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     

Reflection-on-practice: enhancing student learning

The writing of a reflective diary is viewed as an effective tool for promoting reflection and learning in students, and for self-assessment and evaluation of a clinical learning experience This work is a study of 30 undergraduate nurses and then- use of reflective diaries during a period of community health care practice The theoretical basis of the study is based on Schon's work on reflection-in-action The research tool, developed for the study of nursing practice by Powell, is based on Mezirow's levels of reflectivity The findings are that, in the sample used, students do reflect on their practice according to Mezirow's levels of reflectivity, but that the highest number of reflections occur at the lower levels of reflectivity (94% of the total number of scores) However, although only 6% of the total number of scores were found at the higher levels of reflectivity, some 22 of the sample of 30 students did attain conceptual and theoretical reflectivity, the highest levels of reflectivity     

Clinical role activities of nurse teachers in Project 2000 programmes

This paper presents the findings related to the clinical role activities of nurse teachers in Project 2000 programmes Data were collected by a Delphi survey of 25 colleges of nursing that had implemented Project 2000 between September 1989 and April 1991 The findings from the Delphi survey were explored more fully through in-depth interviews with a sample of the respondents The findings identified a very strong commitment of the respondents to a clinical liaison role But they did not perceive their role to be one of teaching students through 'hands on care', they felt this was the role of the qualified staff in the clinical areas The respondents considered it important to maintain their clinical credibility through theoretical updating rather than being able to perform as an expert practitioner     

Positioning of the stroke patient: a review of the literature

Stroke in a common and disabling illness, adversely affecting the quality of life of hundreds of people each year. While there are many therapeutic approaches to stroke patient rehabilitation, encouraging patients to adopt “reflex-inhibiting” patterns of posture is a widely advocated strategy for helping patients to avoid complications of hemiplegia such as spasticity and contractures. However, while the central role of nurses in thus helping patients is recognized, the influence of posture on recovery from stroke has never been evaluated. Prior to undertaking such an evaluative study, texts on stroke patient care were reviewed to clarify the received view about the recommended positioning for patients with hemiplegia. Consensus on some issues was evident (such as positioning the patient with the affected shoulder protracted, spine straight, fingers extended and avoiding external rotation of the affected hip). However, opinion was divided on others and a number of potentially important aspects were ill-covered. This paper integrates a summary of the findings of this review with the physiological rationale for the recommendations. The main areas of agreement are highlighted and issues as yet unanswered are raised for further consideration.     

Zero tolerance: A policy in conflict with current opinion on aggression and violence management in health care

Aggression and violence are common in the emergency department setting. In recent years, there has been a greater recognition of this problem with State Governments in Australia responding with zero tolerance policies. This paper examines the current recommendations from nursing and medical literature with regard to the minimisation and management of aggression and violence in health care. A consistent theme throughout the literature is that early recognition and use of de-escalation strategies aimed at diffusing a volatile situation is the preferred approach. Use of restraint and a zero tolerance approach are last resort measures. It is important to have practical policies, protocols and procedures in place to manage aggression and violence in the emergency department. An emphasis on training and skill development, particularly communication and negotiation strategies, is imperative for all health care professionals.     

Florence Nightingale, feminism and nursing

Three key aspects of Florence Nightingale's remarkable life are examined. First, the influences during her formative years: the education and guidance provided by her father, the resistance by her family when she decided to become a nurse; and the rejection by Nightingale of the societal expectations of a woman in the Victorian era. Secondly, her professional life is examined, in particular how she appears to have been viewed by certain members of society, and how in turn she viewed them. It is anticipated that her position as an early feminist will be postulated and illuminated. Thirdly, an analysis of her personal and professional life indicates a way forward for the nursing profession.     

The development of theory in British nursing: current position and future prospects

This paper is concerned with the development of theory in the discipline of nursing as it is practised in Great Britain. It stems from dissatisfaction with the generally uncritical adoption by British nurses of models of nursing which have been developed to explain and enhance North American practice. After the introductory paragraph, four roles for nursing theory are proposed. These are: to define nursing by describing nursing phenomena; to form a realistic basis for curriculum design; to provide tools for the professional practice of nursing; and to provide a nursing language. It is then argued that although British nurses have recognized the need for an adequate theoretical basis for practice, their response has been rather uncritical adoption of American models of nursing. As a basis for practice, it is argued that American models generally fail to meet the needs described above, and therefore fail to have impact on clinical work. Structural and philosophical reasons for this failure are identified. Following a brief discussion of the inductive and deductive approaches to the development of theory, the paper closes with the argument that British nurses should be concerned with the development of new theory which, if grounded in the reality of practice, would be likely to be both useful and realistic.