NURSING RESEARCH (NUR 404)

UNIT I BY DR ANKA
Introduction
Nurses are expected to provide the highest quality of care in a kind manner, at the same time being aware of
the costs of healthcare services. To achieve these diverse and conflicting objectives, nurses must access and
evaluate extensive clinical information, and incorporate it into their clinical decision-making. In today’s
world, nurses must be ready to learn always, capable of reflecting on, evaluating, and modifying their
clinical practice based on new knowledge. In addition, Nurses are increasingly expected to become
producers of new knowledge through research, particularly nursing research. Note that the ultimate goal of
research is to develop, refine, replicate, and expand a body of knowledge.

Definition of Research
Research is defined as the process of finding solutions to a particular problem after a thorough study and
analysis of the situational factor (Sekaran & Bougie, 2013).

Neuman (2006) define research as a way of going about finding answers to questions. This scholar adds that
research is the process of learning something new.

Definition of Nursing Research

Several scholars defined nursing research in a number of ways; however, for the purpose of this course the
following basic definitions are useful:

Generally, the term nursing research is defined as the systematic, objective process of analyzing phenomena
of importance to nursing. Using this definition, nursing research includes all studies concerning nursing
practice, nursing education, and nursing administration. Also, studies concerning nurses themselves are
included in the broad category of nursing research.

Polit and Beck (2004) defined nursing research as “systematic inquiry designed to develop knowledge about
issues of importance to the nursing profession, including nursing practice, education, administration, and
informatics”.

Additionally, nursing research is a systematic approach to gathering information for the purposes of
answering questions and solving problems in the pursuit of creating new knowledge about nursing practice,
education and policy. (Hek& Moule, 2006).

The term clinical nursing research is a form of nursing research involving studies that have the potential for
affecting the care of clients.Specifically, nursing research in clinical practice examines “patient symptom
management, behavior intervention, prevention and health promotion as opposed to the medical model,
which is the treatment” (Williams, 2005). .

Importance of Nursing Research

1. Nursing research findings from rigorous studies provide the best sources of evidence based practice
(EBP, Sackett, 1996), which helps nurses to use best clinical evidence in care decision. In essence,
nursing research guides nurses to use appropriate research findings, expertise and contributions from
clients in the care of patients.
2. By adding high-quality research evidence into clinical decisions in the care of patients, nurses are
also strengthening the identity of nursing as a profession.
3. Nursing research helps to save costs of health care services to patients, healthcare administrators,
insurance companies and government. By producing research findings that document the social
 relevance and effectiveness of care, some research assist in removing nursing actions that do not
improve nursing care, invariably saving cost.
4. Nursing research helps to identify practices that improve healthcare result as well as the cost of the
healthcare (e.g. exclusive breastfeeding, breast self-examination, etc.)
5. Research permits nurses to describe the characteristics of particular nursing situation, of which little
is known about it before the research findings (e.g. behavior of men following VVF treatment etc.)
6. Research helps to explain certain phenomenon that is necessary to be considered in planning nursing
care (e.g. socio-cultural, religious and economic considerations).
7. Research helps to predict the potential outcome of certain nursing decision (this could be achieved
by developing hypothesis).
8. Nursing research helps to initiate activities to promote desired clients behavior (e.g. intervention
programs)

Characteristics of Scientific Research

1. Purposiveness- Scientific research should have definite purpose or aim. So for example “the purpose
of this research is to discover the influence of social support on student’s enrollment into college of
nursing using phenomenological orientation”.
2. Rigor- Rigor refers to the carefulness/meticulous and the degree of accuracy in research
investigation. It implies the theoretical and methodological precision followed in conducting study.
3. Testability- A scientific hypothesis must be testable. A hypothesis must not be vague. Examples of
hypothesis that cannot be tested include “God created the earth”.
4. Replicability- This is the extent to which a re-study is made possible by the provision of the design
detail of the study in the research report.
5. Precision and Confidence-This refers to the closeness of the research result to ‘reality’ based on a
sample. In other words, the term reflects the degree of accuracy or exactitude of the result on the
basis of the sample to what really exist in the universe.
For example, it is favorably close or accurate if estimate shows that a patient lost between 30kg and
40kg of weight based on my estimation as against the actual 35kg of weight compared more
favorably than if it were indicated that loss of weight due to dietary regulation was somewhat
between 20kg-50kg Confidence interval is what we call precision.

Confidence-This refers to the probability that our estimations are correct. That it is not enough to be
precise, but it is also important that we can confidently claim that 95% of the time our results will be
true and there are only 5% chances of our being wrong. This is what we call confidence level
6. Objectivity- Conclusion drawn through the interpretation of result of data analysis should be
objective not based on personal interest of the researcher; it should be based on the findings of
research.
Example, If we have a hypothesis which states that ‘wound dressing encourages healing of wound’
but after the hypothesis was tested it proved otherwise, the researcher should be fair enough to report
the result as it is.
7. Generalizability-This refer to the scope of applicability of the research findings. The wider the range
of applicability of the solution generated by research the more useful the research.
8. Parsimony- This refers to the efficient explanation of the variance in the dependent variables of
interest through the use of a smaller rather than a large number of dependent variables.

Historical Trends Areas of High Priority for Nurse Researchers

Florence Nightingale of Italy is the first ‘nurse researcher’. Her research in the 1850s focused on soldiers’
morbidity and mortality during the Crimean War. Nightingale identified ‘research’ questions in practice and
undertook a systematic collection of data and analysis to find answers to the problems of why soldiers at the
war front were contracting disease and why they die. Based on herskillful analyses and presentations, she
was successful in making some changes in nursing care,--generally, in public health. For example, changes
in the environment for sick people including cleanliness, adequate ventilation, clean water and adequate diet.
Since after the Nightingale’s work, there was little research about Nursing. Some attributed this absence to
the nature of nursing education. Most studies conducted between 1900 and 1940 concerned nurses’
education.For example, in 1923, a group called the Committee for the Study of Nursing Education produced
what is known as ‘Goldmark Report’, which studied the educational preparation of nurse teachers,
administrators, and public health nurses and the clinical experiences of nursing students. The Goldmark
Reportidentified many shortcomings in the educational backgrounds of the groups studied and decided that
nurses are required to undergo advanced educational preparations. As more nurses received university-based
education, studies concerning nursing students—their differential characteristics, problems, and satisfactions
—became more numerous.

In line with the Goldmark Report on inadequacies of nursing education during the 1940s, Brown (1948)
recommended that the education of nurses should be based in institution of higher education (universities,
colleges etc.).

In the 1950s several developments combined to raise nursing research rapidly, such as an increase in the
number of nurses with advanced educational degrees, the establishment of a nursing research centers, an
increase in funding both fromgovernment and private foundations.The American Journal of
Nursingpublished some studies in the 1930s. Moreover, due to increasing number of studies being
conducted during the 1950s, nurses started studying themselves: Who is the nurse? What does the nurse do?
Why do individuals choose to enter nursing? What are the characteristics of the ideal nurse? How do other
groups perceive the nurse?

In the 1960s, knowledge development throughnursing research began seriously.Some of the development
include: the beginning of the emergence in literature of practice-oriented research on various clinical topics,
emergence in the literature of terms such as conceptual framework, conceptual model,nursing process, and
theoretical base of nursingpractice, increase infundingboth for the educational training of nurses and for
nursing research. Nursing research began to spread worldwide in the 1960s. The International Journal of
NursingStudies began publication in 1963.

In the 1970s, the major developments on nursing research includeJournal of Advanced Nursing, which
communicate nursing research output. Moreover, other development in the 1970s include change in
emphasis in nursing research from areas such as teaching, curriculum, and nurses themselves to the
improvement of client care—signifying a growing awareness by nurses of the need for a scientific base from
which to practice.

The 1980s brought nursing research to a new level ofdevelopment. There was an increase in the number of
qualified nurse researchers, the widespread availability of computers for the collection and analysis of
information. More attention was paid to the types of questions being asked andthe methods of collecting and
analyzing information being used.

