Research methods in nursing
Pmcid: pmc4287271nihmsid: nihms642265mixed methods in nursing research : an overview and practical examplesardith z. Doorenbos, school of nursing, university of washington, usa, box 357266, seattle, wa 98177;author information ► copyright and license information ►copyright notice and disclaimerabstractmixed methods research methodologies are increasingly applied in nursing research to strengthen the depth and breadth of understanding of nursing phenomena. This article describes the background and benefits of using mixed methods research methodologies, and provides two examples of nursing research that used mixed methods. The examples provided demonstrate specific benefits in the creation of a culturally congruent picture of chronic pain management for american indians, and the determination of a way to assess cost for providing chronic pain uctionmixed methods is one of the three major research paradigms: quantitative research, qualitative research, and mixed methods research. Mixed methods research combines elements of qualitative and quantitative research approaches for the broad purpose of increasing the breadth and depth of understanding. The definition of mixed methods, from the first issue of the journal of mixed methods research, is “research in which the investigator collects and analyzes data, integrates the findings, and draws inferences using both qualitative and quantitative approaches or methods in a single study or program of inquiry” (tashakkori & creswell, 2007, p. Simultaneous sequencing is postulated to be simultaneous use of qualitative and quantitative methods, where there is limited interaction between the two sources of data during data collection, but the data obtained is used in the data interpretation stage to support each method's findings and to reach a final understanding. Sequential sequencing is postulated to be the use of one method before the other, as when the results of one method are necessary for planning the next the 1960s, the use of mixed methods has continued to grow in popularity (o'cathain, 2009). Currently, although there are numerous designs to consider for mixed methods research, the four major types of mixed methods designs are triangulation design, embedded design, explanatory design, and exploratory design (creswell & plano clark, 2007). The most common and well-known approach to mixed methods research continues to be triangulation are many benefits to using mixed methods. Quantitative data can support qualitative research components by identifying representative patients or outlying cases, while qualitative data can shed light on quantitative components by helping with development of the conceptual model or instrument. During data collection, quantitative data can provide baseline information to help researchers select patients to interview, while qualitative data can help researchers understand the barriers and facilitators to patient recruitment and retention. During data analysis, qualitative data can assist with interpreting, clarifying, describing, and validating quantitative broad types of research situations have been reported as benefiting particularly from mixed methods research.
Nursing research methodology
Purpose of this article is to illustrate mixed methods methodology by using examples of research into the chronic pain management experience among american indians. Mixed methods to overcome barriers to researchbarriers to effective research into chronic pain management among american indians include the relatively small number of american indian patients in any circumscribed area or tribe, the limitations of individual databases, and widespread racial misclassification. A mixed methods research approach is needed to understand the complex experience, epidemiology, and management of chronic pain among american indians and to address the strengths and weaknesses of quantitative methodologies (large sample size, trends, generalizable) with those of qualitative methodologies (small sample size, details, in-depth). Of qualitative dataat level 3, qualitative research through focus groups and key informant interviews will provide even more refined information about perceptions of recommended and received care. The phrase “indigenous methodologies” refers to an evolving framework for creating research that places the epistemologies of indigenous participants and communities at the center of the work, while building an equitable and respectful setting for bidirectional learning (evans, hole, berg, hutchinson, & sookraj, 2009 ; louis, 2007. Although the tenets of indigenous methodologies vary according to the source, there is agreement among sources that research with indigenous populations should be wellness-oriented, holistic, community-oriented, and focused on indigenous knowledge, and should incorporate bidirectional learning (louis, 2007 ; smith, 2004). The researchers have conducted focus groups with the needs and priorities of the participants placed at the forefront, to best achieve the goals of learning and building knowledge that reflects the participants' experiences. The high familiarity among the participants and the research team was an important component of the bidirectional learning: it helped reduce much of the mistrust that has historically prevented medical researchers from obtaining high-quality data in similarly vulnerable populations (guadagnolo, cina, & helbig, 2009). Of triangulation design: multilevel modelin summary, only a mixed methods study that included quantitative and qualitative methods could provide the data required for a comprehensive multilevel assessment of the chronic pain experience among american indians. The mixed methods approach for this transaction cost analysis used a unique triangulation design with a data transformation model to build a body of evidence for telehealth pain ever increasing mandates to reduce the cost and increase the quality of pain management, health care institutions are faced with the challenge of demonstrating that new technologies provide value while maintaining or even improving the quality of care (harries & yellowlees, 2013). Transaction cost analysis can provide this evidence by using mixed methods research methodologies to provide comparative evaluation of the costs and consequences of using alternative technologies and the accompanying organizational arrangements for delivering care (williamson, 2000). Throughout the process, these community providers are responsible for direct patient care, and they act on recommendations of the consulting pain two care delivery models discussed above — traditional in-clinic consultation at the center for pain relief and telehealth case consultation through telepain — provided this mixed methods study using triangulation design and a data transformation model with two comparative arrangements for delivering the same transaction: delivery of pain care to patients (see figure 2). For the tele-pain transaction, team members interviewed included the telepain nurse care coordinator, two pain specialists, an information technology specialist, and the clinic following details the process of the mixed methods analysis.
