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This article has a correction. Please see:

• Correction: How to appraise quantitative research - April 01, 2019

• Xabi Cathala 1 ,
• Calvin Moorley 2
• 1 Institute of Vocational Learning , School of Health and Social Care, London South Bank University , London , UK
• 2 Nursing Research and Diversity in Care , School of Health and Social Care, London South Bank University , London , UK
• Correspondence to Mr Xabi Cathala, Institute of Vocational Learning, School of Health and Social Care, London South Bank University London UK ; cathalax{at}lsbu.ac.uk and Dr Calvin Moorley, Nursing Research and Diversity in Care, School of Health and Social Care, London South Bank University, London SE1 0AA, UK; Moorleyc{at}lsbu.ac.uk

https://doi.org/10.1136/eb-2018-102996

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Introduction

Some nurses feel that they lack the necessary skills to read a research paper and to then decide if they should implement the findings into their practice. This is particularly the case when considering the results of quantitative research, which often contains the results of statistical testing. However, nurses have a professional responsibility to critique research to improve their practice, care and patient safety. 1  This article provides a step by step guide on how to critically appraise a quantitative paper.

Title, keywords and the authors

The authors’ names may not mean much, but knowing the following will be helpful:

Their position, for example, academic, researcher or healthcare practitioner.

Their qualification, both professional, for example, a nurse or physiotherapist and academic (eg, degree, masters, doctorate).

This can indicate how the research has been conducted and the authors’ competence on the subject. Basically, do you want to read a paper on quantum physics written by a plumber?

The abstract is a resume of the article and should contain:

Introduction.

Research question/hypothesis.

Methods including sample design, tests used and the statistical analysis (of course! Remember we love numbers).

Main findings.

Conclusion.

The subheadings in the abstract will vary depending on the journal. An abstract should not usually be more than 300 words but this varies depending on specific journal requirements. If the above information is contained in the abstract, it can give you an idea about whether the study is relevant to your area of practice. However, before deciding if the results of a research paper are relevant to your practice, it is important to review the overall quality of the article. This can only be done by reading and critically appraising the entire article.

The introduction

Example: the effect of paracetamol on levels of pain.

My hypothesis is that A has an effect on B, for example, paracetamol has an effect on levels of pain.

My null hypothesis is that A has no effect on B, for example, paracetamol has no effect on pain.

My study will test the null hypothesis and if the null hypothesis is validated then the hypothesis is false (A has no effect on B). This means paracetamol has no effect on the level of pain. If the null hypothesis is rejected then the hypothesis is true (A has an effect on B). This means that paracetamol has an effect on the level of pain.

Background/literature review

The literature review should include reference to recent and relevant research in the area. It should summarise what is already known about the topic and why the research study is needed and state what the study will contribute to new knowledge. 5 The literature review should be up to date, usually 5–8 years, but it will depend on the topic and sometimes it is acceptable to include older (seminal) studies.

Methodology

In quantitative studies, the data analysis varies between studies depending on the type of design used. For example, descriptive, correlative or experimental studies all vary. A descriptive study will describe the pattern of a topic related to one or more variable. 6 A correlational study examines the link (correlation) between two variables 7  and focuses on how a variable will react to a change of another variable. In experimental studies, the researchers manipulate variables looking at outcomes 8  and the sample is commonly assigned into different groups (known as randomisation) to determine the effect (causal) of a condition (independent variable) on a certain outcome. This is a common method used in clinical trials.

There should be sufficient detail provided in the methods section for you to replicate the study (should you want to). To enable you to do this, the following sections are normally included:

Overview and rationale for the methodology.

Participants or sample.

Data collection tools.

Methods of data analysis.

Ethical issues.

Data collection should be clearly explained and the article should discuss how this process was undertaken. Data collection should be systematic, objective, precise, repeatable, valid and reliable. Any tool (eg, a questionnaire) used for data collection should have been piloted (or pretested and/or adjusted) to ensure the quality, validity and reliability of the tool. 9 The participants (the sample) and any randomisation technique used should be identified. The sample size is central in quantitative research, as the findings should be able to be generalised for the wider population. 10 The data analysis can be done manually or more complex analyses performed using computer software sometimes with advice of a statistician. From this analysis, results like mode, mean, median, p value, CI and so on are always presented in a numerical format.

The author(s) should present the results clearly. These may be presented in graphs, charts or tables alongside some text. You should perform your own critique of the data analysis process; just because a paper has been published, it does not mean it is perfect. Your findings may be different from the author’s. Through critical analysis the reader may find an error in the study process that authors have not seen or highlighted. These errors can change the study result or change a study you thought was strong to weak. To help you critique a quantitative research paper, some guidance on understanding statistical terminology is provided in  table 1 .

• View inline

Some basic guidance for understanding statistics

Quantitative studies examine the relationship between variables, and the p value illustrates this objectively.  11  If the p value is less than 0.05, the null hypothesis is rejected and the hypothesis is accepted and the study will say there is a significant difference. If the p value is more than 0.05, the null hypothesis is accepted then the hypothesis is rejected. The study will say there is no significant difference. As a general rule, a p value of less than 0.05 means, the hypothesis is accepted and if it is more than 0.05 the hypothesis is rejected.

The CI is a number between 0 and 1 or is written as a per cent, demonstrating the level of confidence the reader can have in the result. 12  The CI is calculated by subtracting the p value to 1 (1–p). If there is a p value of 0.05, the CI will be 1–0.05=0.95=95%. A CI over 95% means, we can be confident the result is statistically significant. A CI below 95% means, the result is not statistically significant. The p values and CI highlight the confidence and robustness of a result.

Discussion, recommendations and conclusion

The final section of the paper is where the authors discuss their results and link them to other literature in the area (some of which may have been included in the literature review at the start of the paper). This reminds the reader of what is already known, what the study has found and what new information it adds. The discussion should demonstrate how the authors interpreted their results and how they contribute to new knowledge in the area. Implications for practice and future research should also be highlighted in this section of the paper.

A few other areas you may find helpful are:

Limitations of the study.

Conflicts of interest.

Table 2 provides a useful tool to help you apply the learning in this paper to the critiquing of quantitative research papers.

Quantitative paper appraisal checklist

• 1. ↵ Nursing and Midwifery Council , 2015 . The code: standard of conduct, performance and ethics for nurses and midwives https://www.nmc.org.uk/globalassets/sitedocuments/nmc-publications/nmc-code.pdf ( accessed 21.8.18 ).
• Gerrish K ,
• Moorley C ,
• Tunariu A , et al
• Shorten A ,

Competing interests None declared.

Patient consent Not required.

Provenance and peer review Commissioned; internally peer reviewed.

Correction notice This article has been updated since its original publication to update p values from 0.5 to 0.05 throughout.

Linked Articles

• Miscellaneous Correction: How to appraise quantitative research BMJ Publishing Group Ltd and RCN Publishing Company Ltd Evidence-Based Nursing 2019; 22 62-62 Published Online First: 31 Jan 2019. doi: 10.1136/eb-2018-102996corr1

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200+ Quantitative Research Topics for Nursing Students [Updated 2023]

Quantitative research plays an important role in the field of nursing education. It empowers nursing students to develop critical thinking skills, fosters evidence-based practice, and paves the way for career growth in the nursing profession. However, the journey of a nursing student in selecting the right quantitative research topic can be daunting. In this blog, we’ll delve into the world of quantitative research topics for nursing students. 

We’ll discuss why these topics matter, offer tips on choosing them, and provide a comprehensive list of intriguing research ideas across various nursing subfields.

Benefits of Quantitative Research for Nursing Students

Table of Contents

Before we dive into the world of quantitative research topics for nursing students, let’s understand why quantitative research is so crucial for nursing students:

• Enhancing Critical Thinking Skills: Nursing students often find themselves in situations where they must assess, analyze, and make decisions that directly impact patient care. Engaging in quantitative research hone these critical thinking skills, enabling students to approach complex problems methodically.
• Contributing to Evidence-Based Nursing Practice: Evidence-based practice is the cornerstone of modern healthcare. Quantitative research empowers nursing students to explore and apply the latest evidence in their clinical practice, ensuring the best possible care for patients.
• Career Advancement: As nursing professionals progress in their careers, research experience becomes increasingly valuable. Nurses who can conduct and interpret quantitative research are more likely to secure leadership roles, contribute to policy development, and influence positive change in healthcare systems.