Nursing science came into its maturity during the1990s due to the following developments: National
Institute of Nursing Research (NINR)was born,funding for nursing research has also grown-in and outside
US, several research journals were established including Qualitative HealthResearch, Clinical Nursing
Research, ClinicalEffectiveness, and Outcomes Management forNursing Practice.

By 2000s, some of the major development in nursing research includes the following:
1. Focus on outcome research such as intervention programs to assess the effectiveness of healthcare
services.
2. Promotion of evidence based practice
3. Development of knowledge through confirmatory studies undertaken through replication of studies
on the same issue.
 4. Strengthening multidisciplinary collaboration both inter (between nurses and other health workers)
and intra disciplinary (among nurses).
5. Increase dissemination of research findings through the internet.

UNIT II

Historical Context for Ethical Codes, Ethical Principles and Human Rights

Historical Background
In nursing research, humans are used as study respondents; therefore, care must be taken in making sure that
the rights of those individuals are well protected. As contemporary, educated societies, it appears as if
violation of the rights of patients occurred only in the dark ages rather than in the modern time, however,
this is not correct. Some of the famous examples of recent violation of ethical conduct include:

1. The Nazi medical Experiments of the 1930s and 1940s:The Nazi program of research involved the
use of prisoners of war and racial “enemies” in numerous experiments designed to test human
reaction to diseases and untested drugs. The studies were unethical not only because they exposed
these people to permanent physical harm and even death but because subjects could not refuse
participation.
2. The United States Experiments between 1932 and 1972: A study known as the Tuskegee Syphilis
Study, sponsored by the U.S. Public Health Service, investigated the effects of syphilis among 400
men from a poor African-American community. Medical treatment was deliberately withheld to
study the course of the untreated disease.
3. Jewish Hospital in Brooklyn, USA: One morefamous unethical research involved the injection of live
cancer cells into elderly patients at the Jewish Chronic Disease Hospital in Brooklyn, without the
consent of those patients.
4. The US Federal Agencies 1940s: In recent time, it was revealed in 1993 that U.S. federal agencies
had sponsored radiation experiments since the 1940s on hundreds of people, many of them prisoners
or elderly hospital patients.

Ethical Codes, Ethical Principles and Human Right

Most disciplines have established their owncode of ethics. The American Nurses’ Association(ANA) put
forth a document in 1995 entitled EthicalGuidelines in the Conduct, Dissemination, andImplementation of
Nursing Research (Silva, 1995), which presents the nine ethical principles as follows:
1. Respects autonomous research participants’ capacity to consent to participate in research and to
determinethe degree and duration of that participation without negative consequences.
2. Prevents harm- Study participants should be protected from harm, including physical (injury,
fatigue), psychological (fear, stress) social (loss of friends).
3. Respects the personhood of research participants, their families, and significant others, valuing their
diversity.
4. Ensures that the benefits and burdens of research are equitably distributed in the selection of research
participants.
5. Protects the privacy of research participants to the maximum degree possible.
6. Ensures the ethical integrity of the research process by use of appropriate checks and balances
throughoutthe conduct, dissemination, and implementation of the research.
7. Reports suspected, alleged, or known incidents of scientific misconduct in research to appropriate
institutionalofficials for investigation.
8. Maintains competency in the subject matter and methodologies of his or her research, as well as in
otherprofessional and societal issues that affect nursing research and the public good.

CONSENT PROCESS
Informed Consent
Informed consent means that participants have adequate information regarding the research, are capable of
comprehending the information, and have the power of free choice, enabling them to consent to ordecline
participation voluntarily. Potential research respondents should be communicated to the following pieces of
information:
1. They should be informed that data they provide will be used for research purposes.
2. Study goals. The overall goals of the research should be stated, in lay rather than technical terms. The use
to which the data will be put should be described.
3. Type of data. Prospective participants should be told the type of data that will be collected.
4. Procedures. Prospective participants shouldbe given a description of the data collection
procedures, and of the procedures to be usedin any innovative treatment.
5. Nature of the commitment. Information should be provided regarding participants’estimated time
commitment at each point of contact.
6. Potential risks. Prospective participants should be informed of any foreseeable risks(physical,
psychological, social, or economic)or discomforts that might be incurred as a result of participation, and any
efforts that will be taken to minimize risks.
7. Potential benefits. Specific benefits to participants,if any, should be described, as well asinformation on
possible benefits to others.
8. Confidentiality pledge. Prospective participantsshould be assured that their privacy willat all times be
protected. If anonymity can beguaranteed, this should be noted.
9. Voluntary consent. Researchers should indicatethat participation is strictly voluntary andthat failure to
volunteer will not result in anypenalty or loss of benefits.
10. Right to withdraw and withhold information.
11. Researchers usually document the informed consentprocess by having participants sign a consent form

In some qualitative studies, especially thoserequiring repeated contact with the same participants,it is
difficult to obtain a meaningful informedconsent at the outset. Qualitative researchers do notalways know in
advance how the study will evolve.

The Risk/Benefit Ratio

In designing a study, researchers must carefullyassess and share with research participants the risks and
benefits that they might experience so that they can evaluate whether it is in theirbest interest to participate.
People agree to participate in research investigations for a number of reasons.

Summary of the Major Potential Benefits to Participants

(i) Access to an intervention that might otherwise be unavailable to them
(ii) Comfort in being able to discuss their situation or problem with a friendly, objective person
(iii) Increased knowledge about themselves or their conditions, either through opportunity for
introspection andself-reflection or through direct interaction with researchers
(iv) Satisfaction that information they provide may help others with similar problems or
conditions
(v) Direct monetary or material gains through stipends or other incentives

Major Potential Risks to Participants

1. Physical harm, including unanticipated side effects
2. Physical discomfort, fatigue, or boredom
3. Psychological or emotional distress resulting from self-disclosure, fear of the unknown,
discomfortwith strangers, fear of eventual repercussions, anger or embarrassment at the type of
questionsbeing asked
4. Social risks, such as the risk of stigma, adverse effects on personal relationships, loss of status
5. Loss of privacy
6. Loss of time
 7. Monetary costs (e.g., for transportation, child care, time lost from work)

In quantitative studies, most of the details ofthe study are usually spelled out in advance, andtherefore a
reasonably accurate risk/benefit ratioassessment can be developed. Qualitative studies,however, usually
evolve as data are gathered, and itmay therefore be more difficult to assess all risks atthe outset of a study.
Qualitative researchers thusmust remain sensitive to potential risks throughout the research process.

Types of Research and Approaches/Methods in Research

Research can be divided into four (4) types as follows: (1) based on methodological approaches/strategy, (2)
based on techniques(3) based on purpose/goal of the study, and(4) based on reasoning.

Research approaches/methods are divided into three (3) main types, namely (1) quantitative, (2) qualitative
and (3) mixed methods.

Types of Research
(1) Based on methodological approaches or Research Strategy:
a. Experimental Research-The experimental research is positivist in nature. The research is common in the
natural science (chemistry and physics) and related fields (medicine, agriculture and engineering). A basic
distinction in quantitative studies is the difference between experimental and non-experimental research. In
experimental research, researchers actively introduce an intervention or treatment. In non-experimental
research, on the other hand, researchers collect data without making changes or introducing treatments.
Some types of experimental studies include clinical trials, evaluations, and intervention research.

Clinical trials are studies designed to assess the effectiveness of clinical interventions. Evaluation research
assesses the effectiveness of a program, policy, or procedure to assist decision-makers in choosing a course
of action.Intervention research is a term sometimes used to refer to a distinctive process of planning,
developing, implementing, testing, and disseminating interventions.

b .Non-experimental research.
(i) Survey research- The study examines people’s characteristics, behaviors, attitudes, intentions and
perceptions by asking them to answer a series of questions. Survey study can be cross-sectional (collection
of data within short period) or longitudinal (data collection over a long period)

The preferred survey method is through personal interviews, in which interviewers meet respondents
face-to-face and question them. Telephone interviews are more economical, but are not recommended if the
interview is long or detailed or if the questions are sensitive or personal. Questionnaires are self-
administered(i.e., questions are read by respondents, who then give written responses) or researcher-
administered (i.e., questions are read by the researcher to the hearing of the respondent. The researcher then
marks the option chosen by the respondent.

