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Master of Science in verpleegkunde en vroedkunde
Methodologie: kwantitatief onderzoek
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METHODOLOGIE : KWANTITATIEF
Schooljaar : 2018-2019
NURSING RESEARCH 10DE EDITIE
1
,Inhoudsopgave
1 RESEARCH PROBLEMS, RESEARCH QUESTIONS AND HYPOTHESES..........................................5
1.1 OVERVIEW OF RESEARCH PROBLEMS..........................................................................................................5
1.1.1 Basic terminology............................................................................................................................................... 5
1.1.2 Research problems and paradigms............................................................................................................. 5
1.1.3 Sources of research problems........................................................................................................................ 5
1.2 DEVELOPING AND REFINING RESEARCH PROBLEMS.............................................................................................. 6
1.2.1 Selecting a topic................................................................................................................................................... 6
1.2.2 Narrowing the topic........................................................................................................................................... 6
1.2.3 Evaluating research problems...................................................................................................................... 6
1.3 COMMUNICATING RESEARCH PROBLEMS AND QUESTIONS................................................................................... 7
1.3.1 Statement of purpose........................................................................................................................................ 7
1.3.2 Research questions............................................................................................................................................. 7
1.3.3 Problem statement............................................................................................................................................. 8
1.4 RESEARCH HYPOTHESES........................................................................................................................................... 8
1.4.1 Fuction in quantitative studies..................................................................................................................... 8
1.4.2 Characteristics of testable hypotheses....................................................................................................... 8
1.4.3 The derivation of hypotheses......................................................................................................................... 8
1.4.4 Wording of hypotheses..................................................................................................................................... 9
2 ETHIEK IN VERPLEEGKUNDIG ONDERZOEK..................................................................................... 9
2.1 ETHICS AND RESEARCH............................................................................................................................................. 9
2.1.1 Codes of ethics...................................................................................................................................................... 9
2.1.2 Government regulations for protecting study participants..............................................................9
2.1.3 Ethical dilemmas in conducting research................................................................................................9
2.2 ETHICAL PRINCIPLES FOR PROTECTING STUDY PARTICIPANTS.........................................................................10
2.2.1 Beneficence (weldadigheid)......................................................................................................................... 10
2.2.2 Respect for human dignity........................................................................................................................... 10
2.2.3 Justice.................................................................................................................................................................... 11
2.3 PROCEDURES FOR PROTECTING STUDY PARTICIPANTS...................................................................................... 12
2.3.1 Risk/benefit assessments.............................................................................................................................. 12
2.3.2 Informed consent and participant authorization..............................................................................12
2.3.3 Confidentiality Procedures........................................................................................................................... 13
2.3.4 Debriefings, communications and referrals..........................................................................................14
2.3.5 Treatment of vulnerable groups................................................................................................................ 14
2.3.6 External reviews and the protection of human rights......................................................................14
2.3.7 Building ethics into the design of the study..........................................................................................15
2.4 OTHER ETHICAL ISSUES.......................................................................................................................................... 15
2.4.1 Ethical issues in using animals in research........................................................................................... 15
2.4.2 Research misconduct...................................................................................................................................... 15
3 QUANTITATIVE RESEARCH DESIGN.................................................................................................. 15
3.1 GENERAL DESIGN ISSUES........................................................................................................................................ 15
3.1.1 Causality............................................................................................................................................................... 15
3.2 EXPERIMENTAL DESIGN......................................................................................................................................... 16
3.2.1 Randomized controlled trial........................................................................................................................ 16
3.2.2 Specific experimental designs..................................................................................................................... 18
3.3 QUASI EXPERIMENTS.............................................................................................................................................. 19
3.3.1 Quasi-experimental designs......................................................................................................................... 19
3.3.2 Quasi-experimental and comparison conditions................................................................................21
3.3.3 Strenghts and limitations of quasi-experiments.................................................................................21
3.4 NONEXPERIMENTAL/OBSERVATIONAL RESEARCH............................................................................................. 21
3.4.1 Correlational cause-probing research.................................................................................................... 21
3.4.2 Descriptive research........................................................................................................................................ 23
2
, 3.4.3 Strenghts and limitations of correlational research.........................................................................24
4 RIGOR(STRENGHEID) AND VALIDITY IN QUANTITATIVE RESEARCH....................................24
4.1 VALIDITY AND INFERENCE..................................................................................................................................... 24
4.1.1 Study validity (studiegeldigheid).............................................................................................................. 24
4.1.2 Controlling confounders................................................................................................................................ 25
4.2 STATISTICAL CONCLUSION VALIDITY.................................................................................................................... 25
4.2.1 Low statistical power..................................................................................................................................... 26
4.2.2 Restriction of range (beperking van bereik)........................................................................................26
4.2.3 Unreliable implementation of a treatment (onbetrouwbare implementatie van een
behandeling)................................................................................................................................................................. 26
4.3 INTERNAL VALIDITY................................................................................................................................................ 26
4.3.1 Threats (gevaren) to internal validity.................................................................................................... 26
4.3.2 Internal validity and research design...................................................................................................... 27
4.3.3 Internal validity and data analysis........................................................................................................... 28
4.4 CONSTRUCT VALIDITY............................................................................................................................................ 28
4.4.1 Enhancing (verbeteren) construct validity...........................................................................................28
4.4.2 Threats to construct validity....................................................................................................................... 29
4.5 EXTERNAL VALIDITY............................................................................................................................................... 29
4.5.1 Enhancing (verbeteren) external validity.............................................................................................29
4.5.2 Threats to external validity.......................................................................................................................... 30
4.6 TRADE-OFFS AND PRIORITIES IN STUDY VALIDITY............................................................................................. 30
5 SPECIFIC TYPES OF QUANTITATIVE RESEARCH........................................................................... 30
5.1 CLINICAL TRIALS..................................................................................................................................................... 30
5.1.1 Phases of clinical trials (klinische proef)...............................................................................................30
5.1.2 Noninferiority and equivalence trials...................................................................................................... 31
5.1.3 Practical clinical trials................................................................................................................................... 31
