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3916_FM_i-xx 21/10/14 11:29 AM Page i

Bailey's
Research for
the Health
Professional
THIRD EDITION
3916_FM_i-xx 21/10/14 11:29 AM Page ii
3916_FM_i-xx 21/10/14 11:29 AM Page iii

Bailey's Research
for the Health
Professional
THIRD EDITION

Angela N. Hissong, DEd, OTR/L, CMCP, CMMT

Program Director
Occupational Therapy
The Pennsylvania State University
Mont Alto, Pennsylvania

Jennifer E. Lape, OTD, OTR/L

Assistant Professor
Occupational Therapy
Chatham University
Pittsburgh, Pennsylvania

Diana M. Bailey, EdD, OTR, FAOTA

Professor Emerita, Tufts University
Medford, Massachusetts
3916_FM_i-xx 21/10/14 11:29 AM Page iv

F. A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com

Copyright © 2015 by F. A. Davis Company

Copyright © 2015 by F. A. Davis Company. All rights reserved. This product is protected by copyright. No part of it may be reproduced,
stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise,
without written permission from the publisher.

Printed in the United States of America

Last digit indicates print number: 10 9 8 7 6 5 4 3 2 1

Senior Acquisitions Editor: Christa Fratantoro

Manager of Content Development: George W. Lang
Developmental Editor: Karen Carter
Art and Design Manager: Carolyn O’Brien

As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies
undergo changes. The author(s) and publisher have done everything possible to make this book accurate, up to date, and in accord
with accepted standards at the time of publication. The author(s), editors, and publisher are not responsible for errors or omissions
or for consequences from application of the book, and make no warranty, expressed or implied, in regard to the contents of the book.
Any practice described in this book should be applied by the reader in accordance with professional standards of care used in regard
to the unique circumstances that may apply in each situation. The reader is advised always to check product information (package
inserts) for changes and new information regarding dose and contraindications before administering any drug. Caution is especially
urged when using new or infrequently ordered drugs.

Library of Congress Cataloging-in-Publication Data

Bailey, Diana M., 1942- , author.

Research for the health professional / Angela N. Hissong, Jennifer E. Lape, Diana M. Bailey. — Third edition.
p. ; cm.
Preceded by: Research for the health professional / Diana M. Bailey. 2nd ed. c1997.
Includes bibliographical references and index.
ISBN 978-0-8036-3916-4 — ISBN 0-8036-3916-3
I. Hissong, Angela N., author. II. Lape, Jennifer E., author. III. Title.
[DNLM: 1. Research Design. 2. Data Collection—methods. 3. Data Interpretation, Statistical. 4. Publishing. 5. Writing. W 20.5]

R850
610.72—dc23

2014025756

Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by
F. A. Davis Company for users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that
the fee of $.25 per copy is paid directly to CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been
granted a photocopy license by CCC, a separate system of payment has been arranged. The fee code for users of the Transactional
Reporting Service is: / + $.25.
3916_FM_i-xx 21/10/14 11:29 AM Page v

For students, practitioners, and educators

embarking on the research journey . . .
It is easy to think of an idea.
It is challenging to make your idea a reality.
It is inspiring to see the idea change lives.

There are blue skies and

endless territory to explore.
3916_FM_i-xx 21/10/14 11:29 AM Page vi
3916_FM_i-xx 21/10/14 11:29 AM Page vii

Preface
Research for the Health Professional was designed to be way. This text is appropriate for those just beginning
a practical and informative guide for research and in the research or evidence-based practice journey, but
evidence-based practice for a variety of healthcare stu- can also be an effective tool for more advanced stu-
dents and professionals. The text will guide you to: dents and practitioners or those needing a refresher
course. With these goals in mind, each chapter con-
1. Differentiate research from evidence-based
tains several features.
practice
First, Learning Outcomes define the chapter
2. Discriminate between quantitative, qualitative,
goals and let you know what you can expect to learn
and mixed methods research methodologies
in each chapter. Second, Skill-Building Tips are in-
3. Access and critically evaluate literature related to
cluded at the end of each chapter in bulleted format
your practice area
to summarize practical suggestions for understand-
4. Ignite your passion for your profession or chosen
ing and applying chapter content. These tips have
practice area to inspire participation in research
been accumulated through our experiences in con-
and evidence-based practice activities
ducting research and evidence-based practice and in
5. Apply principles of research and evidence-based
teaching others to do the same. These tips should
practice to design, implement, and evaluate
allow you to avoid some of the common pitfalls and
meaningful research studies or innovative
to move through the research process with greater
evidence-based practice projects
ease. Third, Learning Activities conclude each chap-
6. Share research and evidence-based practice
ter and provide opportunities for critical thinking
findings through a variety of methods
about the chapter content. These questions can serve
7. Engage in collaborative and self-directed learning
as a foundation for each phase of the research
activities to become researchers, evidence-based
process, by allowing you to consider chapter content
practitioners, and professional leaders
from the perspective of your clinic, practice, or re-
We have taken a straightforward, positive, and search situation. Finally, additional resources and
engaging approach to research and evidence-based templates are available within the chapters and in the
practice that draws upon our combined 25 years of online resources through DavisPlus to guide you
teaching experience, from the associate to doctoral through the research process. In addition, a variety of
levels. Understanding and engaging in research and examples from multiple disciplines have been in-
evidence-based practice can be challenging, but with cluded throughout the chapters to demystify more
use of a structured process and a passion for the cho- complex concepts.
sen topic, both can be extremely rewarding and en- Reviewing the chapters in chronological order
lightening. The philosophy of the text is to learn by reflects the approach we have found to be most effec-
“doing,” meaning that mastery of the content is facil- tive for research in traditional, online, and blended
itated via hands-on activities, engaging assignments academic settings. For those more interested in
and discussions, and collaboration with others. evidence-based practice, we recommend reviewing
Our intention was not to write a comprehensive re- sections in the following order: Section I, Section III,
search text, but rather to lead you through each phase Section II, Section IV. In either case, we hope this text
of the research process in a simplified and systematic will guide you to design and conduct a successful
vii
3916_FM_i-xx 21/10/14 11:29 AM Page viii