How to Choose Quantitative Research Topics

Selecting suitable quantitative research topics for nursing students is the first and often the most critical step in the research process. Here are some tips for nursing students on how to choose the right quantitative research topic:

Opt for a topic that aligns with your interests and career goals. Research is a long journey, and enthusiasm for your topic will sustain your motivation.

Feasibility

Consider the resources available to you. Assess the feasibility of data collection, analysis, and the overall research process. A well-planned study within your means is more likely to succeed.

Literature Review

Conduct a thorough literature review to identify gaps in existing research. Your topic should address an unanswered question or provide a fresh perspective on an existing issue.

Consult with Advisors

Seek guidance from your professors or mentors. They can help you refine your research question and provide valuable insights based on their experience.

200+ Quantitative Research Topics for Nursing Students

Now, let’s explore a range of quantitative research topics that nursing students can consider across different subfields:

Nursing Workforce and Patient Outcomes

• The Impact of Nurse-Patient Ratios on Patient Outcomes in Critical Care Units.
• Assessing the Relationship Between Nurse Staffing Levels and Falls Among Hospitalized Patients.
• The Effect of Nursing Workload on Medication Errors in Acute Care Settings.
• Investigating the Influence of Nurse Experience on Surgical Site Infections.
• Nurse Burnout and Its Consequences on Patient Safety and Satisfaction.
• Examining the Link Between Nurse-to-Patient Ratios and Pressure Ulcer Development.
• The Role of Nurse Education and Certification in Reducing Hospital Readmissions.
• Assessing the Impact of Nursing Leadership Styles on Patient Outcomes.
• Investigating the Association Between Nurse Retention Rates and Patient Mortality.
• The Effect of Multidisciplinary Team Collaboration on Patient Care in Oncology Units.
• Nurse-Patient Communication and Its Effect on Pain Management in Postoperative Patients.
• The Influence of Nurse Staffing on the Length of Hospital Stay for Surgical Patients.
• Examining the Relationship Between Nurse-Patient Ratios and Delirium in Elderly Patients.
• The Impact of Shift Length and Overtime on Nurse Performance and Patient Safety.
• Assessing the Effectiveness of Nurse-Managed Early Warning Systems in Identifying Deteriorating Patients.
• Investigating the Link Between Nurse Workforce Diversity and Cultural Competence in Patient Care.
• Nurse-to-Patient Ratios and the Incidence of Healthcare-Associated Infections in Long-Term Care Facilities.
• The Role of Nursing Workforce Development Programs in Enhancing Patient-Centered Care.
• Exploring the Effect of Nurse Staffing Levels on Patient Satisfaction and Hospital Ratings.
• Nurse Burnout and Its Influence on Discharge Planning and Patient Education.

Telehealth and Remote Monitoring

• The Effectiveness of Telehealth in Improving Access to Mental Health Services in Rural Areas.
• Assessing the Impact of Remote Monitoring on Medication Adherence Among Chronic Disease Patients.
• Telehealth for Pediatric Care: Examining Parental Satisfaction and Child Outcomes.
• Investigating the Use of Telehealth in Post-Operative Care and Its Effect on Recovery Rates.
• Telehealth and Diabetes Management: A Comparative Analysis of Telemedicine vs. Traditional Care.
• The Role of Telehealth in Preventive Care: Evaluating its Effectiveness in Promoting Healthier Lifestyles.
• Telehealth for Stroke Rehabilitation: A Study on Functional Outcomes and Cost Savings.
• Telemedicine in Mental Health Crisis Intervention: Assessing Crisis Resolution and Patient Satisfaction.
• Exploring the Use of Wearable Devices and Remote Monitoring in Monitoring Elderly Patients’ Health.
• Telehealth and Chronic Pain Management: A Comparative Study of Virtual vs. In-Person Consultations.
• The Impact of Telehealth on Reducing Hospital Readmissions Among Heart Failure Patients.
• Telehealth and Maternal Care: Investigating its Role in Prenatal Monitoring and Postpartum Support.
• Telemedicine in Emergency Medical Services: Evaluating its Effectiveness in Triage and Decision-Making.
• Telehealth and Home-Based Palliative Care: A Study on Patient Comfort and Quality of Life.
• Remote Monitoring of COVID-19 Patients: Assessing its Role in Early Detection of Complications.
• Telehealth for Geriatric Care: Analyzing its Impact on Aging-in-Place and Independence.
• Investigating the Cost-Effectiveness of Telehealth Interventions in Managing Obesity and Weight Loss.
• Telemedicine in Speech Therapy for Children with Speech Disorders: Evaluating Speech Outcomes.
• Telehealth for Dermatology Consultations: A Comparative Analysis of Diagnostic Accuracy.
• The Use of Telehealth in Mental Health Crisis Intervention for Veterans: Assessing PTSD Symptom Reduction.

Mental Health Nursing

• The Efficacy of Telehealth Interventions in Providing Mental Health Support to Remote or Underserved Populations.
• Assessing the Impact of Peer Support Programs on the Recovery of Individuals with Severe Mental Illness.
• Exploring the Relationship Between Childhood Trauma and the Development of Mental Health Disorders in Adulthood.
• The Role of Mindfulness-Based Interventions in Reducing Anxiety and Depression Among College Students.
• Investigating the Effectiveness of Art Therapy in Improving Emotional Regulation in Adolescents with Behavioral Disorders.
• Assessing the Impact of Music Therapy on Agitation Levels in Dementia Patients in Long-Term Care Facilities.
• The Influence of Nurse-Administered Cognitive Behavioral Therapy on Depression Remission Rates.
• Exploring the Use of Digital Mental Health Apps in Improving Treatment Adherence Among Individuals with Bipolar Disorder.
• Investigating the Association Between Sleep Patterns and Mental Health Outcomes in Adolescents.
• The Effect of Family Involvement in Therapy on the Outcomes of Schizophrenia Patients.
• Evaluating the Role of Mental Health Nurses in Suicide Prevention and Postvention Strategies.
• Assessing the Effectiveness of School-Based Mental Health Programs in Reducing Bullying and Its Impact on Mental Health.
• Exploring the Use of Animal-Assisted Therapy in Reducing Anxiety and Depression in Psychiatric Patients.
• Investigating the Relationship Between Social Media Use and Mental Health in Young Adults.
• The Impact of Cultural Competence Training on Mental Health Care Delivery for Diverse Populations.
• Assessing the Effect of Physical Activity and Exercise Programs on the Mental Health of Individuals with Schizophrenia.
• Exploring the Role of Gender Identity and Sexual Orientation in Mental Health Disparities and Access to Care.
• Investigating the Influence of Stigma on Help-Seeking Behavior Among Individuals with Mental Health Disorders.
• The Effectiveness of Psychoeducation Programs in Reducing Relapse Rates in Individuals with Bipolar Disorder.
• Assessing the Impact of Trauma-Informed Care in Mental Health Settings on Patient Outcomes and Staff Well-being.

Pediatric Nursing

• The Impact of Parental Involvement in Pediatric Pain Management.
• The Effectiveness of Child Life Specialists in Reducing Pediatric Anxiety During Medical Procedures.
• Assessing the Role of Pediatric Nurse Practitioners in Early Childhood Development Screening.
• Investigating the Relationship Between Pediatric Obesity and Long-Term Health Outcomes.
• Exploring the Use of Play Therapy in Pediatric Pain Management.
• The Impact of Pediatric Palliative Care on Quality of Life for Seriously Ill Children and Their Families.
• The Role of School Nurses in Promoting Mental Health Awareness Among School-Aged Children.
• Investigating the Efficacy of Pediatric Vaccination Education Programs in Increasing Immunization Rates.
• The Effect of Parenting Styles on Pediatric Asthma Management and Control.
• Assessing the Impact of Pediatric Sickle Cell Disease Management Programs on Disease Outcomes.
• Exploring the Influence of Family-Centered Care on Pediatric Hospitalization Experiences.
• The Relationship Between Childhood Trauma and Mental Health Outcomes in Adolescents.
• Investigating the Effectiveness of Pediatric Telehealth Services for Rural and Underserved Populations.
• The Impact of Pediatric Nursing Interventions on Neonatal Abstinence Syndrome in Infants Born to Substance-Using Mothers.
• Assessing the Efficacy of Pediatric Nutrition Education Programs in Reducing Childhood Obesity Rates.
• Exploring the Use of Technology and Apps for Pediatric Diabetes Management.
• The Role of Pediatric Nurses in Early Detection and Intervention for Developmental Delays.
• Investigating the Relationship Between Childhood Vaccination Rates and School Immunization Policies.
• The Effect of Child Abuse Prevention Programs on Reducing Child Maltreatment Incidents.
• Assessing the Impact of Pediatric Pain Assessment Tools on Pain Management Practices in Pediatric Settings.