5.2 EVALUATION RESEARCH......................................................................................................................................... 32
5.2.1 Process/implementation analysis............................................................................................................. 32
5.2.2 Outcome analysis.............................................................................................................................................. 32
5.2.3 Impact analysis................................................................................................................................................. 32
5.2.4 Cost analysis....................................................................................................................................................... 33
5.3 HEALTH SERVICES AND OUTCOMES RESEARCH................................................................................................... 34
5.3.1 Models of health care quality...................................................................................................................... 34
5.3.2 Nursing processes and interventions....................................................................................................... 34
5.3.3 Patient risk adjustment................................................................................................................................. 35
5.3.4 Nursing-sensitive outcomes......................................................................................................................... 35
5.4 SURVEY RESEARCH.................................................................................................................................................. 35
5.5 OTHER TYPES FO RESEARCH.................................................................................................................................. 36
6 SAMPLING IN QUANTITATIVE RESEARCH....................................................................................... 37
6.1 BASIC SAMPLING CONCEPTS.................................................................................................................................. 37
6.1.1 Population........................................................................................................................................................... 37
6.1.2 Eligibility criteria (geschiktheidscriteria).............................................................................................37
6.1.3 Samples and sampling.................................................................................................................................... 37
6.1.4 Strata..................................................................................................................................................................... 38
6.1.5 Staged sampling................................................................................................................................................ 38
6.1.6 Sampling bias..................................................................................................................................................... 38
6.2 NONPROBABILITY SAMPLING................................................................................................................................. 39
6.2.1 Convenience sampling.................................................................................................................................... 39
6.2.2 Quota sampling................................................................................................................................................. 39
6.2.3 Consecutive sampling..................................................................................................................................... 39
6.2.4 Purposive sampling......................................................................................................................................... 39
6.3 PROBABILITY SAMPLING........................................................................................................................................ 40
3
, 6.3.1 Simple random sampling.............................................................................................................................. 40
6.3.2 Stratifief random sampling.......................................................................................................................... 40
6.3.3 Multistage cluster sampling........................................................................................................................ 41
6.3.4 Systematic sampling....................................................................................................................................... 41
6.4 SAMPLE SIZE IN QUANTITATIVE STUDIES............................................................................................................ 41
6.4.1 Sample size basic.............................................................................................................................................. 41
6.4.2 Factors affecting sample size requirements in quantitative research......................................41
6.4.3 Power analysis................................................................................................................................................... 42
7 DATA COLLECTION IN QUANTITATIVE RESEARCH...................................................................... 42
7.1 DEVELOPING A DATA COLLECTION PLAN............................................................................................................. 42
7.1.1 Identifying data needs.................................................................................................................................... 42
7.1.2 Selecting types of measures......................................................................................................................... 43
7.1.3 Selecting and developing instruments.................................................................................................... 43
7.1.4 Pretesting the data collection package..................................................................................................44
7.1.5 Developing data collection forms and procedures.............................................................................44
7.2 STRUCTURED SELF-REPORT INSTRUMENTS......................................................................................................... 44
7.2.1 Types of structured questions..................................................................................................................... 44
7.2.2 Composite scales (samengestelde schalen) and other structured self-reports......................45
7.2.3 Questionnaires vs interviews....................................................................................................................... 46
7.2.4 Designing structured self-report instruments.....................................................................................46
7.2.5 Administrering structured self-report instruments...........................................................................47
7.2.6 Evaluation of structured self-reports...................................................................................................... 48
7.3 STRUCTURED OBSERVATION.................................................................................................................................. 49
8 MEASUREMENT AND DATA QUALITY............................................................................................... 49
8.1 MEASUREMENT....................................................................................................................................................... 50
8.1.1 Theories of measurement............................................................................................................................. 50
8.1.2 Errors of measurement.................................................................................................................................. 50
8.1.3 Major types of measures................................................................................................................................ 51
8.2 MEASUREMENT PROPERTIES : AN OVERVIEW..................................................................................................... 51
8.2.1 A measurement taxonomy............................................................................................................................ 51
8.2.2 Measurement and statistics......................................................................................................................... 52
8.3 RELIABILITY............................................................................................................................................................. 52
8.3.1 Reliability............................................................................................................................................................. 52
8.3.2 Internal consistency........................................................................................................................................ 53
8.3.3 Measurement error.......................................................................................................................................... 53
8.4 VALIDITY.................................................................................................................................................................. 54
8.4.1 Content and face validity.............................................................................................................................. 54
8.4.2 Criterion validity............................................................................................................................................... 55
8.4.3 Construct validity............................................................................................................................................. 56
8.5 RELIABILITY OF CHANGE SCORES.......................................................................................................................... 57
8.5.1 Measuring change............................................................................................................................................ 57
8.5.2 The smallest detectable change (SDC).................................................................................................... 57
8.5.3 The reliable change index (betrouwbare veranderingsindex).....................................................57
8.6 RESPONSIVENESS..................................................................................................................................................... 57
8.6.1 The criterion approach to responsiveness............................................................................................. 57
8.6.2 The construct approach to responsiveness...........................................................................................57
9 BASIC OF MIXED METHODS RESEARCH........................................................................................... 58
9.1 OVERVIEW OF MIXED METHODS RESEARCH........................................................................................................ 58
9.2 GETTING STARTED ON A MIXED METHODS STUDY.............................................................................................. 58
9.2.1 Specific mixed method designs................................................................................................................... 59
9.3 SAMPLING AND DATA COLLECTION IN MIXED METHODS STUDIES....................................................................60
4
,1 Research problems, research questons and hypotheses.
