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Survey Research
Message From the Chairperson Survey Research
T
HE USE OF self-administered surveys is considered to be an important tool for researchers. But even if you never plan to conduct a survey, understanding the basics of survey design will assist to evaluate survey research. It is also helpful in becoming an “educated consumer” especially because we are exposed to survey research almost on a daily basis. Just pick up a newspaper or magazine, turn on the television or radio, or listen to a political speech. Chances are you will read or hear the phrase “research shows” with survey research results being implied. Knowing who is conducting and funding a survey is also important in terms of bias issues. It may be significant to know whether the surveyor’s interests are related to the survey results when interpreting survey research findings.
Survey Design Survey development has its roots in three areas including the U.S. Bureau of the Census, commercial polling firms such as the Gallup Poll, and American universities. Whereas a census is used to study all members of the population, surveys gather relevant information © 2006 by the National Kidney Foundation, Inc. 1051-2276/06/1604-0010$32.00/0 doi:10.1053/j.jrn.2006.07.001
348
from a select sample of a population of interest. The survey process involves analyzing the results in a quantitative manner and determining correlations among different responses. The conclusions drawn from the analysis can then be generalized to the population from whom the sample was selected. The basic steps in a survey project are as follows: Goal setting: What is the surveyor trying to learn? Sample selection: Who is being interviewed? Select the method of interviewing: What are the means of data collection? Question development: What will be asked? Pilot test the questionnaire: Assess the questions. Administer the survey: The questions are asked. Collect and analyze the data: The results are reported. The three basic goals of survey research are description, explanation, and exploration. Surveys are often performed to make a descriptive discovery about a select population, such as the distribution of certain traits or characteristics. Surveys using multivariate analysis have an added objective of making explanatory claims about the population, such as why survey participants prefer one thing over another. Surveys can also act as an exploring or searching mechanism to discover critical
elements on a subject that could otherwise be missed. A study may have one or all three of these objectives. The units of analysis, or those being studied, are usually people, but can also be groups such as cities, companies, or organizations. It is critical to select the right population and appropriate sample size to successfully meet the study objectives. Considerations to avoid a biased sample must also be taken into account. The conclusions drawn from the research should be appropriate to the unit of analysis. Traditional interviewing methods include personal interviews, telephone surveys, and mail surveys. Technology has changed the way researchers conduct surveys. The use of e-mail, the Web, and touch-tone data entry to administer surveys is quickly increasing because they are cost-effective and save time. Questions are carefully constructed to make these selfadministered surveys simple to comprehend and answer. All methods have pros and cons that should be evaluated in selecting the best way to administer the survey. Question design involves selecting the type of questions such as multiple choice or numeric, and use of rating or agreement scales. Keeping questions simple, concise, and easy to answer is ideal. Surveys that ask ambiguous questions
Journal of Renal Nutrition, Vol 16, No 4 (October), 2006: pp 348 –350
MESSAGE FROM THE CHAIRPERSON
or do not depict clearly defined concepts will wind up with misleading results. For self-administered surveys in particular, the questions should be developed so that every potential respondent will interpret it the same way, be willing to answer, and be capable of responding accurately. The order in which the questions are asked, the answer choice order, and the length of the survey are also important matters to take into consideration. The indicators chosen should be valid and reliable measures of the concepts being studied. Pilot testing the survey with a small group can eliminate problems such as unclear wording, misinterpretation of terms, or questions that are difficult to understand. This feedback will assist to improve and clarify the survey. Data analysis involves using the proper statistical techniques and examining all appropriate variables. Tests to determine statistical significance should be used and interpreted correctly. Careful correlation of variables should be considered to prevent conclusions based on false relations. Details of the study design and implementation should be reported in full.1-3
Survey Participation We are inundated with requests to take part in surveys in our personal lives from retail stores, restaurants, hotels, and numerous other service providers. Questionnaires come to us by regular mail, e-mail, and telephone. It is easy to understand that with our busy schedules,
many of these surveys are ignored. But when it comes to professional surveys as part of research investigation, participation should be taken more seriously. As Council on Renal Nutrition members, we are often asked to participate in surveys because we represent a unique group of registered dietitians who specialize in nephrology care. Because of this specialty we have the ability to provide information that can shape the future of our profession and renal nutrition by identifying similarities and differences in our clinical practices. A survey usually originates when a need for information becomes apparent and there are insufficient data available. Here are examples of three surveys that present information needs and are worthy of our attention. The first is titled “Job Functions of Renal Dietitians Survey,” administered by Bonnie Thelen, RD, for her Master of Science thesis. The purpose is to assess what functions renal dietitians are performing, how practices may vary by geographic region, and what barriers impact professional roles and activities. This body of work will be used to further evaluate scope of practice in renal nutrition. A second analysis of the data will be used to categorize the functions of renal dietitians into generalist, specialty, or advanced levels of clinical practice. The second project is being initiated by the European Dialysis and Transplant Nurses Association/European Renal Care Association nutrition interest group for development of the European Consensus Statement on Nutrition Sup-