(ii) Phenomenology-This is an approach to thinking about what life experiences of people are like and what
they mean. The phenomenological researcher asks the questions: what is the meaning of the phenomena to
those who experience it?

(iii)Field/Ethnography Research- It is a qualitative study in which a researcher directly observes and

participates in small-scale setting and usually in the researcher’s home culture. Most field researchers
conduct case study.

(iv) Case studies ;are in-depth investigations of a single entity or a small number of entities. The entity
maybe an individual, family, group, institution, community ,or other social unit.
(v). Historical Comparative Research-This is a qualitative research in which the researcher examines data or
event and condition in the historical past and or in different time.

(vi) Narrative research is a strategy of inquiry in which the researcher studies the lives of individuals and
asks one or more individuals to provide stories about their lives. This information is then often retold or re-
storied by the researcher into a narrative as they happened.

(vii) Grounded theory – in this approach, the researcher derives a general theory of a process, action or
interactions grounded on the views of participants. The process involves multiple data collection and
interrelationship of information. Hauck and Irurita (2002) conducted a grounded theory study to explain the
maternal process of managing late stages of breastfeeding and weaning the child from the breast.

(2) Based on Use of Technique

(i)Quantitative- This technique involves the collection of data in the form of numeric (number) in order to
examine the behavior, attitude or perceptions of respondents on particular problem.
(ii). Qualitative- This technique involves the collection of data in the form of words that are descriptive in
nature. Quantitative researchers usually believe that they know exactly what type of knowledge they expect
to obtain by doing a study, and then strive to obtain it. Qualitative researchers, by contrast, enter the study
not knowing what it is about the phenomenon that will drive the inquiry forward.

(3) Based on Purpose /goal of Research:

The general purpose of nursing research is toanswer questions or solve problems of relevance to the nursing
profession. Sometimes a distinction is made between basic and applied research.
1. Basic or Fundamental research- This is under taken to extend the base of knowledge in a discipline, or to
formulate or refine a theory. For example, a researcher may perform an in-depth study to better understand
normal grieving processes, without having explicit nursing applications in mind. Basic research is
appropriate for discovering general principles of human behavior.
2. Applied research- This focuses on finding solutions to existing problems. For example, a study to
determine the effectiveness of a nursing intervention to ease grieving would be applied research. Applied
research is designed to indicate how these principles can be used to solve problems in nursing practice.

The specific purposes of nursing research include identification, description, exploration, explanation,
prediction, and control.
1. Identification- Researchers tries to identify and answer questions about phenomenon by asking
‘’what is the phenomenon and its name’’, especially in qualitative study. In quantitative study,
identification of the phenomenon is already made by previous studies.
2. Description- In a descriptive study, researchers observe, count, delineate, and classify. Description
can be a major purpose for both qualitative and quantitative researchers. Quantitative description
focuses on the prevalence, incidence, size, and measurable attributes of phenomena. Qualitative
researchers, on the other hand, use in-depth methods to describe the dimensions, variations, and
importance of phenomena.
3. Exploratory-In quantitative study, exploratory research investigates the full nature of the
phenomenon, the manner in which it is manifested, and the other factors to which it is related.
However, qualitative methods are especially useful for exploring the full nature of a little-understood
phenomenon.
4. Explanatory- The goals of explanatory research are to understand the underpinnings of specific
natural phenomena, and to explain systematic relationships among phenomena. Whereas
descriptiveresearch provides new information, and exploratoryresearch provides promising insights,
explanatoryresearch attempts to offer understanding of theunderlying causes or full nature of a
phenomenon.

(4) Based on Logical Reasoning

Solutions to many perplexing problems are developed by logical thought processes. Logical reasoning as a
method of knowing combines experience, intellectual faculties, and formal systems of thought.
1. Inductive reasoning is the process of developing generalizations from specific observations. For
example, a nurse may observe the anxious behavior of (specific) hospitalized children and conclude
that (in general) children’s separation from their parents is stressful.
2. Deductive reasoning is the process of developing specific predictions from general principles. For
example, if we assume that separation anxiety occurs in hospitalized children (in general), then we
might predict that (specific) children inHospital whose parents do not room-in will manifest
symptoms of stress.

Both systems of reasoning are useful as a means of understanding and organizing phenomena, and
both play a role in nursing research. However, reasoning in and of itself is limited because the
validity of reasoning depends on the accuracy of the information (or premises) with which one starts,
andreasoning may be an insufficient basis for evaluating accuracy.

Approaches in Research
1. Quantitative
2. Qualitative and
3. Mixed methods

UNIT III
Research Problem
Introduction
A research problem is an enigmatic, perplexing, or troubling condition.

Steps in problem statement

1. Do a good literature review
2. Understand the structure of chapter one
3. Statement of the problem
(i) What we know about the problem:
In the first paragraph, write the actual problem in the first line, followed by stating what we
know about the problem. Example: Pre-eclampsis is….
“Numerous researchers have studied the incidence of pre-eclampsia among pregnant women (Wall,
2012, Zainab, 2014 & Monsurat, 2018)”.
(ii) What we don’t know: Example,
“Despite all our knowledge around the problem of pre-eclampsia, researchers have pointed out that
there is still what we do not know such as the age category of women affected, their socio-economic
status and level of education” (citation)
(iii) What they want us to know: Example,
“Contemporary researchers have urged us to study these areas of the problem (the age category of
women affected, their socio-economic status and level of education)(citation).

Therefore, the purpose of this study is to describe/explore/assess etc.

Source of Research Problem

Students may want to know where do ideas for research problems come from. How do researchers select
topic areas and develop research questions? The research topics originate with researchers’ interests.
Because research is a time consuming enterprise, curiosity about and interest in a topic are essential to a
project’s success. The sources that might increase researchers’ curiosity include experience, the nursing
literature, social issues, theories, and ideas from others.
 1. Experience and Clinical Fieldwork
The nurse’s everyday clinical experience is a rich source of ideas for research problems. As you are
performing your nursing functions, you are bound to find a wealth of research ideas if you are
curious about why things are the way they are or about how things could be improved if something
were to change. Example: Why do many patients complain ofbeing tired after being transferred from
a coronary care unit to a progressive care unit?
2. Nursing Literature
Ideas for research projects often come from reading the nursing literature. Beginning nurse
researchers can profit from regularly reading nursing journals, either clinical specialty journals or
research journals such as Nursing Research or the Western Journal of Nursing Research. Non
research articles can be helpful in alerting researchers to clinical trends and issues of importance in
clinical settings. Published research reports may suggest problem areas indirectly by stimulating the
imagination and directly by specifying further areas in need of investigation.
3. Social Issues
The idea for a study may come from a familiarity with social concerns or controversial social
problems or issues of relevance to the health care community. For example, the feminist movement
has raised questions about such topics as sexual harassment, domestic violence, and gender equity in
health care and in research.
4. Theory
The fourth major source of research problems lies in the theories and conceptual schemes that have
been developed in nursing and related disciplines. To be useful in nursing practice, theories must be
tested through research for their applicability to hospital units, clinics, classrooms, and other nursing
environments.
5. Ideas from External Sources
External sources can sometimes provide the impetus for a research idea. In some cases, a research
topic may be given as a direct suggestion. For example, a faculty member may give students a list of
topics from which to choose or may actually assign a specific topic to be studied. Organizations that
sponsor funded research, such as government agencies, often identify topics on which research
proposals are encouraged. Ideas for research are also being noted on various websites on the
internet.

What to Consider in Selecting Research Problem

There are no rules for making a final selection of aresearch problem. Some criteria, however, should be kept
in mind in the decision-making process. The four most important considerations are: (1) the significance, (2)
researchability, (3) feasibility of the problem, and (4) its interest to the researcher.