1.1 OVERVIEW OF RESEARCH PROBLEMS
1.1.1 Basic terminology
Onderzoeksprobleem – research problem
Een raadselachtige of verondrustende toestand binnen een bepaald onderwerp.
Het doel van onderzoek is om het probleem op te lossen.
Probleemstelling – problem statement
Onderzoekers formuleren een probleem en leggen de nood aan een studie uit
door een argument te ontwikkelen.
Onderzoeksvraag – research question
Een specifieke vraag die een onderzoeker wil beantwoorden bij het aanpakken
van een probleem.
Hypothese
Voorspellingen over antwoorden op onderzoeksvragen
Verklaring van het doel – statement of purpose
Onderzoeksdoelen – research aims
1.1.2 Research problems and paradigms
De aard van de onderzoeksvraag is gekoppeld aan paradigma’s 1 en
onderzoekstradities binnen paradigma’s.
Kwantitatief onderzoek
Legt de focus op concepten die redelijk goed ontwikkeld zijn, waarover al
bestaand bewijs bestaat en waarvoor betrouwbare meetmethoden zijn
ontwikkeld.
Kwalitatief onderzoek
Wordt vaak gebruikt omdat men een rijk en contextgebonden begrip van
een slecht begrepen fenomeen wil ontwikkelen. Om het bewustzijn te
vergroten en een dialoog te creëren over een fenomeen.
1.1.3 Sources of research problems
Ervaring – clinical experience
Kwaliteitsverbetering inspanningen – quality improvement effort
1
Paradigma = een zienswijze. Een samenhangend stelsel van modellen en theorieën.
5
, Verpleegkundige literatuur – nursing literature
Maatschappelijke problemen – social issues
Theoriën
Ideeën van externe bronnen – ideas from external sources
1.2 Developing and refning research problems
1.2.1 Selectng a topic
Het is een creatief proces. Ideeën worden genoteerd waarna die ideeën worden
gesorteerd naar interesse, kennis en uitvoerbaarheid.
Om een onderzoeksprobleem op te stellen is er een hypothese nodig bijvoorbeeld
a is beter dan b. Men vertrekt altijd vanuit een nul-hypothese, er is dus geen
verschil in a en b. Aan de hand van een onderzoek wordt een verschil aangetoond.
1.2.2 Narrowing the topic
Wanneer een onderwerp gekozen is, kan men beginnen met het stellen van een
aantal brede vragen. Vb “What is the meaning of…” of “What is going on with…”
Let op voor te brede of te ingewikkelde vragen.
Ook kunnen er verschillende mogelijke onderzoeksproblemen naar voor komen.
Elk onderzoeksprobleem moet anders bestudeerd worden.
Een kritische evaluatie van de verschillende ideeën is noodzakelijk.
1.2.3 Evaluatng research problems
Er zijn 4 belangrijke zaken die in het achterhoofd gehouden moeten worden bij
het opstellen van een onderzoeksprobleem.
Betekenis van het probleem
Het probleem moet relevant zijn voor de verpleegkundige praktijk of voor
de patiënt. Er moeten voldoende argumenten zijn om over een bepaald
probleem een onderzoek op te starten, het moet belangrijk genoeg zijn.
Die argumenten moeten objectief zijn.
Doorzoekbaarheid van het probleem
Bijvoorbeeld etische of morale problemen kunnen niet opgezocht worden.
Het moet meetbaar zijn.
Haalbaarheid van het probleem
Tijd
Ervaring in onderzoek
Medewerking van anderen
Beschikbaarheid van studiedeelnemers
Ethische overwegingen
Mogelijkheden en apparatuur
geld
Interesses van de onderzoeker
6
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