Qual Report

7/28/2019 Qual Report

1/8

Research in Nursing and Health, 1984, 7, 17-24

Interpreting and ReportingQualitative ResearchKathleen Astin Knafl and Marion J. Howard

The aims of this paper were to clarify the nature and purpose of qualitative researchand to suggest specific guidelines for reporting the results of qualitative studies. Con-fusion about the purpose of qualitative research and the absence of a standardizedformat for reporting such research make it difficult to assess the validity of qualitativestudies. Four general purposes of qualitative research were discussed: instrument de-velopment, illustration of results, description, and conceptualization. A framework forreporting qualitative research that provides a guide for assuring consistency acrossoriginal study purpose, study design, and final report was presented and can be usedfor either evaluating or writing a report of qualitative research.

The reporting of study results confronts thequalitative researcher with a difficult problem.Unlike the person who has undertaken an exper-imental or survey s tudy, the quali tat ive re-searcher has no well-codified, generally ac-c e p t e d , p r o t o c o l a v a i l a b l e a s t o h o w t h emethodology and findings of such a study bestcan be communicated. Focusing on techniquesand problems of data collection, processing, andanalysis, qualitative methods texts and articlesgive the researcher comparatively few guidelinesfor communicating data in a way that convincesthe reader of their validity and reliability. As aresult, reports of qualitative studies follow vary-ing formats (Glaser & Strauss, 1966; Klenow,1981), many of which may appear highly unor-thodox and unacceptable to the reader who isaccustomed to reading the results of surveys andexperiments. Using the latter as a standard forevaluation, readers often find reports of qualita-tive research interesting but unconvincing.Th e present article is predicated on the follow-ing two assumptions: (a) the absence of a standardformat for reporting qualitative research makes itdifficult for even the methodologically sophisti-cated reader to assess the validity of a qualitativestudy, and (b) difficulties in understanding andevaluating qualitative research stem from con-fusion over the underlying nature and purposes

of qualitative research. Building on these as-sumptions, the aims of this article are to clarifythe nature and purposes of qualitative researchand to suggest specific guidelines for reportingthe results of qualitative studies.

NATURE AND PURPOSE OF QUALITATIVERESEARCH

In this section the desired products of quali-tative nursing research and the means for attain-ing these are discussed. Qualitative research typ-ically has been defined in terms of researchmethods. Comparing quantitative and qualitativeresearch, Cook and Reichardt (1979) stated:By quantitative methods, researchers have cometo mean the techniques of randomized exper-iments, quasi-experiments, paper and pencilobjective. tests, multivariate statistical anal-yses, sam ple surveys, and the like. In contrast,qualitative methods include ethnography, casestudy, indepth interviews, and participant ob-servation. (p. 7)Quali tat ive research is equated with thosemethods or data gathering techniques which gen-

erate narrative as opposed to numerical data.Dr. Kathleen Knafl is a professor in psychiatric nursing in the College of Nursing at the Universityof Illinois-Chicago. Ms. Marion Howard i s a research associate at the Erie Family Health Center,Inc., Chicago, Illinois.This article was received J une 7, 1982, wos revised, ond an December 10, 1982, was acceptedfor publication.Requests for reprints moybeaddressed to Dr. Kathleen Astin Knafl, Professor, Psychiatric Nursing,

College of Nursing, Universityof Illinois-Chicago, 845 South Damen Avenue, Chicago, I16061 2.0 1984 Wiley 01 60-6891/84/010017-08$04.00 17


2/8

18 RESEARCH IN NURSING AND HEALTHQualitative data take the form of verbatim inter-view and/or field note transcripts.What the preceding distinctions fail to take intoaccount are the purposes served by qualitativemethods and data gathering techniques. Ethnog-raphies, case studies, intensive interviews, andparticipant observation can serve a variety of re-search purposes. For example, nurse authors de-scribed the purpose of their qualitative studies inthe following ways:

In this paper I shall discuss a research ap-proach . . . in which a given problem area isstudied for the purpose of developing a con-ceptual framew ork [emphasisours] for under-standing and explaining what takes place in therealm of patient care, given certain sets of cir-cumstances. (Quint, 1967, p. 109)The final goal of which the nurse ethnographershould never lose sight is to grasp the pa tien tspoint of view [emphasis ours], relation to life,to his vision of the phenomenon of health andillness. (Ragucci, 1972, pp. 489-490)

