What is nursing research: evolving approaches to methods and content.

In addressing what constitutes nursing research in the 1990s, approaches to conducting nursing research and examples of studies are discussed in the context of historical forces. The early studies were characteristically educational in focus and quantitative by design. Nursing research has come a long way in regard to foci of the questions asked, diversity of approaches to knowledge development, and sophistication of research methods. Three approaches are described to illustrate the diversity in nursing research: quantitative, qualitative, and triangulation.     

Methodological pluralism in clinical nursing research

Clinical nursing research can benefit from an approach that blends discovery oriented qualitative methods with the objective, numerically based quantitative methods. This paper describes current approaches to clinical research in either the quantitative or qualitative paradigm. The strengths and weaknesses of each of these approaches are discussed. A rationale for methodological pluralism--the blending of the two methods--to understand clinical phenomena is presented.     

The strengths and weaknesses of quantitative and qualitative research: what method for nursing?

The overall purpose of research for any profession is to discover the truth of the discipline This paper examines the controversy over the methods by which truth is obtained, by examining the differences and similarities between quantitative and qualitative research The historically negative bias against qualitative research is discussed, as well as the strengths and weaknesses of both approaches, with issues highlighted by reference to nursing research Consideration is given to issues of sampling, the relationship between the researcher and subject, methodologies and collated data, validity, reliability, and ethical dilemmas The author identifies that neither approach is superior to the other, qualitative research appears invaluable for the exploration of subjective experiences of patients and nurses, and quantitative methods facilitate the discovery of quantifiable information Combining the strengths of both approaches in triangulation, if time and money permit, is also proposed as a valuable means of discovering the truth about nursing It is argued that if nursing scholars limit themselves to one method of enquiry, restrictions will be placed on the development of nursing knowledge     

The use of qualitative research methodology in orthopaedics – tell it as it is

The article reviews the relatively weak position of qualitative research within health care in the UK. A comparison is made between quantitative and qualitative paradigms of research from the perspective of health care professionals. The tensions and paradoxes between nursing and medical research in orthopaedics are made explicit. Reliability and validity are taken as cornerstones of both types of research, with triangulation as the key to substantiating qualitative research approaches. We describe the evolution of research methodologies to a design we call Diagnostic Research. This is an eclectic design where hypothesis generation is derived from clinical practice using qualitative research methodologies. Subsequently these are tested robustly, using quantitative methods to establish their validity, and in turn become part of professional knowledge. Nursing research currently has a leaning towards qualitative approaches that are held in low esteem when brought into the health care research arena. This article proposes that qualitative research has a place in health care research and is probably the necessary precursor and support to much quantitative research. Even our medical colleagues are beginning to realise the importance of this complementary methodology.     

Triangulation in nursing research: issues of conceptual clarity and purpose

The controversy concerning the value of qualitative, quantitative and triangulation approaches to nursing research for understanding human behaviour and increasing nursing knowledge has been an increasing source of debate among nurse scholars. However, the differences and similarities of these three perspectives have not been fully compared as either philosophies or methodologies. The purposes of this paper are to provide an understanding of the origin and development of the triangulation research method, clarify major sources of confusion in the presentation of a triangulation study, and discuss the problems and possible solutions of a triangulation study. Finally, an example of multiple triangulation in a nursing research within a Taiwanese cultural context —turning points of recovery from cardiac surgery during the intensive care unit transition — is presented. In the course of the paper, suggestions are also given to help nurse researchers recognize when it is most appropriate to use a certain research method, whether that be qualitative, quantitative or triangulation.     

The problem of rigor in qualitative research

There are few explicit discussions in nursing literature of how qualitative research can be made as rigorous as it is relevant to the perspective and goals of nursing. Four factors complicate the debate about the scientific merits of qualitative research: the varieties of qualitative methods, the lack of clear boundaries between quantitative and qualitative research, the tendency to evaluate qualitative research against conventional scientific criteria of rigor, and the artistic features of qualitative inquiry. A framework for understanding the similarities and differences in research approaches and a summary of strategies to achieve rigor in qualitative research are presented.     

Combining qualitative and quantitative research within mixed method research designs: A methodological review

Objectives

It has been argued that mixed methods research can be useful in nursing and health science because of the complexity of the phenomena studied. However, the integration of qualitative and quantitative approaches continues to be one of much debate and there is a need for a rigorous framework for designing and interpreting mixed methods research. This paper explores the analytical approaches (i.e. parallel, concurrent or sequential) used in mixed methods studies within healthcare and exemplifies the use of triangulation as a methodological metaphor for drawing inferences from qualitative and quantitative findings originating from such analyses.

Design

This review of the literature used systematic principles in searching CINAHL, Medline and PsycINFO for healthcare research studies which employed a mixed methods approach and were published in the English language between January 1999 and September 2009.