viii Preface

study or project, and to pursue grant writing or to healthy and fulfilling life, and we remind our stu-
present and publish to share your work with others. dents of this frequently. The chapter photos were
One final feature that we chose to include is the in- taken throughout our writing journey for this book,
spirational quotes and photos that open each chap- as we tried to stay true to our own philosophy. We
ter to set the tone for a positive and engaging learning hope you enjoy the journey and embrace the joys of
experience. Research and evidence-based practice can research and conducting evidence-based practice! The
be challenging and time-consuming, but we believe process will surely change you if you let it!
that it can also be inspiring and fun with proper life
balance. Balancing competing activities and finding Angela N. Hissong
time to enjoy the simple leisures is fundamental to a Jennifer E. Lape
3916_FM_i-xx 21/10/14 11:29 AM Page ix

Reviewers
Diana M. Bailey, OTR, EdD, FAOTA Shirley J. Jackson, MS, OTR/L, FAOTA
Professor Emerita Associate Professor and Former Chairperson
Tufts University Department of Occupational Therapy
Medford, Massachusetts Howard University
Washington, District of Columbia
Joseph A. Beckett, EdD, ATC
Chair, Department of Sports Medicine & Frances E. Kistner, PT, PhD, CEAS
CAAHEP-accredited Athletic Training Education Assistant Professor
Program Director School of Physical Therapy
University of Charleston Massachusetts College of Pharmacy and Health
Charleston, West Virginia Sciences
Worcester, Massachusetts
Nicceta Davis, PT, PhD, MSPT, MPH
Associate Professor Rosemary M. Lysaght, PhD, OTR/L
Doctor of Physical Therapy Program Assistant Professor
Loma Linda University Department of Occupational Therapy
Loma Linda, California University of Utah
Salt Lake City, Utah
Deanna C. Dye, PT, PhD
Physical Therapist Cheryl A. Manthei, NCTMB, MT, MS-IDT,
Wound Care Department BBA, AAS MSG, AAS CHEM
Eastern Idaho Regional Medical Center Program Director, Therapeutic Massage and
Idaho Falls, Idaho Bachelor of Health Services Administration
Department of Health Sciences
Vickie S. Freeman, PhD Baker College of Allen Park
Department Chair and Professor Allen Park, Michigan
Department of Clinical Laboratory Sciences
University of Texas Medical Branch Kevin C. Miller, PhD, AT, ATC
Galveston, Texas Associate Professor
Department of Athletic Training
Rita M. Heuertz, PhD, MT(ASCP) Central Michigan University
Professor, Director of Departmental Research Mount Pleasant, Michigan
Clinical Laboratory Science, Doisy College of Health
Sciences
Saint Louis University
St. Louis, Missouri

ix
3916_FM_i-xx 21/10/14 11:29 AM Page x

x Reviewers

Maralynne D. Mitcham, PhD, OTR/L, FAOTA Holly Schmies, PhD, ATC

Professor and Director Assistant Professor
Occupational Therapy Educational Department Department of Athletic Training
Department of Rehabilitation Sciences School of Physical Education and Athletic Training
College of Health Professions University of Wisconsin—Stevens Point
Medical University of South Carolina Stevens Point, Wisconsin
Charleston, South Carolina
Karen Sladyk, PhD, OTR, FAOTA
Annie Morien, PhD, PA-C, LMT Professor and Chair
Lead Instructor Department of Occupational Therapy
Florida School of Massage Therapy Bay Path College
Gainesville, Florida Vernon, Connecticut

Stanley Paul, MD, PhD, OTR/L Frank B. Underwood, PT, PhD, ECS
Associate Professor Professor
Department of Occupational Science and Therapy Department of Physical Therapy
Keuka College, New York University of Evansville
Keuka Park, New York Evansville, Indiana

Kimberly S. Peer, EdD, ATC, FNATA Janet H. Watts, PhD, OTR, CRC
Athletic Training Education Program Coordinator Associate Professor and Director of
and Associate Professor Post-Professional Graduate Studies
School of Health Sciences Department of Occupational Therapy
Kent State University Virginia Commonwealth University
Kent, Ohio Richmond, Virginia

James R. Roush, PT, PhD, ATC Michael B. Worrell, PhD

Associate Professor Assistant Professor
Department of Physical Therapy Department of Occupational Therapy
Arizona School of Health Sciences Indiana University and University of Indianapolis
Mesa, Arizona Indianapolis, Indiana

Victoria Schindler, PhD, OTR, BCMH, FAOTA

Associate Professor
Department of Occupational Therapy
Richard Stockton College of NJ
Galloway, New Jersey
3916_FM_i-xx 21/10/14 11:29 AM Page xi

Acknowledgments
Our deepest gratitude goes to:
Joe and Jere, for understanding our need to flee to the woods, the ocean, or
the spa in order to make this book a reality. We couldn’t have done it with-
out you.
Our family and friends, for your concern and support along the way.
Our faithful and loving canines, Chloe and Sophia, who slept on our laps as we
wrote and gently reminded us to take time to enjoy the simple things in life.
Christa, Karen, and Liz, for believing in us and guiding us throughout the
journey.
Finally, to our students—past and present—who inspired us through their
journeys of research and evidence-based practice, to write a sensible and
lighthearted book to ease the process.

