In this third edition of Greenhalgh's award-winning Understanding Research Methods for Evidence-Based Practice in Health, students will gain a complete overview of the most common topics covered in a standard 12-week evidence-based practice unit for Nursing and Allied Health courses. Throughout the text, they will find engaging and insightful content, which has a unique focus on consumers of research – keeping students focused on the skills most relevant to them.
About the authors viii Chapter 1 Introduction to research, the research process and EBP 1 1.1 The meaning of 'evidence-based practice' 2 1.2 Research informs evidence-based practice 4 1.3 Apprehension towards research and evidence-based practice 5 1.4 Before you start: formulate the problem 8 Chapter 2 Asking questions and searching for evidence 13 2.1 Different types of searching for evidence 14 2.2 Differences between primary and secondary research 15 2.3 Effective search strings 16 2.4 Other avenues for how to search for evidence 21 Chapter 3 Reviewing literature 25 3.1 Is a paper worth reading at all? 27 Question 1. Who wrote the paper? 27 Question 2. Is the title appropriate and illustrative, and is the abstract informative? 27 Question 3. What was the research design, and was it appropriate to the question? 28 Question 4. What was the research question, and why was the study needed? 28 Question 5. Do the results or findings answer the question? 28 3.2 Reviewing the methods of primary research papers 29 3.3 Reviewing the methods of secondary (review) papers 31 Question 1. What is the focused clinical question that the review addressed? 31 Question 2. Was a thorough search of the appropriate database(s) carried out, and were other potentially important sources explored? 31 Question 3. Who evaluated the studies, and how? 32 Question 4. How sensitive are the results to the way the review has been performed? 32 Question 5. Have the results been interpreted sensibly, and are they relevant to the broader aspects of the problem? 33 Chapter 4 Qualitative research 37 4.1 Qualitative research explained 38 4.2 The difference between qualitative and quantitative research 39 4.3 Qualitative methodologies and data collection strategies 41 4.4 Evaluating papers that describe qualitative research 43 Question 1. Did the paper describe an important clinical problem addressed via a clearly formulated question? 44 Question 2. Was a qualitative approach appropriate? 44 Question 3. How were (a) the setting and (b) the subjects selected? 44 Question 4. What was the researcher’s perspective, and has this been taken into account? 45 Question 5. What methods did the researcher use for collecting data, and are these described in enough detail? 45 Question 6. What methods did the researcher use to analyse the data, and what quality control measures were implemented? 45 Question 7. Are the results credible and, if so, are they clinically important? 46 Question 8. What conclusions were drawn, and are they justified by the results? 46 Question 9. Are the findings of the study transferable to other settings? 47 Chapter 5 Quantitative research 51 5.1 Why and how quantitative research is done 53 5.2 Quantitative research designs 54 5.3 Measurement 57 Chapter 6 Levels of evidence 65 6.1 Clinical questions in healthcare 66 6.2 How bias threatens the validity of research evidence 68 6.3 Matching clinical questions to NHMRC levels of evidence 70 6.4 Evaluating the evidence — quality of evidence and grades of recommendations for practice guidelines 75 6.5 Levels beyond levels 76 Chapter 7 Statistics for the non-statistician 83 7.1 Storing quantitative data in a data set 84 7.2 Descriptive statistics for summarising sample characteristics 85 7.3 The researchers ‘setting the scene’ 87 7.4 Probability and confidence 90 7.5 Clinical importance of treatment effects 92 7.6 Summarising treatment effects from multiple studies of interventions in a systematic review 96 Chapter 8 Mixed methods research 101 8.1 An overview of mixed methods research 102 8.2 Different mixed methods designs 103 8.3 Integration in mixed methods research 106 8.4 Mixed methods design considerations 107 Chapter 9 Sampling 111 9.1 Understanding the terminology around populations and sampling 112 9.2 Types of sampling 114 9.3 Sampling error 116 9.4 Calculating sample size 117 Chapter 10 Ethics 123 10.1 Ethical principles 124 Autonomy: patients/clients are free to determine their own actions 124 Beneficence: acting to benefit human kind 125 Justice: obligation to treat fairly 125 Non-maleficence: avoiding or minimising harm 125 Respect for human dignity 125 Confidentiality: maintenance of privileged information, including the right to privacy and anonymity 126 Veracity: obligation to tell the truth 126 10.2 The role and function of human research ethics committees 126 10.3 Indigenous research 128 10.4 Judging the ethical aspects of a published journal article 129 Chapter 11 Getting evidence into practice 133 11.1 Adoption of evidence-based practice (EBP) 134 11.2 Encouraging individuals to implement evidence-based practice 135 11.3 Organisational support of evidencebased practice 136 11.4 The client perspective in evidencebased practice 138 Chapter 12 Challenges to evidence-based practice 143 12.1 When evidence-based practice is done badly 145 12.2 When evidence-based practice is done well 146 12.3 Achieving evidence-based practice 149 Summary 151 Key terms 151 Websites 151 Endnotes 151 Acknowledgements 153 Index 155
