Employing quantitative and qualitative methods in one study

Integrating qualitative and quantitative research methods

There are a growing number of authors arguing the case for integrating qualitative and quantitative research methods within research projects. A study was carried out to identify the amount of published work integrating qualitative and quantitative research methods and to assess the quality of the outcomes of studies purporting to use both methods. Electronic searches of the health literature and critical appraisal of a random sample of papers retrieved was undertaken as well as a hand search of five journals. Over one-quarter (130, or 27%) of the papers from the electronic searches were theoretical discussions about the merits of mixing research methods, 22% (110) were papers purporting to have used mixed methodologies. Critical appraisal of the sample papers showed the qualitative and quantitative elements varied. Where the results of the different parts of the study were integrated, the outcomes from the research were more convincing than they might otherwise have been. Other papers had little discussion about the balance or integration of the different types of results. Hand searching revealed very few mixed method papers. Further work is required to refine and develop ways to mix methods to generate the evidence required to support practice.

Religious and spiritual variables in three major oncology nursing journals: 1990-1999

PURPOSE/OBJECTIVES

To review qualitative and quantitative research studies measuring religious and spiritual variables published in American oncology nursing journals from 1990-1999 and the types of measures used.

DATA SOURCES

All research studies published from 1990-1999 in Oncology Nursing Forum, Cancer Nursing, and the Journal of Pediatric Oncology Nursing.

DATA SYNTHESIS

A higher percentage of qualitative (27%) than quantitative (14%) oncology nursing studies reported findings on religious and spiritual variables. Religion or spirituality was the major focus of 14% of qualitative studies, and these concepts emerged in qualitative studies even when they were not a study's research focus. Religion or spirituality was the primary independent or dependent variable in 10% of quantitative studies and was a prominent measure in quantitative studies on patients' needs, coping, and quality of life.

CONCLUSIONS

Nursing researchers in oncology are more likely to study issues relating to religion and spirituality than researchers in other fields of nursing, and substantially more research on these topics has been reported in oncology nursing than in the research literature on psychology or various fields of medicine.

IMPLICATIONS FOR NURSING

Implications include the value of (a) combining qualitative and quantitative methods in a single study, (b) incorporating demographic measures, such as religious denomination, as independent variables in analyses, (c) using separate and multiple measures of religion and spirituality in research, and (d) differentiating between religious and spiritual needs in research and practice.

Examining critical care nurses' critical incident stress after in hospital cardiopulmonary resuscitation (CPR)

The object of this study was to determine if critical care nurses' emotional responses to having performed cardiopulmonary resuscitation were indicative of critical incident stress. A descriptive approach was employed using a survey questionnaire of 31 critical care nurses, with supportive interview data from 18 of those participants. Analysis of the data generated from the questionnaire indicated that the respondents experienced thought intrusion and avoidance behaviour. A majority of those interviewed disclosed that they had experienced a wide range of emotional stressors and physical manifestations in response to having performed the procedure. The findings from both questionnaire and interview data were congruent with signs of critical incident stress, as described in the literature. This has been found to be detrimental to employees' mental health status and, for this reason, employers have a duty of care to minimise the risk of its occurrence and to manage problems as they arise.

Triage in accident and emergency. 2: Educational requirements

The first article in this two-part series on the review of the concept of triage (Vol 8(2): 86-102) examined the areas of waiting times, patient satisfaction and the difficulty of trying to implement universal standards into accident and emergency (A&E) departments because of their varying infrastructures. This article aims to identify the educational requirements needed to become a triage nurse. Indeed, none of the reviewed literature explicitly addresses this issue. Educational literature tends to focus on the scientific aspect of practice rather than acknowledging that art, where interactions between the nurse and patient are essentially social acts that can never be accounted for by science, is also an inherent part of nursing practice. This article also investigates and analyses the use of research methods utilized to investigate triage and suggests that a re-evaluation of these methods is needed if the true effects of triage are to be ascertained.

The qualitative-quantitative debate: moving from positivism and confrontation to post-positivism and reconciliation

Critiques of logical positivism form the foundation for a significant number of nursing research papers, with the philosophy being inappropriately deemed synonymous with empirical method. Frequently, proposing an alternative method to those identified with the quantitative paradigm, these critiques are based on a poor foundation. This paper highlights an alternative philosophy to positivism which can also underpin empirical inquiry, that of post-positivism. Post-positivism is contrasted with positivism, which is presented as an outmoded and rejected philosophy which should cease to significantly shape inquiry. Though some acknowledgement of post-positivism has occurred in the nursing literature, this has yet to permeate into mainstream nursing research. Many still base their arguments on a positivistic view of science. Through achievement of a better understanding of post-positivism and greater focus on explicating the philosophical assumptions underpinning all research methods, the distinctions that have long been perceived to exist between qualitative and quantitative methodologies can be confined to the past. Rather methods will be selected solely on the nature of research questions.

A critical appraisal of the role of triangulation in nursing research

Triangulation is a research strategy that has received considerable practical and theoretical interest in nursing research. However, despite its popularity, triangulation raises a number of problematic methodological and philosophical issues. Four such issues are discussed in this paper. First, it is argued that triangulation is not always a necessary ingredient of a research project, as some questions, framed in fairly specific terms, may be adequately answered with the use of a single method. Second, triangulation is often advanced as a means of securing the validity of data; however, this claim often makes unwarranted assumptions as to the criterial status of one method in relation to others. To the extent that triangulation does secure validity, this is likely to be in respect of content validity (i.e. the scope of findings) rather than, as is often suggested, criterion-related validity (i.e. the 'accuracy' of findings). Third, the bringing together of quantitative and qualitative methods in triangulation tends to ignore fundamental questions as to whether data generated by methods that come from divergent epistemological frameworks can meaningfully be combined. Finally, the use of different theoretical frameworks, in theory triangulation, mistakes the true nature of a theory and overlooks the distinctness and incommensurability of different theoretical perspectives. In conclusion, nurse researchers should approach triangulation in a cautious and critical way, with due regard to the rather dubious assumptions upon which it frequently rests.

The research basis of health care decision making

Regarding health care services, the decision-making process occurs at three primary levels: macro (national), mid-range (hospital) and micro (individual practitioner). The research basis for this process at each of these levels is briefly discussed, with an emphasis concerning which type of data is and/or should be utilized. The paradigm assumptions behind data generation are also explored with reference to methodologies which seek to combine different types of data. The nursing profession, within the changing structure of the NHS, needs to take account of data generation if it is to play an active research role, and therefore be able to influence the health care decision-making process.

An examination of nurses' practices when performing aseptic technique for wound dressings

The purpose of this study was to establish if nurses' actions when carrying out 'aseptic technique' using the 'gloves technique' are simple and based on up-to-date knowledge and do not incur unnecessary wastage. A sample of convenience was used involving 21 trained nurses. Observation and formal interviews were used to collect quantitative and qualitative data. Results showed that not all nurses in the sample applied a 'simple aseptic technique'. The rationale for the practice of aseptic technique was not always research based, though other aspects of wound management were derived from research findings. The study highlighted other areas of aseptic technique which require investigations.