,Understanding Nursing Research
Building an Evidence-Based Practice
SEVENTH EDITION
Susan K. Grove, PhD, RN, ANP-BC, GNP-BC
Professor Emerita, College of Nursing and Health Innovation, The University of Texas at Arlington,
Arlington, Texas
Adult Nurse Practitioner, WellMed Clinic, Grand Prairie, Texas
Jennifer R. Gray, PhD, RN, FAAN
Associate Dean, College of Natural and Health Sciences, Oklahoma Christian University, Oklahoma City,
Oklahoma
Professor Emerita, College of Nursing and Health Innovation, The University of Texas at Arlington,
Arlington, Texas
2
,Table of Contents
Cover image
Contents
Title page
Copyright
Contributors and Reviewers
Dedication
Preface
Learning resources to accompany understanding nursing research, 7th edition
Acknowledgments
Chapter 1: Introduction to Nursing Research and Its Importance in Building an Evidence-Based
Practice
What is nursing research?
What is evidence-based practice?
Historical development of research in nursing
Acquiring knowledge in nursing
Acquiring knowledge through nursing research
Purposes of research for implementing an evidence-based nursing practice
Understanding your role in nursing research
Determining the best research evidence for practice
Key Points
Chapter 2: Introduction to Quantitative Research
What is quantitative research?
Problem-solving and nursing processes: basis for understanding the quantitative research process
Identifying the steps of the quantitative research process
Reading research reports
Practice reading a quasi-experimental study
Key Points
3
,Chapter 3: Introduction to Qualitative Research
Identifying the steps of the qualitative research process
Qualitative research approaches
Sampling and recruitment
Data collection methods
Data management and analysis
Rigor in qualitative research
Key Points
Chapter 4: Examining Ethics in Nursing Research
Unethical research: 1930s through the 1980s
Ethical standards for research
Protecting human subjects
Understanding informed consent
Understanding institutional review
Current issues in research ethics
Key Points
Chapter 5: Examining Research Problems, Purposes, and Hypotheses
What are research problems and purposes?
Identifying the problem and purpose in quantitative and qualitative studies
Determining the significance of a study problem and purpose
Examining the feasibility of a study problem and purpose
Examining research objectives, questions, and hypotheses in research reports
Understanding study variables and research concepts
Key Points
Chapter 6: Understanding and Critically Appraising the Literature Review
Purpose of the literature review
Sources included in a literature review
Critically appraising literature reviews
Reviewing the literature
Key Points
Chapter 7: Understanding Theory and Research Frameworks
Understanding the elements of theory
Levels of theoretical thinking
Examples of critical appraisal of research frameworks
Key Points
Chapter 8: Clarifying Quantitative Research Designs
Identifying quantitative research designs in nursing studies
4
, Understanding concepts relevant to quantitative research designs
Examining the design validity of quantitative studies
Descriptive designs
Correlational designs
Elements of designs examining causality
Quasi-experimental designs
Experimental designs
Key Points
Chapter 9: Examining Populations and Samples in Research
Understanding the key concepts of sampling theory
Representativeness of a sample in quantitative research
Probability sampling methods
Nonprobability sampling methods commonly used in quantitative research
Sample size in quantitative studies
Sampling in qualitative research
Sample size in qualitative studies
Research settings
Key Points
Chapter 10: Clarifying Measurement and Data Collection in Quantitative Research
Concepts of measurement theory
Accuracy, precision, and error of physiological measures
Use of sensitivity, specificity, and likelihood ratios to determine the quality of diagnostic tests
Measurement strategies in nursing
Data collection process
Key Points
Chapter 11: Understanding Statistics in Research
Understanding theories and concepts of the statistical analysis process
Identifying the steps of the data analysis process
Statistics conducted to describe variables
Determining the appropriateness of inferential statistics in studies
Statistics conducted to examine relationships
Statistics conducted to predict outcomes
Statistics conducted to examine differences
Interpreting research outcomes
Key Points
Chapter 12: Critical Appraisal of Quantitative and Qualitative Research for Nursing Practice
Purpose of conducting critical appraisals of studies in nursing
Key principles for conducting intellectual critical appraisals of quantitative and qualitative studies
5
, Understanding the quantitative research critical appraisal process
Example of a critical appraisal of a quantitative study
Understanding the qualitative research critical appraisal process
Example of a critical appraisal of a qualitative study
Key Points
Chapter 13: Building an Evidence-Based Nursing Practice
Benefits and challenges related to evidence-based nursing practice
Developing clinical questions to search for existing research-based evidence for use in practice
Critically appraising research syntheses: systematic reviews and meta-analyses
