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Sensor technologies for health care, research, and consumers have expanded and evolved rapidly. Many technologies developed in commercial or engineering spaces, lack theoretical grounding and scientific evidence to support their need, safety, and efficacy. Theory is a mechanism for synthesizing and guiding knowledge generation for the discipline of nursing, including the design, implementation, and evaluation of sensors and related technologies such as artificial intelligence and machine learning. In this paper, three nurse scientists summarize their presentations at the Council for the Advancement of Nursing Science 2019 Advanced Methods Conference on Expanding Science of Sensor Technology in Research discussing the theoretical underpinnings of sensor technologies development and use in nursing research and practice. Multiple theories with diverse epistemological roots guide decision-making about whether or not to apply sensors to a given use; development of, components of, and mechanisms by which sensor technologies are expected to work; and possible outcomes., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Sensor-based technologies are used today in clinical practice, research, and for monitoring people's health in homes across the United States. Although the increasing growth and complexity of such technologies promises both direct and indirect benefits, significant ethical concerns are raised. We discuss several of these concerns, particularly those that arise in clinical research and outline ethical considerations that pertain to the concept of informed consent, participants' understanding of risks and benefits and the need for tailored and accessible information that will enable participants to fully understand research implications. Balancing the benefits with the potential risks of advanced information technology will require ethically astute researchers who can address the challenges that might arise while advancing knowledge with innovation that can improve the lives of patients and families., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Anecdotal reports from across the country highlight the fact that nurses are facing major challenges in moving new evidence-based practice (EBP) initiatives into the electronic health record (EHR)., Purpose: The purpose of this study was to: (a) learn current processes for embedding EBP into EHRs, (b) uncover facilitators and barriers associated with rapid movement of new evidence-based nursing practices into the EHR and (c) identify strategies and processes that have been successfully implemented in healthcare organizations across the nation., Methods: A qualitative study design was utilized. Purposive sampling was used to recruit nurses from across the country (N = 29). Nine focus group sessions were conducted. Semistructured interview questions were developed. Focus groups were conducted by video and audio conferencing. Using an inductive approach, each transcript was read and initial codes were generated resulting in major themes and subthemes., Results: Five major themes were identified: (a) barriers to advancing EBP secondary to the EHR, (b) organizational structure and governing processes of the EHR, (c) current processes for prioritization of EHR changes, (d) impact on ability of clinicians to implement EBP and (e) wait times and delays., Linking Evidence to Action: Delays in moving new EBP practice changes into the EHR are significant. These delays are sources of frustration and job dissatisfaction. Our results underscore the importance of a priori planning for anticipated changes and building expected delays into the timeline for EBP projects. Moreover, nurse executives must advocate for greater representation of nursing within informatics technology governance structures and additional resources to hire nurse informaticians., (© 2020 Sigma Theta Tau International.)

Twitter is a communication platform that can be used to conduct health science research, but a full understanding of its use remains unclear. The purpose of this narrative literature review was to examine how Twitter is currently being used to conduct research in the health sciences and to consider how it might be used in the future. A time-limited search of the health-related research was conducted, which resulted in 31 peer-reviewed articles for review. Information relating to how Twitter is being used to conduct research was extracted and categorized, and an explanatory narrative was developed. To date, Twitter is largely being used to conduct large-scale studies, but this research is complicated by challenges relating to collecting and analyzing big data. Conversely, the use of Twitter to conduct small-scale investigations appears to be relatively unexplored., (© The Author(s) 2014.)

Aim: To report a pilot study for the development and validation of an instrument to measure quality in historical research papers., Background: There are no set criteria to assess historical papers published in nursing journals., Design: A three phase mixed method sequential confirmatory design., Methods: In 2012, we used a three-phase approach to item generation and content evaluation. In phase 1, we consulted nursing historians using an online survey comprising three open-ended questions and revised the items. In phase 2, we evaluated the revised items for relevance with expert historians using a 4-point Likert scale and Content Validity Index calculation. In phase 3, we conducted reliability testing of the instrument using a 3-point Likert scale., Results: In phase 1, 121 responses were generated via the online survey and revised to 40 interrogatively phrased items. In phase 2, five items with an Item Content Validity Index score of ≥0·7 remained. In phase 3, responses from historians resulted in 100% agreement to questions 1, 2 and 4 and 89% and 78%, respectively, to questions 3 and 5., Conclusion: Items for the QSHRP have been identified, content validated and reliability tested. This scale improves on previous scales, which over-emphasized source criticism. However, a full-scale study is needed with nursing historians to increase its robustness., (© 2014 John Wiley & Sons Ltd.)

