Chapter 3

RECENT TRENDS AND CONSTRAINTS

IN NURSING RESEARCH

Learning Targets

At the end of the chapter, the learner will be able to:

 Trace the evolution of research in nursing education and practice
 Explore the constraints in nursing research
 Outline the trends and gains of nursing research
 Anticipate future directions of nursing research

"After all, the ultimate goal of all research is not objectivity, but truth."
-Helene Deutsch

This chapter looks into the evolution of research in nursing

education and practice. It will then discuss the trends and constraints of
nursing research. It seeks to establish the direction that nursing
research is heading.

Chapter Outline
 Nature of trends and constraints in nursing research
 Evolution of nursing research
 Gains in nursing research
 Nursing research constraints
 Recent trends in nursing research
Terms to Remember
 Promotion and prestige
 Knowledge and expertise
 Postgraduate studies
 Outcomes research
 Replication studies

Nature of Trends and Constraints in Nursing Research

The growth of nursing research is directly related to the
development of nursing education. This, in turn is influenced by socio-
political changes and technological advancements. The transformations
in these areas have encouraged nurses to pursue higher studies and
training to qualify for nursing practice and undertake research studies to
improve their practice.

Continuing research brings about the expansion of clinical

programs, theory development, technical expertise and improved quality
of nursing care. It increases the possibility of identifying cause-and-effect
relationships among problems, issues and concerns affecting nurses and
the nursing profession.

Evolution of Nursing Research

The emergence of nursing as a profession coincided with the growth of
nursing research. From then on, nursing research has progressed and
members of the nursing profession began to base their practice on
research rather than on simple traditional practice.
In the West, Florence Nightingale elevated the practice of nursing
as a science and art. Working to improve conditions of soldiers in the
Crimean War, she laid the foundation for professional nursing through
the propagation of the principles summarized in her book Notes on
Nursing: What It Is and What It Is Not. These principles are practical tips
on caring for the wounded. These notes were a product of her daily
observations as the war progressed. Nightingale identified a problem and
by taking copious notes she was able to develop solutions that helped
her make soldiers' lives better.

In the United Kingdom, Doreen Norton distinguished herself for

pioneering nursing research. In the course of her work with the elderly,
she identified upon a problem that many geriatric patients suffered from,
the formation of back sores. As a result, she developed a quick
evaluation chart to grade the bedsores of the elderly, the Norton Scale.
While this assessment modality has lost acceptance now in the wake of
modern research findings, it is still widely used because of its easy
facility (Watson, et. al., 2008).

In the Philippines, nursing research started as early as the

introduction of nursing as a profession in the islands. The early forms of
nursing research came as a reaction to the indigenous practices of the
`albularyos' (herb doctors) who attributed the health and sickness of the
natives to the power of the gods and deities. Difficulty in childbirth was
often associated to the 'num sa punso' who the pregnant woman may
have displeased.
These early superstitious beliefs and practices about health and
care of the sick eventually gave way to new ideas and practices
introduced and propagated by the early religious sisters-nurses who
came to the islands. They introduced the western ways of caring for the
sick. As technology advances, nurses are now encouraged to conduct
research to improve the ways of caring for the sick and well individuals.
The formality of teaching nursing research came only in the sixties (60's).
The early problems about which research dealt were concerned with
issues in nursing administration and education. There was little research
output on patient care and other related topics (Williams, 1980).

As in other parts of the world, the growth of nursing research was

slow but steady focused mainly on nursing education. Today the area of
clinical practice, aside from nursing education has gained ground a field
of research.

Gains in Nursing Research

Research promotes creative thinking and allows movement away
from the status quo and traditional practice. By performing tasks in a
systematic and scientific ways, the nurse is able to reap the benefits of
research as a way to improve one's practice.

Research improves the ability of the nurse to think critically at a

conceptual and scholarly levels since their inferences are validated by
factual data. A nurse who researches thoroughly can relate theories
studied to the reality observed in the course of her work and is able to
understand well the occurrence of a phenomenon. For conclusions to be
accurate, it is important that the data gathered is both precise and clear
so that it is comprehensible and capable of articulation.

In other words, research is the most important way of improving

nursing care because it is by cultivating inquisitiveness that one is able
to determine the most efficient and effective way of implementing nursing
care modalities. A nurse who is research-oriented is held in high regard
and gains professional standing aimed at improving nursing practice and
community health.

In practical terms, research in nursing has six (6) identifiable gains.

1. Knowledge and Expertise.
The most important gain that one can draw from research is
the advancement of one's knowledge and expertise and the
satisfaction of contributing something to the cultural storehouse of
man. As one does research, one is exposed to various reading
materials and the implementation of the theory being tested. The
failure or success of such implementation in the care of client can
further the knowledge and expertise of the nurse-researcher.