Critically appraising meta-syntheses
Critically appraising mixed-methods systematic reviews
Models to promote evidence-based practice in nursing
Implementing evidence-based guidelines in practice
Introduction to evidence-based practice centers
Introduction to translational research
Key Points
Chapter 14: Introduction to Additional Research Methodologies in Nursing: Mixed Methods and
Outcomes Research
Mixed methods research and design
Outcomes research
Key Points
Glossary
Index
6
,Contents
1 Introduction to Nursing Research and Its Importance in Building an Evidence-Based
Practice, 1
2 Introduction to Quantitative Research, 29
3 Introduction to Qualitative Research, 59
4 Examining Ethics in Nursing Research, 90
5 Examining Research Problems, Purposes, and Hypotheses, 119
6 Understanding and Critically Appraising the Literature Review, 150
7 Understanding Theory and Research Frameworks, 172
8 Clarifying Quantitative Research Designs, 191
9 Examining Populations and Samples in Research, 228
10 Clarifying Measurement and Data Collection in Quantitative Research, 259
11 Understanding Statistics in Research, 292
12 Critical Appraisal of Quantitative and Qualitative Research for Nursing Practice, 333
13 Building an Evidence-Based Nursing Practice, 387
14 Introduction to Additional Research Methodologies in Nursing: Mixed Methods and
Outcomes Research, 430
Glossary, 467
7
,Copyright
3251 Riverport Lane
St. Louis, Missouri 63043
UNDERSTANDING NURSING RESEARCH: BUILDING AN EVIDENCE-BASED PRACTICE,
SEVENTH EDITION
ISBN: 978-0-323-53205-1
Copyright © 2019 by Elsevier, Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and
retrieval system, without permission in writing from the publisher. Details on how to seek
permission, further information about the Publisher’s permissions policies and our arrangements
with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency,
can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical
treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described herein. In
using such information or methods they should be mindful of their own safety and the safety of
others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the
most current information provided (i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or formula, the method and duration
of administration, and contraindications. It is the responsibility of practitioners, relying on their
own experience and knowledge of their patients, to make diagnoses, to determine dosages and the
best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors,
assume any liability for any injury and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of any methods, products,
instructions, or ideas contained in the material herein.
Previous editions copyrighted 2015, 2011, 2007, 2003, 1999, and 1995.
Library of Congress Cataloging-in-Publication Control Number: 2018944739
Content Strategist: Lee Henderson
8
,Content Development Specialist: Laurel Shea
Publishing Services Manager: Julie Eddy
Senior Project Manager: Rachel E. McMullen
Design Direction: Renee Duenow
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
9
, Contributors and Reviewers
CONTRIBUTORS
Christy J. Bomer-Norton , PhD, RN, CNM, IBCLC Concord, Massachusetts
Kathryn M. Daniel , PhD, MS, BSN, BA Associate Professor, College of Nursing and Health
Innovation, The University of Texas at Arlington, Arlington, Texas
REVIEWERS
Sue Ellen Bingham , PhD, RN Professor of Nursing, Clayton State University, Morrow, Georgia
Sara L. Clutter , PhD, RN Professor of Nursing, Waynesburg University, Waynesburg,
Pennsylvania
Angela N. Cornelius , DNP, RN, CNE, CNL Associate Professor of Nursing, Central Methodist
University, Fayette, Missouri
Polly A. Hulme , PhD, CNP, RN Professor, College of Nursing, South Dakota State University,
Brookings, South Dakota
Tamara M. Kear , PhD, RN, CNS, CNN Associate Professor of Nursing, College of Nursing,
Villanova University, Villanova, Pennsylvania
Llynne C. Kiernan , DNP, MSN, RN-BC Assistant Professor of Nursing, Norwich University
School of Nursing, Northfield, Vermont
Kathleen S. Murtaugh , MSN, RN, CNA Assistant Professor, Saint Joseph College—St. Elizabeth
School of Nursing Cooperative Program, Rensselaer, Indiana
Michael Perlow , DNS, RN Professor of Nursing, School of Nursing and Health Professions,
Murray State University, Murray, Kentucky
10
Building an Evidence-Based Practice
SEVENTH EDITION
Susan K. Grove, PhD, RN, ANP-BC, GNP-BC
Professor Emerita, College of Nursing and Health Innovation, The University of Texas at Arlington,
Arlington, Texas
Adult Nurse Practitioner, WellMed Clinic, Grand Prairie, Texas
Jennifer R. Gray, PhD, RN, FAAN
Associate Dean, College of Natural and Health Sciences, Oklahoma Christian University, Oklahoma City,
Oklahoma
Professor Emerita, College of Nursing and Health Innovation, The University of Texas at Arlington,
Arlington, Texas
2
,Table of Contents
Cover image
Contents
Title page
Copyright
Contributors and Reviewers
Dedication
Preface
Learning resources to accompany understanding nursing research, 7th edition
Acknowledgments
Chapter 1: Introduction to Nursing Research and Its Importance in Building an Evidence-Based
Practice
What is nursing research?
