5 MAJOR STEPS OF RESEARCH PROCESS

RESEARCH
PHASE 1: CONCEPTUAL PHASE
 Scientific method (Experiment) - formal way to discover
new things  Formulating & developing research problem

 Research - more formal, intensive, and comprehensive  Reviewing related literature

method to discover new things  synthesis of reviews studies - related to the problem

 months to years of interest

 5 steps  PURPOSE

 Problem identification  Get an idea or background about the study

 Formulation of hypothesis (nagawa/ hindi pa nagagawa)

 Experiment  Undertaking a clinical fieldwork

 Observation & analysis  same with RRL - because they compliment each

 Conclusion other

 Nursing research  Defining framework & conceptual definitions

 Deals with clinical problems - encountered during  Graphical presentation of concepts and

clinical area relationships between concepts (flow chart) - from

 Most common RRL

 Research in nursing  Not include the findings

 More broader study of nursing in the profession  2 TYPES OF FRAMEWORK

 RRL + clinical field works  CONCEPTUAL

 Focuses more in issues  Relate the concept from the topic

 Educational issues  THEORETICAL

 Professional issues  Relate the concept from the existing

 Social issues theory (environmental theory/ or own

= which affect nursing profession theory (what ifs))

 Definition of terms
EVIDENCE BASED PRACTICE  Define the variables
 Operational definitions - on how they
 Use of current best evidence in practice were use in the study
 Latest findings  Highly technical terms - definitions
 Example: Experimental drug covid-19 found in the reference
 *if talks about finding = wrong/false
 Formulating the hypothesis
IMPORTANCE OF RESEARCH PHASE 2: DEFINING & PLANNING PHASE

- most rigorous/ spend more of time (mas pinag-iisipan)

 Professionalism - to enhance
 Selecting the research design
 Increase accountability - to see how far can nurisng go
 Developing the protocols for the interventions
 Social relevance
 optional
 Research & Decision making - mainly for
 For experimental research - consists intervention
& manipulations
 For accurate results = uniform process during
ULTIMATE GOAL IN RESEARCH
before, during, & after the intervention
 Identifying the population to be studied
 Highest goal of research - to improve the practice of the
 Designing the sampling plan
profession (across all discipline)
 Probability
 To improve client care/ patient care/ health care/ nursing
 Non-probability
care
 Specifying the methods on how to measure research
 Covers all the importance of research
variables
 Tools or Instrument for the data collection/
 gathering = to know the limitations  Use of existing data - already available
 Developing a method on how to safeguard human/animal  case presentation - by using pt chart
rights  Any forms of documentation/ reports -
 Reviewing & finalizing the plan graph of the doh
PHASE 3: EMPIRICAL PHASE  Self reports - can gather data by oral or

- Longest phase writing

 Collecting the data  Gathered by researchers

 Preparing the data for analyzing  Interviews & Questionnaire - most widely

 levels of measurement used forms of data collection

 It can gather data that cannot gather by
PHASE 4: ANALYTIC PHASE
other methods
 Analyzing the data
 Gather opinions
 Interpreting the results
 Cannot gather through equipment
 differential
and gadgets
 Inferential statistics
 Data - can be gathered through
PHASE 5: DISSEMINATING PHASE
equipment and gadgets
 Communicating the findings  Most common used
 Utilizing the findings into practice  Flexible - can jump from 1 question to
 Evidence based practice another
 Versatile
PROBLEM  Disadvantages:
 Sources of research problem  Validity & accuracy (most crucial)
 Nursing literatures  Observation
 Ideas from external sources  Participant observer
 Theory - existing/ own theory  You give an intervention then
 Experience & clinical fieldwork* - rich from observe
information  Disguised yourself as subjects
 Social issues - from the society (autism, drug  Non-participant
addiction)  Not to give intervention
 Scientific research - previous research; done again  Only observe

since there could be modifications & innovations -  Phenomena observer (amenable to