Gerontological Nursing

• The Impact of Comprehensive Geriatric Assessment on Hospital Readmission Rates in Elderly Patients with Multiple Comorbidities.
• Evaluating the Effectiveness of Fall Prevention Interventions in Nursing Homes for Older Adults with Dementia.
• The Role of Family Caregivers in Managing Chronic Illnesses and Maintaining Quality of Life for Elderly Patients.
• Investigating the Relationship Between Social Isolation and Cognitive Decline in the Aging Population.
• Assessing the Effectiveness of Palliative Care Services in Improving End-of-Life Quality for Elderly Patients.
• The Influence of Nutrition and Diet on Functional Independence in Older Adults.
• Examining the Impact of Gerontological Nursing Education on the Competence and Confidence of Nursing Students in Caring for Older Adults.
• Exploring the Role of Exercise and Physical Activity in Preventing Falls and Fractures in Elderly Individuals.
• The Effect of Medication Management Programs on Medication Adherence and Health Outcomes in Older Adults.
• Investigating the Prevalence and Risk Factors of Elder Abuse in Long-Term Care Facilities.
• Assessing the Impact of Cognitive Training Programs on Delaying the Onset of Alzheimer’s Disease in Older Adults.
• Exploring the Relationship Between Sleep Quality and Cognitive Function in the Aging Population.
• The Role of Gerontological Nurses in Promoting Advance Care Planning and End-of-Life Decision-Making in Older Adults.
• Evaluating the Effectiveness of Home-Based Telehealth Services in Managing Chronic Conditions for Elderly Patients Living Alone.
• Investigating the Influence of Multimorbidity on Healthcare Utilization and Quality of Life in Older Adults.
• The Impact of Music Therapy on Emotional Well-Being and Quality of Life in Nursing Home Residents with Dementia.
• Assessing the Effectiveness of Interventions to Reduce Polypharmacy in Older Adults.
• Exploring the Role of Gerontological Nurses in Addressing Loneliness and Social Isolation in Older Adults.
• The Relationship Between Oral Health and Overall Health in the Aging Population: Implications for Nursing Care.
• Investigating the Use of Robotics and Assistive Technologies in Promoting Independence and Quality of Life for Older Adults.

Women’s Health Nursing

• The Impact of Midwife-Led Care on Maternal and Neonatal Outcomes.
• Assessing the Effectiveness of Prenatal Education Programs in Reducing Maternal Anxiety and Stress.
• Investigating the Relationship Between Maternal Nutrition and Birth Weight in Low-Income Communities.
• The Role of Postpartum Support in Preventing Postpartum Depression.
• Exploring the Barriers to Accessing Reproductive Health Services Among Underserved Women.
• Evaluating the Effectiveness of Intimate Partner Violence Screening and Intervention in Obstetric Care.
• The Association Between Breastfeeding Duration and Postpartum Weight Loss in Mothers.
• Assessing the Impact of Menopause Education Programs on Women’s Quality of Life.
• Investigating the Role of Nurse Practitioners in Providing Comprehensive Menopausal Care.
• The Effect of Body Image and Self-Esteem on Women’s Health Behaviors.
• Exploring Factors Influencing Women’s Decision-Making Regarding Contraceptive Methods.
• Evaluating the Efficacy of Sex Education Programs in Preventing Teenage Pregnancy.
• The Relationship Between Fertility Awareness-Based Methods and Contraceptive Efficacy.
• Assessing the Effect of Pelvic Floor Muscle Training in Managing Urinary Incontinence in Women.
• Investigating the Impact of Hormone Replacement Therapy on Cardiovascular Health in Postmenopausal Women.
• The Role of Preconception Health Promotion in Reducing Adverse Pregnancy Outcomes.
• Exploring the Use of Telehealth for Gynecological Consultations and Follow-Up.
• The Association Between Body Mass Index (BMI) and Infertility in Women.
• Assessing the Effectiveness of Nurse-Led Support Groups for Women with Polycystic Ovary Syndrome (PCOS).
• Investigating the Influence of Cultural and Socioeconomic Factors on Maternal Health Disparities in Minority Populations.

Community Health Nursing

• The Impact of Community Health Education Programs on Smoking Cessation Rates in High-Risk Populations.
• Evaluating the Effectiveness of School-Based Nutrition Interventions in Reducing Childhood Obesity.
• Assessing the Role of Community Health Nurses in Promoting Vaccination Compliance and Preventing Infectious Disease Outbreaks.
• Investigating the Relationship Between Access to Green Spaces and Mental Health in Urban Communities.
• The Effect of Community-Based Diabetes Management Programs on Glycemic Control and Health Outcomes.
• Exploring the Challenges and Strategies in Providing Culturally Competent Care in Diverse Community Settings.
• The Influence of Social Determinants of Health on Health Disparities in Underserved Communities.
• Assessing the Impact of Mobile Health (mHealth) Apps in Promoting Healthy Lifestyles in Rural Areas.
• Investigating the Role of Community Health Nurses in Disaster Preparedness and Response.
• The Effectiveness of Community Health Worker (CHW) Programs in Reducing Healthcare Costs and Hospital Readmissions.
• Exploring the Relationship Between Community Health Nursing Interventions and Reductions in Substance Abuse Rates.
• Evaluating the Impact of Maternal and Child Health Programs on Infant Mortality Rates in Low-Income Communities.
• Assessing the Effectiveness of Community-Based Mental Health Support Services in Preventing Hospitalizations.
• Investigating the Influence of Community Health Promotion Campaigns on Immunization Rates.
• The Role of Community Health Nurses in Addressing the Opioid Epidemic Through Harm Reduction Strategies.
• Exploring the Impact of Community Health Initiatives on Improving Access to Healthcare Services in Rural Areas.
• Assessing the Effect of Home Visiting Programs on Maternal and Child Health Outcomes.
• Investigating the Relationship Between Food Insecurity and Chronic Disease Management in Urban Communities.
• The Effectiveness of Telehealth Services in Providing Mental Health Support to Underserved Populations.
• Exploring the Implementation of Community-Based Palliative Care Programs and Their Impact on Quality of Life for Terminally Ill Patients.

Nursing Education and Training

• The Impact of Simulation-Based Training on Nursing Student Competency.
• Evaluating the Effectiveness of Blended Learning Models in Nursing Education.
• Assessing the Integration of Cultural Competence Training in Nursing Curricula.
• Investigating the Role of Interprofessional Education in Preparing Nursing Students for Collaborative Practice.
• The Influence of Emotional Intelligence Training on Nursing Students’ Interpersonal Skills.
• Exploring the Use of Virtual Reality (VR) and Augmented Reality (AR) in Nursing Education.
• The Effect of Peer Mentoring Programs on Retention and Success Rates of Nursing Students.
• Analyzing the Efficacy of Team-Based Learning in Nursing Curriculum.
• Investigating the Impact of Preceptorship Programs on Transition to Practice for New Graduates.
• Assessing the Role of Reflective Practice in Developing Clinical Decision-Making Skills in Nursing Students.
• The Influence of Evidence-Based Practice (EBP) Training on Nursing Student’s EBP Implementation.
• Exploring the Integration of Mindfulness and Resilience Training in Nursing Education.
• Investigating the Use of Social Media and Technology in Enhancing Nursing Education.
• Assessing the Role of Nursing Simulation Centers in Improving Clinical Competence.
• The Effect of Cultural Immersion Experiences on Cultural Competency Development in Nursing Students.
• Analyzing the Impact of High-Fidelity Patient Simulators on Critical Thinking Skills in Nursing Education.
• Investigating the Use of Competency-Based Education in Nursing Programs.
• Assessing the Role of Clinical Reasoning Development in Nursing Education.
• The Influence of Team-Based Care Training on Nursing Students’ Understanding of Collaborative Healthcare Models.
• Exploring Strategies to Enhance Clinical Placement Experiences for Nursing Students.