349
port in Adults on Renal Replacement Therapy. The survey will be conducted in a minimum of six European countries and the United States to assess their nutritional support practices and recommendations for adults on renal replacement therapy. The objectives are to develop an expert consensus and recommendations on nutrition support methods to ensure clinically effective practice and to establish evidence-based recommendations assessed by an expert panel to form the basis of recommended guidelines for nutritional support in adults receiving renal replacement therapy. The project will also contribute to a new goal that the European Dialysis and Transplant Nurses Association/European Renal Care Association has of “establishing collaborative work with other associations and renal organizations.” Finally, a survey on “The Nutrition Practices in Hemodialysis Centers Throughout the United States,” by doctoral candidate Joyce M. Vergili, MS, RD, will address gaps in our knowledge regarding how renal dietitians deliver nutrition care to adults on maintenance hemodialysis. The purpose of this study is to learn how dietitians working in nephrology care with adult patients on hemodialysis are currently practicing in the absence of formally established guidelines for certain nutrition issues (e.g., target goals for serum potassium) and practices for which guidelines do exist, but are surrounded by controversy (e.g., the appropriate weight to use when calculat-
350
ing protein and energy needs for overweight patients). The results of this survey will contribute to the development of renal nutrition practice guidelines where none currently exist. The effort put into these well-designed research surveys is evident and will provide information that will benefit our patients as well as our profes-
DEBORAH BROMMAGE
sion. Let us be sure to seize the opportunity to make a scientific contribution the next time a professional survey comes our way. The information and benefits gained will far outweigh the time it takes to participate. Deborah Brommage, MS, RD, CSR, CDN CRN Chairperson
References 1. Babbie E: Survey Research Methods. Belmont, CA, Wadsworth Publishing Company, 1997 2. Creative Research Systems: The survey system. Available at: http://www. surveysystem.com/sdesign.htm. Accessed July 6, 2006 3. Dillman DA: Mail and Internet Surveys—The Tailored Design Method. New York, NY, John Wiley & Sons, Inc., 2000
T
HE USE OF self-administered surveys is considered to be an important tool for researchers. But even if you never plan to conduct a survey, understanding the basics of survey design will assist to evaluate survey research. It is also helpful in becoming an “educated consumer” especially because we are exposed to survey research almost on a daily basis. Just pick up a newspaper or magazine, turn on the television or radio, or listen to a political speech. Chances are you will read or hear the phrase “research shows” with survey research results being implied. Knowing who is conducting and funding a survey is also important in terms of bias issues. It may be significant to know whether the surveyor’s interests are related to the survey results when interpreting survey research findings.
Survey Design Survey development has its roots in three areas including the U.S. Bureau of the Census, commercial polling firms such as the Gallup Poll, and American universities. Whereas a census is used to study all members of the population, surveys gather relevant information © 2006 by the National Kidney Foundation, Inc. 1051-2276/06/1604-0010$32.00/0 doi:10.1053/j.jrn.2006.07.001
348
from a select sample of a population of interest. The survey process involves analyzing the results in a quantitative manner and determining correlations among different responses. The conclusions drawn from the analysis can then be generalized to the population from whom the sample was selected. The basic steps in a survey project are as follows: Goal setting: What is the surveyor trying to learn? Sample selection: Who is being interviewed? Select the method of interviewing: What are the means of data collection? Question development: What will be asked? Pilot test the questionnaire: Assess the questions. Administer the survey: The questions are asked. Collect and analyze the data: The results are reported. The three basic goals of survey research are description, explanation, and exploration. Surveys are often performed to make a descriptive discovery about a select population, such as the distribution of certain traits or characteristics. Surveys using multivariate analysis have an added objective of making explanatory claims about the population, such as why survey participants prefer one thing over another. Surveys can also act as an exploring or searching mechanism to discover critical