LEAST BEING USED observe)
 Characteristics & Condition of the

CRITERIA OF GOOD RESEARCH PROBLEM subjects

 Example: newborns with rh
 Significance of the study
incompatibility- jaundice
 address to the people - target of the research
 Activities and Behavior of the
 address to the society at large - not the target of
subjects
the research
 example: autism - ignore
 address to the profession - to improve the practice
tantrums
 easy to make
 Skill attainment & performance
 Availability of subjects
 example: return demonstration
 To get the information (Research about GBS - 1/
 Environmental characteristics
100 000 people)
 example: surroundings
 Limitation of the subjects (cannot read/ write)
 Verbal communication
 Time allotment + researchers ability
 example: manner how to
 Pre-research - do feasibility study (to determine the
answer the questions
ability)
 Assess the true emotions &
 Limitation of tools
feelings
 Major forms of data gathering
  Speech, tone, intonation  what vary in the population
 Non-verbal communication  Paiba iba = nagbabago
 example:  Relationship
 Gesture  Population to which it applies - most neglect but
 Facial expression MOST IMPORTANT
 Posture  1st to identify
 Body language  Include all the characteristics + sets ( if 2 or
 To assess true emotion & more then concentrate to characteristics which
feelings is different ) (researcher who sets)
 Biophysical measurements
 Use of equipment & gadgets
 In-vivo
 the measurement perform
directly to the subjects
 Cbg analysis, oxygen
saturation
 In-vitro
 the measurement is perform
outside
 Gather the specimen to the
laboratory
 Fecalysis, urinalysis
 1 set
 tip: characteristics have no significance = eliminate
CRITERIA TO KNOW THE EFFECTIVITY OF THE TOOL  Go back to the hypothesis and ask “what is being
studied?”
 VALIDITY - measure what is supposed to be
measure MANIPULATION (experimental)
 same tools = same results  Anything that is given to the subjects
 RELIABILITY - consistency or repeatability of the  All manipulation is considered INDEPENDENT
tool VARIABLE
 SENSITIVITY - detect small variations of the
differences
RESEARCH DESIGNS
- if the does not meet the criteria! They used different tools
 According to motive (purpose)
 Interest of the researchers  Pure/ basic research
 Novelty  Increase knowledge
 Newest and freshness of research  Applied
 This is why scientific research is LEAST USED!  Use knowledge into practice
 According to the levels of investigation
 level 1 - Exploratory = pure/ basic
HYPOTHESIS
 You wanted to identify the variables
 Educated guess, wild guess - tentative prediction of the  Walang alam, pero may gusto kang malaman
relationship between variables  Researchers looking for OPINION
 4 parts  QUALITY (quality of life of brgy masigla)
 Independent variable - Cause  If the researcher trying to get CENSUS/
 characteristic na magkaiba FREQUENCY (favorite color of brgy makulay)
 Fixed = set  Level 2 - Descriptive = pure/basic
 Dependent variable - Effect  Wanted to know whether the variables are
 accumulated or related 3. Case study - DESCRIPTIVE
 May alam pero gustong madagdagan  in-dept/in-detail study of person or entities
 “FACTS & ISSUES” “STUDY” “ANALYSIS” 4. Methodological - DESCRIPTIVE
1. Descriptive - you wanted to describe the  study of methods/ results/ procedures
variables as it is 5. Analytical - DESCRIPTIVE
 “DESCRIBE”  further her analysis of issues or events -
 Example: the new bsn curriculum PRESENT
2. Descriptive correlation - wanted to describe  Experimental
the relationship of the variables to each other  With manipulation
 “RELATIONSHIP”  2 sets of group (always present)
 Example: new bsn curriculum and the  experimental group - where we give
readiness of the students manipulation
3. Descriptive comparative- compare the  control group - where we compare the
variables to each other results of the experimental group
 “SIMILARITIES” 1. True experiment
 Example: the old and new bsn curriculum  STRICT CONTROL over the variables
 Elements of an experimental research should be
 level 3 - Experiment = applied present
 wanted to find out the cause and effect of the  Randomization
variables to each other  Have no idea about the samples = equal
 music therapy can increase/decrease chance
anxiety levels  Manipulation
 “EFFECT”  Anything that is given
 If there’s manipulation  At least 3 trials
 medication  Experimental group - give experimental
 Treatment manipulation
 Education  Blind experiment - subjects do not know
 Massage which group they belong
 both experimental & control group
PROCESS OF ELIMINATION  Double blind - researcher and groups do
 read the choices not know which group they belong =
 Opinion/ Census = exploratory prevent bias
 survey  Control group
 Manipulation = experimental  who received placebo effect -
 quasi without therapeutic effect
 Descriptive  Sugar, Sterile water, Nss
 Historical  we can give others
 Case Study  music therapy, vitamins
 Methodological  WHERE TO GIVE??
 Analyticl  Without comparison = PLACEBO
 With comparison = OTHERS
 According to the approach or design  Control
 Non-experimental  where to compare the results
 without manipulation 2. Quasi experiment
1. Historical - DESCRIPTIVE  “quasi” - just like a true experiment
 Study of the past - about issues  lacks randomization = non-random
2. Survey - EXPLORATORY  Overcome the manipulation = ineffective
 Use of survey & questionnaires to gather  The control overcomes the variables = high
PUBLIC OPINION chance of bias
  presence of manipulation & control  Samples readily available
2. Quota sampling
 According to time frame  Get the portion of the population
1. Cross sectional  There’s a limit
 One time study 3. Purposive/ Judgmental
2. Longitudinal  Hand pick of the researchers
 Repetitive study  Based on the knowledge of the sample
3. Retrospective 4. Snowball
 Study of the past to explain the present  Networking or Referral system
4. Prospective  Probability Sampling
 Study of the present to predict the future  Random
 Example: global warming  No idea = every sample has a chance to be pick
1. Simple Random sampling
 Everybody has a chance to become a
POPULATION
sampling
 Entire aggregate of cases that the researcher would like  Bingo, drawlots, mini manimo
to study  No groupings = all are present
2. Stratified Sampling
Eligibility criteria  you create a strata of population, then divide
 exact criteria to narrowed down the population the population into homogenous group
 All 1st takers  Basis - is the strata/ or characteristics
 Homogenous group - group them based on
Accessible population the same characteristics
 Entire aggregate cases that is redeem within reach  W grouping & basis = strata
of the researchers 3. Cluster Sampling
 All first taker in metro manila  Cluster mean big group
 Successive random sampling of units
Target population  No distinct characteristics
 Entire aggregate cases what researches would like 4. Systematic Sampling
to make generalization  Get the Kth of the list
 This is where to FOCUS
 “universe”
 All 1sy takers from 3 school in metro manila