Healthcare Quality and Patient Safety

• The Impact of Electronic Health Records (EHRs) on Patient Safety and Data Accuracy.
• Strategies to Reduce Medication Errors in Hospital Settings.
• The Role of Nurse Staffing Levels in Preventing Adverse Patient Outcomes.
• Assessing the Effectiveness of Rapid Response Teams in Hospitals.
• Investigating the Relationship Between Hospital Accreditation and Patient Safety.
• The Use of Human Factors Engineering to Enhance Healthcare Quality and Patient Safety.
• Evaluating the Implementation of Surgical Safety Checklists and Their Impact on Surgical Complications.
• Analyzing the Link Between Hand Hygiene Compliance and Hospital-Acquired Infections.
• The Role of Patient and Family Engagement in Promoting Healthcare Quality and Safety.
• Investigating the Effect of Healthcare Provider Burnout on Patient Safety.
• Assessing the Impact of Telemedicine on Patient Safety and Care Quality.
• Strategies for Reducing Diagnostic Errors in Healthcare.
• The Role of Artificial Intelligence (AI) and Machine Learning in Predicting and Preventing Patient Safety Incidents.
• Examining the Influence of Organizational Culture on Patient Safety Practices.
• The Effectiveness of Team-Based Training in Enhancing Communication and Reducing Errors in Healthcare.
• Investigating the Relationship Between Nurse Leadership Styles and Patient Safety Culture.
• Assessing the Impact of Patient Safety Initiatives on Healthcare Costs.
• Strategies for Improving Patient Handoff Communication to Enhance Continuity of Care.
• Analyzing the Effect of Healthcare Policy Changes on Patient Safety Outcomes.
• The Role of Interdisciplinary Collaboration in Enhancing Healthcare Quality and Patient Safety.

Cultural Competence in Nursing

• The Impact of Cultural Competence Training on Nurses’ Knowledge, Attitudes, and Practices in Diverse Healthcare Settings.
• Exploring the Role of Cultural Competence in Reducing Health Disparities Among Minority Populations.
• Assessing the Influence of Cultural Competence on Patient-Centered Care and Patient Satisfaction.
• The Relationship Between Language Proficiency and Effective Communication in Cross-Cultural Nursing Care.
• Investigating the Effect of Cultural Competence on Nursing Student Preparedness for Providing Culturally Sensitive Care.
• The Influence of Cultural Competence on Nurse-Patient Trust and Rapport Building in Multicultural Healthcare Settings.
• Evaluating the Impact of Cultural Competence Education on Nursing Curricula and Program Outcomes.
• Exploring the Challenges and Barriers Faced by Nurses in Providing Culturally Competent Care.
• The Effect of Cultural Competence on Medication Adherence and Health Outcomes Among Diverse Patient Groups.
• Assessing the Cultural Competence of Healthcare Organizations and Its Relationship to Quality of Care.
• Investigating the Influence of Cultural Competence on Ethical Decision-Making in Nursing Practice.
• The Role of Cultural Competence in Reducing Healthcare Misdiagnoses and Medical Errors.
• Exploring the Effectiveness of Cultural Competence Models and Frameworks in Nursing Education.
• Assessing the Cultural Competence of Nursing Leadership and Its Impact on Staff Morale and Retention.
• Investigating the Influence of Cultural Competence on End-of-Life Care Preferences and Decision-Making in Diverse Populations.
• The Relationship Between Cultural Competence and the Delivery of Culturally Tailored Health Promotion Programs.
• Evaluating the Role of Cultural Competence in Shaping Nursing Practice Guidelines and Protocols.
• Exploring the Impact of Cultural Competence on the Management of Chronic Diseases in Culturally Diverse Patient Populations.
• Assessing the Effectiveness of Culturally Competent Care in Reducing Hospital Readmission Rates.
• Investigating the Link Between Cultural Competence and Health Equity Initiatives in Healthcare Systems.

Tips for Conducting Quantitative Nursing Research

Now that you have a glimpse of potential research topics, it’s essential to understand the key steps involved in conducting quantitative nursing research:

• Research Design and Methodology: Choose the most appropriate research design (e.g., cross-sectional, longitudinal, experimental) and methodology (e.g., surveys, experiments) for your research question.
• Data Collection Methods: Determine how you’ll collect data. Will it involve surveys, observations, or analysis of existing datasets? Ensure your data collection methods align with your research design.
• Data Analysis Techniques: Familiarize yourself with statistical analysis tools and techniques (e.g., regression analysis , t-tests) to analyze your data accurately.
• Data Management: Develop a robust data management plan to organize, store, and protect your research data. Adherence to ethical data handling is crucial.
• Ethical Considerations: Always prioritize ethical principles in your research. Obtain informed consent from participants, maintain confidentiality, and seek ethical approval if required.

Resources for Nursing Students

To support your journey in quantitative research topics for nursing students, here are some recommended resources:

• “Nursing Research: Generating and Assessing Evidence” by Denise F. Polit and Cheryl Tatano Beck.
• “Quantitative Research in Nursing and Healthcare” by Immy Holloway and Stephanie Wheeler.
• “Journal of Nursing Scholarship”
• “Research in Nursing & Health”

Online Resources

• The National Institute of Nursing Research (NINR) offers valuable research resources and funding opportunities.
• Online courses and webinars on research methods and statistical analysis (e.g., Coursera, edX).

Quantitative research is an indispensable tool for nursing students looking to make a meaningful impact in their field. By choosing the right quantitative research topics for nursing students and following ethical research practices, nursing students can contribute to the body of nursing knowledge, improve patient care, and advance their careers. 

So, don’t hesitate to embark on your quantitative research journey, and let your curiosity and passion drive you toward excellence in nursing practice.

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Mixed Methods in Nursing Research : An Overview and Practical Examples

Ardith z. doorenbos.

School of Nursing, University of Washington, USA, Box 357266, Seattle, WA 98177

Mixed methods research methodologies are increasingly applied in nursing research to strengthen the depth and breadth of understanding of nursing phenomena. This article describes the background and benefits of using mixed methods research methodologies, and provides two examples of nursing research that used mixed methods. Mixed methods research produces several benefits. The examples provided demonstrate specific benefits in the creation of a culturally congruent picture of chronic pain management for American Indians, and the determination of a way to assess cost for providing chronic pain care.

Introduction

Mixed methods is one of the three major research paradigms: quantitative research, qualitative research, and mixed methods research. Mixed methods research combines elements of qualitative and quantitative research approaches for the broad purpose of increasing the breadth and depth of understanding. The definition of mixed methods, from the first issue of the Journal of Mixed Methods Research, is “research in which the investigator collects and analyzes data, integrates the findings, and draws inferences using both qualitative and quantitative approaches or methods in a single study or program of inquiry” ( Tashakkori & Creswell, 2007 , p.4).

Mixed methods research began among anthropologists and sociologists in the early 1960s. In the late 1970s, the term “triangulation” began to enter methodology conversations. Triangulation was identified as a combination of methodologies in the study of the same phenomenon to decrease the bias inherent in using one particular method ( Morse, 1991 ). Two types of sequencing for mixed methods design have been proposed: simultaneous and sequential. Type of sequencing is one of the key decisions in mixed methods study design. Simultaneous sequencing is postulated to be simultaneous use of qualitative and quantitative methods, where there is limited interaction between the two sources of data during data collection, but the data obtained is used in the data interpretation stage to support each method's findings and to reach a final understanding. Sequential sequencing is postulated to be the use of one method before the other, as when the results of one method are necessary for planning the next method.