These methods used to determine transaction costs provide an excellent example of mixed methods research, where both qualitative and quantitative data and analysis are needed to provide the transaction cost sionmixed methods are increasingly being used in nursing research. We have detailed two studies in which mixed methods research with triangulation design brought a richness to the examination of the phenomenon that a single methodology would not in the two examples described, a major advantage of the triangulation design is its efficiency, because both types of data are collected simultaneously. Both simultaneous and sequential data collection lend themselves to team research, in which the team includes researchers with both quantitative and qualitative nges include the effort and expertise required due to the simultaneous data collection, and the fact that equal weight is usually given to each data type. Thus this research requires a team, or extensive training in both quantitative and qualitative methodologies, and careful adherence to the methodological rigor required for both methodologies. Nursing researchers may face the possibility of inconsistency in research findings arising from the objectivity of quantitative methods and the subjectivity of qualitative methods. The multilevel model was useful in designing this study as different methods were needed at different levels to fully understand the complex health care system. This required the development of procedures for transforming the qualitative data, related to, time spent on a step and salary of the provider, into quantitative cost two studies presented as examples demonstrate mixed methods research resulting in the creation of (a) a rich description of the american indian chronic pain experience, and (b) a way to assess cost for providing chronic pain care via tribal clinics. In both examples, the quantitative data and their subsequent analysis provide a general understanding of the research problem. Research using a single methodology would not have been able to achieve the same ledgmentsresearch reported in this paper was supported by the national institute of nursing research of the national institutes of health under award number #r01nr012450 and the national cancer institute of the national institutes of health under award number #r42 ca141875. Common insights, differing methodologies : toward a fusion of indigenous methodologies, participatory action research, and white studies in an urban aboriginal research agenda. 2002;16(3):171–s:article | pubreader | epub (beta) | pdf (243k) | > major work > research methods & entals of applied evaluation | research methods & evaluation (general). 2010 | 1 288 pages | sage publications ad flyer recommend to g research is a diverse discipline which draws on methods and methodologies from across the social, behavioural and biomedical sciences. Few if any of the approaches to research used within nursing are unique; however, their application within the complex milieu of nursing care has frequently raised distinctive challenges and generated novel applications.
Nursing research methods brings together seminal sources that illustrate both the origins and the state of the art of research in nursing. The editors draw on methodological sources from outside the discipline that are influential and have shaped nursing research as well as discussions and debates about the application of particular methods within the text is organised around a selection of 8-10 seminal studies which have been selected based on their significance and ability to represent the broad scope of the discipline. Studies are selected to provide a vehicle to cover key methods for nursing research and to represent some of the diversity of the research topics that constitute the discipline. Because of the wide international audience, the editors take a broad view of the 'family' of nursing to include health visiting, public health nursing and midwifery and nurse one: quantitative ational and quasi-experimental -staffing levels and the quality of care in needleman, peter buerhaus, soeren mattke, maureen stewart and katya ' reports on hospital care in five h. Ce nightingale gets no respect: as a statistician that al construction and ms and methods in ting new knowledge from existing data: the use of large data sets for nursing magee, susan m. Tution of a nursing-led inpatient unit for acute services: randomized controlled trial of outcomes and cost of nursing-led intermediate griffiths, ruth harris, gerald richardson, nancy hallett, shelley heard and jenifer s to validity in randomized clinical fogg and deborah tics notes: how to s g. Martin ent effectiveness research and design consolidated standards of reporting trials (consort): guidelines for reporting randomized g-led in-patient units for intermediate care: a survey of multidisciplinary discharge planning experiment: is it worthwhile? Pment of the practice environment scale of the nursing work the nursing work index measuring up? Ative data as a potential source of theory in ing 'plausible stories': interviewing student ed theory in the 21st century: applications for advancing social justice occupational demarcation: the 'boundary-work' of nurse managers in a district general ethnographic approach and nursing ette t. Raphic evidence: the value of applied ethnography in ethodological insights into insider-outsider relationships in nursing ethnographies of healthcare ations of performance ethnography in a. Re)writing ethnography: the unsettling questions for nursing research raised by post-structural approaches to 'the field'. People with motor neurone disease talk about living with their illness: a narrative brown and julia g stories: narrative approaches in qualitative ete ive methods in quality improvement research. Morality, and emotions: phase i and phase ii clinical trials and patients with y of life: a phenomenological perspective on explanation, prediction, and understanding in nursing enologies as research methodologies for nursing: from philosophy to researching people in accident and emergency: the use of action research to explore the interface between services in an acute bridges and julienne ers in group dynamics: channels of group life; social planning and action assessment of the scientific merits of action i.