A special thank you from Angela to Dr. Julie Beck for contributing to the Adult & Trans-
formative Learning Influences on the Inquiry Process dialogue in Chapter 2.

xi
3916_FM_i-xx 21/10/14 11:29 AM Page xii
3916_FM_i-xx 21/10/14 11:29 AM Page xiii

Photographs
The chapter opener photos taken during our writing journey are:
EPIGRAPH: The Cabin, Breezewood, Pennsylvania
CHAPTER 1: Harbor of Christiansen, St. Croix, U.S. Virgin Islands
CHAPTER 2: Breathe & Balance Lecture, Philadelphia, PA
CHAPTER 3: Seaside Mahoe Tree, Carambola Beach Resort, St. Croix, U.S.
Virgin Islands
CHAPTER 4: Osprey Nest, Westport, Ontario, Canada
CHAPTER 5: Grandfather Mountain, Linville, North Carolina
CHAPTER 6: Woody Pines—Whitetail Mountain Forest, Beech Creek,
Pennsylvania
CHAPTER 7: North Atlantic Ocean, Island of Bermuda
CHAPTER 8: Enchantment Resort, Sedona, Arizona
CHAPTER 9: Moais Stone Head, Valparaíso, Chile
CHAPTER 10: Cape Hatteras Lighthouse, Buxton, North Carolina
CHAPTER 11: Snowy Stream, Springwood Farm, Pennsylvania
CHAPTER 12: Butterfly, Dupont State Forest, North Carolina
CHAPTER 13: Bald Cypress Tree in the Bayou, New Orleans, Louisiana
CHAPTER 14: Wright Brothers National Memorial, Kill Devil Hills, North
Carolina
CHAPTER 15: Bee & Lily, Garrison Institute, New York
(Photos taken by Angela Hissong, Jennifer Lape, and Joe Lape.)

xiii
3916_FM_i-xx 21/10/14 11:29 AM Page xiv
3916_FM_i-xx 21/10/14 11:29 AM Page xv

Brief Contents
SECTION 1: Beginning the Journey 1 SECTION 4: Common Tasks Along the
CHAPTER 1: Concepts of Research: Journey 149
Embarking on the Journey 3 CHAPTER 11: Before Implementing Your
CHAPTER 2: Identifying a Topic: Purpose Plan: Important Steps and
Balanced With Passion 9 Considerations 151
CHAPTER 3: Reviewing the Literature for CHAPTER 12: The Art of Writing Up the Research
Research and Practice 17 Study or Evidence-Based Practice
CHAPTER 4: Refining the Topic of Interest Project 161
and Developing the Background CHAPTER 13: The Art of Presenting the Research
Story 27 Study or Evidence-Based Practice
Project 177
SECTION 2: Research Methodologies CHAPTER 14: The Art of Publishing the Research
and Designs 33 Study or Evidence-Based Practice
Project 193
CHAPTER 5: Getting Started in the Research
CHAPTER 15: Grant Funding:Insights and
Process 35 203
Approaches
CHAPTER 6: Quantitative Research
APPENDIX A Example of Mixed Quantitative–
Methodology and Design 45
Qualtitative Study 209
CHAPTER 7: Technical Aspects of Quantitative
APPENDIX B Example of Qualitative Study 221
Research 69
APPENDIX C Example of Evidence-Based
CHAPTER 8: Qualitative Research
Practice Project 233
Methodology and Design 95
APPENDIX D Outline for an Informed
CHAPTER 9: Technical Aspects of Qualitative
Consent 239
Research 115
APPENDIX E Guidelines for Informed
Consent for Human Subjects
SECTION 3: Evidence-Based Practice 123
in a Study 241
CHAPTER 10: Understanding the Triad of APPENDIX F Example of Informed
Evidence-Based Practice: Consent—Practitioner Study 245
Evidence; Practitioner Skills and APPENDIX G Example of Informed
Knowledge; and Client Goals, Consent—Student Thesis 247
Values, and Circumstances 125

xv
3916_FM_i-xx 21/10/14 11:29 AM Page xvi

xvi Brief Contents

APPENDIX H Example of a Permission Form for APPENDIX M Guidelines for Contributors

Photograghs and Other Media to American Journal of
Materials 249 Occupational Therapy 261
APPENDIX I Professional Journals and APPENDIX N Author Guidelines for
Publishers 251 International Journal of Yoga
APPENDIX J Indexes and Abstracts 253 Therapy 267
APPENDIX K Evidence-Based Practice APPENDIX O Outline of a Grant Proposal 269
Resources by Healthcare INDEX 271
Discipline 257
APPENDIX L Author Guidelines for Health
Professional Journals and
Publications 259
3916_FM_i-xx 21/10/14 11:30 AM Page xvii