1. Significance of the Problem

A crucial factor in selecting a problem to be studied is its significance to nursing—especially to nursing
practice. Evidence from the study should have the potential of contributing meaningfully to nursing
knowledge. Researchers should pose the following kinds of questions: Is the problem an important one?
Will patients, nurses, or the broader health care community or society benefit from the evidence that will be
produced?
2. Researchability of the Problem
Not all problems are open to study through scientific investigation. Problems or questions of amoral or
ethical nature, although provocative, areincapable of being researched. Take, for example,the following:
Should assisted suicide be legalized?The answer to such a question is based on a person’svalues. There are
no rightsor wrong answers,only points of view. The problem is suitable todebate, not to research. To be sure,
it is possible toask related questions that could be researched.

In quantitative studies, researchable problems are ones involving variables that can be precisely defined and
measured. For example, suppose a researcher is trying to determine what effect early discharge has on
patient well-being. Well-being is too vague a concept for a study. The researcher would have to sharpen and
define the concept so that it could be observed and measured. That is, the researcher would have to establish
criteria againstwhich patients’ progress toward well-being couldbe assessed.
3. Feasibility/likelihood of Addressing the Problem
A problem that is both significant and researchable may still be inappropriate if a study designed to address
it is not possible to carryout. Feasibility involves several factors.
a. Time- Most studies have deadlines or at least goals for completion. Therefore, the problem must be
one that can be adequately studied within the time allotted. This means that the scope of the problem
should be sufficiently restricted that enough time will be available.
b. Availability of Study Participants-In any study involving humans, researchers need to consider whether
individuals with the desired characteristics will be available and willing to cooperate.
c. Cooperation of Others-Often, it is insufficient to obtain the cooperation of prospective study participants
alone. If the sample includes children, mentally incompetent people, or senile individuals, it would
be necessary to secure the permission of parents or guardians.
d. Facilities and Equipment-A researcher should provide what is needed and whether they will be available
before embarking on a project to avoid disappointment and frustration. The following is partial lists
of considerations include audiotape, videotape, space, telephone, office equipment, transportation,
printing and photocopy machine etc.
e. Funding- This is needed for personnel cost, computer services, transportation etc.
f. Experience of the Researcher-The problem should be chosen from a field about which investigators have
some prior knowledge or experience. Researchers have difficulty adequately developing a study on a
topic that is totally new and unfamiliar.
4. Interest to the Researcher
Even if the tentative problem is researchable, significant, and feasible, there is one more criterion:
theresearcher’s own interest in the problem. Genuine interest in and curiosity about the chosen
researchproblem are critical prerequisites to a successful study. A great deal of time and energy are
expended in a study; there is little sense devoting these personal resources to a project that does not generate
enthusiasm.
Statements of Purpose
Research statement of purpose are worded in thedeclarative form, usually in one or two clear sentences—the
essence of the study. The purpose statement establishes the general direction of the investigation. The words
purpose or goal usually appears in a purpose statement (e.g., the purpose ofthis study was..., or, the goal of
this study was...), butsometimes the words intent, aim, or objective is used instead.

In a quantitative study, a statement of purpose identifies the key study variables and their
possibleinterrelationships, as well as the nature of the populationof interest. In qualitative studies, the
statement of purpose indicates the nature of the inquiry, the key concept or phenomenon, and the group,
community, or setting under study

Verbs and Terms/Buzz words used in Statement of Problems

1. Qualitative Studies-
a. Phenomenological Studies-Explore, Describe (verbs), Experience; lived experience; meaning; essence
(Buzz words)
b. Ethnographic Studies- Explore, Describe (verbs), Culture; roles; myths; cultural behavior (Buzz words)
c. Grounded Theory-understand, discover, develop, or generate(verbs), Processes; social structures; social
interactions (Buzz words)
2. Quantitative Studies
a. Experimental Studies- Test,determine or evaluate the effectivenessof an intervention
b. Non-Experimental Studies-Examine, Assess the relationship between two variables

Research Questions
A research questionis the specific queryresearchers want to answer in addressing theresearch problem. In
quantitative studies, researchquestions usually are about the existence, nature,strength, and direction of
relationships

Research questions are, in some cases, direct rewordings of statements of purpose, phrased interrogatively
rather than declaratively, as in the following example:
SP: The purpose of this study is to assess the relationship between the dependency level of renal
transplant recipients and their rate of recovery.
RQ: What is the relationship between the dependency level of renal transplant recipients and their rate of
recovery?

The question form has the advantage of simplicity and directness. Questions invite an answer and help to
focus attention on the kinds of data that would have to be collected to provide that answer. Some research
reports thus omit a statement of purpose and state only research questions. Other researchers use a set of
research questions to clarify or lend greater specificity to the purpose statement.

Research Questions in Quantitative Studies

In quantitative studies, research questions identify the key variables (especially the independent and
dependent variables), the relationships among them, and the population under study. The variables are all
measurable concepts, and the questions suggest quantification. Example:
Is there a relationship between lecture attendance and success in examination?

Research Questions in Qualitative Studies

Researchers in the various qualitative traditions varyin their conceptualization of what types of questionsare
important. Grounded theory researchers arelikely to ask process questions, phenomenologiststend to ask
meaning questions, and ethnographersgenerally ask descriptive questions about cultures.The terms
associated with the various traditions, discussedpreviously in connection with purpose statements,are likely
to be incorporated into the researchquestions.

Example of a research question from aphenomenological study:

What is the lived experience of caring for a familymember with Alzheimer’s disease at home?

RESEARCH HYPOTHESES
A hypothesis is a prediction about the relationship between two or more variables. A hypothesis thus
translates a quantitative research question into a precise prediction of expected outcomes. In qualitative
studies, researchers do not begin with a hypothesis, in part because there is usually too little known about the
topic to justify a hypothesis, and in part because qualitative researchers want the inquiry to be guided by
participants’ viewpoints rather than by their own. Thus, this discussion focuses on hypotheses used to guide
quantitative inquiries (some of which are generated within qualitative studies).

Hypotheses sometimes follow directly from a theoretical framework. Scientists’ reason from theories to
hypotheses and test those hypotheses in the real world. The validity of a theory is never examined directly.
Rather, it is through hypothesis testing that the worth of a theory can be evaluated. Not all hypotheses are
derived from theory. Even in the absence of a theory, well-conceived hypotheses offer direction and suggest
explanations.

How to Develop Hypotheses

Two basic processes—induction and deduction—constitute the intellectual machinery involved in deriving
hypotheses. An inductive hypothesis is a generalization based on observed relationships. Researchers
observe certain patterns, trends, or associations among phenomena and then use the observations as a basis
for predictions. Related literature should be examined to learn what is already known on a topic, but an
important source for inductive hypotheses is personal experiences, combined with intuition/awareness and
critical analysis. For example, a nurse might notice that pre-surgical patients who ask a lot of questions
relating to pain or who express many pain-related apprehensions have a more difficult time in learning
appropriate postoperative procedures. The nurse could then formulate a hypothesis, such as the following,
that could be tested through more rigorous procedures: Patients who are stressed by fears ofpain will have
more difficulty in deep breathing andcoughing after their surgery than patients who arenot stressed.
Qualitative studies are an important source of inspiration for inductive hypotheses.

Deductive Hypotheses:Through deductive reasoning, a researcher can develop hypotheses based on general
theoretical principles, from general observations to specific. Inductive hypotheses begin with specific
observations and move toward generalizations; deductive hypotheses have as starting point theories that are
applied to particular situations. The following syllogism illustrates the reasoning process involved:
• All human beings have red and white blood cells.
• John Doe is a human being.
• Therefore, John Doe has red and white blood cells.

Wording of Hypotheses
In general, hypotheses should be worded in the present tense. Hypotheses are never proved or disproved in
an ultimate sense—they are accepted or rejected, supported or not supported by the data.
1. Simple hypotheses express a predicted relationship between one independent variable and one dependent
variable. Example:
a. There is a relationship between the age of apatient and the risk of falling.
b. The older the patient, the greater the risk thatshe or he will fall.
2.Complex/Multivariate hypotheses state an anticipated relationship between twoor more independent
variables and two or moredependent variables (or state predictions aboutmediating or moderating variables).
Example:
a. The implementation of an evidence-based protocol for urinary incontinence [X] will result in decreased
frequency of urinary incontinence episodes (Y1), decreased urine loss per episode [Y2], and
decreased avoidance of activities [Y3] amongwomen in ambulatory care settings
b. Hypotheses with moderator or mediator.
3.Directional hypotheses predict the direction of a relationship. Example: There is a relationship between
high dietary intake and weight gain
4.Non-directional hypotheses predictthe existence of relationships, not their direction. Example: There is a
relationship between dietary intake and weight.
5.Research hypotheses predict the existence of relationships.
6.Statistical or null hypothesesexpress the absence of a relationship.