Background and Purpose: Many instruments in which religious involvement is measured often (a) contain unclear, poorly developed constructs; (b) lack methodological rigor in scale development; and (c) contain language and content culturally incongruent with the religious experiences of diverse ethnic groups. The primary aims of this review were to (a) synthesize the research on instruments designed to measure religious involvement, (b) evaluate the methodological quality of instruments that measure religious involvement, and (c) examine these instruments for conceptual congruency with African American religious involvement., Methods: An updated integrative research review method guided the process (Whittemore & Knafl, 2005)., Results: 152 articles were reviewed and 23 articles retrieved. Only 3 retained instruments were developed under methodologically rigorous conditions. All 3 instruments were congruent with a conceptual model of African American religious involvement., Conclusions: The Fetzer Multidimensional Measure of Religious Involvement and Spirituality (FMMRS; Idler et al., 2003) was found to have favorable characteristics. Further examination and psychometric testing is warranted to determine its acceptability, readability, and cultural sensitivity in an African American population.

Aims: The aims of this paper were (1) to raise awareness of the issues in questionnaire development and subsequent psychometric evaluation, and (2) to provide strategies to enable nurse researchers to design and develop their own measure and evaluate the quality of existing nursing measures., Background: The number of questionnaires developed by nurses has increased in recent years. While the rigour applied to the questionnaire development process may be improving, we know that nurses are still not generally adept at the psychometric evaluation of new measures. This paper explores the process by which a reliable and valid questionnaire can be developed., Methods: We critically evaluate the theoretical and methodological issues associated with questionnaire design and development and present a series of heuristic decision-making strategies at each stage of such development. The range of available scales is presented and we discuss strategies to enable item generation and development. The importance of stating a priori the number of factors expected in a prototypic measure is emphasized. Issues of reliability and validity are explored using item analysis and exploratory factor analysis and illustrated using examples from recent nursing research literature., Conclusion: Questionnaire design and development must be supported by a logical, systematic and structured approach. To aid this process we present a framework that supports this and suggest strategies to demonstrate the reliability and validity of the new and developing measure., Relevance to Clinical Practice: In developing the evidence base of nursing practice using this method of data collection, it is vital that questionnaire design incorporates preplanned methods to establish reliability and validity. Failure to develop a questionnaire sufficiently may lead to difficulty interpreting results, and this may impact upon clinical or educational practice. This paper presents a critical evaluation of the questionnaire design and development process and demonstrates good practice at each stage of this process.

Multiple choice questions are used extensively in nursing research and education and play a fundamental role in the design of research studies or educational programs. Despite their widespread use, there is a lack of evidence-based guidelines relating to design and use of multiple choice questions. Little is written about their format, structure, validity and reliability of in the context of nursing research and/or education and most of the current literature in this area is based on opinion or consensus. Systematic multiple choice question design and use of valid and reliable multiple choice questions are vital if the results of research or educational testing are to be considered valid. Content and face validity should be established by expert panel review and construct validity should be established using 'key check', item discrimination and item difficulty analyses. Reliability measures include internal consistency and equivalence. Internal consistency should be established by determination of internal consistency using reliability coefficients while equivalence should be established using alternate form correlation. This paper reviews literature related to the use of multiple choice questions, current design recommendations and processes to establish reliability and validity, and discusses implications for their use in nursing research and education.