SAMPLING TECHNIQUE

SAMPLING
 Process used to get the representative f the population

1. Simplify first the denominator

SAMPLE
2. Marginal error is always given
 The representative
3. EXe
 1 characteristics = representativeness, presentation
4. X pop
5. +1
SAMPLING PLAN
6. / by pop
2 types
 Non-probability sampling
 Have an idea who is the sample = everyone has no
chance to be a sample
 Non-random = not equal chance
1. Convenience/ Accidental sampling
 4 BASIC RIGHTS OF RESEARCH SUBJECTS  Mean - average (+ all the values then ? By all
the values)
1. Right not to be harm
 Median - middle value
a) Beneficence
 Mode - one that frequently appears
b) Non-beneficence
 Measure of Variability
2. Right to full disclosure
 Simple rank, Range, Variance & Standard
a) Veracity
Deviation
3. Right to self-determination
2. Inferential Analysis
a) Autonomy
 Is to prove the hypothesis
4. Right to anonymity, confidentiality & privacy
 Population = count the number of set
 ANOVA
 If 3 or more sets —> with 1 comparable
PLANNING & FINALIZATION
variable
 Chi-square
LEVEL OF MEASUREMENT
 If 1 set —> with 2 comparable variable and
focus on the frequency
 Assignment of numbers according to rules
 T-tests
1. Nominal
 Student t-test or independent
 Categorical
 If have 2 set of population, compared to 1
 Just name the category
variable
 Name , Gender
 Paired t-test
 It only represent to the category
 If only have 1 set with dependent groups/
2. Ordinal
results
 Categorical
 Dependent group results =
 Shows ranking of events
dependent to one another
 It only shows orders
 Before & after
 ranking of board examiners , best-good-not
Pearson R
good
 1 set —> 2 or more comparable variable but focus
3. Interval
on interval/ ratio data
 Numerical
 Shows ranking of events with equal of
intervals
TIP:
 0 is not absolute = 0 has a value
3 or more = anova
 Temperature, IQ
2 = student
4. Ratio
1 = look forr ( before & after) = paired
 Numerical
= number = pearson
 Show ranking bot 0 is absolute
= if both are not = chi-square
 If 0 is the always last number
 weight

