATH, PhD, RN
University of Alberta Faculty of Nursing
Canada DENISE F. POLIT, PhD
Saratoga Springs, New York CHERYL TATANO BECK, DNSc, CNM, FAAN
University of Connecticut School of Nursing
Storrs, Connecticut LWBK437-FM_i-x.qxd 30/10/2009 08:45 AM Page ii Aptara Acquisitions Editor: Hilarie Surrena
Product Manager: Helen Kogut
Vendor Manager: Beth Martz
Director of Nursing Production: Helen Ewan
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Art Director, Illustration: Brett MacNaughton
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Production Services: Aptara, Inc.
Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins
Copyright © 2007, 2004 by Lippincott Williams & Wilkins. All rights reserved. This book is protected by copyright. No part of it may be reproduced, or transmitted, in any form or by any means,
including as photocopies or scanned-in or other electronic copies, or utilized by any information
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above-mentioned copyright. To request permission, please contact Lippincott Williams & Wilkins
at 530 Walnut Street, Philadelphia, PA 19106, via e-mail at [email protected] or via website at
http://lww.com (products and services).
9 8 7 6 5 4 3 2 1
Printed in China Library of Congress Cataloging-in-Publication Data
Canadian essentials of nursing research / Carmen G. Loiselle . . . [et al.]. ? 3rd ed.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-60547-729-9 (alk. paper)
1. Nursing?Research?Methodology. 2. Nursing?Research?Canada. I.
Loiselle, Carmen G.
[DNLM: 1. Nursing Research?methods?Canada. WY 20.5 C2115 2011]
Care has been taken to confirm the accuracy of the information presented and to describe generally accepted practices. However, the authors, editors, and publisher are not responsible for
errors or omissions or for any consequences from application of the information in this book and
make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of
the contents of the publication. Application of this information in a particular situation remains
the professional responsibility of the practitioner; the clinical treatments described and recommended may not be considered absolute and universal recommendations.
The authors, editors, and publisher have exerted every effort to ensure that drug selection and
dosage set forth in this text are in accordance with the current recommendations and practice at
the time of publication. However, in view of ongoing research, changes in government regulations,
and the constant flow of information relating to drug therapy and drug reactions, the reader is
urged to check the package insert for each drug for any change in indications and dosage and for
added warnings and precautions. This is particularly important when the recommended agent is a
new or infrequently employed drug.
Some drugs and medical devices presented in this publication have Food and Drug Administration
(FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care
provider to ascertain the FDA status of each drug or device planned for use in his or her clinical practice.
LWW.com LWBK437-FM_i-x.qxd 30/10/2009 08:45 AM Page iii Aptara R E V I E W E R S
Ethel Bratt, RN, BSCN
Katharina Kovacs Burns, MSc,
University of Alberta
Edmonton, Alberta Helen Ewing, RN, BN, MN, DHSc
Dolly Goldenberg, RN, BScN,
MA(Eng), MScN, PhD
Professor and Chair of Graduate
Programs in Nursing
University of Western Ontario
London, Ontario Patricia Grainger, RN, BN, MN
Nurse Educator and Research Office
Centre for Nursing Studies
St. John?s, Newfoundland
Lyle G. Grant, BComm, LLB,
BSN, MSN, PhD Student
New Westminster, British Columbia Nicole Letourneau, PhD, MN,
Professor and Canada Research Chair in
Healthy Child Development
University of New Brunswick
Fredericton, New Brunswick Tracey Rickards, BN, MN
Outreach/Research Nurse, Clinical
Instructor, Course Instructor
University of New Brunswick
Fredericton, New Brunswick
Darlene Steven, BScN, BA,
Thunder Bay, Ontario Beverly Temple, RN, BScN,
University of Manitoba
Cynthia Toman, RN, BScN,
University of Ottawa
Ottawa, Ontario Elizabeth VanDenKerkhof, RN,
BScN, MSc, DrPH
Kingston, Ontario Kristen Gulbransen, RN, MN
Red Deer College
Red Deer, Alberta Claudette Kelly, RN, BScN,
Thompson Rivers University
Kamloops, British Columbia iii LWBK437-FM_i-x.qxd 30/10/2009 08:45 AM Page iv Aptara LWBK437-FM_i-x.qxd 30/10/2009 08:45 AM Page v Aptara P R E F A C E
This third edition of Canadian Essentials of Nursing Research continues to feature
state-of-the-art research undertaken by Canadian nurse researchers, as well as
additional Canadian content relating to the history of nursing research, ethical
considerations, models of nursing, and models of research utilization. At the
same time, this edition contains all the innovative features that made the original
award-winning text so popular. Essentials of Nursing Research is widely hailed by
faculty, clinicians, and students alike for its up-to-date, clear, and ?user-friendly?