Results

In total, 168 studies were included in the results. Most studies originated in the United States of America (USA), the United Kingdom (UK) and Canada. The analytic approach most widely used was parallel data analysis. A number of studies used sequential data analysis; far fewer studies employed concurrent data analysis. Very few of these studies clearly articulated the purpose for using a mixed methods design. The use of the methodological metaphor of triangulation on convergent, complementary, and divergent results from mixed methods studies is exemplified and an example of developing theory from such data is provided.

Conclusion

A trend for conducting parallel data analysis on quantitative and qualitative data in mixed methods healthcare research has been identified in the studies included in this review. Using triangulation as a methodological metaphor can facilitate the integration of qualitative and quantitative findings, help researchers to clarify their theoretical propositions and the basis of their results. This can offer a better understanding of the links between theory and empirical findings, challenge theoretical assumptions and develop new theory.     

Beyond the divide: Comparing and contrasting aspects of qualitative and quantitative research approaches

As an introduction to this journal issue devoted to qualitative research methods in stuttering research, the present paper provides an overview of some of the underlying questions and issues arising from the use of qualitative approaches in research. The overview is written mindful of the historical domination of quantitative approaches to stuttering research and the likelihood that many readers of the present issue will have long experience and familiarity with quantitative approaches as opposed to qualitative ones. Consequently, qualitative research approaches are overviewed with particular reference to what have been, in our experiences, recurring queries about those methods from within the quantitative perspective. A broad definition of the inductive methods of qualitative approaches is offered and contrasted with the deductive methods of quantitative research. Subsequently, the issue of “bias” in qualitative approaches is considered, along with insights into ways of determining the quality of such approaches. It is concluded that there is no future in trying to understand or conceptualise either quantitative or qualitative research approaches using understandings transported from the other. Such an unproductive polemic or “paradigm clash” (Ingham, 1984) must be avoided as qualitative approaches to stuttering research grow in influence.     

An overview of three different approaches to the interpretation of qualitative data. Part 1: Theoretical issues

In this paper, the first of two, Helena Priest, Paula Roberts and Leslie Woods discuss the essential features and methods inherent within three approaches to the interpretation of qualitative data. An overview of three methodologies commonly used in nursing and healthcare research is presented: grounded theory, qualitative content analysis and narrative analysis. The paper considers the philosophical bases of the three methods and the principles inherent within each analytical approach. Key stages and steps are presented and described.     

Nursing research and the human sciences

Nursing has long been associated with the natural sciences. However, more recently some nurses have begun to identify it as a human science. The epistemological and ontological bases then shift, with clear implications for the research approaches that are regarded as the most useful. This column offers a discussion of the worldviews represented in contemporary nursing knowledge, focusing particularly on the newer paradigm that includes the view of nursing as a human science, and the place of qualitative and quantitative research. Neither the human sciences nor the natural sciences are seen as providing a sufficient base for all nursing knowledge. Both qualitative and quantitative approaches are viewed as potentially useful strategies given the nature of the phenomenon to be explored. Parallels to current discussions of worldviews and research methods in transpersonal psychology are identified.     

Triangulation in Qualitative Research: Evaluation of Completeness and Confirmation Purposes

The term triangulation has been applied to research strategies intended to serve two distinct purposes, confirmation and completeness. Many researchers who claim to have used a triangulated approach fail to provide evidence to show that their approach contributed to either confirmation or completeness of the data set. This paper reviews these distinct purposes and describes how triangulation of qualitative and quantitative methods was built into a study to achieve them. Analysis of data related to a single construct illustrates how data generated by qualitative and quantitative methods can provide both convergent validity and a broader understanding of one's subject matter.     

Methodological triangulation in a study of social support for siblings of children with cancer

Triangulation is an approach to research that is becoming increasingly popular among nurse researchers. Five types of triangulation are used in nursing research: data, methodological, theoretical, researcher, and analytical triangulation. Methodological triangulation is an attempt to improve validity by combining various techniques in one study. In this article, an example of quantitative and qualitative triangulation is discussed to illustrate the procedures used and the results achieved. The secondary data used as an example are from a previous study that was conducted by the researcher and investigated nursing interventions used by pediatric oncology nurses to provide social support to siblings of children with cancer. Results show that methodological triangulation was beneficial in this study for three reasons. First, the careful comparison of quantitative and qualitative data added support for the social support variables under investigation. Second, the comparison showed more in-depth dimensions about pediatric oncology nurses providing social support to siblings of children with cancer. Finally, the use of methodological triangulation provided insight into revisions for the quantitative instrument.     