ANALYSIS

1. Descriptive analysis
 This does not to prove the hypothesis
 It only summarize the data
 Frequency of Distribution
 Use of tables and graphs
 are the one’s communicate to the readers
 Measures of Central Tendency
  Pt should fully understand
 Pt should voluntarily consented
BIOETHICAL PRINCIPLES
 There’ s no violence, force, coercion
1. AUTONOMY  Pt should be coherent, sound, and conscious
 Auto - means self  Pt should voluntarily sign the consent
 Nomo - means governance
 Self governance REQUIREMENT
 It is the right of individual to decide for her/him  For pt to sign the consent
 Decision making = Autonomy 1. AGE
 If pt refuse - ACCEPT (article 3, section 6)  18 ↑
 After the refusal what is the priority: DOCUMENT!  Contract is already valid and legal in binding
IMMEDIATELY THE REFUSAL  Except if married
 If anything happens to the pt, chart is the  You can only be married if 18 ↑
first to check  If ↓ the marriage will be VOID
 If not written in the chart = it is your  21 ↓ = need parents consent = it is
accountability avoidable
 21 ↑ - need parents advice = but X
CODE OF ETHICS: BON RES 2205. 2004 not avoidable
 ARTICLE 1: PREAMBLE  But can delay marriage license
 ARTICLE 2-6 : RESPONSIBILITY 2. SHOULD SOUND MIND
 ARTICLE 8 : PENALTIES, REPEALING CLAUSE, &  Conscious, Coherent
EFFECTIVITY  Ability to read & write = is not requirement
 Don’t ask for waver = it is the decision of the  Thumb mark = if can’t write
MD
 Don’t explain the action of the drug = it is the  IF MINOR
role of the MD = NEVER EXPLAIN  Next of kin - follow the hierarchy
 Because before giving them the drug  Parents
during administration, you already inform  Siblings - age of the majority (18 y/old)
them about it  Grandparents
*if patient refuse to take drugs - Accept  Legal guardian
* Jehovah pt refuse for blood transfusion - Accept  LEGAL AGE
* What if medication is new and pt is refuse - Explain the  But not coherent, conscious
CONSEQUENCES of the refusal  Next of kin
 Not the action or procedure  Spouse - legal
 Children who is legal age
PATERNALISM  Parents
 Decide behalf of the patient is the MD  Grand parents
 Withhold the autonomy of the patient  Legal guardian
* Jehovah witness accident which had excessive blood loss =  IF BABY, BUT MINOR MOTHER
MD decide what is the best treatment for the pt  Next of kin
 Father - if legal
INFORMED CONCENT
 Birth certificate = it should be
acknowledge
 It is a agreement or serves as contract
 If minor = can’t give consent
Who gives the consent = PT
 Grandparents - only in the mother side
Who explains the consent, procedure & treatment = MD
 Because the baby is illegitimate
Witness = NURSING
 Legal guardian
 Actual conversation between MD & PT
 It is decided by the board
 Full or sufficient explanation coming from the MD
 if X legal guardian = government
  DSWD  Emergency room
 Last, is MD (paternalism)  Prioritize the patient have severe condition/
who needed the most attention
*IMMEDIATE FAMILY IS THE PRIORITY
6. CONFIDENTIALITY, ANONYMITY, & PRIVACY
2. VERACITY
 Truthfulness/ Honesty ANONYMITY
 Full disclosure - nature, length of study, side effects,  We don’t disclose the name of the patient = to protect
benefits, consequence contact info of researchers their identity
 Veracity in the ward is different in nursing research  Example: Case Presentation - used initial of the pt
 Ward: we only say information that MD order
 Research: research is responsible to tell CONFIDENTIALITY
everything truth to the participants  We don’t disclose any information or case of the subjects
 Especially personal info (to reach easily)  Disclose - only to professionally and directly involved
 PRINCIPLE OF BENEVOLENT DECEPTION  Unless will coordinate with other department
 Deception - deceive  Or required/ allowed by law
 Withhold truth to the patient or the benefit of  Case of malpractice
the pt due to the pt condition is unstable  Subpeona duces tecum (court orders)
 Do not lie to pt, but just hold the truth  This is a court order asking the person to
 MD - burden to tell the truth appear in court bring along with
records/ documents within his control
3. BENEFICIENCE  Within in your possession or
 To do (may ginawa lang) disposal = with authority
DOUBLE
EFFECTS Court order - process how situation take place
4. NON-MALEFICENCE  Subpeona ad testificandum (court orders)
 To prevent or to protect  Court order asking a person to appear in
court to testify
PRINCIPLES DOUBLE EFFECTS  Subpeona summon
 Good & Bad effect  Not a court order wherein a notice
 Good effects should overcomes the bad effect informing the accused that there is a case
 Even though there’s a side effects, we still give filed against him; informing him about the
it to pt nature and cause of accusation against
 Example: Chemotherapy him and asking him to appear or to
 Bad effects overthrows the Good effect = STOP! answer in a specified date and time.
 You can stop even though without MD order  Requirement of the due process
 If cover only by the Double Effects  Notice and Hiring
 But REPORT TO THE MD IMMEDIATELY  Within 15 days
 Example: Chemotherapy - ↑ wbc = infection  If don’t answer to the notice;
repercussion = you wave the right to
5. PRINCIPLES OF JUSTICE defend yourself
 Equal or Fair treatment to your patient that are similarly 
situated
 If we always apply the justice = X TRIAGING *Perjury = if you lie
 TRIAGE - prioritization based on the severity of the
condition 2 TYPES OF WITNESS
 Disaster - reverse 1. ORDINARY WITNESS
 Save many pt as possible  To testify others within your personal knowledge
 The health-care personnel is the priority  Knowledge or information that you have acquired
 through your senses organization (PNA) = RA 9173 (one of the
2. WITNESS grounds for revocation & suspension of license
 Knowledge comes from 3 person
rd
is violation of the code of ethics - article 16&
 Not use in court 17 = be a member)

