Research in Nursing

Research is an inseparable component of the nursing discipline. Dozens of professional nurses express their willingness to participate in research activities. Unfortunately, few of them actually decide to conduct a research project, either due to the lack of resources or because of the poor knowledge of the research process (Arslanian, 2000). The process of conducting nursing research incorporates several essential elements and stages, from needs assessment to the analysis and evaluation of research outcomes (Arslanian, 2000). Still, any research begins with the preliminary analysis of the selected issue and the development of research questions for the future study. At times, nurse colleagues can provide a relevant and grounded feedback and facilitate the development of a sound research framework. Such responses offer a unique insight into the nature and urgency of the selected research issue and help determine the feasibility of the proposed research.

Original Research Questions

Quantitative

  1. Does breast cancer increase the risks of other gynecologic malignancies in female oncology patients?
  2. What is the relationship between mammography and the risks of thyroid cancer in female patients?

Qualitative

  1. What do patients feel about being diagnosed with cancer of unknown primary (CUP)?
  2. What do nurses think about the unique features of caring in the oncology unit?

Identifying Colleagues by Job Title

For the purpose of the current assignment, the following colleagues were asked to provide their feedback:

  1. Clinical Nurse Educator.
  2. Unit Nurse Practitioner.
  3. Clinical Research Coordinator Nurse.

Brief Account of the Information Received from the Colleagues

To begin with, the choice of peers and colleagues for the current study was based on their experience and expertise in nursing research. It was assumed that such experiences would render their feedback as more grounded, relevant, reasonable, and realistic. The clinical nurse educator, the unit nurse practitioner, and the clinical research coordinator nurse were asked to review the list of the research questions mentioned above. Their task was to analyze the feasibility, appropriateness, design, and format of the four questions and their potential to become an object of nursing research.

 

Quantitative Question 1

The first quantitative question was designed to evaluate the significance of the statistical relationship between diagnosed breast cancer and the risks of developing other gynecologic malignancies in female oncology patients. The clinical nurse educator responded that the question was particularly relevant, because if breast cancer was responsible for the development of other gynecologic malignancies, oncology nurses would be better equipped to prevent their occurrence in women. The unit nurse practitioner noted that the relationship between breast cancer and other gynecologic conditions was quite obvious, and the proposed question would hardly yield any remarkable study results. The clinical research coordinator nurse concluded that the proposed study would require using a longitudinal design. That is, the process of generating evidence, processing it, and analyzing its implications for practice will take years, given the nature and complexity of cancers and malignancies that develop in human subjects. The clinical research coordinator nurse believes that, beyond the amount of time required for this type of study, it will be subject to numerous external influences. For example, some participants may refuse from further involvement in the research process at any time (Walker, 2005).

Quantitative Question 2

In terms of the relationship between exposure to mammography and the risks of developing thyroid cancer, both the clinical nurse educator and the clinical research coordinator nurse were rather clear: they believe the question to be unfeasible, irrelevant, and even unprofessional. The clinical research coordinator nurse believes that evidence is abundant that mammography is not related to thyroid cancer risks in any way. Moreover, she states that the growing incidence of thyroid cancer in women is a result of improved diagnostic techniques rather than the negative effects of mammography and similar procedures on women's health (Buzzi, 2012). The unit nurse practitioner said that it could be interesting and useful to look at the relationship between these variables from a new perspective. However, she also believes that other research questions could be more important than the study of thyroid cancer risks following mammography.

Qualitative Question 1

Cancer of unknown primary (CUP) is one of the most challenging diagnoses facing nurses in oncology units. The clinical nurse educator made a remark that, in her professional experience, CUP had always been one of the most complicated subjects to explain to adult learners. With the rapid advancement of diagnostic and treatment technologies, oncology nurses are better equipped to deal with the most serious forms of cancer, but only when they know where it started. Otherwise, providing treatment to patients will become a task that is close to impossible. The unit nurse practitioner noted that she and her colleagues always feel confused, when CUP is diagnosed. The issue becomes particularly disturbing, when CUP is diagnosed in a young patient. The clinical research coordinator nurse agrees: nurses' confusion surrounding CUP is well-known and recognized. Meanwhile, little is known of what patients with CUP feel, when they receive the diagnosis. The clinical research coordinator nurse suggests that patients' perceptions of diagnosis, disease, and treatment play a huge role in managing the desired health outcomes. According to Petrie and Weinman (2006), patients construct mental models that guide their treatment and recovery efforts. These cognitive models predetermine the ways, in which individuals respond to their illness (Petrie & Weinman, 2006). Thus, better knowledge of the issue could inform the choices and decisions of oncology nurses and increase the efficacy of their treatment efforts.