elements on a subject that could otherwise be missed. A study may have one or all three of these objectives. The units of analysis, or those being studied, are usually people, but can also be groups such as cities, companies, or organizations. It is critical to select the right population and appropriate sample size to successfully meet the study objectives. Considerations to avoid a biased sample must also be taken into account. The conclusions drawn from the research should be appropriate to the unit of analysis. Traditional interviewing methods include personal interviews, telephone surveys, and mail surveys. Technology has changed the way researchers conduct surveys. The use of e-mail, the Web, and touch-tone data entry to administer surveys is quickly increasing because they are cost-effective and save time. Questions are carefully constructed to make these selfadministered surveys simple to comprehend and answer. All methods have pros and cons that should be evaluated in selecting the best way to administer the survey. Question design involves selecting the type of questions such as multiple choice or numeric, and use of rating or agreement scales. Keeping questions simple, concise, and easy to answer is ideal. Surveys that ask ambiguous questions
Journal of Renal Nutrition, Vol 16, No 4 (October), 2006: pp 348 –350
MESSAGE FROM THE CHAIRPERSON
or do not depict clearly defined concepts will wind up with misleading results. For self-administered surveys in particular, the questions should be developed so that every potential respondent will interpret it the same way, be willing to answer, and be capable of responding accurately. The order in which the questions are asked, the answer choice order, and the length of the survey are also important matters to take into consideration. The indicators chosen should be valid and reliable measures of the concepts being studied. Pilot testing the survey with a small group can eliminate problems such as unclear wording, misinterpretation of terms, or questions that are difficult to understand. This feedback will assist to improve and clarify the survey. Data analysis involves using the proper statistical techniques and examining all appropriate variables. Tests to determine statistical significance should be used and interpreted correctly. Careful correlation of variables should be considered to prevent conclusions based on false relations. Details of the study design and implementation should be reported in full.1-3
Survey Participation We are inundated with requests to take part in surveys in our personal lives from retail stores, restaurants, hotels, and numerous other service providers. Questionnaires come to us by regular mail, e-mail, and telephone. It is easy to understand that with our busy schedules,
many of these surveys are ignored. But when it comes to professional surveys as part of research investigation, participation should be taken more seriously. As Council on Renal Nutrition members, we are often asked to participate in surveys because we represent a unique group of registered dietitians who specialize in nephrology care. Because of this specialty we have the ability to provide information that can shape the future of our profession and renal nutrition by identifying similarities and differences in our clinical practices. A survey usually originates when a need for information becomes apparent and there are insufficient data available. Here are examples of three surveys that present information needs and are worthy of our attention. The first is titled “Job Functions of Renal Dietitians Survey,” administered by Bonnie Thelen, RD, for her Master of Science thesis. The purpose is to assess what functions renal dietitians are performing, how practices may vary by geographic region, and what barriers impact professional roles and activities. This body of work will be used to further evaluate scope of practice in renal nutrition. A second analysis of the data will be used to categorize the functions of renal dietitians into generalist, specialty, or advanced levels of clinical practice. The second project is being initiated by the European Dialysis and Transplant Nurses Association/European Renal Care Association nutrition interest group for development of the European Consensus Statement on Nutrition Sup-
349
port in Adults on Renal Replacement Therapy. The survey will be conducted in a minimum of six European countries and the United States to assess their nutritional support practices and recommendations for adults on renal replacement therapy. The objectives are to develop an expert consensus and recommendations on nutrition support methods to ensure clinically effective practice and to establish evidence-based recommendations assessed by an expert panel to form the basis of recommended guidelines for nutritional support in adults receiving renal replacement therapy. The project will also contribute to a new goal that the European Dialysis and Transplant Nurses Association/European Renal Care Association has of “establishing collaborative work with other associations and renal organizations.” Finally, a survey on “The Nutrition Practices in Hemodialysis Centers Throughout the United States,” by doctoral candidate Joyce M. Vergili, MS, RD, will address gaps in our knowledge regarding how renal dietitians deliver nutrition care to adults on maintenance hemodialysis. The purpose of this study is to learn how dietitians working in nephrology care with adult patients on hemodialysis are currently practicing in the absence of formally established guidelines for certain nutrition issues (e.g., target goals for serum potassium) and practices for which guidelines do exist, but are surrounded by controversy (e.g., the appropriate weight to use when calculat-
350
ing protein and energy needs for overweight patients). The results of this survey will contribute to the development of renal nutrition practice guidelines where none currently exist. The effort put into these well-designed research surveys is evident and will provide information that will benefit our patients as well as our profes-
DEBORAH BROMMAGE
sion. Let us be sure to seize the opportunity to make a scientific contribution the next time a professional survey comes our way. The information and benefits gained will far outweigh the time it takes to participate. Deborah Brommage, MS, RD, CSR, CDN CRN Chairperson
References 1. Babbie E: Survey Research Methods. Belmont, CA, Wadsworth Publishing Company, 1997 2. Creative Research Systems: The survey system. Available at: http://www. surveysystem.com/sdesign.htm. Accessed July 6, 2006 3. Dillman DA: Mail and Internet Surveys—The Tailored Design Method. New York, NY, John Wiley & Sons, Inc., 2000