CONCEPTUAL AND OPERATIONAL DEFINITIONS

Researchers define terms so that readers can understand the context in which the words are being used or
their unusual or restricted meaning.
1. Conceptual definition-This refers to the definition of a construct by scholars or the definition given by
dictionary or experts.
Example:The concept of “attitude of health personnel” is conceptually defined as “the behavior of health
personnel shown towards the sick, which may be positive or negative (Holmes et al., 2012)”.

2. Operational definition- This refers to the definition of variable in terms of the specific operation or actions
that a researcher carries out or actions the researcher measures.
Example: In this case, the attitude of health personnel is operationally defined as the positive attitude and
behavior of health personnel towards the patients with diseases, which increase participation in treatment.

This researcher measured attitude of health personnel as an independent variable using 8 items adapted
from Bouquiren, et al. (2015) and Holmes, et al. (2012), as itemized below.
1. Health workers treat me with respect.
2. The staff treats me with kindness.
 3. Health workers are friendly to me.
4. Health workers abuse me.
5. Staff attacks me because they blame me for the cause of my disease.
6. The staff takes my disease condition seriously.
7. Health workers behave themselves well to me.
8. Staffs do not keep my disease condition secret from other people.

A Likert scale/additive scale or summative scale is usually used to measure the ordinal level of a person’s
attitude or opinion in a survey study. The scale has advantages in that it tries to give a total of scores based
on the total number of responses that a participant answered. In a survey study where Likert scale is adopted
in designing the questionnaire, it aims at measuring attitude and or opinion about something through asking
participants to 2013).indicate if they agree or disagree with a claim or situation, if they approve or
disapprove if something is usually true, seldom true and so on. Likert scale employed to develop a
questionnaire may contain at least two (2) to eight categories, as more options allow researchers to record
participant’s attitude.

A scale that has 5 points is appropriate because (1) it gives a better result and it is more reliable than the use
of scales that are higher or lower and (2) it is less stressful for respondents to answer than 7 points scale
(Neuman, 2006). Therefore, in this study, the items used to measure constructs was based on 5 points’ Likert
scales (Strongly disagree–1, Disagree–2, Neutral-3, strongly agree–4, Agree-5), which is in line with the
suggestion made by Sekaran & Bougie.

LITERATURE REVIEW
A research literature review is a written summary of the state of existing knowledge on a research problem.
Some qualitative researchers deliberately bypass an in-depth literature search before entering the field to
avoid having their inquiries constrained or biased by prior work on the topic.

Types of Literature Review

Conceptual Review
As the name suggest, in this review, literature include the definitions and development of the variables and
concepts used in the study. Review should include how the variable concepts developed or evolves over
time, starting from early works to the latest definition.
Additionally, conceptual review is the most common type of review employed by authors by linking a
specific study to a larger body of knowledge. This review more often appears at the beginning of research
report and it introduces the study by situating it within the larger framework.

Integrative Review
In this type of review, the author presents and summarizes the current state of knowledge on topic,
highlighting agreement and disagreements (this could lead to moderator use) with it. It is often combined
with conceptual review.

Methodological Review
This is a specialized type of integrated review in which the author compares and evaluates the relative
methodological strength of various studies and show how different methodologies (e.g. research design,
measures, sample etc.) account for different results.

Theoretical Review
The author in this type of review focuses on the theoretical explanations about the relationships between
variables under study. Moreover, the theories explaining the phenomenon (e.g. health seeking behavior,
health education, etc.) should also be included in the study.
Empirical Review
This type of review includes the relationship between Dependent and Independent variables. This review,
specifically, implies to what previous studies found on the relationship between the variables under study.
This review also has the elements of integrative and methodological review.

Purposes of a Literature Review

The task of reviewing researchliterature involves the identification, selection,critical analysis, and written
description of existinginformation on a topic.

a. Identification of a research problem and developmentor refinement of research questions orhypotheses

b. Location what is known and not knownabout an area of inquiry.
c. To ascertain what researchcan best make a contribution to the existingknowledge.
d. Determination of any gaps or inconsistencies ina body of research.
e. Determination of a need to replicate a priorstudy in a different setting or with a differentstudy
population.
f. Identification or development of new or refinedclinical interventions to test through empiricalresearch.
g. Identification of relevant theoretical or conceptualframeworks for a research problem.
h. Identification of suitable designs and data collectionmethods for a study.
i. The research findings are related to the findings of others.

Sources of Literature
a. Scholarly journal articles
b. Textbooks related to the topic,
c. Conference proceedings related to the topic
d. Theses.
e. Unpublished manuscripts
f. Government reports/document
g. Newspapers
h. Internet sources
i. Institutional policy reports

Locating Relevant Literature for a Research Review

a. Electronic journals-This could be provided by your library when it subscribed to journals that are
published or made available online.
b. Full text data base are full texts of articles provided by your library
c. Dissertation abstracts data base. If the abstract is suitable request for the full dissertation
d. Bibliographic data base-This contain the authors’ name, name of article or book, publication date,
volume and page number. It can be found in the library or book list.

Literature Reviews in Qualitative Research Traditions

Qualitative researchers have different views about reviewing the literature as part of a new study. Some of
the differences reflect viewpoints associated with various qualitative research traditions.

In grounded theory studies, researchers typically collect data in the field before reviewing the literature. As
the data are analyzed, the grounded theory begins to take shape. Once the theory appears to be sufficiently
developed, researchers then turn to the literature.Thus, grounded theory researchers defer the literature
review, but then determine how previous research fits with or extends the emerging theory.

Phenomenologists often undertake a search for relevant materials at the outset of a study. In reviewing the
literature for a phenomenological study, researchers look for experiential descriptions of the phenomenon
being studied. The purpose is to expand the researcher’s understanding of the phenomenon from multiple
perspectives. VanManen (1990) suggests that, in addition to past research studies, artistic sources of
experiential descriptions should be located such as poetry, novels, plays etc.

Ethnography starts with a conscious attitude of almost complete ignorance;a review of the literature that led
to the choice of the cultural problem to be studied is often done before data collection.

UNIT V

RESEARCH DESIGN

Research Design Definition

Research design is the plans and procedure a researcher employs from broad assumption to detail methods
of data collection and analysis as well as interpretation of data. (Sakaren& Bougie, 2013 & Creswell, 2014).

Types and Components of Research Designs

There are three main types (quantitative, qualitative & mixed methods) and three main components
(paradigm, strategies of inquiry and methods of research) of research designs.