Purpose/objectives: To identify the significant dimensions of the clinical trials nursing role and to construct a reliable and valid survey instrument to reflect these dimensions., Design: Methodologic survey., Setting/sample: The judge panel consisted of six national nurse experts. The focus group sample was comprised of 24 clinical research nurses from the West, Northeast, and Great Lakes regions of the United States and five research nurses from Canada. The sample for instrument testing consisted of 40 oncology clinical research nurses from the Southeast., Methods: Several strategies were used to develop the Clinical Trials Nursing Questionnaire (CTNQ): literature review, conceptualization of the subscales, development of items for each subscale, development of the tool, expert judge panel evaluation, focus group testing, administration of the tool, and psychometric analysis of the results., Main Research Variables: Frequency and importance of clinical trials nursing activities., Findings: Content validity was established at 0.95. The alpha reliability coefficient was 0.92 for the frequency scale and 0.95 for the importance scale. A two-week test-retest reliability of 0.88 was obtained for the frequency scale and 0.92 for the importance scale. The final CTNQ contained 12 sections with 154 items., Conclusions: The CTNQ has acceptable content validity, internal consistency, and stability reliability. This instrument is promising for the assessment of the research nurse role, and its use in further research is appropriate., Implications for Nursing: A valid and reliable measure can be used to delineate the subspecialty of clinical trials nursing, thus providing a better understanding of how nursing professionals contribute to the cancer research enterprise.

This article describes the key aspects in the design, construction and adaptation of survey questionnaires. There are different types of questionnaire, each of which has its advantages and disadvantages. Aspects of constructing the questionnaire are discussed in detail; choosing the mode of administration; the objectives of the survey; availability of resources; characteristics of the target population; and quality of data. Issues concerning the identification of the questionnaire's content, wording and sequencing of the questions through to the overall appearance and layout of the questionnaire are also considered. Differences in the role of open-ended and closed questions, together with their strengths and weaknesses, are outlined, and the need to undertake pre-testing and piloting as an integral part of questionnaire development is highlighted. Finally, issues around the adaptation of existing questionnaires are discussed with particular emphasis on their use in different language and cultural groups, and the need to achieve conceptual, content, semantic, operational and functional equivalence is described. An overview of the translation process is provided.

In this column, I have outlined some of the basic strategies for finding appropriate research instruments and for evaluating them so that you can determine the best one to use for your own research. These strategies, as basic as they are, will help to guide you as you make decisions. Of course, there are complex issues surrounding the development and refinement of research instruments and you would do well to review reliability, validity, and sensitivity in research texts before choosing an instrument.

The benefits of item response theory (IRT) analysis in obtaining empirical support for construct validity make it an essential step in the instrument development process. IRT analysis can result in finer construct interpretations that lead to more thorough descriptions of low- and high-scoring respondents. A critical function of IRT is its ability to determine the adequacy with which the attitude continuum underlying each dimension is assessed by the respective items in an instrument. Many nurse researchers, however, are not reaping the benefits of IRT in the development of affective instruments. The purpose of this article is to familiarize nurse researchers with this valuable approach through a description of the Facets computer program. Facets uses a one parameter (i.e., item difficulty) Rasch measurement model. Data from a survey of 525 new mothers that assessed the psychometric properties of the Postpartum Depression Screening Scale are used to illustrate the Facets program. It is hoped that IRT will gain increased prominence in affective instrument development as more nurse researchers become aware of computer programs such as Facets to assist in analysis.

Although blood pressure (BP) is a frequently used variable in nursing studies, measurements are likely to be inaccurate for a variety of reasons: incorrect technique, operator error, and environmental factors. Ambulatory BP monitoring (ABPM) reduces measurement error, is relatively easy to use, and yields many more BP parameters than do clinic BP measurements. The cost of equipment for ABPM ranges from $2,500 to $5,000 per monitor and from $2,000 to $3,000 for computer software. A research assistant can easily be trained to follow a standardized procedure. Researchers have used ABPM to study normal BP patterns, complications of hypertension, effects of antihypertensive drugs, and the prognosis of cardiovascular events. This article provides the nurse researcher with an introduction to this technology and an overview of information gained from ambulatory blood pressure monitoring.

Instruments for quantitative nursing research are a mean to objectify and measure a variable or a phenomenon in the scientific research. There are direct instruments to measure concrete variables and indirect instruments to measure abstract concepts (Burns, Grove, 1997). Indirect instruments measure the attributes by which a concept is made of. Furthermore, there are instruments for physiologic variables (e.g. for the weight), observational instruments (Check-lists e Rating Scales), interviews, questionnaires, diaries and the scales (Check-lists, Rating Scales, Likert Scales, Semantic Differential Scales e Visual Anologue Scales). The choice to select an instrument or another one depends on the research question and design. Instruments research are very useful in research both to describe the variables and to see statistical significant relationships. Very carefully should be their use in the clinical practice for diagnostic assessment.