Contents
SECTION 1: Beginning the Journey 1 How Long Should the Literature
Review Be? 23
CHAPTER 1: Concepts of Research: Points to Remember When Writing
Embarking on the Journey 3 the Literature Review 23
Introduction to Research 3 Chapter Summary 23
Journey of Exploration in Research 4
Estimate Time to Complete a CHAPTER 4: Refining the Topic of Interest and
Research Project 4 Developing the Background Story 27
Steps in the Research Process 5 Refine the Question and Develop
Research Process Challenges 6 the Background 27
Synopsis of This Book 6 Problem 27
Background 28
CHAPTER 2: Identifying a Topic: Purpose Purpose of the Study 29
Balanced With Passion 9 Importance of the Study 29
Identifying a Topic: Passion Within Research Question 30
One’s Profession 9 Chapter Summary 31
Adult and Transformative Learning
Influences on the Inquiry Process 10 SECTION 2: Research Methodologies
Educational Aims During the Inquiry
Process 13
and Designs 33
Developing a Topic of Interest 13 CHAPTER 5: Getting Started in the Research
Embracing and Situating the Purpose
Process 35
of the Inquiry 14
Therapeutic Intervention 15 Research Methodologies 35
Management of Healthcare Program 15 Comparison of Quantitative
Environmental and Technological and Qualitative Research 35
Adaptations for Clients 15 Purpose 35
Evaluation of Healthcare Evaluation Designs 35
Procedures 15 Subjects 36
Chapter Summary 15 Researcher’s Relationship With Subjects 36
Data Collection 36
CHAPTER 3: Reviewing the Literature for Data Generated 36
Data Analysis 36
Research and Practice 17 Outcomes 36
Reviewing the Literature 17 Potential Issues 37
How to Do a Literature Search 18 Mixed Methods Designs 37
The Electronic Catalog and Reference General Considerations for Any
Books 19 Research Study 39
U.S. Government Documents 19 Defining and Operationalizing Terms 39
Health Professional Databases, Assumptions 39
Indexes, and Abstracts 20 Scope of the Study and Guiding
Searching and Selecting Databases 21 Conceptual Framework 42
Locating Articles and Books 21 Limitations of the Study 42
Organizing the Material 22 Chapter Summary 43

xvii
3916_FM_i-xx 21/10/14 11:30 AM Page xviii

xviii Contents

CHAPTER 6: Quantitative Research Inferential Statistics 84

Methodology and Design 45 Statistical Software 90
Reporting Data and Drawing
Features of Quantitative Research 45
Conclusions 90
Manipulation 45
Chapter Summary 91
Control 46
Randomization 47
Experimental Designs 49
CHAPTER 8: Qualitative Research Methodology
Basic Experimental Design 49 and Design 95
Pretest–Posttest Design With Qualitative Research: Expectations,
Follow-Up 50 Potential, and Opportunities 95
Posttest-Only Design 50 Constructs of Qualitative Research 96
Solomon Four-Group Design 51 Naturalistic Settings 97
Factorial Designs 51 Local Groundedness 97
Quasi-Experimental Designs 52 Phenomenological Perspective 97
Quasi-Experimental Design Lacking Data as Thick Description 97
Control 53 Lived Experience 98
Quasi-Experimental Design Lacking Power of Qualitative Data 98
Randomization 54 Recurring Features of Qualitative
Cohort Designs 54 Research 98
Time-Series Designs 55 Qualitative Strategies 98
Nonexperimental Designs 57 The Ethnographic Research Design 99
Correlational Research 57 The Case Method Research Design 100
Survey Research 57 The Historical Research Design 100
Quantitative Case Study Research 58 The Narrative Analysis Inquiry
Methodological Research 61 Research Design 101
Evaluation Research 62 Preparing for a Qualitative Research
Validity and Reliability of Study 101
Quantitative Research 62 General Components of Qualitative
Validity 63 Research 102
Reliability 64 The Problem 102
Chapter Summary 65 Theory 102
Research Questions 103
CHAPTER 7: Technical Aspects of Quantitative Participant Selection 104
Research 69 Data Collection 105
Data Analysis 105
Considerations in Quantitative
Report Writing 105
Research 69
Qualitative Research Designs 106
Subject Inclusion and Exclusion Criteria 69
Research Design: Ethnography 106
Subject Recruitment 70
Research Design: The Case Study
Sampling 70
Method 109
Sample Size 71
Research Design: Historical 110
Data Collection Techniques 72
Research Design: Narrative Analysis 112
Observation 72
Chapter Summary 113
Interview 72
Surveys 73
Record Review 77
CHAPTER 9: Technical Aspects of Qualitative
Equipment Used in Research 78 Research 115
Tests, Assessments, and Inventories 78 Establishing Boundaries for the
Analyzing Quantitative Data 80 Qualitative Research Study 115
Consulting a Statistician 80 Assumptions and Limitations 115
Descriptive Versus Inferential Statistics 81 Participant Criteria and Selection 116
Types of Data 81 Data Collection Procedures for
Descriptive Statistics 84 Qualitative Research 117
3916_FM_i-xx 21/10/14 11:30 AM Page xix