Types of Research Design:

 Quantitative- Researcher collects data in the form of numbers to test the relationships among
variables through measuring instruments. The data is analyzed using statistical instruments and the
final written report is structured into introduction, literature review and theory, method, result and
discussion
 Qualitative- The Researcher collects data in the form of words. The researcher focus on exploring
and understanding of the meaning people attached to the social or human problems.
 Mixed methods- This approach combine both the collection of data in the forms of numbers and
words(qualitative and quantitative methods of research). The combination of the methods helps to
neutralize the weakness in either research.
Components of Research Designs:
1. Paradigm/worldview/philosophical assumption/epistemologies and ontologies (research
methodologies)-Paradigm refers to the belief that a researcher holds about the world, which leads to
either conducting quantitative, qualitative or mixed methods research. In addition, it is defined as the
belief that guides action. Four sets of beliefs are identified:
 Positivism/empirical science-This belief holds that a researcher should detaches self from
participants or remains independent/objective while collecting data. Researcher should collect
information using measuring instrument and should utilize questions or hypotheses.
 Social constructivism/Interpretivism-This is a belief that a researcher should be in close
contact with objects of the study. The approach pays attention to gaining an in-depth
experience of participants in their own words (Grays, 2004; & Creswell, 2014).
 Pragmatic approach-This combines both the characteristics of positivist and constructivist.
A researcher utilizes empirical, descriptive and survey research methods to obtain study’s
findings. This approach holds that solution to problems is best provided when the
perceptions, attitude and behavior are examined in combination with the lived experiences of
participants.
 Advocacy/participatory-The approach holds that positivist do not represent the marginalized.
Instead, the proponents suggest that studies should focus on empowerment, inequality,
oppression, suppression and alienation.
2. Strategies of inquiry-The strategies, methodologies or approaches to research include
quantitative, qualitative and mixed methods strategies.
 Quantitative strategies-This include experimental and non-experimental designs.
  Experimental design-This approach involves applying treatment to a particular
group while controlling another. It is aimed at examining if a treatment influences
an outcome.
 Non-experimental design-This include a survey, which could be either cross-
sectional or longitudinal, aimed at assessing the attitude, behavior and perceptions
of participants on social problems.
 Qualitative strategies- The strategies include phenomenology, Ethnography, grounded
theory and case study.
 Phenomenology- is an approach to thinking about what life experiences of people
are like and what they mean. The phenomenological researcher asks the questions:
what is the meaning of the phenomena to those who experience it?
 Ethnography-This focuses on studying the meanings, patterns, and experiences of
a defined cultural group in a holistic fashion. Ethnographers typically engage in
extensive fieldwork, often participating in the life of the culture under study.
 Case studiesare a strategy of inquiry in which the researcher explores in depth a
program, event, activity, or one or more individuals. Case study researchers
collect detailed information using a variety of data collection procedures over a
sustained period of time (Stake, 1995).
 Narrative research is a strategy of inquiry in which the researcher studies the lives
of individuals and asks one or more individuals to provide stories about their lives.
This information is then often retold or re-storied by the researcher into a narrative
as they happened
 Grounded theory – in this approach, the researcher derives a general theory of a
process, action or interactions grounded on the views of participants. The process
involves multiple data collection and interrelationship of information. Hauck and
Irurita (2002) conducted a grounded theory study to explain the maternal process
of managing late stages of breastfeeding and weaning the child from the breast.

3. Research Methods- This is the third element or component of research design. It focuses on the
forms of data collection, techniques, analysis and interpretation.

Population of the Study

According to Sekaran & Bougie (2013), population refers to the whole group of individuals, things or event
that a particular research is interested in examining. Example of population is VVF patients in Sokoto state
(maybe numbering 500).
Sample Size and Sampling Technique
There are several ways to determine sample sizes;one of the techniques is reference for
determining sample size as suggested by Krejcie and Morgan (1970). These scholars provided a
table to be used as a reference point of the appropriate sample size (S) based on the number of
population (N) as shown below.

Population and Sample Size

N S N S N S N S N S
10 10 100 80 280 162 800 260 2800 338
15 14 110 86 290 165 850 265 3000 341
20 19 120 92 300 169 900 269 3500 346
25 24 130 97 320 175 950 274 4000 351
30 28 140 103 340 181 1000 278 4500 354
35 32 150 108 360 186 1100 285 5000 357
40 36 160 113 380 191 1200 291 6000 361
45 40 170 118 400 196 1300 297 7000 364
50 44 180 123 420 201 1400 302 8000 367
55 48 190 127 440 205 1500 306 9000 368
60 52 200 132 460 210 1600 310 10000 370
65 56 210 136 480 214 1700 313 15000 375
70 59 220 140 500 217 1800 317 20000 377
75 63 230 144 550 226 1900 320 30000 379
80 66 240 145 600 234 2000 322 40000 380
85 70 250 152 650 242 2200 327 50000 381
90 73 260 155 700 248 2400 331 75000 382
95 76 270 159 750 254 2600 335 100000 384
Source: Krejcie and Morgan (1970) Note: N=Population size, S=Sample Size

Therefore, using Krejcie and Morgan (1970) technique, the sample size is 217.

Data Analysis
Data analysis involves both quantitative and qualitative analysis. The Quantitative data analysis
involve the analysis numeric, which can be undertaken with the aid of quantitative tools, such as
simple frequencies,statistical package for social sciences (SPSS), SEM-PLS among others.
Whereas, qualitative data analysis involves the analysis of words using thematic analysis,
qualitative tools such as Nvivoand manual method can be used in analysis of qualitative data.

Validity and Reliability

According to Sekaran & Bougie (2013), reliability and validity test are carried out to ensure the
goodness of items that are measuring certain constructs. Specifically, researcher conduct validity
and reliability tests to make sure that the items used in a study are good. While, validity
measures the capability of indicators to assess what it was intended to measure, reliability test
gauges the degree to which indicators are consistent and free from errors.
Validity Test
Essentially, to establish the validity, four approaches are important, namely, face, content,
criterion and construct validity. However, two methods are commonly used, i.e. content validity
and construct validity.

According to Sekaran and Bougie (2013), a panel of judges or experts might be used to establish
the content validity of an instrument. The experts that could be consulted included Nurses,
Doctors, government officials and other experts in order to test the clearness of the research
instruments. This researcher used a technique of assessment of content validity that was
established by Lawshe (1975). This technique relies on agreement among raters or the judges on
the importance of a specific indicator (Lawshe, 1975). Experts are expected to rate the indicators
based on the following questions: Is the knowledge by this item 1. ‘Essential’ 2.‘Useful but not
essential’, 3. ‘Not necessary’ to the performance of a specific construct?. Furthermore, Lawshe
(1975) states that where more than half of the judges chose essential for an indicator, it shows the
indicator has some degree of content validity, and the more several judges chose the greater the
content validity. Note that some items could be reworded based on experts; recommendations.

Similarly, construct validity van be established through the use of convergent validity and
discriminant validity (Hair, et l. 2014). The convergent validity is achieved when the scores from
two or more instruments are measuring the same concept and are correlated with other measures
of the same construct (Sekaran & Bougie, 2013). Discriminant validity is achieved when each
construct is different from other constructs. In other words, the indicators of a construct should
not be highly correlated with other construct’s indicators (Hair et al. 2011). Construct validity
can be established through factor analysis, multi-method matrix, and correlation analysis (Hair et
al. 2011).

Reliability Test
Reliability entails, whether a study when repeated can yield the same results and conclusions as
for the one conducted earlier (Sekaran & Bougie, 2013). To improve reliability, a clear definition
of all the concepts used in a study is important. Once concepts definitions are clear without
vagueness, results can be trustworthy, consistent and dependable (Neumam, 2006). To ensure
reliability, the researcher needs to increase the level of measurements, which also helps to make
concepts reliable, because it makes the concepts more explicit. The use of multiple indicators
also improves reliability because multiple indicators for a variable are more dependable than one
indicator (Sekaran & Bougie, 2013). In addition, another way to improve reliability is to conduct
a pilot study, i.e. to conduct a small-scale testing of the instruments designed, in order to test for
their efficacy as well as to see the feasibility of the entire study design (Neuman, 2006).

Pilot Study in Quantitative Method

A pilot study assesses the validity and reliability of the adapted instruments and secondly, it
provides an insight on the real situation of the impact assessment, which permits the researcher
to expect problems that may arise and make necessary adjustment when carrying out the actual
study (Neuman, 2006). The Pilot study’s main concerns are the validity and reliability of the
instrument employed in this research. Sekaran and Bougie (2010) opined that validity measures
the degree to which a given instrument is measuring what it is supposed to be measured, whereas
reliability measures the level to which a given instrument is error-free, stable and consistent
across several items of the measure.