Since the 1960s, the use of mixed methods has continued to grow in popularity ( O'Cathain, 2009 ). Currently, although there are numerous designs to consider for mixed methods research, the four major types of mixed methods designs are triangulation design, embedded design, explanatory design, and exploratory design ( Creswell & Plano Clark, 2007 ). The most common and well-known approach to mixed methods research continues to be triangulation design.

There are many benefits to using mixed methods. Quantitative data can support qualitative research components by identifying representative patients or outlying cases, while qualitative data can shed light on quantitative components by helping with development of the conceptual model or instrument. During data collection, quantitative data can provide baseline information to help researchers select patients to interview, while qualitative data can help researchers understand the barriers and facilitators to patient recruitment and retention. During data analysis, qualitative data can assist with interpreting, clarifying, describing, and validating quantitative results.

Four broad types of research situations have been reported as benefiting particularly from mixed methods research. The first situation is when concepts are new and not well understood. Thus, there is a need for qualitative exploration before quantitative methods can be used. The second situation is when findings from one approach can be better understood with a second source of data. The third situation is when neither a qualitative nor a quantitative approach, by itself, is adequate to understanding the concept being studied. Lastly, the fourth situation is when the quantitative results are difficult to interpret, and qualitative data can assist with understanding the results ( Creswell & Plano Clark, 2007 ).

The purpose of this article is to illustrate mixed methods methodology by using examples of research into the chronic pain management experience among American Indians. These examples demonstrate the methodology used to provide (a) a detailed multilevel understanding of the chronic pain care experience for American Indians using triangulation design (multilevel model), and (b) a comparison of cost for two different chronic pain care delivery models, also using triangulation design (data transformation model).

An Example : Understanding the Pain Management Experience Among American Indians

Chronic pain poses unique challenges to the American health care system, including ever-escalating costs, unintentional poisonings and deaths from overdoses of painkillers, and incalculable suffering for patients as well as their families. Approximately 100 million adults in the United States are affected by chronic pain, with treatment costs and losses in productivity totaling $635 billion annually ( Institute of Medicine, 2011 ). Symptoms of pain are the leading reason patients visit health care providers ( Hing, Cherry, & Woodwell, 2006 ).

At the level of the community-based primary care provider, especially in tribal areas of the United States, there is often not enough capacity to manage complex chronic pain cases, and this is often due to lack of access to specialty pain care ( Momper, Delva, Tauiliili, Mueller-Williams, & Goral, 2013 ). The American Indian population in particular is underserved by health care and the most vulnerable to the impact of chronic pain, with high rates of drug poisoning due to opioid analgesics ( Warner, Chen, Makuc, Anderson, & Minino, 2011 ). There are 2.9 million people who report exclusive and an additional 1.6 million who report partial American Indian ancestry in the United States. They are a diverse group, residing in 35 states and organized into 564 federally recognized tribes ( U.S. Census Bureau, 2010 ). However, there is a scarcity of published literature exploring the experience, epidemiology, and management of pain among American Indians ( Haozous, Knobf, & Brant, 2010 ; Haozous & Knobf, 2013 ; Jimenez, Garroutte, Kundu, Morales, & Buchwald, 2011 ).

Using Mixed Methods to Overcome Barriers to Research

Barriers to effective research into chronic pain management among American Indians include the relatively small number of American Indian patients in any circumscribed area or tribe, the limitations of individual databases, and widespread racial misclassification. A mixed methods research approach is needed to understand the complex experience, epidemiology, and management of chronic pain among American Indians and to address the strengths and weaknesses of quantitative methodologies (large sample size, trends, generalizable) with those of qualitative methodologies (small sample size, details, in-depth).

This first example is from an ongoing study that uses triangulation design to provide a better understanding of the phenomenon of chronic pain management among American Indians. The study uses a multilevel model in which quantitative data collected at the national and state levels will be analyzed in parallel with the collection and analysis of the qualitative data at the patient level (see Figure 1 ). This allows the weakness of one approach to be offset by the strengths of the other. The results of the separate level analyses will be compared, contrasted, and blended leading to an overall interpretation of results.

Role of quantitative data

Previous examination of U.S. national databases has reported a higher prevalence of lower back pain in American Indians than in the general population (35% compared to 26% ; Deyo, Mirza, & Martin, 2002 ). Thus, at level 1, quantitative administrative data sets representing health care received by American Indians, both across the United States and in broad regions, will be used to evaluate macro-level trends in utilization of health care and in basic outcomes, such as opioid-related deaths.

At level 2, more detailed quantitative Washington state tribal clinic data will be used to identify American Indian populations, evaluate breakdowns in the delivery of care, and identify processes that lead to unsuccessful outcomes. For example, in a study conducted with community health practitioners in Alaska, participants reported low levels of knowledge and comfort around discussing cancer pain ( Cueva, Lanier, Dignan, Kuhnley, & Jenkins, 2005 ).

Role of qualitative data

At level 3, qualitative research through focus groups and key informant interviews will provide even more refined information about perceptions of recommended and received care. These interviews will provide insight into selected immediate and proximal factors. These factors include patients' choice and use of services; attitudes, motivations, and perceptions that influence their decisions; interpersonal factors, such as social support; and perceived discrimination. This qualitative data will shed light on potential barriers to care that are not easily recognized in administrative or clinical records, and thereby will provide greater detail about patient views of chronic pain care.

Role of (qualitative) indigenous methodologies

Since the focus of this study is on the chronic pain experience among American Indian patients, it is important that the qualitative work in level 3 be guided by indigenous methodologies, in both data collection and analysis. The phrase “indigenous methodologies” refers to an evolving framework for creating research that places the epistemologies of indigenous participants and communities at the center of the work, while building an equitable and respectful setting for bidirectional learning ( Evans, Hole, Berg, Hutchinson, & Sookraj, 2009 ; Louis, 2007 .; Smith, 2004 ). Although the tenets of indigenous methodologies vary according to the source, there is agreement among sources that research with indigenous populations should be wellness-oriented, holistic, community-oriented, and focused on indigenous knowledge, and should incorporate bidirectional learning ( Louis, 2007 ; Smith, 2004 ).

The ongoing project aligns with these guidelines by building knowledge about the chronic pain experience from the perspective of American Indian patients. The data is being interpreted with the goal of designing a usable and relevant model that will resonate at the American Indian community level. The researchers have conducted focus groups with the needs and priorities of the participants placed at the forefront, to best achieve the goals of learning and building knowledge that reflects the participants' experiences. Specifically, the focus groups were scheduled within three tribes, ensuring high familiarity and social support among group members. These focus groups met either at a tribal community center or in a nearby tribally owned casino in the evening. Each focus group started with a dinner, followed by discussion.

The focus group facilitator was well-known to the community, and although not American Indian, had been an active participant in community events and had provided expert knowledge and consultation to the tribes. Additionally, each focus group was co-facilitated by a tribal elder. The high familiarity among the participants and the research team was an important component of the bidirectional learning: it helped reduce much of the mistrust that has historically prevented medical researchers from obtaining high-quality data in similarly vulnerable populations ( Guadagnolo, Cina, & Helbig, 2009 ).

Benefits of Triangulation Design: Multilevel Model

In summary, only a mixed methods study that included quantitative and qualitative methods could provide the data required for a comprehensive multilevel assessment of the chronic pain experience among American Indians. Although this study is ongoing, the plan is for a nationwide analysis of variations in chronic pain outcomes among American Indians to examine the structure of service delivery and organization. Analysis of the state tribal clinic data will address intermediate factors and will examine community-level variation in pain management and local access to pain specialists. Preliminary analysis of the focus group data has already demonstrated that there is insufficient pain management among American Indians, due in part to lack of knowledge about pain management among providers and lack of access to pain specialists.