Contents xix

Validity 118 Chapter 1: Introduction and

Reliability 119 Overview of the Topic of Interest 161
Analyzing, Reporting, and Drawing Chapter 2: Literature Review 162
Conclusions About Qualitative Data 121 Describing and Synthesizing the
Literature 163
SECTION 3: Evidence-Based Practice 123 Chapter 3: Methodology 163
Subject or Participant Recruitment
CHAPTER 10: Understanding the Triad of & Selection 164
Evidence-Based Practice: Evidence; Chapter 4: Implementation and Results 164
Describing Subjects or Participants 164
Practitioner Skills and Knowledge;
Reporting Results 164
and Client Goals, Values, and Chapter 5: Evaluation, Discussion
Circumstances 125 and Conclusions 170
What Is Evidence-Based Practice? 125 What If Results Do Not Support the
Client-Centeredness 126 Project Question or Hypothesis? 170
Evidence-Based Practice Versus Research 127 Limitations 170
Why Is Evidence-Based Practice Needed? 127 Future Implications 171
Challenges to Evidence-Based Practice 127 The Abstract 171
Steps in Conducting an Evidence-Based Scientific Writing Styles 171
Practice Project 129 Becoming a Better Writer 172
Identifying a Need and an Evidence-Based Use of an Outline 172
Practice Question 129 Grammar and Organization 172
Searching the Evidence 131 Use of Software Features 173
Appraising and Synthesizing the Evidence 133 Chapter Summary 174
Applying the Evidence 136
Evaluating the Project 141 CHAPTER 13: The Art of Presenting the
Stories of Evidence-Based Practice 142 Research Study or Evidence-
Program and Protocol Development 142
Based Practice Project 177
Guidance for Unique Clinical Scenarios 143
Why Present? 178
Justifying the Need for Staff, Equipment,
What Is a Presentation? 178
or Services 144
Learning Styles 179
Mentoring, Teamwork, and Motivation 145
Oral Presentations 179
Chapter Summary 146
Visual Support for Oral Presentations 179
Oral Presentation Etiquette 182
SECTION 4: Common Tasks Along the Practice 182
Journey 149 Poster Presentations 183
Poster Design 183
CHAPTER 11: Before Implementing Your Printing and Transporting the Poster 185
Plan: Important Steps and Poster Etiquette 186
Considerations 151 Cyber Presentations 187
Important Preparations 151 Presentation Tools/Platforms for Cyber
Human Participants Committee Presentations 188
Procedures 151 Chapter Summary 189
Healthcare Research Ethics 154
The Pilot Study: A Helpful Measure CHAPTER 14: The Art of Publishing the
of a Researcher’s Readiness 155 Research Study or Evidence-
Implementing the Project 157 Based Practice Project 193
Chapter Summary 157 Why Publish? 193
Defining Publishing Goals 193
CHAPTER 12: The Art of Writing Up the Choosing a Publication 195
Research Study or Evidence- Peer-Reviewed Journals 195
Based Practice Project 161 Non–Peer-Reviewed Publications 196
3916_FM_i-xx 21/10/14 11:30 AM Page xx

xx Contents

Author Guidelines 196 APPENDIX I Professional Journals and

Format of the Article 197 Publishers 251
Peer-Reviewed Articles 197
Non-Peer-Reviewed Articles 199 APPENDIX J Indexes and Abstracts 253
Publication Procedures 200
Revising 201 APPENDIX K Evidence-Based Practice
What If My Article Is Rejected? 201
Resources by Healthcare
Article Acceptance 202
Chapter Summary 202
Discipline 257
General Healthcare 257
CHAPTER 15: Grant Funding: Insights Health and Fitness or Sports Medicine 257
Laboratory Science 257
and Approaches 203
Massage Therapy 257
Charge to Engage in Grant Writing 203
Nursing 257
Grant Writer’s Skills and Knowledge 204
Occupational Therapy 257
Grant Writing 101 205
Physical Therapy 258
Enablers and Barriers 205
Physician Assistant 258
Chapter Summary 207
Radiologic Science 258
Social Work 258
APPENDIX A Example of Mixed Quantitative–
Qualitative Study 209 APPENDIX L Author Guidelines for Health
Professional Journals and
APPENDIX B Example of Qualitative Study 221
Publications 259
APPENDIX C Example of Evidence-Based Athletic Training 259
Clinical Laboratory Sciences 259
Practice Project 233
Massage Therapy 259
Nursing 260
APPENDIX D Outline for an Informed Consent 239 Occupational Therapy 260
Physician Assistant 260
APPENDIX E Guidelines for Informed Physical Therapy 260
Consent for Human Subjects Radiologic Technology 260
in a Study 241 Social Work 260
General Information 241 Yoga and Bodywork 260
A. Written Informed Consent 241
1. Description and Explanation APPENDIX M Guidelines for Contributors
of Procedure 241 to American Journal of Occupational
2. Risks and Discomforts 242 Therapy 261
3. Potential Benefits 242
4. Alternative 242 APPENDIX N Author Guidelines for International
5. Consent 242 Journal of Yoga Therapy 267
B. Other Types of Consent 243
C. Participation of Children in APPENDIX O Outline of a Grant Proposal 269
Consent Process 243
Grant Proposal Format 269
A. ABSTRACT 269
APPENDIX F Example of Informed Consent—
B. NARRATIVE 269
Practitioner Study 245 C. ATTACHMENTS 269
APPENDIX G Example of Informed Consent— INDEX 271
Student Thesis 247