What is evidence-based practice?
Historical development of research in nursing
Acquiring knowledge in nursing
Acquiring knowledge through nursing research
Purposes of research for implementing an evidence-based nursing practice
Understanding your role in nursing research
Determining the best research evidence for practice
Key Points
Chapter 2: Introduction to Quantitative Research
What is quantitative research?
Problem-solving and nursing processes: basis for understanding the quantitative research process
Identifying the steps of the quantitative research process
Reading research reports
Practice reading a quasi-experimental study
Key Points
3
,Chapter 3: Introduction to Qualitative Research
Identifying the steps of the qualitative research process
Qualitative research approaches
Sampling and recruitment
Data collection methods
Data management and analysis
Rigor in qualitative research
Key Points
Chapter 4: Examining Ethics in Nursing Research
Unethical research: 1930s through the 1980s
Ethical standards for research
Protecting human subjects
Understanding informed consent
Understanding institutional review
Current issues in research ethics
Key Points
Chapter 5: Examining Research Problems, Purposes, and Hypotheses
What are research problems and purposes?
Identifying the problem and purpose in quantitative and qualitative studies
Determining the significance of a study problem and purpose
Examining the feasibility of a study problem and purpose
Examining research objectives, questions, and hypotheses in research reports
Understanding study variables and research concepts
Key Points
Chapter 6: Understanding and Critically Appraising the Literature Review
Purpose of the literature review
Sources included in a literature review
Critically appraising literature reviews
Reviewing the literature
Key Points
Chapter 7: Understanding Theory and Research Frameworks
Understanding the elements of theory
Levels of theoretical thinking
Examples of critical appraisal of research frameworks
Key Points
Chapter 8: Clarifying Quantitative Research Designs
Identifying quantitative research designs in nursing studies
4
, Understanding concepts relevant to quantitative research designs
Examining the design validity of quantitative studies
Descriptive designs
Correlational designs
Elements of designs examining causality
Quasi-experimental designs
Experimental designs
Key Points
Chapter 9: Examining Populations and Samples in Research
Understanding the key concepts of sampling theory
Representativeness of a sample in quantitative research
Probability sampling methods
Nonprobability sampling methods commonly used in quantitative research
Sample size in quantitative studies
Sampling in qualitative research
Sample size in qualitative studies
Research settings
Key Points
Chapter 10: Clarifying Measurement and Data Collection in Quantitative Research
Concepts of measurement theory
Accuracy, precision, and error of physiological measures
Use of sensitivity, specificity, and likelihood ratios to determine the quality of diagnostic tests
Measurement strategies in nursing
Data collection process
Key Points
Chapter 11: Understanding Statistics in Research
Understanding theories and concepts of the statistical analysis process
Identifying the steps of the data analysis process
Statistics conducted to describe variables
Determining the appropriateness of inferential statistics in studies
Statistics conducted to examine relationships
Statistics conducted to predict outcomes
Statistics conducted to examine differences
Interpreting research outcomes
Key Points
Chapter 12: Critical Appraisal of Quantitative and Qualitative Research for Nursing Practice
Purpose of conducting critical appraisals of studies in nursing
Key principles for conducting intellectual critical appraisals of quantitative and qualitative studies
5
, Understanding the quantitative research critical appraisal process
Example of a critical appraisal of a quantitative study
Understanding the qualitative research critical appraisal process
Example of a critical appraisal of a qualitative study
Key Points
Chapter 13: Building an Evidence-Based Nursing Practice
Benefits and challenges related to evidence-based nursing practice
Developing clinical questions to search for existing research-based evidence for use in practice
Critically appraising research syntheses: systematic reviews and meta-analyses
Critically appraising meta-syntheses
Critically appraising mixed-methods systematic reviews
Models to promote evidence-based practice in nursing
Implementing evidence-based guidelines in practice