2. Promotion and Prestige.

Most institutions value research and gives it a high premium
for promotion purposes. Thus, research can be a platform for
promotion in the workplace. Undertaking research can provide
prestige to the nurse-researcher. However, this will depend on both
the quality of researches done and the degree of importance of the
subject matter to the nursing profession.
3. Recognition by Peers.
The studies done are critically read by the peers of the
researcher and often discussed and presented through a research
forum. When the research passes the standards set by the peers,
the nurse-researcher naturally gains their respect and recognition.
Oftentimes, one's peers are the number one critic of a researcher.
So to gain the approval of one's peers is the most difficult part of
nursing research.

4. Scholarship Grants.
Institutions that grant scholarships often require the
applicant to have an ability to conduct research. Those who are
willing to undertake further studies may be able to gain
scholarship grants because of their interest in furthering research.

5. Increase in Pay.
Notably, those who are able to do research in an area of
interest are able to get increases in pay just as much as a
promotion on the job.

6. Used for Accreditation in Schools.

The credibility of a school is judged by the quantity and quality
of researches made in a given period. The accrediting body such as
the PAASCU and PACU-COA often require schools to have
researches undertaken by their students, faculty and
administrators. The ability of a school to undertake and develop
new knowledge marks its commitment to further excellence.
Nursing Research Constraints
Research in nursing, like all scholarly endeavors, fraught with
hurdles. While it can be a source of joy, it can also generate frustrations.
Some of the difficulties accompanying research arise from a variety of
constraining factors which to some extent, are due to certain causes,
such as the following:

1. Research Content
The scientific method cannot be used to answer questions
that are moral or ethical in nature. Problems of measurement exist
such as in the case of behavioral or psychological phenomena.
There is also possible artificiality that restricts the scope of
experiments.

2. The Researcher
The individual researcher may not have sufficient background
knowledge and skills to study the particular subject, identify the
problems and pursue the research process. Measuring tools may
also be inadequate or not available for assessing and analyzing
research data.

3. Sources of Data
There are research problems which may be constrained by
the availability of data at the time when the study is being
conducted. These limitations may place the researcher in a
doubtful situation which will eventually affect the accuracy of study
results due to lack of reliable data.
4. Related Literature and Studies
Most studies are anchored on knowledge derived from past
researches. These past literature and studies strengthen the analysis
Ilk mad interpretation of research findings as well as suggest clues for
the treatment and measurement of data. These theories from the
literature and previous studies also serve as basis for testing the
hypothesis, analysis and interpretation, conclusions and
recommendations of the study as well as its use for future researches.
Libraries, both actual and virtual, like the internet, can provide
abundant sources of related literature. However, when available
literature on the topic is scarce, this limits the researcher's ability to
justify the findings of the study as well as to document its importance
or significance to the nursing profession.

5. Time Management
A nurse is always challenged to balance time for work and family.
Often, nurses work long hours and barely have time for their selves.
The stress levels are often high which can sometimes lead to chronic
fatigue syndrome. The addition of conducting clinical research will
only add to the already considerable burden borne by the nurse.

6. Administrative and Economic Support

The nurse researcher is also faced with the cost of conducting
clinical research. Aside from this, those nurses willing to conduct
research are faced with money constraints and lack of administrative
support. Not all institutions have developed a culture of research to
support client care. Sometimes, the system of doing things can
override new ways of making the same thing work better and faster.
7. Ethical Issues
Ethical issues can also come into play and in fact a breach of
ethics, whether actual or perceived, in the course of research could
even result in lawsuits, the mere prospect of which could considerably
dampen enthusiasm for more research work. Professional jealousy
could also hinder further research since those who are more research
inclined could face co-employees who are not.

Recent Trends in Nursing Research

These days nurses are more proactive and no longer content with
following and obeying orders without reflection on its impact to nursing
practice. They continually seek to improve themselves as well as the
profession. The following are recent trends in nursing research:
1. There is an increasing demand for nurses to pursue graduate and
postgraduate studies: Master of Arts in Nursing and Doctor of
Philosophy in Nursing. The Philippine Nursing Law of 2002 (R.A.
9173) requires nurses to be holders of these graduate degrees to
qualify for nursing positions in the nursing service or in nursing
education;
2. Special research departments are being created in a growing
number of educational institutions, hospitals and organizations
which takes care of research activities and publications;
3. There is now greater emphasis on research in undergraduate
programs with six (6) units of research in the new BSN curriculum
(CMO 14, S. 2009);
4. The number of research materials being published, including books
and articles on research methodology in nursing journals, is
increasing significantly;
5. The amount of published and funded research studies now serve as
basis for promotion of nurses working in the academic field;
6. More research outputs are required in hospitals and educational
institutions by accrediting bodies to qualify them for recognition
and accreditation towards excellence;
7. There is now an increased use of effective strategies in research
development in nursing, such as the following:
 Acquisition of research facilities;
 Establishment of research linkages;
 Increased research funding;
 Practical application of research results;
 Broadened scope of researches;
 Greater administrative support;
 Presence of research experts to supervise and monitor
research activities
8. There is continuous capacity building of Registered nurses both in
nursing practice and education. Institutions are obliged to develop
their nurses in terms of knowledge and skills in doing research if
they aspire towards accreditation and academic excellence. It is the
research department that takes care of these.
9. There is provision of sufficient and protected time for nurses to do
research. The time may be paid, however, this is dependent on
existing institutional policies and availability of funding.
10. More research grants and scholarships are funded by government
and non-government organizations which provides better
opportunities for researchers to hone their knowledge, skills and
interest in conducting research to help pursue local and national
goals for development.
Future Directions in Nursing Research
Trends in nursing research indicate how far nursing has
progressed through the years in relation to higher education, economics,
scientific breakthroughs, technological advancements and interest of
individuals to get into nursing.
In the past years, the quantitative approach to research dominated
the field. But as more sophisticated research designs evolved which
researchers themselves thought were more responsive to the needs of the
nursing profession, it has been determined that both quantitative and
qualitative or the triangulation approach to research can often explain
and account more accurately problems in nursing practice than just a
single method.
Aside from qualitative research, outcome-oriented research which
explores the result of the care and changes in the health care of the
client is also increasingly pursued in the field of nursing research.
Nurse researchers are also interested in pursuing for replication or
triangulation studies. Replication studies which involves the repetition of
a study with all the conditions of the original study, is a direction that
nursing research is going now. Replication studies helps validate and
accept or refute existing theories, and a source for evidence-based data
necessary for research utilization in nursing practice.