APPENDIX H Example of a Permission Form

for Photograghs and Other
Media Materials 249
3916_Ch01_001-008 20/10/14 10:47 AM Page 1

Section 1

Beginning the
Journey
3916_Ch01_001-008 20/10/14 10:47 AM Page 2
3916_Ch01_001-008 20/10/14 10:47 AM Page 3

Chapter 1

Concepts of Research:
Embarking on the
Journey
The universe is full of magical things, patiently waiting for
our wits to grow sharper.
—Eden Phillpotts

reviewing numerous sources of literature on a given

LEARNING OUTCOMES
topic and drawing new conclusions about that topic,
The information provided in this chapter will assist the
manipulating certain variables to see what happens
reader to:
to other variables, or searching for the meaningful-
■ Understand the components of engaging in the ness of a variable to an individual or group.
research process. Systematic investigation involves the process of
■ Define the steps required to complete a logic, often called deductive and inductive reasoning.
research process. Deductive reasoning starts with a general theory and
■ Identify potential challenges in the research ends with a specific conclusion; this is sometimes
process. called a “top-down” approach. For example, the re-
searcher starts with a general theory, forms a hypoth-
esis based on the theory, tests the hypothesis, assesses
Introduction to Research
the results, and forms a conclusion (Box 1-1).
Research can be an enjoyable, stimulating, and fasci- Inductive reasoning starts with a specific observation
nating activity to engage in along one’s professional that eventually forms a general theory; this is sometimes
journey. Often anyone who is required to write a called a “bottom-up” approach. In this type of reason-
research thesis starts out overwhelmed by the idea, yet ing, the researcher starts with an interesting observation,
comes to enjoy the challenge and ends up feeling then looks for a pattern of similar observations. From
proud of the results. Great satisfaction can be derived this pattern, the researcher develops a hypothesis, which
from completing this exacting, often complex, and forms the basis of a general theory (Box 1-2).
always stimulating process. When using inductive reasoning, one accepts or
Unfortunately, some people avoid research because believes a finding about a situation and then applies
of their preconceived notions. Research is the system- that belief to all similar individuals, assuming that the
atic investigation of a problem, issue, or question un- finding will be true for all. For example, if a healthcare
dertaken to increase our knowledge. This includes practitioner finds that having clients complete a

3
3916_Ch01_001-008 20/10/14 10:47 AM Page 4

4 Section 1 ■ Beginning the Journey

that the principle will probably not apply to all other

BOX 1-1 ■ Deductive Reasoning cases that follow.
Theory → Hypothesis → Observations →
Conclusion Journey of Exploration in Research
An occupational therapist believes that posi- Research in the health sciences is a challenging task;
tive encouragement improves patient out- however, it can be accomplished with the proper tools
comes (general theory) and hypothesizes and guidance. Human behavior is extremely complex
that positive reinforcement will decrease and, therefore, difficult to isolate and measure. Be-
stroke recovery time. The therapist tests the cause we are working in the health field, added di-
hypothesis on 100 patients and finds that mensions must be considered when working with and
stroke recovery time decreased by 50% (ob- conducting research with clients. These may include
servations). The therapist concludes that time constraints of the client and the healthcare prac-
positive reinforcement decreases stroke re- titioner, complicated medical diagnoses, working
covery time (conclusion). This confirms the within the many layers of the healthcare system, and
original theory. the numerous ethical issues involved when doing re-
search with people. With that said, we are nonetheless
seeing more support for healthcare practitioners as
BOX 1-2 ■ Inductive Reasoning they conduct research in the community setting with
a focus on preventative or wellness programs.
Observation → Pattern → Hypothesis → When considering your research agenda, keep the
Theory following six points in mind:
An occupational therapist observes that a ■ First and foremost, explore and understand the
patient’s ability to climb stairs improves when types of research and determine which type best
preceded by a balance task (e.g., standing on fits the question you are pondering (Table 1-1);
one leg with eyes closed). Over the next sev- ■ Be aware that finding collaborators who are inter-
eral months, the therapist looks for a pattern ested in your research is time-consuming;
whether the balance task causes improve- ■ Give considerable thought to the type of research
ments in other areas (cognition, motor skills, project you want to engage in;
etc.). After observing improvements in other ■ Learn as much as you can about the embedded
areas, the therapist believes that the balance systems or structural rules that will affect, and at
task should be performed at the beginning of times overrule, how you conduct your research;
every occupational session (hypothesis) and ■ Be willing to compromise and accept that perse-
implements this as standard protocol for all verance is a key asset during the research process;
therapists (theory). ■ Finalize your research question, then sit down
and write up a time line (Figure 1-1).

specific questionnaire about their health history is

beneficial during an initial evaluation, the practitioner
Estimate Time to Complete a Research
may choose to give all subsequent clients the question-
Project
naire to fill out. Practitioners often ask, “How long will it take to com-
The point of consideration with deductive reason- plete a research study?” or “How long should I devote
ing is that, although the principle is usually true, there to conducting research each day or week?” In my expe-
may be exceptions. The point of consideration with rience in advising graduate occupational therapy stu-
inductive reasoning is that the individual upon whom dents in their thesis preparation and writing, the time
you have based the principle may be the exception, so frame is an average of 6 to 12 months. This includes
3916_Ch01_001-008 20/10/14 10:47 AM Page 5

Chapter 1 ■ Concepts of Research: Embarking on the Journey 5

Table 1-1 ■ Description of Categories of Research

A Basic Applied
Abstract, general, and concerned with generating Designed to answer a practical question to help people
new theory and gaining new knowledge for knowl- do their jobs better.
edge’s sake.