Quint emphasized the usefulness of qualitativeresearch in the generation of theory or the con-ceptual rendering of an area of interest. She notedthat qualitative studies often provide the empir-ical grounding for more rigorously structured re-search. On the other hand, Ragucci, paraphrasingher previous quote of Malinowski, stressed thatthe accurate and detailed description of a pointof view, a social world, is the major contributionof qualitative research. We would add that qual-itative research also serves as an adjunct to stud-ies which are primarily quantitative in nature.Depending on the researchers purpose, qual-itative methods may be used for instrument de-velopment, illustration, sensitization, or concep-tualization. In the first instance, qualitative dataare important in developing or refining the in-strument(s) used in a quantitative study. In thesecond instance, limited qualitative data are col-lected and used to illustrate the results of a larger,quantitative project. As a sensitizing device,qualitative findings are important in and of them-selves since it is the richness and detail of the

data that give the reader an understanding of thesubjects social world. As the raw material oftheory, qualitative data are important as a meansto an end. The raw data are translated into con-cepts and, in turn, used to illustrate the concepts.In this case, the investigator uses the raw dataprimarily as a catalyst for conceptualization.In reviewing published qualitative studies, thereporting styles reflected an absence of guidelines

related to purpose. For example, in a study ofreality shock among new baccalaureate graduatenurses in medical center hospitals, Kramer (1969)reported the qualitative component of her studyin grounded theory terms when she actually usedthe qualitative data to illustrate predominantlyquantitative findings. Other authors inadequatelydescribed methods or inconsistently defined pur-poses across the various sections of the researchreport. Stem (1978) described her entire researchmethodology simply as constant comparativeanalysis @. 50). Kueffner (1976) concluded herreport with statements reflecting a purpose ofsensitization rather than conceptual developmentas presented in earlier sections of the article.

CO MM UN ICA TING QUALITATIVE RESEARCHOne might expect this diversity of purposeacross qualitative studies reflected in a diversityof final products. A researcher whose goal is toprovide baseline data for future research will for-mulate a different final report than a researcherwhose aim is to provide a descriptive base fornursing practice. Similarly, the end product of agrounded theory study will differ from that of adescriptive study. The reader should evaluate thequality and usefulness of a qualitative study withinthe context of the authors purpose. The readershould not expect theory when the purpose hasbeen to describe; similarly, a grounded theoryreport may not result in recommendations forsubsequent quantitative study. Authors may useidentical data gathering techniques, but with dif-ferent ends in mind. A clearly stated purpose willhelp the reader formulate a realistic set of expec-

tations.Existing guidelines for reporting the processand product of qualitative research usually fail todiscuss the issue of purpose. Most are writtenfrom the assumption that the authors goal is togenerate theory. In fact, many qualitative re-searchers equate excellence in qualitative reportswith going beyond description to conceptualiza-tion of the data (Becker, 1970; Glaser& Strauss,1967; Lofland, 1976; Quint, 1967; Schatzman &Strauss, 1973). However, the fact remains thatnot all qualitative studies result in conceptuali-zations because not all qualitative researchers havethat purpose in mind.The remainder of this article delineates howreports of qualitative research with differing pur-poses are likely to vary when reported in thestandardized format of several nursing researchjournals. Table 1 is a guideline for either eval-uating or reporting the results of a qualitative


3/8

Te1.