An Example; Comparing the Costs of Two Models for Providing Chronic Pain Care to American Indians

Telehealth is one innovative approach to providing access to high-quality interdisciplinary pain care for American Indians. A telehealth model with a unique approach based on provider-to-provider videoconference consultations allows community-based providers to present complex chronic pain cases to a panel of pain specialists through a videoconferencing infrastructure that also incorporates longitudinal outcomes tracking to monitor patient progress. Telehealth is an innovative model of health care delivery, and its use among American Indians has been expanding over the past several years ( Doorenbos et al., 2010 ; Doorenbos et al., 2011a ; 2011b ). Although the use of telehealth for providing chronic pain consultation is still in early stages, the long-term effectiveness of this approach and its impact on increasing capacity for pain management among community providers is being investigated ( Haozous et al., 2012 ; Tauben, Towle, Gordon, Theodore, & Doorenbos, 2013 ). The mixed methods approach for this transaction cost analysis used a unique triangulation design with a data transformation model to build a body of evidence for telehealth pain management.

With ever increasing mandates to reduce the cost and increase the quality of pain management, health care institutions are faced with the challenge of demonstrating that new technologies provide value while maintaining or even improving the quality of care ( Harries & Yellowlees, 2013 ). Transaction cost analysis can provide this evidence by using mixed methods research methodologies to provide comparative evaluation of the costs and consequences of using alternative technologies and the accompanying organizational arrangements for delivering care ( Williamson, 2000 ).

The theory of transaction cost developed from the observation that our structures for governing transactions—the ways in which we organize, manage, support, and carry out exchange — have economic consequences ( Williamson, 1991 ). Though prices matter, this theory recognizes that prices can and do deviate from the cost of production and do not include the cost of transacting ( Coase, 1960 ). Setting aside neoclassical economic conceptions of price, output, demand, and supply, the transaction becomes the unit of analysis ( Williamson, 1985 ).

In transactions, there are typically two parties engaging in the exchange of goods or services, and both exert effort to carry out the transaction, incurring costs in the hope or with the expectation of realizing benefits. Some ways of structuring or supporting a given transaction, such as consultation or treatment for a patient from a health care provider, may be more efficient than others. The analysis examines the actual costs incurred and the related consequences experienced by the parties over time, with the hypothesis that efficiency results from the discriminating alignment of transactions with alternative, more efficient structures of governance ( Williamson, 2002 ).

Specialty health care services participating in the study described here included the University of Washington (UW) Center for Pain Relief and the UW TelePain program. The UW Center for Pain Relief is an outpatient multispecialty consultation and treatment clinic that uses the assembled expertise and skills of physicians and other medical team providers to assist in diagnosis and care for chronic pain, for example for people with painful disorders that have persisted beyond expected duration, or for people who have persistent uncontrolled pain despite appropriate treatment for the underlying medical condition. The clinic also offers pain consultation and treatment for a variety of new-onset or acute problems that may benefit from selective anesthetic procedures, such as nerve blocks or spinal nerve root compression.

The UW TelePain program serves tribal providers in the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region. These tribal providers include primary care physicians, physician assistants, and nurse practitioners. The tribal providers have access to weekly videoconferences both with other community providers and with university-based pain and symptom management experts. During videoconferences, providers manage cases, engage in evidence-based practice activities, and receive peer support. Throughout the process, these community providers are responsible for direct patient care, and they act on recommendations of the consulting pain specialists.

The two care delivery models discussed above — traditional in-clinic consultation at the Center for Pain Relief and telehealth case consultation through TelePain — provided this mixed methods study using triangulation design and a data transformation model with two comparative arrangements for delivering the same transaction: delivery of pain care to patients (see Figure 2 ).

Qualitative and Quantitative Data Collection Procedures

Participant observation and structured interviews were used to identify and describe two comparable completed transactions for patients with chronic pain. Members of the clinical care teams selected one transaction from each service for which the care could be said to represent the routines and norms of their health care organization. The chosen transactions were carried out with patients of the same gender, similar age, and similar health characteristics. For the study, clinical care teams from each service provided two qualitative on-site interviews documenting clinical work flow and processes (i.e., the steps in the transaction). For the in-clinic transaction, members of the clinical care team interviewed included a nurse care coordinator, pain specialist, medical assistant, patient outcomes assessment coordinator, nurse triage manager, patient support services supervisor, and financial authorization specialist. For the Tele-Pain transaction, team members interviewed included the TelePain nurse care coordinator, two pain specialists, an information technology specialist, and the clinic provider.

The following details the process of the mixed methods analysis. First, individual steps, or discrete tasks, within each transaction (in-clinic versus TelePain) were identified using qualitative interviews and itemized in detail. Details from the qualitative data included a description of each task, the person (s) engaged, the duration of engagement of each person in minutes, the information accrued to the patient's medical record, the technologies employed, and the locations where tasks were conducted and information was transmitted or stored.

The quantitative data collected included date and time, and therefore duration in business days, that accumulated with each step in the transaction. Finally, the costs of each step collected from the qualitative data were identified and transformed into quantitatively estimated data for each transaction. Analysis focused on the primary costs in health care: the value of people's time. These values were limited to labor costs for the in-clinic and telehealth personnel; proxies for the value of time were used with estimates of time for the patient. Costs were estimated as a function of time spent per task and per patient, and the actual wage, including benefits, of personnel engaged in the transaction.

Qualitative and Quantitative Data Analysis

Personal identifiable information was redacted from each patient's medical record, and the records were reviewed for comparability as well as for norms and routines of care for the in-clinic and telehealth organizations. The characteristics of the two patients were similar. Both were first-time patients to their respective organizations, and were referred by their primary care providers for specialized care. The reasons for seeking care and report of conditions potentially related to chronic pain were similar. Both transactions resulted in a consultation recommending referral for additional specialized care or treatment.

Two work flows, one in-clinic and one telehealth, were developed by documenting actual tasks undertaken during the transactions. In follow-up interviews, these work flows were presented to participants for review and comment. These interviews resulted in a complete itemized list of dates, personnel, and time spent per person on discrete steps or tasks. Tables and graphs expressing the steps, with cost accrual over time and in sum, were developed and compared for each transaction, to each other, and with respect to participants' rationales for the tasks in each transaction.

The equation expressing the cost per transaction is as follows, where the total cost of the transaction ( C T ) is the sum of the costs of each discrete task ( k i ) in the transaction, measured per participant ( x, y, z …) on the task, as the product of time ( t ) and wage rate ( w ), or in the case of the patient ( x, y, z …), a proxy for the value of time ( w ) and estimated time ( t ).

In total, 46 discrete steps were taken for the typical in-clinic transaction at the UW Center for Pain Relief (one patient case, reviewed by two pain specialists) versus 27 steps for the typical TelePain transaction (three patient cases, reviewed by six pain specialists). The greater number and types of administrative steps taken to schedule, execute, and follow up the in-clinic consultation resulted in greater duration of time between receipt of initial referral request and completion of the initial consultation with the pain specialists. A total of 153 business days (213 calendar days) elapsed between referral and the completion of the entire in-clinic transaction, versus 4 business days (4 calendar, days) for the TelePain transaction. Importantly, for the transaction at the UW Center for Pain Relief, 72 business days transpired before consultation concluded with a referral for the patient's record; the same conclusion was reached in 4 days in the TelePain transaction. These methods used to determine transaction costs provide an excellent example of mixed methods research, where both qualitative and quantitative data and analysis are needed to provide the transaction cost results.

Mixed methods are increasingly being used in nursing research. We have detailed two studies in which mixed methods research with triangulation design brought a richness to the examination of the phenomenon that a single methodology would not In the two examples described, a major advantage of the triangulation design is its efficiency, because both types of data are collected simultaneously. Each type of data can be collected and analyzed separately and independently, using the techniques traditionally associated with each data type. Both simultaneous and sequential data collection lend themselves to team research, in which the team includes researchers with both quantitative and qualitative expertise.

Challenges include the effort and expertise required due to the simultaneous data collection, and the fact that equal weight is usually given to each data type. Thus this research requires a team, or extensive training in both quantitative and qualitative methodologies, and careful adherence to the methodological rigor required for both methodologies. Nursing researchers may face the possibility of inconsistency in research findings arising from the objectivity of quantitative methods and the subjectivity of qualitative methods. In these cases, additional data collection may be required.