B Experimental Descriptive
Manipulate a variable to see its effect on another Describe a group, a situation, or an individual to gain
variable, control for as many other variables as knowledge that may be applied to other groups or
possible, and randomly assign subjects to groups. situations, as in case studies or trend analyses.

C Clinical Laboratory
Performed in the “real world” where control over Performed in laboratory surroundings that are con-
variables is quite difficult. trolled.

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr

Prepare research project

Intervention

Analyze & interpret data

Write up results & publish

Figure 1-1 Time Line for Tasks of a Research Project

conceptualizing the issue to be studied, carrying out therapists enough free time during the day to do the
the project, and writing the study. Students are usually extra work required to complete a research study.
not carrying a caseload of clients or tied to a 40-hour
work week; however, they do have classes to attend and
Steps in the Research Process
often are working full-time on an affiliation.
Research conducted by practitioners tends to take It is helpful to remember that research is a circular
longer—about 1 year to 18 months—with some time process. The researcher starts with a question in
spent on the project each week. Of course, different mind, goes through the investigative stages, and
phases of the research demand more or less input. For ends up with an answer to the question. More often
example, if a new treatment approach is being investi- than not, further questions arise during the analysis
gated, the practitioner must adhere to the number and and interpretation of the data, leading to yet more
length of treatment sessions stipulated in the research research ideas.
protocol and put time into preparation and record- There are different points of entry into the research
keeping. Activities such as reading the literature and process. Some people enjoy starting afresh at the
writing the results are done on one’s own time and on a question identification stage; others may discover
less precise schedule. A therapist who works from 9 to some study results that they question and feel they
5 should plan on reading and writing in the evening would like to investigate for themselves. Still others
and on weekends because few clinical situations afford enter at various phases along the way. Whatever the
Exploring the Variety of Random
Documents with Different Content
 Mutta kun kello kukahtelee kahtatoista, menee hän levolle ja
nukahtaa heti.

*****

Kun Aku Hamberg seuraavana päivänä päivälliseltä tullessaan

menee kirjakauppaan, ei hän kuitenkaan ole yhtä tyyni. On lämmin
auringonpaisteinen päivä, mutta Aku Hambergia värisyttää, vaikka
hänellä on paksu päällystakki yllään. Ja kuta lähemmäksi matkansa
määrää hän tulee, sitä levottomammaksi käy hänen mielensä:

— Jollei hän olekaan siellä yksin, jos siellä on ostajia tahi kenties
se toinen vanha myyjätär…

— Jos on ostajia, niin odotan kunnes he ovat menneet, ajattelee

Aku
Hamberg. — Mutta entä jos sorakieli on siellä! Niin, mitä silloin?
Täytyy kysyä, milloin neitiä saisi tavata…

Samassa hän onkin jo perillä. Päättäväisesti aukaisee hän oven,

kello kilahtaa ja hän on sisällä. Siellä ei ole ketään ihmistä. Ja ennen
kuin tyttö pääsee sisähuoneesta tiskin luo, ehtii Aku Hamberg
todeta:

— Onni näyttää myötäiseltä!

Mutta heti kun tyttö saapuu tiskin taakse, tuntee Aku Hamberg
lämpimän veriaallon vyörähtävän läpi ruumiinsa, se takertuu
kurkkuun estäen häntä sanomasta hyvää päivää, nousee vähitellen
ylemmäs, saa posket hohtamaan ja polttaa aivoja aivan kuin kuuma
viini. Aku Hamberg huomaa, että hänen ajatuksensa menevät aivan
sekaisin. Kaikki tarkkaan harkitut lauseet häipyvät harmaaseen
sumuun.

Mutta tyttö seisoo siinä vain veitikkamaisesti hymyillen eikä näytä

ensinkään huomaavan toisen ahdistusta.

Vihdoin saa Aku Hamberg sanotuksi:

— Kun viimein kävin täällä…

Mutta siihen lause keskeytyy auttamattomasti.

Tyttö naurahtaa kevyesti:

— … niin taisi Teidän asianne unohtua. Mikähän siihen mahtoi olla

syynä?

Tuota pikaa vastaa Aku Hamberg:

— Te siihen olitte syynä!

Mutta samassa hän säikähtää sanojaan, sillä hän käsittää aivan

liian valmistelematta ja suin päin tulleensa in medias res. Tyttökin
hätkähtää ja sanoo ihmetellen:

— En tosiaankaan ymmärrä, kuinka minä olisin voinut…

Aku Hamberg huomaa tulleensa upottavalle suolle; hän käsittää,

ettei nyt enää auta peräytyä, täytyy vain astua eteenpäin minkä
suinkin voi. Ja epätoivon vimmalla alkaa hän puhua, kiihkeästi ja
katkonaisesti:

— Neiti, olen tuntenut Teidät jo kauan… tuntenut omalla

tavallani…
Olen ihaillut Teitä… silmiänne, käyntiänne, ruumistanne, sieluanne…
Uskokaa minua, olen joka päivä ikävöinyt…

Nyt suuttui tyttö, joka ilmeisesti luuli olevansa tekemisissä

synnissä harmaantuneen ketun kanssa; hänen silmäkulmiensa väliin
ilmestyi tuima viiva ja hänen äänensä vavahteli, kun hän sanoi:

— Lopettakaa jo ilveilynne! Minusta on hyvin rumaa tällä tavoin

kohdella avutonta yksinäistä tyttöä… Hävetä pitäisi Teidän, vanhan,
harmaantuneen ukon…

Kyyneleet nousivat hänen silmiinsä ja hänen äänensä tukahtui

nyyhkytykseen.