Nursing research is the conduct of systematic studies to generate new knowledge pertaining to health and illness-related experiences. Nurse researchers are
scientists who seek answers to pressing questions through systematic observation
and recording of nursing-related phenomena. There is a growing expectation that
nurses?especially those in clinical practice?will increasingly utilize the results of
scientific studies as a basis for their practice. The need to apply new knowledge
from research requires that we overcome the challenges related to accessing, reading, understanding, translating, and disseminating research findings into practice.
One main purpose of this book is to assist beginning consumers of nursing
research in evaluating the adequacy of research findings in terms of their scientific
merit and potential for utilization.
The twenty-first century is a very exciting era for nursing research in Canada.
Current nursing research agendas are more dynamic, more responsive to societal
needs, and more closely aligned with innovation in health care delivery. In addition, the explosion of information technology has enabled clinicians, administrators, researchers, and other stakeholders to readily transcend geographical distances and time zones so that they may work together to answer important health
care questions. In addition, an ever increasing critical mass of nursing research
leaders make for a more visible, productive, and collaborative health-related
research enterprise. A concerted effort to conduct transdisciplinary research also
has stimulated new, innovative, and productive partnerships adding to a renewed
body of knowledge. One challenge for the future, however, remains to diversify and
increase communication channels so that the best nursing evidence becomes more
accessible and more readily disseminated within and across disciplines and across
relevant fields. Nursing research too often remains a well-kept secret.
Growing evidence indicates that the presentation of knowledge that is personally relevant to students contributes to optimal learning. Course evaluations and
informal feedback from our students who have used the first or second edition
clearly show that the timely exposure to examples of research conducted by Canadian nurse researchers enhances their understanding, appreciation of, and commitment to nursing research. This third edition should continue to stimulate students to become well-informed consumers of research and stay actively involved in
the discovery of new nursing knowledge. We are honoured to have had the opportunity to update Canadian Essentials of Nursing Research during a most promising
moment in the history of nursing research in Canada. NEW TO THIS EDITION
? * Early introduction to evidence-based practice. To enhance the reader?s appreciation of requirements to conduct rigorous nursing research and highlight its relevance to practice, we have introduced the idea of evidence-based practice
much earlier in the book. Chapter 1 provides concrete examples of nursing
research in Canada that have led to innovative developments guiding EBP such
as the creation of clinical practice guidelines.
v LWBK437-FM_i-x.qxd 30/10/2009 08:45 AM Page vi Aptara PREFACE vi * Sustained emphasis throughout the chapters on the relevance of nursing research
to evidence-based practice. All chapters build on these notions to guide nurses in
their evaluation of study quality and ensuing evidence in terms of rigour and
potential use in practice.
* New resources for students and instructors. New resources based on this edition
of Canadian Essentials of Nursing Research are available on
learning and instruction. ORGANIZATION OF THE TEXT
? The content of this edition is organized into six main parts.
* Part 1?Overview of Nursing Research serves as the overall introduction to fundamental concepts in nursing research. Chapter 1 introduces and summarizes
the history and future of nursing research both in Canada and elsewhere, discusses the philosophical underpinnings of qualitative research versus quantitative research, and describes the major purposes of nursing research. Chapter 2
introduces readers to key terms, with new emphasis on terms related to the
quality of research evidence. Chapter 3 presents an overview of the steps in the
research process for both qualitative and quantitative studies. Chapter 4 provides an introduction to research reports?what they are and how to read them.