Dying declaration 8. PRINCIPLE OF ADVOCACY

 Not oral will  Active support of an idea or cause
 The deceased will confess to other person the  To do everything to protect life
circumstances of his/her death  Shall take appropriate steps to safeguard their
 Applicable: if there’s a impending death, the rights and privileges = AS A ADOCATE OF THE
sudden death PATIENTS
 Ensure that needs are given
Notarial will
 Executed in the presence of 3 confident/ competent
NEGLIGENCE & MALPRACTICE
wittiness (witness = to witness due execution)
 due execution - not force, but coherent and * MALPRACTICE IS ALSO NEGLIGENCE = PROFESSIONAL

conscious and in sound mind NEGLIGENCE

Holographic will 1. NEGLIGENCE

 Written , Dated, and Signed by the hand of testator/  Commission or omission of an act pursuant to the duty

testator him self reasonable prudent person would or would not do

 May ginawa ka or may hindi ka ginawa

3. Expert witness  Simply means - CARELESSNESS

 Testify ion the matter in their field of specialization  You didn’t practice due diligence

Unwilling witness ELEMENTS OF NEGLIGENCE:

 Direct contempt - direct disobedience to a court  Existence of duty

 you will be arrested  Failure to meet the standard/ breech of duty

 Required to attend  Foresee-ability of harm/ proximate causation

 Warrant of arrest - can be given to witness if there is  Injury - is a material

unwillingness of witness
 Purpose of 3 witness *Absence of INJURY = NO case of negligence