Pilot Test: Reliability and Convergent Validity (n=50)

Constructs Items CAC AVE
Attitude of Health Personnel 8 .78 0.71
Decision-making 4 .88 0.77
Intention 11 .80 0.76
Intervention programs 21 .90 0.65
Low Stigma 8 .88 0.79
Quality of Health 4 .48 0.67
Social Support 7 .78 0.72
Transportation 9 .72 0.63

Questionnaire Administration
The survey instrument is the most suitable method of quantitative data collection (Sekaran &
Bougie, 2013 and Neuman, 2006). Survey instrument in the form of self-administered
questionnaire (SAQ)or researcher-administered questionnaire (RAQ) can be used for the
collection of primary data.However, in the case of respondents with low-level of education it
provides the justification for the use of researcher-administered-questionnaire method. The
method provides high response rate, which helps to curtail the problems of non-response bias,
i.e. to say non-response bias does not make a study worthless.

Advantage
1. It allows researchers to collect data within a short period.
2. It is stress-free to the participants and ensures that contradictions in
findings are avoided.
Disadvantage

Qualitative Research Design

Qualitative research design includes a face-to-face in-depth interview, the selection of
respondents, validity and reliability, data analysis, and potential ethical concerns guiding the
conduct of qualitative inquiry.

Through the qualitative method, the intention is not to quantify results by the use of statistical
analysis. Instead, qualitative design emphasizes onphenomenological orientation,
ethnography/case study or grounded theory approaches, which used descriptive methods of data
analysis.

1. Face-to-face In-Depth Interviews

Face-to-face in-depth interview provides the most frequently utilized technique of collection of
data that provides high response rate. Additionally, the technique permits the interviewer the
chance to explore the immediate environment of the study through utilizing non-verbal
communication, and through making a lengthy interview session. The lengthy session gives an
added advantage to the researcher by providing him with an opportunity to ask several questions,
as well as probing questions at length where need be.

Advantages:
1. The unstructured interviews permit respondents to say their opinions in their own words so
that the researcher has the advantage of documenting them.
2. The face-to-face interview has an advantage of allowing the interviewee to make an
investigation, especially about challenging phenomena.
3. It permits the researcher to establish a good rapport with the participants, apart from the rich
data opportunity the method offers.

Disadvantage
1. The interview method can be expensive
2. It is prone to bias.
3. It consumes time.

Selection of Respondents and Sample size

The choice of participants for the purpose of qualitative study is linked directly to the main
objective of a research. Thestakeholders selected are based on the importance they play on the
topic of discussion.

Concerning sample size in qualitative interviews, several sample sizes are available, which
depend on the requirement of the study (Collins, Onwuegbuzie& Jiao, 2007). However, Creswell
(2014) suggested that the larger the number of respondents the ungainly the study becomes,
which leads to a narrow understanding of the phenomenon under study. Invariably, the fewer the
number of cases investigated, the broader and in-depth the understanding of the phenomenon
under study (Puvenesvary, et al. 2011 & Creswell, 2014).

According to Glaser and Strauss’s (1967) saturation is the main determining factor in the choice
of the number of respondents that a researcher should consider adequate. This is because, in
qualitative studies, the main concern is on establishing the meaning of social phenomenon rather
than a generalization of findings to the universe after testing hypotheses (Puvenesvary, et al.
2011 & Creswell, 2014). Similarly, Mason (2010) argue that saturation refers to the point where
a collection of further or additional data do not seem to be adding further understanding of the
issues under study. At a given point, increases in the number of interviews do not lead to an
increase in information that a researcher is sourcing (Mason, 2010).

In qualitative interviews, instead of fixing a sample, saturation should be the essential criteria for
determining sample size (Collins, et al. 2007 &Mason, 2010). Numerous criteria have been
identified in choosing a qualitative sample, which mostly ranges from 5 to 60 respondents
depending on the nature of research.
1. In Case study, 3-5 participants will be a good choice.
2. In phenomenological studies, theresearcher should select and make 7-10 in-depth interviews.
3. Ethnographic Studies - One cultural setting will be good. In ethological studies 100-200 units
4. In focus group interviews use6-10 respondents.
Reliability and Validity of Qualitative Method
Unlike quantitative study where statistical methods are used in establishing reliability and
validity of research result, the qualitative study used methodological strategies during research
design and implementation, in order to ensure reliability and or trustworthiness of research
findings (Noble & Smith, 2015). Although no generally accepted terms and criteria exist in
evaluating qualitative studies, however, certain strategies can be used to enhance the reliability
of the study’s result (Noble, et al 2015). Therefore, in ensuring reliability and validity this
discussion used the cardinal concepts of:
1. Truth-value and
2. Consistency/neutrality

1. The truth-value regarding enhancing credibility in this study includes adhering to the concerns
of
a. Reflectivity-Study had to strictly follow its earlier perspective of positivism,
constructivism/interpretivism or pragmatism in producing results. Specifically, a study could use
phenomenological, ethnographic/case study or grounded theory orientation in the collection,
analysis, and interpretation of results. Second, this researcher ensures
b. Representativeness of research findings related to the phenomena. The sample of respondents
should be adequate to provide further explanation from respondents for validation, to ensure that
information provided represents the actual outcome of the research. Additionally, audio/video
recorded interviews or notes taken verbatim should permit researcher to check the data
repeatedly, to ensure that themes created are actually the accounts of the participants.
2. Consistency/Nuetrality.
In terms of consistency/neutrality, a researcher should make his procedure for data collection and
analysis clear and transparent, i.e. the methodology used in the study and reporting process be
made explicit.

Pilot Study in Qualitative Method

In the qualitative pilot study prior to the main study, an unstructuredinterview schedule questions
are administered to the few selected participants who should answer all the questions. Thedata
analysis can be done either manually or through the use of qualitative software for analysis (e.g.
Nvivo 10) could produce themes and sub-themes.This permits the researcher to interpret results
and then make necessary adjustment before the main study.

UIT VI
COMPARE AND CONTRAST QUALITATIVE WITH QUANTITATIVE RESEARCH

Key Terms used in Quantitative and Qualitative Research

CONCEPT QUANTITATIVE TERM QUALITATIVE TERM
Person Contributing Subjects, -
Information study participants, Study participants,
Respondents informants, key informants
Person Undertaking Researcher Researcher
the study Investigator Investigator
Scientist -
 That Which Is Being - Phenomena
Investigated Concepts Concepts
Constructs -
Variables -
System of Organizing Theory, theoretical framework Theory
Concepts Conceptual framework, Conceptual framework,
conceptual model sensitizing framework
Information Gathered Data (numerical/statistical values) Data (words, narrative description)
Connections Between Relationships (cause-and-effect, Pattern of association
Concepts functional)
Quality of the Reliability Truth-value (Reflectivity,
Evidence Validity representativeness)
Generalizability Consistency/Neutrality
Objectivity

QUANTITATIVE RESEARCH QUALITATIVE RESEARCH

Hypothesis Testing Capture and discover meaning
Concepts in the form of distinct variable Concepts in the forms of themes, categories
Data in the form of numbers from precise Data in the form of words from documents,
measurement observation, transcripts
Theory is largely causal and deductive Theory can be causal or non-causal and often
inductive
Replication is assumed Replication is rare
Analysis using statistic, charts, tables, Analysis done by extracting themes
software for quantitative analysis
Measure objective facts Construct social reality, cultural meaning
Focus on variables Focus on interactive processes, events
Large case, subjects Few cases. Subject
Statistical analysis Thematic analysis
Researcher is detached Researcher is involved

Research Traditions inQualitative Research

Qualitative studies are often rooted in researchtraditions that originate in the disciplines of
anthropology,sociology, and psychology. Three suchtraditions have had especially strong
influences onqualitative nursing research and are briefly describehere.

1. The grounded theory - Developed in the 1960s by two sociologists, Glaserand Strauss (1967).
It is a strategy of inquiry in which the researcher derives a general, abstract theory of a process,
action, or interaction grounded in the views of participants.