Chapter 5 is devoted to a discussion of ethics in research studies.
* Part 2?Preliminary Steps in the Research Process includes three chapters and
focuses on the steps that are taken in getting started on a research project.
Chapter 6 focuses on the development of research questions and the formulation of research hypotheses. Chapter 7 discusses how to prepare and critique
literature reviews. Chapter 8 presents information about theoretical and conceptual frameworks.
* Part 3?Designs for Nursing Research presents material relating to the design of
qualitative and quantitative nursing studies. Chapter 9 describes some fundamental design principles and discusses many specific aspects of quantitative
research design. Chapter 10 addresses the various research traditions that have
contributed to the growth of naturalistic inquiry and qualitative research.
Chapter 11 provides an introduction to some specific types of research (e.g.,
evaluations, surveys, secondary analyses, case studies), and also describes integrated qualitative/quantitative designs. Chapter 12 presents various designs for
sampling of study participants.
* Part 4?Data Collection deals with the collection of research data. Chapter 13
discusses the full range of data collection options available to researchers,
including both qualitative and quantitative approaches. Chapter 14, an especially important chapter for critiquing qualitative studies, explains methods for
assessing data quality.
* Part 5?Data Analysis is devoted to the organization and analysis of research
data. Chapter 15 reviews methods of quantitative analysis. The chapter
assumes no prior instruction in statistics and focuses primarily on helping
readers to understand why statistics are needed, what tests might be appropriate in a given research situation, and what statistical information in a research
report means. Chapter 16 presents a discussion of qualitative analysis, greatly
expanded and improved in this edition.
* Part 6?Critical Appraisal and Utilization of Nursing Research is intended to
sharpen the critical awareness of consumers with respect to several key issues.
Chapter 17 discusses the interpretation and appraisal of research reports.
Chapter 18, the final chapter, offers guidance for research utilization and EBP. LWBK437-FM_i-x.qxd 30/10/2009 08:45 AM Page vii Aptara PREFACE vii KEY FEATURES
? This third edition continues to place an emphasis on relevance and rigour of nursing studies. In addition, because research has shown that more personally relevant
materials are better processed and recalled, we have made every effort to ensure
that examples of nursing studies depict the work of various nurse researchers from
across the country.
Research Examples and Critical Thinking Activities: Each chapter includes
examples of studies in abstract style so that the gist is conveyed while providing the
full citations so that students wanting more information can easily retrieve the
journal articles. In addition, critical thinking activities are provided so that students can evaluate features of actual studies with full reports included in the
Tips: Each chapter contains numerous tips on what to expect in research reports
vis-à-vis the topics that have been discussed in the chapter. In these tips, we pay
special attention to help students read research reports, thus enabling them to
translate the material presented in the textbook into meaningful concepts as they
approach the research literature.
Guidelines for Critiquing Research Reports: Boxes containing guidelines for
conducting a critique provide a list of questions that walk students through a
study, drawing attention to various aspects that are amenable to appraisal by
Learning Objectives: Learning objectives are identified at the outset of each chapter to focus students? attention to critical content.
Summary Points: A summary of key points is provided at the end of each chapter.
Methodologic and Theoretical References: A list of methodologic and theoretical references is provided at the end of the book to direct the student?s further
Teaching/Learning Package: A variety of teaching/learning resources is available
for students and instructors who purchase Canadian Essentials of Nursing
Research, 3rd edition. Visit
at http://thePoint.lww.com to learn about this
Carmen G. Loiselle, PhD, RN
Joanne Profetto-McGrath, PhD, RN
Denise F. Polit, PhD
Cheryl Tatano Beck, DNSc, CNM, FAAN LWBK437-FM_i-x.qxd 30/10/2009 08:45 AM Page viii Aptara I N A P P R E C I A T I O N
With the continued success of Canadian Essentials of Nursing Research, we
remained most committed to producing a third edition of the book. Many thanks
go to our nursing colleagues from across Canada for so willingly sharing their
research findings with us and for continuing to provide informative ?behind the
We are indebted to the Lippincott Williams & Wilkins team, Carol McGimpsey,
Corey Wolfe, Barry Wight, Hilarie Surrena, and Helen Kogut, Product Manager,
who remain great supporters of the ?Canadianization? of Essentials of Nursing
McGill University and the University of Alberta provided the authors with a most
stimulating intellectual working environment. In addition, we thank our colleagues, from various institutions and affiliations, Drs. Nancy Feeley, Thomas
Hack, Dorothy Forbes, Lesley Degner, and Lynne McVey, for their support and passion for research and clinical practice and for their pursuit of excellence in all
realms of life. We acknowledge the significant contributions of Dr. Sylvie Lambert,
Dr. Michelle Proulx, Kylie Hugo, and Okimi Peters who rigorously and diligently
assisted us in finding the most relevant studies to be included in this new edition.