Qualitative Question 2

The issue of caring is always relevant – this is what the clinical nurse educator said, looking at the qualitative question related to caring in the oncology unit. In her view, caring in an oncology setting acquires a different meaning, since nurses should be able to combine their optimism with the need to assist patients in making end-of-life decisions. Despite the relevance and importance of the selected issue, the clinical nurse educator does not think that the question of caring deserves any attention. Besides, many nursing students and scholars currently focus on the study of caring, which is why it would hardly bring any remarkable results. The unit nurse manager also claims that the analysis of patients' perceptions of caring is important but not as much as to translate into a separate research project. As for the clinical research coordinator nurse, her position is that studying patients' perceptions alone is not feasible. Much more useful would be comparing such perceptions, based on the complexity of the diagnosis. Also, patients' perceptions could be compared with those of nurses, but a similar study was published by Piorier & Sossong (2010). Therefore, given that the existing research resources are limited, the proposed question would hardly win the race for feasibility. 

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Choosing a Question that Is More Worthwhile Pursuing than Others

Based on the feedback provided by the three colleagues, the question that is worth pursuing is related to patients' perceptions of cancer of unknown primary. The choice of the proposed question is based on the following factors. First, all three colleagues agree that cancer of unknown primary is a serious diagnostic challenge facing oncology nurses. Second, the ways in which patients perceive their diagnosis have profound implications for the success of their treatment, as long as they develop cognitive models that guide their efforts towards recovery. Third, the colleagues believe that the current knowledge of what patients feel, when they are diagnosed with CUP, is scarce. Therefore, it would be feasible and useful to provide oncology nurses with a qualitative insight into the nature of patients' perceptions in the context of CUP. Both quantitative questions are feasible, but they are less interesting, since they do not provide an in-depth understanding of the qualitative phenomena surrounding nursing care. The first question requires the use of longitudinal designs, which is hardly possible in the context of the present work. Finally, the study of caring in an oncology unit is neither surprising nor new, which is why the analysis of CUP and patients' perceptions will become the research question of choice.

Revising Original Questions

Given the recommendations provided by the three colleagues, the two quantitative questions need to be revised. The original question related to the study of breast cancer and gynecologic malignancies should be reconsidered to avoid the use of longitudinal designs. This being said, the new question will sound as "What is the relationship between breast cancer and other gynecologic malignancies at the time of the diagnosis?" Such study will measure the frequency of other gynecologic complications identified at the time breast cancer is diagnosed. The results will help oncology nurses to create a holistic picture of breast cancer, while the gynecologic conditions identified will guided nurses' efforts in diagnosing breast cancer. 

The second quantitative question was claimed to be unfeasible and even unprofessional, although the unit nurse practitioner believes that it has some research potential. The nature of the responses provided suggests that it could be transformed into an instrument of qualitative inquiry. In other words, the proposed quantitative question can be revised to become a qualitative one. For instance, it is possible to explore women patients' perceptions of thyroid cancer risks, as they are undergoing mammography. The following question will be more interesting to oncology nurse researchers: "How do women undergoing mammography feel about the effects of radiation on their bodies?" 

Finally, the second qualitative question has received some negative feedback, which is why it can be revised to include an element of comparison. Also, its subject could be narrowed down to a specific population group. Bearing in mind that the majority of nurses in the oncology unit are women, it could useful to look behind male patients' perceptions of caring. Thus, the new question will be "How do the caring perceptions of nurses dealing with patients with prostate cancer differ from the caring perceptions in their clients?" 

Summarizing the Experience

The experiences gained in the present assignment confirm that the process of nursing research is associated with numerous difficulties. One of the key ones is selecting a viable topic and developing a feasible research question. The latter launches the process of investigation, which is expected to improve the quality of nursing care. The questions proposed in the current paper were based on my professional experiences and observations of patients' daily interactions with nurses. What I have learned is that, when choosing a prospective area for nursing research, such experiences should be backed up by a thorough analysis of the existing literature. My position would have been much stronger, had I presented evidence to prove that all questions deserved equal attention and could be equally feasible in the context of nursing research. Simultaneously, the process of designing a research question is not an easy one. Any feedback provided by colleagues could be useful and inform future research activities. However, such feedback should also be grounded in research, particularly when a topic of the future study  is claimed to be uninteresting and even redundant.

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Jul 11, 2019 in Research
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