Aku Hambergin sydän pysähtyi, mutta hänen aivoissaan risteilivät

ajatukset salamoina. Hän tunsi uppoavansa suohon. Tällaiseksi ei
hän todellakaan ollut tätä kohtausta suunnitellut. Näinkö kohteli
häntä tuo tyttö, jonka ympärille hän yksinäisyytensä unelmista oli
kutonut ihailun kirkkaan sädekehän? Romahtivatko nyt kaikki hänen
tuulentupansa? Näinkö palkitsi toinen hänen ikävänsä, kaipuunsa,
kärsimyksensä…

Hän katsoi pitkään tyttöä, joka jo oli hiukan rauhoittunut, ja sanoi:

— Vakuutan Teille, neiti, että minun aikomukseni olivat mitä

puhtaimmat ja vakavimmat. Olette käsittänyt minut aivan väärin, ja
se surettaa minua syvästi. Uskokaa minua, lupaattehan…

Hän oli tahtomattaan eksynyt samaan ylenmäärin juhlalliseen

äänensävyyn, jota hän toisinaan käytti konttorin juoksupoikaa
toruessaan. Ja tytön täytyi kyyneltensäkin lomitse vähän hymyillä.
Sitä hänen kuitenkaan ei olisi pitänyt tehdä, sillä Aku Hamberg käsitti
tuon hymyn aivan väärin. Hän ojensi molemmat kätensä neitiä kohti
ja kuiskasi tulisesti:

— Minä rakastan Teitä!

Tyttö kirkasi:

— Jollette jätä minua rauhaan, huudan apua!

Silloin Aku Hamberg tajusi, että kaikki oli kadotettu. Tuntui aivan
siltä kuin hänessä jotain olisi särkynyt. Hänen silmissään alkoi huone
pyöriä, kirjahyllyt pöydät… Ja hänen täytyi tarttua molemmin käsin
tiskin reunaan pystyssä pysyäkseen.

Vähitellen hän kuitenkin alkoi tointua. Hän loi tyttöön pitkän

surumielisen katseen, ja kyyneleet pyrkivät hänen silmiinsä.

Mutta tyttö oli lentänyt tulipunaiseksi, hänen suupielensä

värähtelivät ja silmät leimusivat. Aku Hamberg käsitti, että häntä olisi
hyvin vaikea lepyttää, ja hän ymmärsi myöskin, ettei hänellä siihen
ollut voimia. Senvuoksi hän ei sitä yrittänytkään, vaan käänsi
alistuvaisesti katseensa maahan.

Silloin virkkoi tyttö ivallisella äänellä:

— Eikö Teillä nytkään ollut mitään asiaa tänne?

Aku Hamberg tuijotti häneen jähmettyneenä. Sitten hän

sanaakaan sanomatta otti lakkinsa ja meni hiljaa ovesta ulos.

*****

Hän asteli katua kuin unissakävijä, ei nähnyt mitään, ei kuullut

mitään; silmien edessä oli harmaata sumua ja korvissa humisi kuin
koskenpauhu. Hän koetti selvitellä ajatuksiaan, mutta ne olivat niin
sotkuisena vyyhtenä, ettei niitä hevin järjestykseen saanut. Kului
kotvan aikaa ennen kuin hän täydelleen käsitti, mitä oli tapahtunut.
Mutta sitten se selveni: rukkaset. Se merkitsi, että unelmat aivan
auttamattomasti olivat särkyneet, että hänen elämänsä jäi ennalleen,
yhtä yksinäiseksi, yhtä ilottomaksi kuin ennenkin. Se oli katkeraa,
raudankovaa… Mutta sitä ei voinut muuttaa…

Aku Hamberg kierteli katuja kunnes hän kuuli kirkonkellon lyövän

viittä. Silloin hän meni konttoriin ja kiipesi korkealle tuolilleen. Kenties
oli hän hiukan kalpeampi kuin tavallisesti, mutta ei hänestä mitään
erikoista voinut huomata. Aivan tyynesti pyyhkieli hän kultasankaisia
lasejaan, ja kun taaskin oli saanut ne nenälleen, aukaisi hän
kirjansa:

— Ihmisen on elettävä siksi kunnes hän kuolee…

*****

Illalla kotiintullessaan otti hän esille huilunsa ja sytytti alttarinsa

kynttilät. "Nuoruuden unelmat"… Soittaessaan hän silmäili tuon
tuostakin kelloa. Kun hän oli päässyt siihen kohtaan, jossa sävel
alkoi tyyntyä talvi-illan rauhaksi, otti hän hetkeksi huilun huuliltaan ja
kuunteli. Jo kuuluivat kadulta tutut askeleet. Mutta Aku Hamberg ei
vilkaissutkaan ikkunaan. Hän huokasi vain pari kertaa, nosti sitten
huilun huulilleen ja soitti sävellyksensä loppuun…
 *** END OF THE PROJECT GUTENBERG EBOOK PUNAINEN
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