We thank Kelly and Jamie Cassoff for their assistance in proof reading some chapters. We also acknowledge the precious assistance of medical librarian, Rachel
Daly, MLIS, from the Centre for Nursing Research at the Jewish General Hospital
in Montreal for her enthusiastic and dedicated work in cross-checking the numerous citations.
Finally, we acknowledge our respective spouses, Eric Gervais and Larry McGrath,
our children, and our extended families and friends?for their love and support.
They remained eagerly interested in the progress of our collaborative work.
To each of the above individuals we are indebted. Collectively, they made the production of this third edition a most pleasant, stimulating, and gratifying experience.
We dedicate this book to a recently deceased colleague?Dr. Chantal Caron, a wonderful human being and an accomplished nurse researcher at the Université de
Sherbrooke in Québec. Dr. Caron died of cancer last year, at the age of 42. viii LWBK437-FM_i-x.qxd 10/31/09 1:36PM Page ix Aptara Inc C O N T E N T S
PART 1: OVERVIEW OF NURSING RESEARCH
5 Introducing Research and Its Relevance to Nursing Practice
Key Concepts in Qualitative and Quantitative Research
Understanding the Research Process in Qualitative and Quantitative Studies
Reading Research Reports
Reviewing the Ethical Aspects of a Nursing Study PART 2: PRELIMINARY STEPS IN THE RESEARCH PROCESS
8 Scrutinizing Research Problems, Research Questions, and Hypotheses
Finding and Reviewing Studies in the Literature
Examining the Conceptual/Theoretical Basis of a Study 1
127 PART 3: DESIGNS FOR NURSING RESEARCH 143 9
206 Scrutinizing Quantitative Research Design
Understanding Qualitative Research Design
Examining Specific Types of Research
Examining Sampling Plans PART 4: DATA COLLECTION 229 13
258 Scrutinizing Data Collection Methods
Evaluating Measurements and Data Quality PART 5: DATA ANALYSIS 277 15
318 Analyzing Quantitative Data
Analyzing Qualitative Data PART 6: CRITICAL APPRAISAL AND UTILIZATION OF NURSING RESEARCH 343 17
18 Critiquing Research Reports
Using Research in Evidence-Based Nursing Practice 344
368 Methodologic and Theoretical References 399 Glossary 403 Appendices: Research Reports 427 Index 489 ix LWBK437-FM_i-x.qxd 30/10/2009 08:45 AM Page x Aptara LWBK437-C01_001-025.qxd 29/10/2009 11:19 AM Page 1 Aptara ? P A R T 1 Overview
Research 1 LWBK437-C01_001-025.qxd 29/10/2009 11:19 AM Page 2 Aptara C H A P T E R 1 Introducing Research and Its
Relevance to Nursing Practice ? LEARNING OBJECTIVES
On completing this chapter, you will be able to:
1. Describe why research is important to nursing and discuss evidence-based practice
2. Describe historical trends and future directions in nursing research
3. Describe alternate sources of evidence for nursing practice
4. Describe the main characteristics of the positivist and naturalistic paradigms, and discuss
similarities and differences between quantitative and qualitative research
5. Identify several purposes of qualitative and quantitative research
6. Define new terms in the chapter AN INTRODUCTION TO NURSING RESEARCH
? It is an exciting time to be a nurse. Nurses are managing their clinical responsibilities at a time when the nursing profession and the larger health care system
require an extraordinary range of skills and talents. Nurses are expected to
deliver high-quality care, in a compassionate manner, with the added challenge
of being cost-effective. To accomplish these goals, nurses must readily have
access to and evaluate new evidence to decide whether to incorporate it into their
practice. In today?s world, nurses are expected to be lifelong learners, reflecting on,
evaluating, and modifying their clinical practice based on the emerging scientific
knowledge. What Is Nursing Research?