The focus of most grounded theorystudies is on a developing social experience—thesocial and

psychological stages, processes and phases that characterizea particular event or episode. A
major componentof grounded theory is the discovery of a corevariable that is central in
explaining what is going onin that social scene. Grounded theory researchersstrive to generate
comprehensive explanations ofphenomena that are grounded in reality.
Example of a grounded theory study:
Hauck and Irurita (2002) conducted agrounded theory study to explain the maternal process of
managing late stages of breastfeedingand weaning the child from the breast.
2. Phenomenology- Developed byHusserl and Heidegger, is concerned with the livedexperiences
of humans. Phenomenology is an approachto thinking about what life experiences ofpeople are
like and what they mean. The phenomenologicalresearcher asks the questions:What is theessence
of this phenomenon as experienced bythese people? Or, what is the meaning of the phenomenato
those who experience it?
Example of a phenomenological study:Sundin, Norberg, and Jansson (2001) conducteda
phenomenological study to illuminate thelived experiences of healthcare providers who were
highlyskilled communicators in their relationships withpatients with stroke and aphasia.
3. Ethnography- It focuses on studying the meanings, patterns, and experiencesof a defined
cultural group in a holistic fashion.Ethnographers typically engage in extensivefieldwork, often
participating in the life of the culture under study. Ethnographicresearch is in some cases
concerned with broadlydefined cultures (e.g., Haitian refugee communities),but sometimes
focuses on more narrowlydefined cultures (e.g., the culture of emergencydepartments). The aim
of ethnographers is to learn from (rather than to study) members of a cultural group, to
understand their world view as they perceive and live it.
4. Case studies are a strategy of inquiry in which the researcher explores in depth a
program,event, activity, process, or one or more individuals. Cases are bounded by time and
activity, and
researchers collect detailed information using a variety of data collection procedures over
asustained period of time (Stake, 1995).
5. Narrative research is a strategy of inquiry in which the researcher studies the lives of
individuals and asks one or more individuals to provide stories about their lives. This
information is then often retold or re-storied by the researcher into a narrative chronology. In the
end, the narrative combines views from the participant’s life with those of the researcher’s life in
a collaborative narrative.

TYPES OF TRIANGULATION
According to Creswell (2014), the main purpose of triangulation is that the combination of
qualitative and quantitative methods neutralizes the weakness that is inherent in the use of single
method alone. In essence, combining different sources of method will neutralize the weakness
that would be found in the use of single method alone.
1. Method Triangulation-This combines quantitative and qualitative methods of data collection
and analysis
2. Data Triangulation-This involves the collection of data from different sources. Example data
collection from patients and from case files.
3. Researcher/Observer Triangulation-Several researchers collect and analyze data on the same
study.
4.Theory Triangulation-This involves use of multiple theories/perspectives to interpret and
explain data, example use of TRA and HBM.
SAMPLING METHOD
Sampling is the process of selecting a portion of the population, which is an entire aggregate of
cases.

An element or Unit of analysisis the basic unit about which information is collected—usually an
individual(s) in nursing research, organizations etc. Researchers usually sample from an
accessiblepopulation, but should identify the target populationto which they would like to
generalize their results. A sampling frame is the list of people to be used in a study, which is
usually found a register, example school register, patient’s admission register etc.

The main consideration in assessing a sample in a quantitative study is its representativeness—

the extent to which the sample is similar to the population and avoids bias. Sampling biasrefers
to the systematic over-representation or under-representation of some segment of the population.

Types of sampling
There are two main types of sampling; the probability and non-probability sampling.

Non-Probability Sampling
In non-probability sampling elements are selected by nonrandom methods and every element
does not have the equal chances of being selected. Examples are convenience, quota,
andpurposive sampling.

1. Convenience sampling (or haphazard,accidental sampling)uses the most readily available or

mostconvenient group of people for the sample. The researcher selects the people he/she sees on
the street to interview, Example, Television and radio interview on the street.
2. Snowball/nominated sampling-This is the type of conveniencesampling in which referrals for
potential participantsare made by those already in the sample. Example, a participant with
HIV/AIDS or VVF could refer a researcher to another person with similar disease that he/she
knows.
2. Purposive sampling- This involves obtaining sample from people that are regarded as the only
people with the required characteristics. Two types of purposive sampling are considered here,
judgment and quota sampling.

i. Judgmental- In judgment(or purposive) sampling, participants are hand-picked to be

included in the sample based on the researcher’s knowledge about the population as
well as special characteristics possessed by the sample, which is required by the
researcher.
ii. Quota sampling-In this case, the quota sampler fixes the categories and number of
cases/people in each categories, he/she then uses haphazard sampling to select
sample. Example, If a researcher requires 40 sample size among age groups. The
researcher can categories the population into less than 30 years, 30-60 years and over
60 years. Among under 30 the researcher select 5 females and 5 males, in 30-60 years
select 10females and 10 males and in over 60 years select 5 males 5 females. Note
that in quota sampling researcher ensures that there is some difference, but in
haphazard, all the people interviewed might be of the same sex, age or background
Probability Sampling
Probability sampling techniques, involve the random selection of elements from the population,
which yield more representative samples than nonprobability designs. In this method, every
individual has equal chances of being selected. There are several aspects of probability sampling
including:
a. Simple random sampling-involves the randomselection of elements from a sampling
framethat enumerates all the elements. A researcher could select from the sampling list or
fold paper containing exact number of the individuals containing “yes” and “no”. If to
say the total population is 500 and the required sample is 200. The folded list should
contain 200 yes and 300 no. The papers are then mixed in a box and participants are then
randomly allowed to pick one folded paper each.
b. Stratified randomsampling divides the population into homogeneoussubgroups from which
elements areselected at random.Stratification is often based on such
demographicattributes as age, gender, and income level. Example,Using gender as
stratum, a researcher can select 10 females and 10 males randomly from a list of 50 (1-25
females and 26-50 males).
c. Cluster sampling (or multistage sampling)involves the successive selection of
randomsamples from larger to smaller units by eithersimple random or stratified random
methods.
d. Systematic sampling is the selection of everykth case ( e.g third, eleventh, twelfth etc).
Example, a researcher want select 300 sample from sampling frame out of 900. The
researcher starts by selecting every third name of the 900 in order to get sample of 300.
By this, the sampling interval is 3.

In quantitative studies, researchers should use a power analysis to estimate samplesize needs.
Large samples are preferable to small ones because larger samples tend to be more
representative, but even a large sample does not guarantee representativeness.

Qualitative researchers use the theoretical demands (based suggestions by scholars) of the study
to select articulate and reflective informants with certain types of experience in an emergent way,
capitalizing on early learning to guide subsequent sampling decisions. Example several
researchers suggest sample ranging from 5 to 60 participants in qualitative study. Specifically, 3-
5 participants in case study, 7-10 participants in phenomenological studies, 1 cultural setting in
ethnographic study, 6-10 participants in focus group interview and 100-200 units of observation
in ethological studies (Collins, et al. 2007 & Mason, 2010).

Samples in qualitative studies are typically small and based on information needs. A guiding
principle is data saturation, which involves sampling to the point at which no new information is
obtained and redundancy is achieved.

STEPS IN SCIENTIFIC RESEARCH

1. Format for a Qualitative study
 Introduction
 Statement of the problem (including existing literature about the problem, significance of
thestudy)
 Purpose of the study
 The research questions
 Definitions
 Significance of the study
 Philosophical assumptions of qualitative research
 Types of design used (narrative, phenomenology); explore processes,activities, and
events (case study, grounded theory); or learn about broad culture-sharingbehavior of
individuals or groups (ethnography
 Role of the researcher (how you gain entry into site, steps taken to gain permission, why
site was chosen etc)
 Data collection procedures (types of data, how it will be collected, audio/video,
structured interview schedule etc)
 Data analysis procedure
 Strategies for validating findings
 Preliminary pilot findings (if available)
 Expected outcomes of the research and its relation to theory and literature reviewed
 Appendixes: Interview questions, observational forms, timeline, and proposed budget

2. Quantitative Format
 Introduction
 Statement of the problem
 Purpose of the study and delimitations
 Research questions or hypotheses
 Theoretical perspective
 Definition of Terms
 Significance of the study
 Review of the literature
 Methods
 Research design
 Population, sample, and subject
 Data collection instruments, variables, and materials
 Data analysis
 Anticipated ethical issues in the study
 Preliminary studies or pilot tests
 Appendixes: Instruments