Content experts frequently are used in the judgment-quantification stage of content validation of instruments. However, errors in instrumentation may arise when important steps in selecting and using these experts are not carefully planned. The systematic process of choosing, orienting, and using content experts in the judgment-qualification stage of instrument development is addressed, with particular attention to the often neglected, important step of familiarizing these experts with the conceptual underpinnings and measurement model of the instrument. An example using experts to validate content for a measure of caregiver burden is used to illustrate this stage of instrument review.

Accurate measurement of research variables is necessary so that research consumers can trust that it is the research intervention that affected the change in the outcome variable, not some extraneous error component. Reliability is the accuracy with which the research instruments measure the variable that they are designed to measure. A number of known threats to instrument reliability should be anticipated by the researcher and looked for the consumer. These threats are presented in this article.

Meaningful measurement of events in a research study depends on the use of valid and reliable measurement tools. This article discusses the nature of validity, types of validity, and how researchers demonstrate the validity of their instruments to the reader.

Research papers published on some of the most well known medical and nursing journals are presented and discussed. The main aim of the contribution, which opens a new arena for discussion on the Rivista dell'Infermiere is to critically appraise published research works focusing both on strenghts and novelty as well as weaknesses in the hypothesis formulation, methods and instruments used, discussion of results. A critical analysis should enable nurses to start to learn to read and eventually write a research protocol, possibly avoiding some common mistakes.

This paper describes Haccoun's (1987) technique for validating a translated questionnaire. This method is based on the idea that if a questionnaire is well translated, bilingual subjects will provide equivalent responses to questions in either language. A single group of bilingual subjects is given both language versions of the questionnaires at two different times in random order. Subsequently: 1) test-retest reliability coefficients are computed for the original and translated versions; 2) correlation coefficients between the original and translated versions of the instrument are computed and compared (simultaneous correlations between languages); 3) the correlations between the original version at time 1 and the translated version at time 2 and vice versa are computed and compared (cross-correlations); and 4) the cross-correlations are compared to the test-retest reliabilities within each language. The final step indicates whether the translated version of the instrument is equivalent to the original. The authors use Haccoun's technique to demonstrate that a French translated version of Alcock et al.'s (1990) questionnaire on nurses' perceptions of nursing research is reliable and statistically equivalent to the original.

The purpose of this study was to examine the adequacy (operational, empirical, and pragmatic) and scope of the Roy adaptation model and the gate control theory of pain to guide the cross-cultural study of pain. The sample consisted of 60 Mexican-American and Anglo-American women undergoing elective cholecystectomy. The conceptual-theoretical-empirical structure developed by Fawcett and Downs (1986) provided the framework for designing the study. Operational adequacy was determined by examining the reliability and validity of the empirical indicators used; it was judged adequate. Empirical adequacy was evaluated by comparing empirical data to hypothesized expectations. Only some of the conceptual-theoretical relational statements were supported. Pragmatic adequacy was assessed by determining whether innovative practice strategies might be derived from the data; several were recommended. Finally, the scope was determined by examining the variables identified by the model and several additional variables. Scope was judged adequate to the current stage of the model's development.

The concepts of validity and reliability are defined within the context of applied clinical research. Validity concerns what an instrument measures and how well it does so. Reliability concerns the faith that one can have in the data obtained from use of an instrument, that is, the degree to which any measuring tool controls for random error. The researcher selects a measure that demonstrates content, criterion, or construct validity, according to the intended use of the measurement tool. Similarly, the researcher selects a measure that demonstrates a degree of reliability that is needed for its application. It is possible to have reliability without validity, but it is logically impossible to demonstrate that an unreliable test is valid.

Deciding which instrument scale technique to choose is an important step in instrument development. Measurement theory dictates rules regarding level of measurement and approaches to decrease the error component of true scores. Measurement rules are applied to types of scaling, including methods to quantify demographic data, opinion rating scales, summated rating scales, semantic differential scales, and methods to quantify laboratory data. Consideration to scaling should be made before planning data analysis so that research questions or hypotheses can be answered using the appropriate statistical method.

