400755 Evidence Based Nursing 1

Quantitative Research 1

Prepared by:
Dr Antoinette H. Cotton &
Dr Elizabeth Halcomb 2008

Revised by: Dr Kath Peters 2009

Objectives
● By the end of this session & with additional
readings you will be able to:
– identify and describe the major quantitative
research designs
– explain the principles underpinning
sampling in quantitative research
– understand how the principles of human
ethics apply in quantitative research

Research Design
● The research problem determines the research
design.

Research design is “the overall plan for

collecting data in a research study”
(Borbasi, Jackson and Langford, 2004, p. 284)

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 Levels of Evidence
● I - Systematic Review of Level II studies
● II - Randomised Controlled Trials (RCTs)
● III-1 - Pseudo-randomised controlled trials
● III-2 - Comparative Studies with concurrent controls &
allocation non randomized (cohort studies), case-control
studies or interrupted time series with a control group.
● III-3 - Comparative studies with historical control, two or
more single arm studies, or interrupted time series
without control group
● IV - Case series with either post-test or pre test/post test
outcomes
(NHMRC, 1999, cited in Schneider, Whitehead, Elliott, Lobiondo-Wood and Haber, 2007, p. 308).

Systematic Review
● Systematic secondary critical examination of all
the available research literature on a particular
research topic, clinical practice or intervention
and a judgement of its effectiveness according to
EBP guidelines and protocols.
● Most appropriate for cause and effect type
studies when addressing questions on “What
works?”.

Randomised Controlled Trial (RCT)

● Gold standard for studies of effectiveness
● True experimental design
● Comparison groups with different interventions
● There is a control group (sometimes a placebo)
● Participants are randomly allocated to the groups
(intervention and control): All participants have
equal opportunity to be allocated to either group

Control Intervention

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 Randomisation
● Single Blinded Randomisation
Participants do not know which group they
belong to (control or treatment).

● Double Blinded Randomisation

Both participants and researchers do not know
which group participants are in (control or
treatment).

Pseudo-Randomised Controlled Trial

Level III-1 Evidence
● Not every participant has the same chance
of being allocated to the control or
intervention group
● It is possible to manipulate which group a
participant is allocated to
● Example: allocate by clinic day; ward, eye
colour

Cohort Study
Level III-2 Evidence
● Groups of people are selected on the basis
of differences in their exposure to a particular
agent and followed to see how many develop
a particular disease

Study factor Outcome factor

(smoking) (lung cancer)

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 Cohort Study
Level III-2 Evidence
Smokers

1980 data 1990 data 2000 data

Non smokers

Case Control Study

Level III-2 Evidence

Study Factor Outcome factor

(smoking) (Low birth weight)

Look at babies with an outcome (LWB) see

how many mothers smoked

Pre-test / Post-test Study

Level IV
● Same group of people are tested before
and after an intervention has occurred
● Measures the effect of the intervention
● Participants act as their own controls

Baseline Measures Intervention Follow-up Measures

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 Non-Experimental Designs
● Do not have an independent variable as there is
no manipulation.
● The researcher simply collects information on
several variables and describes the results.
● Reasons for not manipulating variables include:
– Events have already occurred
– The variable cannot be manipulated
– It would be morally / ethically wrong to
manipulate the variable

Sampling
● Population = subjects of interest for a study
● Sample = a subset of the population, usually with
characteristics that are representative of the
population.
● Generalisation = the ability to apply study results
to the population

The type of sampling used determines the ability to

generalise the study findings.

Types of Sampling
● Probability Sampling = randomised selection, each
member of the population has an equal chance of
selection = findings can be generalised.
– Simple random, stratified random, cluster sample,
systematic sample

● Non-probability Sampling = non-random selection,

each member of the population does not have an equal
chance of selection = findings cannot be generalised.
– Convenience, quota, purposive, non randomised
systematic sample

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 Ethics
● Beneficence
– Risk/benefit ratio
– Right to protection from harm / exploitation
– Right to self determination / full disclosure
● Respect for human dignity
● Justice
- Right to fair treatment
- Right to privacy
● Protection of vulnerable groups
(Polit and Beck, 2006, pp 83-98)

Consent
● The ethical and legal requirements of consent
have two aspects: 1) the provision of
information, and 2) the capacity to make a
voluntary choice (NHMRC, 1999).

● Persons with diminished autonomy because of

age, mental incompetence, terminal illness or
confinement to an institution need additional
protection because they cannot give informed
consent.

Integrity
“The guiding value for researchers is integrity,
which is expressed in a commitment to the search
for knowledge, to recognise principles of research
conduct, and in the honest and ethical conduct of
research and dissemination and communication of
results”
(NHMRC, 1999, p.11).

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 References
Australian Nursing & Midwifery Council. (ANMC) (2002). Code of ethics for Nurses in
Australia. Dickson, ACT: ANMC.
Australian Nursing Federation. (ANF). Standards for research for the nursing profession.
Melbourne: ANF
Borbasi, S., Jackson, D. and Langford, R. W. (2004). Navigating the maze of nursing
research: An interactive learning adventure. Sydney: Mosby
Evans, D., & Pearson, A. (2001). Systematic reviews: Gatekeepers of nursing knowledge.
Journal of Clinical Nursing, 10, 593-9.
National Health & Medical Research Council (NHMRC) (1999).National Statement on
ethical conduct in research involving humans. Canberra: Commonwealth of Australia.
National Health & Medical Research Council (NHMRC) (2002). Human research ethics
handbook: Commentary on the national statement on ethical conduct in research
involving humans. Canberra: Commonwealth of Australia.
Polit, D.F., & Beck, C.T (2006). Essential of nursing research: Methods, appraisal, and
utilization (6th ed.). Philadelphia: Lippincott Williams and Wilkins.
Schneider, Z., Whitehead, D., Elliot, D., LoBiondo-Wood, G., & Haber, J. (2007). Nursing &
Midwifery research: Methods and appraisal for evidence-based practice 3rd ed.).
Sydney: Elsevier