 Witness the due execution of the will

 Will appear before the notary public 2. MALPRACTICE
 Mal = WRONG

PRIVACY  Professional negligence = W/ license

 Includes private moment, parts & property  Based on DUTY

 Moments - right to have to be alone  2 GROUNDS

 Parts - cover/ drape the patient during procedure  Stepping beyond one’s authority = doing something

 Property - anything that possess of the pt outside your practice

 Pictures  With or without injury

 Videos  Improper/ unskillful care of patient

 Lack of skill - incompetence

7. PRINCIPLES OF FIDELITY
 Faithfulness/ Loyalty ELEMENTS OF MALPRACTICE:

 Commitment to continual learning and active  Existence of duty

participation in the development and growth of  Failure to meet the standard/ breech of duty

the profession  Foresee-ability of harm/ proximate causation

 To be a member of a accredited professional  Injury - is a material of evidence

  Except: if life and death situation
INCOMPETENCE
 Lack of skill  Plaintiff/ pt did not participate
 Gross incompetence - matagal ka na sa nursing  The injury is come from own doing
pero wala ka pa ring alam
 Can revoked license 3. FORCE MAJEURE
 Irresistible, inevitable, unforeseeable
 Although sometime foreseen, it cannot be prevented
DOCTRINES OF NEGLIGENCE  AOG (ACTS OF GOD)
 Volcanic eruption
1. RESPONDEAT SUPERIOR  Tsunami
 let the master answer for the acts of each subordinate  Flood
 No shifting of liability  Earthquake
 Liability - stay in stay who committed the negligence  Typhoon
 But the superior is also liable = as long as the is  Hurricane
superior-subordinate relationship *WALANG PUMIPIGIL NA MAGDEMANDA = DEFENSE -
 Superior-subordinate relationship FORCE MAJEURE
 Exercise of power over the subordinate
 Command span responsibility - may alam o wala =
TORTS
liable pa rin
 The higher the position = the higher the TORTS
responsibilities  Civil wrong or wrongful act committed by a person
 Employer- employee relationship against another wherein the person is liable for damages
 Vicarious viability - it is delicated responsibility *Damages = danyos
 RA 2180
1. ASSAULT & BATTERY
2. RES IPSA LOQUITOR
 The thing speaks for itself = evidence (INJURY) ASSAULT
 Thing = evidence  Imminent threat of body harm or contact
 Evidence of negligence = INJURY  The threat is immediate
 ELEMENTS  Can happen anytime/ its bound to happen
 Injury will normally occur unless there’s BATTERY
negligence  Unconsented touch or cause bodily harm
CAPTAIN OF THE SHIP  Physical harm
 The surgeon is the responsible to anything that will  Already cause harm
happen inside the operation room
GRAVE THREAT
 Agency/ Instrumentality within control of the  Threats on the lives
defendant  Considered as criminal case
ASSUMPTION OF RISK
 Pt already inform about the risk yet still pushed 2. BREACH OF CONDIDENTIALITY AND INVASION OF
through the procedure, equipment, treatment RIVACY
 Not liable anymore because you already inform the
pt about the risk BREACH OF CONFIDENTIALITY
 Committed through publication of any picture of a pt
*INFORM CONSENT SHOOULD NOT BE WAVE = without the consent
general rule
 Even its emergency
 Consent serves as protection
3. FALSE IMPRISONMENT & ILLEGAL DETENTION

FALSE IMPRISONMENT
 Without violation of the law.
 Limitation of movement only or there is an installment of
an idea that he or she cannot go out
 Restraints - provided by MD order

ILLEGAL DETENTION
 in violation of a law
 Detaining the person against their will while violation of
the law
 Criminal case in nature

4. DEFAMATION
 Destroying reputation of the another person whether true
or not
 LIBEL - public
 Oral
 Written - magazine or diaryo
 SLANDER - private
 Oral - chismis between 2 private person, but
someone hear it
 There should be requirement of witness
 Slander by deed - a form of defamation
through action
 If you slap other = because face of a
person carries the reputation
 CYBER-LIBEL
 Posting someone in social media