Research methodology can be defined as the entire strategy for the study, from the identification of the research problem to the final plans for data collection (Burns & Grove, 2001:223), and presenting the results. Research methodology is what the researcher utilised to solve the research problems or to answer the research questions (Brink, et al., 2012:199). The research method was used to obtain information on the best evidence used in respect of the treatment and management of burn wounds and current practices relating to the management of burn wounds in Gauteng. The findings were used to describe the evidence on the management of burn wounds and to make recommendations on how to improve clinical practice in the form of Evidence Based Guidelines (EBG).
1.10.2 Study design
A study design is a blueprint for conducting a study including specifications for enhancing the study’s integrity (Polit & Beck, 2012: 741; Brink, et al., 2012: 217; LoBiondo- Wood & Haber, 2010:577; Burns & Grove, 2007: 537).
It maximises control over factors that could interfere with the validity of the study. Generally, researchers choose the design that best fits the purpose of the study, is compatible with the resources available to them such as time, money, information, ethical considerations and their personal preferences (Polit & Beck, 2008:66; Brink, van der Walt & van Rensburg, 2006:92). The design is closely associated with the framework of the study and guides planning for implementation of the study.
This study was a mixed methods, QUAN (quantitative dominant) QUAN+QUAL
(quantitative and quantitative occurs at the same time), a non-experimental, explanatory sequential, descriptive design (Polit & Beck, 2012: 608-612; Creswell & Plano Clark, 2011: 104).
This design was chosen to determine what the best evidence is for the management of burn wounds are and to explore and describe the current practice by nurses in the management of burn wounds. This study, conducted in three phases, allowed for a structured approach.
16 An integrative review collected the data in Phase One; in Phase Two (a), nurses working in the burn unit were observed during dressing changes by means of structured observation using a researcher administered checklist; in Phase Two (b), data were collected through semi-structured interviews directed by an interview schedule. Data in Phase Three was collected through a Nominal Group in which findings from Phases One and Two were verified by a group of experts in the management of wounds, guided by an evaluation instrument, AGREE II.
Each aspect of the design is presented below.
Quantitative research
Quantitative research is the investigation of a phenomenon that lends itself to precise measurement and quantification, often involving a rigorous controlled design (Polit & Beck, 2012: 739). In this study the use of numerical data in the integrative review, as well as the structured observation, attempts to quantify the best evidence on the management of burns by nurses in Gauteng.
Characteristics of quantitative research
Quantitative research has the following characteristics according to Burns & Grove (2007:18),: its philosophical origins are in logical positivism, which means there is a single reality that can be defined through careful measurement; its focus is concise, objective and reductionistic and its reasoning is deductive and logistic. The authors argue that the basis for knowing in quantitative research is through describing variables, examining relationships amongst variables and determining cause- and - effect relationships amongst variables. According to Burns & Grove (2007:18), quantitative research is conducted to test theory.
Descriptive research design
Descriptive research provides an accurate portrayal or account of characteristics or circumstances of a particular person, event, or group in real life situations (Polit & Beck, 2012: 725; Brink, et al., 2012: 211; Burns & Grove, 2007: 537).
The conducting of descriptive research is to discover new meaning, describe what exists, determine the frequency with which a certain phenomenon occurs and categorise information (Burns & Grove, 2007: 537).
The descriptive design was appropriate for this study as it provided both an in-depth description on the management of burns as well the current practice of nurses in dealing with burns in Gauteng. Furthermore, this topic has not been studied before and the researcher attempted to identify and describe new knowledge, new insights and new understanding in the management of burn wounds.
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Characteristics of a descriptive research design
Descriptive designs are used where more information is required in a particular field (Polit & Beck, 2012: 226; Brink, et al., 2012: 112; Burns & Grove, 2007: 240). According to the authors descriptive designs observe, describe and document aspects of a situation as it naturally occurs.
Its theoretical focus may be to develop theory, identify problems with current practice, justify current practice, make judgements or determine what other practitioners in similar situations are doing (Polit & Beck, 2012: 226; Brink, et al., 2012: 112; Burns & Grove, 2007: 240).
1.10.3 Study Population 1.10.3.1Population
A population as the entire set of individuals (or objects) having some common characteristics, sometimes called a universe, that are of interest to the researcher (Polit & Beck, 2012:738; Brink, et al., 2012: 216). A population is all elements that meet the sample criteria for inclusion in a study (Polit & Beck, 2012: 274; Brink, et al., 2012: 131; Burns & Grove, 2007:549), and is accessible to the researcher as a pool of subjects for the study.
In this study, the population for both the structured observation and semi-structured interviews included all nurses providing care to patients with superficial to partial thickness burn wounds, admitted to a single burns unit within a public sector tertiary academic hospital. (Refer to Chapter Two for a detailed description).
1.10.4 Sample and Sampling 1.10.4.1 Sample
A sample as a subset of a population, selected to participate in a study (Polit & Beck, 2012: 742; Brink, et al., 2012: 217; LoBiondo- Wood & Haber, 2010:585; Burns & Grove, 2007: 554). De Vos, et al., (2005: 193), furthermore describe a population as setting boundaries with regard to the elements of participants.
In Phase One of this study, the sample consisted of 354 studies. Phase Two (a) consisted of n = 303 dressings observations. In Phase Two (b), eight interviews were conducted. (Refer to Chapter Two for a detailed description).
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1.10.4.2 Sampling
Sampling is the process of selecting a group of people, events, behaviours, or other elements that are representative of the population being studied (Polit & Beck, 2012: 742; Brink, et al., 2012:132; LoBiondo- Wood & Haber, 2010:585; Burns & Grove, 2007: 554). Sampling may provide a more accurate picture of the phenomenon under investigation according to Brink, et al., (2012:130).
For this study, the entire population was included in the sample because the population was small enough to allow for this and since all different rankings of nurses are responsible for the dressings, the researcher concluded that including a small sample of a certain rank would not be reflective of the whole population.
1.10.4.3 Sample size estimation
A sample size is the number of subjects, events, behaviours, or situations examined in a study (Polit & Beck, 2012: 742; Brink, et al., 2012: 143; LoBiondo- Wood & Haber, 2010:585; Burns & Grove, 2007: 554). There are no hard and fast rules applicable for the determination of sample size however, the researcher must consider both scientific and pragmatic factors influencing the sample size when deciding on the number of participants to be included in the study (Brink, et al., 2012: 143).
Due to the size and variations in the target population, the researcher decided to include the entire population as the sample - n= 41 - to avoid sampling error. A smaller sample would not have been reflective of the entire population and would not detect all the important aspects regarding nurses’ knowledge on burn wound management.