The study of the parent's attachment to his or her infant has recently become a research topic of great interest to parent-child nursing practitioners. The parent-infant relationship has been examined using a variety of methodological approaches. Brazelton Neonatal Behavioral Assessment Scale demonstrations, home and laboratory observations, process recordings, videotape analyses, self-reported questionnaires, and developmental screening tools have all been used by researchers to measure the quality of this earliest form of human attachment. However, there are rising concerns as to the validity of attachment research in general, as well as methodological limitations in collecting data on parent-infant interactions. This article discusses issues of methodological concern in attachment research and makes suggestions to strengthen validity.

Nurses have long been in the forefront of health care delivery for adolescents and are becoming more involved in adolescent pregnancy research. This article focuses on six methodological issues for adolescent pregnancy research: formulating the research question, selecting appropriate measures, recruiting subjects, obtaining informed consent, categorizing socioeconomic status, and balancing the clinician-researcher relationship. As we prepare for the 21st Century, we must develop new and creative approaches to adolescent pregnancy research, and we must bridge the gap between research and practice. Ultimately, knowledge derived from research and clinical practice should generate comprehensive health care and social policies for dealing with adolescent pregnancy.

The play of infants and toddlers is a rich and flexible research modality. Play assessment can be an outcome measure of cognition or social ability, or it can be measured in conjunction with related constructs such as language to give a broad view of early development. Play can also be an effective intervention in studies of cognition, language, motor, or social development. This article offers strategies for the researcher who is interested in infant and toddler play. Emphasis is placed on environmental variables that the researcher manipulates to optimize the child's performance. Play measures are briefly addressed.

Research has only recently documented the negative effects of child sexual abuse. Investigators attempting to validate empirically the stress responses of children to sexual abuse are confronted with many methodological issues, including those related to measurement, sample selection, use of comparison subjects, and legal and ethical considerations. This article discusses methodological issues that need to be considered when designing and implementing studies on the impact of child sexual abuse. Suggestions are made for strengthening research designs, and several studies that have incorporated some of these suggestions are reviewed. Recommendations are made for areas that nurse researchers may want to explore in the future, such as parental and sibling response to sexual victimization, characteristics of children that may ameliorate the effects of sexual abuse, and children's responses to examination of the genitalia.

Reliability assessments are appropriate for each research instrument in a study. Measures of internal consistency are a popular set of assessments with Cronbach's alpha being the most favored. Two other measures of internal consistency, theta and omega, have particular characteristics that make their use desirable under certain circumstances. Each of these three measures and its computation is described and examples provided.

The nature of legal research as it relates to other research methods used in nursing is described, its history discussed, and its relevance to nursing science examined. The major concepts of person, health, environment, and nursing can be explicated by legal research and analysis. The phenomenological method is the one considered most likely to be enhanced by legal research. Finally, the following are discussed: the history of legal research, the definition of legal research, steps in the legal research process, legal research source materials, nursing concepts clarified by legal research, and the parallels between phenomenology and legal research.

This article continues the discussion of the theoretical and methodological issues associated with the use of measurement instruments in nursing such as the QUALCARE Scale. The QUALCARE Scale is an observational rating scale designed to quantify the quality of family caregiving to home-dwelling elders in six areas: physical, medical management, psychosocial, environmental, human rights and financial. This manuscript continues the discussion by reporting the psychometric properties of the scale. The QUALCARE Scale was tested in a descriptive correlational study with 249 caregiver-elder dyads. The results supported evidence of interrater reliability, internal consistency, and criterion and construct validity. Three issues in the use of measurement instruments in clinical practice are discussed: (i) quantification versus qualification, (ii) clinical relevance and (iii) the establishment of rating standards.

For nurses wishing to change the course of their careers, many opportunities are available for entering the field of research and can indicate an exciting prospect. Although research involves considerable organization and management, it offers the opportunity to publish findings, which will enhance your curriculum vita. Never undertake an investigation or treatment on a patient without medical back-up, and always put safety first.