Clinical research methods in the nursing discipline framework

Within the nursing discipline, the research helps or should help to develop and assess the theories related to the relevant phenomena. A professional discipline such as ours determines the relevant phenomena through its sphere of activity and the priorities of the society in general. With time, the disciplines develop a preference in the way of thinking about their discipline. At that point, there is no singular approach to the development of knowledge inside the nursing discipline, and no consensus either on the way of carrying out nursing research, whether it is applied or not. From time immemorial, the logical and systematic chain of reasoning coupled with the minute observation, the reflection and the intuition have built up the processes essential to the understanding of the human natural phenomena. Thus, the nursing research was mainly influenced by the two prevailing approaches (quantitative and qualitative) both focused on the experience, but using different strategies to get in touch with reality. Recently, the triangulation of the research elements seems more frequent, whether it is the combination of theories, of methods or of researchers of different disciplines with different perspectives. Each approach has its own methods and criteria to collect and analyse the data, then to interpret and check the results. The reproduction and the confirmation of this knowledge through additional and critical research are essential if we want this knowledge to be recognized by this discipline.     

Developing a framework for critiquing health research: an early evaluation

A new framework for critiquing health-related research is presented in this article. More commonly used existing frameworks tend to have been formulated within the quantitative research paradigm. While frameworks for critiquing qualitative research exist, they are often complex and more suited to the needs of students engaged in advanced levels of study. The framework presented in this article addresses both quantitative and qualitative research within one list of questions. It is argued that this assists the 'novice' student of nursing and health-related research with learning about the two approaches to research by giving consideration to aspects of the research process that are common to both approaches and also that differ between quantitative and qualitative research.     

Triangles and crystals: On the geometry of qualitative research

Triangulation has become increasingly appealing to researchers in nursing as a device to grasp the complexity of human phenomena, operationalize the holistic elan of nursing, and to accommodate both qualitative and quantitative approaches to inquiry. Yet, a misplaced ecumenicism, definitional drift, and conceptual misappropriation are evident in discussions of triangulation, which has become a technique for everything. Moreover, the triangle is somewhat lacking as image and metaphor for qualitative inquiry. As an idea and technique (in)formed by the triangle, triangulation should be used only to refer to a distinctive strategy for confirmation employed within research paradigms in which convergent and consensual validity are valued, and in which it is deemed appropriate to use information from one source to corroborate another. ©1995 John Wiley & Sons, Inc.     

The value of combining qualitative and quantitative approaches in nursing research by means of method triangulation

AIM: The article contributes to the theoretical discussion of the epistemological grounds of triangulation in nursing research. BACKGROUND: In nursing research, the combination of qualitative and quantitative methods is being used increasingly. The attempt to relate different kinds of data through triangulation of different methods is a challenging task as data derived through different methodologies are viewed as incommensurable. CONTENT: Epistemological questions become a vital issue in triangulation of different methods, as qualitative and quantitative methods are built on philosophical differences in the structure and confirmation of knowledge. The epistemology of nursing is manifold, complex and multifarious in character. Contemporary nursing research should be developed on the bases of an epistemology that reflects this multiplicity. The benefits and problems of triangulation are discussed on basis of an epistemological position that acknowledges the need for various types of knowledge and that does not attempt to rank them in a hierarchical order or place different values on them. CONCLUSION: We conclude that the complexity and diversity of reality provides the ontological basis for an alternative epistemological position. The various methods used should be recognized as springing from different epistemological traditions which, when combined, add new perspectives to the phenomenon under investigation. The different types of knowledge should not be seen as ranked, but as equally valid and necessary to obtain a richer and more comprehensive picture of the issue under investigation.     

Pragmatism in practice: Mixed methods research for physiotherapy

The purpose of this paper is to provide an argument for the place of mixed methods research across practice settings as an effective means of supporting evidence-based practice in physiotherapy. Physiotherapy practitioners use both qualitative and quantitative methods throughout the process of patient care—from history taking, assessment, and intervention to evaluation of outcomes. Research on practice paradigms demonstrates the importance of mixing qualitative and quantitative methods to achieve ‘expert practice’ that is concerned with optimizing outcomes and incorporating patient beliefs and values. Research paradigms that relate to this model of practice would integrate qualitative and quantitative types of knowledge and inquiry, while maintaining a prioritized focus on patient outcomes. Pragmatism is an emerging research paradigm where practical consequences and the effects of concepts and behaviors are vital components of meaning and truth. This research paradigm supports the simultaneous use of qualitative and quantitative methods of inquiry to generate evidence to support best practice. This paper demonstrates that mixed methods research with a pragmatist view provides evidence that embraces and addresses the multiple practice concerns of practitioners better than either qualitative or quantitative research approaches in isolation.     

Finding your way around qualitative methods in nursing research

The intention of this paper is to assist neophyte and traditionally educated nurse-researchers to navigate the qualitative research literature with understanding. The labeling language describing the central structures of the qualitative paradigm will be discussed as the key element to facilitating insight. The 'trustworthiness' of this research perspective will also be addressed within the context of the nursing research literature.     

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.