Introduction to evidence-based practice centers
Introduction to translational research
Key Points
Chapter 14: Introduction to Additional Research Methodologies in Nursing: Mixed Methods and
Outcomes Research
Mixed methods research and design
Outcomes research
Key Points
Glossary
Index
6
,Contents
1 Introduction to Nursing Research and Its Importance in Building an Evidence-Based
Practice, 1
2 Introduction to Quantitative Research, 29
3 Introduction to Qualitative Research, 59
4 Examining Ethics in Nursing Research, 90
5 Examining Research Problems, Purposes, and Hypotheses, 119
6 Understanding and Critically Appraising the Literature Review, 150
7 Understanding Theory and Research Frameworks, 172
8 Clarifying Quantitative Research Designs, 191
9 Examining Populations and Samples in Research, 228
10 Clarifying Measurement and Data Collection in Quantitative Research, 259
11 Understanding Statistics in Research, 292
12 Critical Appraisal of Quantitative and Qualitative Research for Nursing Practice, 333
13 Building an Evidence-Based Nursing Practice, 387
14 Introduction to Additional Research Methodologies in Nursing: Mixed Methods and
Outcomes Research, 430
Glossary, 467
7
,Copyright
3251 Riverport Lane
St. Louis, Missouri 63043
UNDERSTANDING NURSING RESEARCH: BUILDING AN EVIDENCE-BASED PRACTICE,
SEVENTH EDITION
ISBN: 978-0-323-53205-1
Copyright © 2019 by Elsevier, Inc. All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any means,
electronic or mechanical, including photocopying, recording, or any information storage and
retrieval system, without permission in writing from the publisher. Details on how to seek
permission, further information about the Publisher’s permissions policies and our arrangements
with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency,
can be found at our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the
Publisher (other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical
treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described herein. In
using such information or methods they should be mindful of their own safety and the safety of
others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the
most current information provided (i) on procedures featured or (ii) by the manufacturer of each
product to be administered, to verify the recommended dose or formula, the method and duration
of administration, and contraindications. It is the responsibility of practitioners, relying on their
own experience and knowledge of their patients, to make diagnoses, to determine dosages and the
best treatment for each individual patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors,
assume any liability for any injury and/or damage to persons or property as a matter of products
liability, negligence or otherwise, or from any use or operation of any methods, products,
instructions, or ideas contained in the material herein.
Previous editions copyrighted 2015, 2011, 2007, 2003, 1999, and 1995.
Library of Congress Cataloging-in-Publication Control Number: 2018944739
Content Strategist: Lee Henderson
8
,Content Development Specialist: Laurel Shea
Publishing Services Manager: Julie Eddy
Senior Project Manager: Rachel E. McMullen
Design Direction: Renee Duenow
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
9
, Contributors and Reviewers
CONTRIBUTORS
Christy J. Bomer-Norton , PhD, RN, CNM, IBCLC Concord, Massachusetts
Kathryn M. Daniel , PhD, MS, BSN, BA Associate Professor, College of Nursing and Health
Innovation, The University of Texas at Arlington, Arlington, Texas
REVIEWERS
Sue Ellen Bingham , PhD, RN Professor of Nursing, Clayton State University, Morrow, Georgia
Sara L. Clutter , PhD, RN Professor of Nursing, Waynesburg University, Waynesburg,
Pennsylvania
Angela N. Cornelius , DNP, RN, CNE, CNL Associate Professor of Nursing, Central Methodist
University, Fayette, Missouri
Polly A. Hulme , PhD, CNP, RN Professor, College of Nursing, South Dakota State University,
Brookings, South Dakota
Tamara M. Kear , PhD, RN, CNS, CNN Associate Professor of Nursing, College of Nursing,
Villanova University, Villanova, Pennsylvania
Llynne C. Kiernan , DNP, MSN, RN-BC Assistant Professor of Nursing, Norwich University
School of Nursing, Northfield, Vermont
Kathleen S. Murtaugh , MSN, RN, CNA Assistant Professor, Saint Joseph College—St. Elizabeth
School of Nursing Cooperative Program, Rensselaer, Indiana
Michael Perlow , DNS, RN Professor of Nursing, School of Nursing and Health Professions,
Murray State University, Murray, Kentucky
10