The first example, regarding the pain management experience among American Indians, used triangulation design in a multilevel model format. The multilevel model was useful in designing this study as different methods were needed at different levels to fully understand the complex health care system. In this example, quantitative data is being collected and analyzed at the national and state levels, and qualitative data is being collected at the patient level. Both qualitative and quantitative data are being collected simultaneously. The findings from each level will then be blended into one overall interpretation.

The second example, a transaction cost analysis, also used triangulation design, but the model used was that of data transformation. As in the multilevel model used in the first example, the data transformation model involved the separate but concurrent collection of qualitative and quantitative data. A novel step in this model involves transforming the qualitative data into quantitative data, and then comparing and interrelating the data sets. This required the development of procedures for transforming the qualitative data, related to, time spent on a step and salary of the provider, into quantitative cost data.

The two studies presented as examples demonstrate mixed methods research resulting in the creation of (a) a rich description of the American Indian chronic pain experience, and (b) a way to assess cost for providing chronic pain care via tribal clinics. In both examples, the quantitative data and their subsequent analysis provide a general understanding of the research problem. The qualitative data and their analysis refine and explain the results by exploring participants' views in more depth. Research using a single methodology would not have been able to achieve the same results.

Acknowledgments

Research reported in this paper was supported by the National Institute of Nursing Research of the National Institutes of Health under award number #R01NR012450 and the National Cancer Institute of the National Institutes of Health under award number #R42 CA141875. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Theoretical and Conceptual Frameworks

  Identify major characteristics of theories, conceptual models, and frameworks   Identify several conceptual models or theories frequently used by nurse researchers   Describe how theory and research are linked in quantitative and qualitative studies   Critique the appropriateness of a theoretical framework—or its absence—in a study   Define new terms in the chapter Key Terms    Conceptual framework    Conceptual map    Conceptual model    Descriptive theory    Framework    Middle-range theory    Model    Schematic model    Theoretical framework    Theory High-quality studies typically achieve a high level of conceptual integration . This happens when the research questions fit the chosen methods, when the questions are consistent with existing evidence, and when there is a plausible conceptual rationale for expected outcomes—including a rationale for any hypotheses or interventions. For example, suppose a research team hypothesized that a nurse-led smoking cessation intervention would reduce smoking among patients with cardiovascular disease. Why would they make this prediction—what is the “theory” about how the intervention might change people’s behavior? Do the researchers predict that the intervention will change patients’ knowledge? their attitudes? their motivation? The researchers’ view of how the intervention would “work” should drive the design of the intervention and the study. Studies are not developed in a vacuum—there must be an underlying conceptualization of people’s behaviors and characteristics. In some studies, the underlying conceptualization is fuzzy or unstated, but in good research, a defensible conceptualization is made explicit. This chapter discusses theoretical and conceptual contexts for nursing research problems. THEORIES, MODELS, AND FRAMEWORKS Many terms are used in connection with conceptual contexts for research, such as theories, models, frameworks, schemes, and maps. These terms are interrelated but are used differently by different writers. We offer guidance in distinguishing these terms as we define them. Theories In nursing education, the term theory is used to refer to content covered in classrooms, as opposed to actual nursing practice. In both lay and scientific language, theory connotes an abstraction . Theory is often defined as an abstract generalization that explains how phenomena are interrelated. As classically defined, theories consist of two or more concepts and a set of propositions that form a logically interrelated system, providing a mechanism for deducing hypotheses. To illustrate, consider reinforcement theory , which posits that behavior that is reinforced (i.e., rewarded) tends to be repeated and learned. The proposition lends itself to hypothesis generation. For example, we could deduce from the theory that hyperactive children who are rewarded when they engage in quiet play will exhibit fewer acting-out behaviors than unrewarded children. This prediction, as well as others based on reinforcement theory, could be tested in a study. The term theory is also used less restrictively to refer to a broad characterization of a phenomenon. A descriptive theory accounts for and thoroughly describes a phenomenon. Descriptive theories are inductive, observation-based abstractions that describe or classify characteristics of individuals, groups, or situations by summarizing their commonalities. Such theories are important in qualitative studies. Theories can help to make research findings interpretable. Theories may guide researchers’ understanding not only of the “what” of natural phenomena but also of the “why” of their occurrence. Theories can also help to stimulate research by providing direction and impetus. Theories vary in their level of generality. Grand theories (or macrotheories ) claim to explain large segments of human experience. In nursing, there are grand theories that offer explanations of the whole of nursing and that characterize the nature and mission of nursing practice, as distinct from other disciplines. An example of a nursing theory that has been described as a grand theory is Parse’s Humanbecoming Paradigm ( Parse, 2014 ). Theories of relevance to researchers are often less abstract than grand theories. Middle-range theories attempt to explain such phenomena as stress, comfort, and health promotion. Middle-range theories, compared to grand theories, are more specific and more amenable to empirical testing. Models A conceptual model deals with abstractions (concepts) that are assembled because of their relevance to a common theme. Conceptual models provide a conceptual perspective on interrelated phenomena, but they are more loosely structured than theories and do not link concepts in a logical deductive system. A conceptual model broadly presents an understanding of a phenomenon and reflects the assumptions of the model’s designer. Conceptual models can serve as springboards for generating hypotheses. Some writers use the term model to designate a method of representing phenomena with a minimal use of words, which can convey different meanings to different people. Two types of models used in research contexts are schematic models and statistical models. Statistical models , not discussed here, are equations that mathematically express relationships among a set of variables and that are tested statistically. Schematic models (or conceptual maps ) visually represent relationships among phenomena and are used in both quantitative and qualitative research. Concepts and linkages between them are depicted graphically through boxes, arrows, or other symbols. As an example of a schematic model, Figure 8.1 shows Pender’s Health Promotion Model , which is a model for explaining and predicting the health-promotion component of lifestyle ( Pender et al., 2015 ). Schematic models are appealing as visual summaries of complex ideas. Frameworks A framework is the conceptual underpinning of a study. Not every study is based on a theory or model, but every study has a framework. In a study based on a theory, the framework is called the theoretical framework ; in a study that has its roots in a conceptual model, the framework may be called the conceptual framework . However, the terms conceptual framework , conceptual model , and theoretical framework are often used interchangeably. A study’s framework is often implicit (i.e., not formally acknowledged or described). Worldviews shape how concepts are defined, but researchers often fail to clarify the conceptual foundations of their concepts. Researchers who clarify conceptual definitions of key variables provide important information about the study’s framework. Quantitative researchers are less likely to identify their frameworks than qualitative researchers. In qualitative research within a research tradition, the framework is part of that tradition. For example, ethnographers generally begin within a theory of culture. Grounded theory researchers incorporate sociological principles into their framework and approach. The questions that qualitative researchers ask often inherently reflect certain theoretical formulations. In recent years, concept analysis has become an important enterprise among students and nurse scholars. Several methods have been proposed for undertaking a concept analysis and clarifying conceptual definitions (e.g., Walker & Avant, 2011 ). Efforts to analyze concepts of relevance to nursing should facilitate greater conceptual clarity among nurse researchers. Example of developing a conceptual definition Ramezani and colleagues (2014) used Walker and Avant’s (2011) eight-step concept analysis methods to conceptually define spiritual care in nursing . They searched and analyzed national and international databases and found 151 relevant articles and 7 books. They proposed the following definition: “The attributes of spiritual care are healing presence, therapeutic use of self, intuitive sense, exploration of the spiritual perspective, patient centredness, meaning-centred therapeutic intervention and creation of a spiritually nurturing environment” (p. 211). The Nature of Theories and Conceptual Models Theories, conceptual frameworks, and models are not discovered ; they are created. Theory building depends not only on observable evidence but also on a theorist’s ingenuity in pulling evidence together and making sense of it. Because theories are not just “out there” waiting to be discovered, it follows that theories are tentative. A theory cannot be proved—a theory represents a theorist’s best efforts to describe and explain phenomena. Through research, theories evolve and are sometimes discarded. This may happen if new evidence undermines a previously accepted theory. Or, a new theory might integrate new observations with an existing theory to yield a more parsimonious explanation of a phenomenon. Theory and research have a reciprocal relationship. Theories are built inductively from observations, and research is an excellent source for those observations. The theory, in turn, must be tested by subjecting deductions from it (hypotheses) to systematic inquiry. Thus, research plays a dual and continuing role in theory building and testing. CONCEPTUAL MODELS AND THEORIES USED IN NURSING RESEARCH Nurse researchers have used both nursing and nonnursing frameworks as conceptual contexts for their studies. This section briefly discusses several frameworks that have been found useful by nurse researchers. Conceptual Models of Nursing Several nurses have formulated conceptual models representing explanations of what the nursing discipline is and what the nursing process entails. As Fawcett and DeSanto-Madeya (2013) have noted, four concepts are central to models of nursing: human beings , environment , health , and nursing . The various conceptual models define these concepts differently, link them in diverse ways, and emphasize different relationships among them. Moreover, the models emphasize different processes as being central to nursing. The conceptual models were not developed primarily as a base for nursing research. Indeed, most models have had more impact on nursing education and clinical practice than on research. Nevertheless, nurse researchers have turned to these conceptual frameworks for inspiration in formulating research questions and hypotheses. TIP The Supplement to Chapter 8 on website includes a table of several prominent conceptual models in nursing. The table describes the model’s key features and identifies a study that claimed the model as its framework. Let us consider one conceptual model of nursing that has received research attention, Roy’s Adaptation Model . In this model, humans are viewed as biopsychosocial adaptive systems who cope with environmental change through the process of adaptation ( Roy & Andrews, 2009 ). Within the human system, there are four subsystems: physiologic/physical, self-concept/group identity, role function, and interdependence. These subsystems constitute adaptive modes that provide mechanisms for coping with environmental stimuli and change. Health is viewed as both a state and a process of being, and becoming integrated and whole, that reflects the mutuality of persons and environment. The goal of nursing, according to this model, is to promote client adaptation. Nursing interventions usually take the form of increasing, decreasing, modifying, removing, or maintaining internal and external stimuli that affect adaptation. Roy’s Adaptation Model has been the basis for several middle-range theories and dozens of studies. Research example using Roy’s Adaptation Model Alvarado-García and Salazar Maya (2015) used Roy’s Adaptation Model as a basis for their in-depth study of how elderly adults adapt to chronic benign pain. Middle-Range Theories Developed by Nurses In addition to conceptual models that describe and characterize the nursing process, nurses have developed middle-range theories and models that focus on more specific phenomena of interest to nurses. Examples of middle-range theories that have been used in research include Beck’s(2012) Theory of Postpartum Depression; Kolcaba’s (2003) Comfort Theory, Pender and colleagues’ (2015) Health Promotion Model, and Mishel’s (1990) Uncertainty in Illness Theory. The latter two are briefly described here. Nola Pender’s (2011) Health Promotion Model (HPM) focuses on explaining health-promoting behaviors, using a wellness orientation. According to the model (see Fig. 8.1 ), health promotion entails activities directed toward developing resources that maintain or enhance a person’s well-being. The model embodies a number of propositions that can be used in developing and testing interventions and understanding health behaviors. For example, one HPM proposition is that people engage in behaviors from which they anticipate deriving valued benefits, and another is that perceived competence (or self-efficacy ) relating to a given behavior increases the likelihood of performing the behavior. Example using the Health Promotion Model Cole and Gaspar (2015) used the HPM as their framework for an evidence-based project designed to examine the disease management behaviors of patients with epilepsy and to guide the implementation of a self-management protocol for these patients. Mishel’s Uncertainty in Illness Theory ( Mishel, 1990 ) focuses on the concept of uncertainty—the inability of a person to determine the meaning of illness-related events. According to this theory, people develop subjective appraisals to assist them in interpreting the experience of illness and treatment. Uncertainty occurs when people are unable to recognize and categorize stimuli. Uncertainty results in the inability to obtain a clear conception of the situation, but a situation appraised as uncertain will mobilize individuals to use their resources to adapt to the situation. Mishel’s conceptualization of uncertainty and her Uncertainty in Illness Scale have been used in many nursing studies. Example using Uncertainty in Illness Theory Cypress (2016) used Mishel’s Uncertainty in Illness Theory as a foundation for exploring uncertainty among chronically ill patients in the intensive care unit. Other Models Used by Nurse Researchers Many concepts in which nurse researchers are interested are not unique to nursing, and so their studies are sometimes linked to frameworks that are not models from nursing. Several alternative models have gained prominence in the development of nursing interventions to promote health-enhancing behaviors and life choices. Four nonnursing theories have frequently been used in nursing studies: Bandura’s (2001) Social Cognitive Theory, Prochaska et al.’s (2002) Transtheoretical (Stages of Change) Model, the Health Belief Model ( Becker, 1974 ), and the Theory of Planned Behavior ( Ajzen, 2005 ). Social Cognitive Theory ( Bandura, 2001 ), which is sometimes called self-efficacy theory , offers an explanation of human behavior using the concepts of self-efficacy, outcome expectations, and incentives. Self-efficacy concerns people’s belief in their own capacity to carry out particular behaviors (e.g., smoking cessation). Self-efficacy expectations determine the behaviors a person chooses to perform, their degree of perseverance, and the quality of the performance. For example, C. Lee and colleagues (2016) examined whether social cognitive theory–based factors, including self-efficacy, were determinants of physical activity maintenance in breast cancer survivors 6 months after a physical activity intervention. TIP Self-efficacy is a key construct in several models discussed in this chapter. Self-efficacy has repeatedly been found to affect people’s behaviors and to be amenable to change, and so self-efficacy enhancement is often a goal in interventions designed to change people’s health-related behavior.

