Volume 47, Issue 8 , Pages 929-930, August 2010
Classic papers in nursing and midwifery research
Article Outline
Keywords: Measurement, Reliability, Correlation, Agreement
Nursing and midwifery are practice disciplines and applied fields of research enquiry. Few, if any, research methods are unique to nursing/midwifery and seminal papers which have informed research in these fields are drawn predominantly from other disciplines. In this issue of the International Journal of Nursing Studies (IJNS) we feature one such paper in the first of what we expect to be an occasional series of ‘classic’ research papers, published together with a commentary which draws out the contribution of the paper to nursing and midwifery research.
This year is the 200th anniversary of the death of Florence Nightingale who is well recognised as the one of the founders of professional nursing. Her role as a pioneer of nursing research is less well known, but her use of hospital mortality statistics to make judgements about the quality of nursing care and the contribution of nursing to patient outcomes broke new ground and had a major political impact. The data with which Nightingale was most concerned raised technical challenges of data collection, but had the advantage of being directly observable and unambiguous – death or discharge. In those days the division of labour in healthcare was simpler than it is today. Once the surgeons had done their work, whether the patient lived or died was attributable to some considerable extent to the quality of nursing they received. Thus mortality was a relatively sensitive indicator of the quality and quantity of nursing care.
Fortunately, the relationship between nursing care and mortality is less close today than it was in Nightingale's day although the nature of the relationship between numbers of nurses, quality of care and patient deaths remains an important question which continues to be pursued; for example, by Aitken and her collaborators (e.g. West et al., 2009, Griffiths, 2009, Van den Heed et al., 2009). Today research into nursing and midwifery is concerned not only with unambiguous phenomena which can be observed directly, or measured indirectly (such as arterial blood pressure) but also those whose presence can only be inferred from self-reports of attitudes, beliefs and experiences or require both observation and the exercise of subjective judgement.
The science of measuring psychological states or directly observed phenomena which can vary in intensity or degree relies substantially on the development of reliable and valid questionnaire and observation scales. Most scales used in nursing research have been derived from other disciplines, but an increasing number have now been developed by nurse researchers and we have published many of these in the IJNS; these include measures of technical skills of operating room nurses (Sevdalis et al., 2009), fear of falling (Huang and Wang, 2009) and risk of pressure ulcers (Kotter et al., 2009, Kotter and Dassen, 2008) and family nursing (Astedt-Kurki et al., 2009).
The classic methods paper by Bland and Altman (1986) reprinted in this issue is primarily concerned with reliability assessment and approaches to determining agreement between clinical measurements but sets out procedures and identifies issues which apply to any measure which can be treated as ratio or interval level. In their commentary on the paper Griffiths and Murrells (2010) point to what is often a blurred distinction between correlation and agreement. We hope that reprinting Bland and Altman's paper will help to dispel this confusion and provide timely guidance to nursing researchers who are engaged in scale development and validation.
References
- . Further testing of a family nursing instrument (FAFHES). International Journal of Nursing Studies. 2009;46(3):350–359
- . Statistical methods for assessing agreement between two measures of clinical measurement. Lancet. 1986;1(8476):307–310
- . Editorial: RN
+RN=better care? What do we know about the association between the number of nurses and patient outcomes?. International Journal of Nursing Studies. 2009;46(10):1289–1290 - . Commentary: reliability assessment and approaches to determining agreement between measurements: classic methods paper. International Journal of Nursing Studies. 2010;47(8):936–937
- . Comparison of three established measures of fear of falling in community-dwelling older adults: psychometric testing. International Journal of Nursing Studies. 2009;46(10):1313–1319
- . An interrater reliability study of the Braden scale in two nursing homes. International Journal of Nursing Studies. 2008;45(10):1501–1511
- . An interrater reliability study of the assessment of pressure ulcer risk using the Braden scale and the classification of pressure ulcers in a home care setting. International Journal of Nursing Studies. 2009;46(10):1307–1312
- . Development, initial reliability and validity testing of an observational tool for assessing technical skills of operating room nurses. International Journal of Nursing Studies. 2009;46(9):1187–1193
- . Nurse staffing and patient outcomes in Belgian acute hospitals: cross-sectional analysis of administrative data. International Journal of Nursing Studies. 2009;46(7):928–939
- . Nursing resources and patient outcomes in intensive care: a systematic review of the literature. International Journal of Nursing Studies. 2009;46(7):993–1011
PII: S0020-7489(10)00179-3
doi:10.1016/j.ijnurstu.2010.05.013
© 2010 Elsevier Ltd. All rights reserved.
Refers to corrigendum:
- Corrigendum to “Classic papers in nursing and midwifery research” [Int. J. Nurs. Stud. 47 (8) 929–930]
Volume 47, Issue 8 , Pages 929-930, August 2010