Research is a systematic inquiry that uses rigorous methods to answer questions
or solve problems. The ultimate goal of research is to develop, refine, and expand
Nurses are increasingly engaged in studies that benefit the profession and the
individuals it serves. As such, nursing research is designed to develop evidence
about issues of importance to various stakeholders.
In this book, we emphasize clinical nursing research, that is, research designed
to inform nursing practice and contribute to the well being and quality of life of
individuals who are facing various challenges or health threats. Clinical nursing
2 LWBK437-C01_001-025.qxd 29/10/2009 11:19 AM Page 3 Aptara CHAPTER 1 * Introducing Research and Its Relevance to Nursing Practice 3 research typically begins with questions stemming from practice-related issues
such as those that you may encounter in your practice.
Examples of nursing research questions * What types of musculoskeletal problems are older nurses most likely to experience (Cameron, ArmstrongStassen, Kane, & Moro, 2008)?
* What are the experiences of women with schizophrenia who had to negotiate support from formal and informal sources (Chernomas, Clarke, & Marchinko, 2008)? The Importance of Research in Nursing
In Canada and elsewhere, nurses increasingly have been encouraged to get
involved in research and adopt an evidence-based practice (EBP). EBP is broadly
defined as the use of the best clinical evidence in making care decisions. Evidence
can come from various sources, but there is general agreement that findings from
rigorous studies constitute the best type of evidence for guiding nurses? decisions
and actions. Nurses who incorporate high-quality evidence into their clinical practice are more likely to provide interventions that are appropriate, cost-effective,
and promote optimal health outcomes.
Example of evidence-based practice
In Canada, nursing research has led to innovative developments guiding EBP such as the creation of clinical
practice guidelines. Clinical practice guidelines include summaries of the best available evidence packaged in a
format that readily guides clinical decision making. These guidelines can contribute to quality health care by
promoting effective interventions based on solid evidence. A team in Ontario that includes Margaret B. Harrison
(Professor, School of Nursing, Queen?s University, Ontario), Marlene Mackey (Corporate Nursing quality coordinator, Ottawa Hospital, Ottawa), and collaborators in Eastern Ontario concerted their efforts toward the implementation of practice guideline recommendations related to the prevention of pressure ulcers. An evidence-based skin
care program was developed and implemented by a transdisciplinary team of nurses, enterostomal therapists, clinical managers, clinical nurses, nurse educators, dieticians, a physiotherapist, occupational therapist, and a clinical
director. In the implementation period, even though more than 25% of patients were considered at high risk for
pressure ulcers, their prevalence decreased from 18% to 14%.
Various nurses associations such as the Registered Nurses Association of Ontario (RNAO) regularly publish evidence-based clinical practice guidelines: www.rnao.org. Roles of Nurses in Research
With the current emphasis on EBP, it has become every nurse?s responsibility to
engage in one or more research activities along a continuum of participation. At
one end of the continuum, nurses? involvement is indirect; they are considered
research consumers as they read research reports to develop new skills and to keep
up-to-date on findings that may affect their practice. At minimum, nurses are
expected to maintain this level of involvement with research.
At the other end of the continuum, nurses actively engage in research activities. They participate in designing, refining, and implementing studies with a keen
emphasis on producing new knowledge that will likely make a difference in the
lives of patients.
Example of research by hospital-based nurses
Dean and Major (2008) each conducted an independent study on the use of humour in health care and compared
their findings to identify common themes. Dean, a senior instructor at the University of Manitoba, observed and interviewed 15 health care providers from a palliative care unit. Major, a clinical nurse specialist at a health centre in Winnipeg, observed and interviewed 15 intensive care nurses. Common themes that emerged from their analysis included
the value of humour for teamwork, emotion management, and maintaining human co…