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Understanding Nursing Research

• Primary Research

What is Quantitative Research?

How do i tell if my article has quantitative research, qualitative research.

• Experimental Design
• Is it a Nursing journal?
• Is it Written by a Nurse?
• Systematic Reviews and Secondary Research
• Quality Improvement Plans

There are two kinds of research: Quantitative and Qualitative

Quantitative is research that generates numerical data. If it helps, think of the root of the word "Quantitative." The word "Quantity" is at its core, and quantity just means "amount" or "how many." Heart rates, blood cell counts, how many people fainted at the jazz festival-- these are all examples of quantitative measures.

Qualitative , on the other hand, is a more subjective measurement. Think of the root of the word again, this time it's "Quality." If someone is called a quality person or someone's selling a high quality product, they're being measured in subjective terms, rather than concrete, objective terms (like numbers.) Qualitative research includes things like interviews or focus groups.

Just like when we examine whether or not our article is an example of Primary Research, the best way to examine what kind of data your article uses is by reading the article's Abstract, Methodologies, and Results sections. That will tell you how the research was conducted and what kind of data (qualitative or quantitative) was collected.

An example of what to look for in the Abstract can be seen here:

You can see that data was evaluated (66% of students were in compliance with school immunization requirements), a strategy was implemented (letters and emails were sent to student's parents/guardians), and at the end of the study, new quantitative data is reported (99.6% of students were in compliance with vaccination requirements).

Finding qualitative research can be trickier, since it can often take more time to collect. Examples of qualitative data include things like interview transcripts, focus group feedback, and journal entries detailing people's experiences and feelings. The easiest way to search for a qualitative study is to include the word "qualitative" as a keyword in your database search along with the search terms about the topic you're interested in.

Check out the video below to see an example of searching for qualitative research in CINAHL.

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Nursing resources: finding quantitative research articles.

• Online Medical Reference E-Books
• Key word search or subject search?
• Finding Qualitative Research Articles
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What is Quantitative Research?

"Quantitative research is a systematic process used to gather and statistically analyze information that has been measured by an instrument. Instruments are used to convert information into numbers. It studies only quantifiable concepts (concepts that can be measured and turned into numbers)." It examines phenomenon through the numerical representation of observations and statistical analysis.

Langford, R. ( 2000). Navigating the Maze of Nursing Research . Elsevier.

Tips for Finding Quantitative Articles with a Keyword Search

If you want to limit your search to quantitative  studies, first try "quantitative" as a keyword, then try using one of the following terms/phrases in your search (example: lactation AND statistics):

Correlational design*

Effect size

Empirical research

Experiment*

Quasi-experiment*

Reliability

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