Summary Of Key Concepts

 Continuing research brings about the expansion of clinical
programs, theory development, technical expertise and improved
quality of nursing care.
 Research promotes creative thinking and allows movement of
nurses away from the status quo and traditional practice.
 Research improves the ability of the nurse to think critically at a
conceptual and scholarly levels since their inferences are validated
by factual data.
 Research has six (6) identifiable gains, namely: promotion and
prestige, knowledge and expertise, recognition by peers,
scholarship grants, increase in pay and used for accreditation in
schools.
 Constraints in nursing research include the following: research
content, the capability of the researcher, sources of data, related
literature and studies, and other limitations of research which
include time, cost, and lack of administrative support.
 Recent Trends in Nursing Research include: an increasing demand
for graduate and postgraduate studies, special research
departments, greater emphasis on research in undergraduate
programs, research publications, funded research studies, more
research outputs in hospitals and educational institutions,
 Increased use of effective strategies in research such as: acquisition
of research facilities, establishment of research linkages, increased
research funding, practical application of research results,
broadened scope of researches, greater administrative support,
presence of research experts to supervise and monitor research
activities, continuous capacity building for nurses, provision of
sufficient and protected, and more research grants.
 Future directions in research include more quantitative qualitative
and triangulation approach.
Application:
Contact a nurse you know who have conducted research and find out
about the relevance of research to their practice. Write here below what
you have gathered.

A. Knowledge Assessment
Answer the following as best as you can.
1. How did research emerge as a primary tool in improving the art and
science of nursing?
2. Discuss six (6) recent trends in nursing research.
3. Explain the strategies in research development in nursing.
4. Explain the five (5) nursing research constraints?
5. How will nurses be able to cope with the recent demands for more
research studies?
6. How will the future directions of nursing research be realized by
nurses?

Chapter 3
B. Practice Test.
Encircle the letter that corresponds to your choice.

1. Research which explores the result of care and changes in the

health of the client.
a. basic research
b. quantitative research
c. outcomes research
d. qualitative research
2. There is an increasing demand for nurses to pursue the following
except:
a. postgraduate studies
b. graduate studies
c. medical tourism
d. clinical studies
3. It strengthens the analysis and interpretation of research findings
as well as suggests clues for the treatment and measurement of
data.
a. clinical studies
b. related literature and studies
c. medical studies
d. postgraduate studies
4. Lack of sufficient background knowledge and skills to study a
particular subject of inquiry, identify the problems and pursue the
research process is what kind of research constraint.
a. researcher
b. sources of data
c. research content
d. related literature and studies
5. Nursing emerged as a profession when nurses started using:
a. traditional practice of caring for the sick
b. caring method more than curing
c. traditional practice more than scientific one
d. more on research than traditional practice
6. The growth of nursing practice was greatly influenced by
a. continuing education
b. continuing research
c. development of nursing as a science
d. continuing professional practice
7. In the Philippines, the early forms of nursing research focused on
the following except:
a. reaction to traditional practices of the herb doctors
b. using gods and deities as the source of wellness and sickness of
the natives
c. the care of the soldiers during World War II
d. early superstitious beliefs and practices about health and illness
8. Hence, nursing research is now mandated in the nursing
curriculum in order for nurses to develop the following except:
a. develop creative and critical thinking
b. relate theories with reality
c. formulate the most efficient and effective nursing care modalities
d. stay with status quo and traditional practice
9. Research gains acquired by the nurse is not any of the following:
a. personality change
b. promotion and prestige
c. knowledge and expertise
d. increase in pay
10. The law that requires nurses to undertake graduate studies to
qualify them for higher position in nursing service and education
is:
a. R.A. 9173
b. R.A. 7193
c. R.A. 9713
d. R.A. 7913