Qualitative methods in health related action y in qualitative ale and standards for the systematic review of qualitative literature in health services popay, anne rogers and gareth size in qualitative ete or rigor mortis: the problem of rigor in qualitative research ete ishing the credibility of qualitative research findings: the plot r. Tales of technical essentialism and three: mixed methods, integration and inants in the development of advanced nursing practice: a case study of primary-care settings in hong twinn, david r. Case for case studies: exploring the use of case study design in community nursing bergen and alison cal considerations in case study research: the relationship between methodology and mcdonnell, myfanwy lloyd jones and susan study: a bridge across the ta luck, debra jackson and kim case for case studies in nursing research: the problem of ison of findings from a single case in relation to those from a systematic review of action ne meyer, karen spilsbury and jacqui al incident ping flanagan's critical incident technique to elicit indicators of high and low quality nursing care from patients and their j. Campbell, elizabeth murray, janet darbyshire, jon emery, andrew farmer, frances griffiths, bruce guthrie, helen lester, phil wilson and ann louise gies for theorizing from process ing qualitative and quantitative sampling, data collection, and analysis techniques in mixed-method ete ating quantitative and qualitative research: how is it done? Paterson, sally thorne and marilyn sleeping position and the sudden infant death syndrome: systematic review of observational studies and historical review of recommendations from 1940 to gilbert, georgia salanti, melissa harden and sarah rest: a potentially harmful treatment needing more careful evaluation systematic reviews in allen, paul glasziou and chris del marjacqueline droogan and nicky atic reviews: gatekeepers of nursing evans and alan nthesis: the state of the art - so ological strategies for the identification and synthesis of 'evidence' to support decision-making in relation to complex healthcare systems and forbes and peter ing qualitative research in systematic reviews: opportunities and dixon-woods, ray fitzpatrick and karen ts, analysis and the development of nursing knowledge: the evolutionary book is not available as an inspection copy. For more information, please refer to our privacy > july-august-september 2004 - volume 27 - issue 3 > research methods and gue's e-mail is name: (optional). You might appreciate this item(s) i saw at advances in nursing a copy to your message has been successfully sent to your error has occurred while processing your request. Issue topic “advances in research methods” drew a strong response from authors, resulting in the extension of this topic for 2 issues. The articles in this, and the previous, issue of ans demonstrate the significant work that nurse scholars have accomplished in developing methods that are well suited to our discipline. Unlike the early debates over the merits of borrowing from other disciplines versus developing our own theories and methods, nurse scholarship today reflects a maturity that acknowledges the worth of a wide array of approaches to develop knowledge needed for excellent, evidence-based nursing quest for new and improved methods is not simply a search for something to replace that which is traditionally accepted practice. Nursing scholarship and nursing practice are built upon an epistemologic stance that seeks knowing of the whole, not just the parts. Similar to the epistemology that gives rise to feminist scholarship,1 this well-recognized epistemologic commitment to wholism gives rise to nursing scholarship. Some of the methods that have served many disciplines well also serve nursing well, but many methods that are well accepted in other disciplines have been found to be wanting when nurse scholars apply them to nursing problems.
Some of the methods can be used in combination with other methods to move closer to a comprehensive understanding of the whole. Some scholars seek new and innovative methods that serve the purposes of their work more ng the whole is not a simple matter, and even grasping what this means challenges the best thinkers in nursing. The newer and more creative methods require long and dedicated testing to determine their worth in terms of scientific merit. Some will fall by the wayside, while others will become a solid part of nursing's accepted methodologic approaches. Their contributions are significant and contribute a forum from which the next generation of nursing scholarship can your ideas and responses to their work in the form of a letter to the editor. 2004 lippincott williams & wilkins, ch methods and es in nursing science27(3):161, july-august-september gue's e-mail is name: (optional). Please try again ental patterns of knowing in wikipedia, the free to: navigation, g research is research that provides evidence used to support nursing practices. Nursing, as an evidence-based area of practice, has been developing since the time of florence nightingale to the present day, where many nurses now work as researchers based in universities as well as in the health care education places focus upon the use of evidence from research in order to rationalise nursing interventions. In england and wales, courts may determine if a nurse acted reasonably based upon whether their intervention was supported by g research falls largely into two areas:Quantitative research is based in the paradigm of logical positivism and is focused upon outcomes for clients that are measurable, generally using statistics. The dominant research method is the randomised controlled ative research is based in the paradigm of phenomenology, grounded theory, ethnography and others, and examines the experience of those receiving or delivering the nursing care, focusing, in particular, on the meaning that it holds for the individual. The research methods most commonly used are interviews, case studies, focus groups and ly in the uk, action research has become increasingly popular in ce-based quality improvement practices[edit]. 2008, the agency for healthcare research and quality ahrq created the ahrq health care innovations exchange to document and share health care quality improvement programs, including hundreds of profiles featuring nursing innovations. 1] each of the nursing profiles contained in this collection contains an evidence rating that assesses how strong the relationship is between the innovative practice and the results described in the profile.
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