SmmayofGudnoR

nQuavR

cB

oStudyPp

PsoM

p

RcPp

Ino

o

Sme

Mue

Poe

Rus

Dso

Inumao

Em

son

poeahw

qtavwk

wcbeo

inum

dom

Iuao

Stzo

Em

so

recpoem

bnae

inagpoe

Em

soa

oecao

nonh

usano

sue

C

uzoEm

soa

(TyBdnohyna

gvsuav

ae

Cmaeo

suesnn

poe

Cmpaeo

suesnag

poeosu

smeom

lagpoe

Reavo

taggoo

ogzo

Tec

Dpoo

nuea

domo

inevewgdo

ovsoe

Dsoohw

qtavda

wecee

ceza

un

inum

dom

Dpoo

nuea

domo

inevewgdo

ovsoe

Dpoo

nuea

domo

inevewgdo

ovsoe

Dpoo

nuea

domo

inevewgdo

ovsoe

QtavapQtavapNmo

n

osun

nmo

dsoue

mo

qtavda

lnospc

mhoco

rec

impco

?e

Bedpo

ohwqtav

aposu

wcmee

Eaoo

hwaw

daceo

teqeo

anh

dpoo

goo

ogzo

Dm

aoo

hwemg

thygd

daceo

Inespsno

qtavdao

hgg

qnov

fnn

Gonoda

inoceeo

tywcee

suesvew

Taaooaw

dano

thec

fomao

iuaebh

da

Nmo

n

dsoue

qtavda

lnospc

mhoco

rec

impco

Smyo

mohma

idcoo

paca

rec

impco

Smyo

thyomao

c

sa

idcoo

paca

rec

impco

Wrn K z0 I.

x Z Rr DZU I0 4 2U


4/8

20 RESEARCH IN NURSING AND HEALTHproject when reported in the format adopted bythe American Psychological Association (Publi-cation Manual of the American PsychologicalAssociation, 1983). We suggest that qualitativeresearchers explicitly structure their final reportsin terms of their original purpose. Similarly, weadvise the reader to formulate expectations andjudgments of the work based on the authors re-search purpose.l n s f r umen faf i on an d Illustration

When the investigator is using qualitative datato develop a structured instrument or to illustratequantitative results, the qualitative component isusually a small piece of a larger quantitative study.This aspect of the study should receive compar-atively little attention in the final reporting ofresults. In the beginning section of the report, thereader is introduced only to the questions andpurposes of the larger quantitative project. Thequalitative aspect of the study is described brieflyin the methods section of the article. Nonproba-bility or convenience sampling for the qualitativecomponent of the study often is the samplingmethod used. The reader should expect the sub-jects to be comparable to those of the larger study.In the measures subsection, the instrument(s)used to complete the qualitative aspect of the studyis described. Unstructured or semistructured (alsoreferred to as intensive or indepth) interviewingand participant observation frequently are usedas data collection techniques. When interviewshave been conducted, the author should indicatethe sources of questions for the interview guideand the major topical areas covered in the guide.If the guide(s) has been pretested, the results ofsuch testing in terms of revision(s) of the instru-ment should be noted. If data have been collectedusing participant observation, then the research-ers role in relation to the subjects should be de-scribed. The description should include the na-ture and extent of the researchers participationin the organizationor group studied and how therole developed and changed over the course ofdata collection.If the qualitative data are used as a basis forinstrumentation, the measures subsection alsoshould describe how qualitative data were cate-gorized and used to develop a structured instru-ment. For example, in developing an instrumentto measure uncertainty in illness, Mishel (198 1)initially interviewed 45 hospitalized patients toidentify statements of uncertainty associated withillness or hospitalization. The qualitative data werecategorized according to sources and types of un-

certainty and transformed to a 54-item Likefi scalewhich was administered to a larger sample ofhospitalized patients and then factor analyzed.The entire report of the qualitative componentwas written in two paragraphs, which succinctlyand adequately presented this aspect of the study.When qualitative data are used for the purposeof instrumentation, there is no necd to refer tothis aspect of the study in the procedure subsec-tion of the report, since it has been describedsufficiently in the measures subsection. How-ever, if the purpose is illustration, the author shouldindicate in the procedure subsection how thequalitative data were collected (i.e. , nterviewsor participant observation).When qualitative data are collected for instru-ment development, the data are not mentioned inthe results section of the report; rather, as indi-cated above, are described in the measures sub-section. If the qualitative data are collected toillustrate quantitative findings, they are inter-spersed sparingly throughout the results section.For example, h e r 1968) interviewed 47 newlyemployed graduates of three baccalaureate nurs-ing programs to supplement quantitative data ob-tained on the nurses service, professional, and

bureaucratic role orientations in their new jobs.Brief excerpts from interview transcripts were re-ported in the results section to illustrateor clarifythe meaning of group scores from quantitativemeasurements. If the author identifies specificmethodologicalor researcli implications based onthe qualitative data then this aspect of the studyis included in the discussion section of the report.However, the author should not include specificqualitative findings in the discussion unless thesealready have been introduced in the measures orresults subsections of the paper.Sensi t izat ion

When the researcher is reporting the results ofa descriptive study, the purpose of which is tosensitize the reader to the viewpoint of a partic-ular group, the introduction should show that eitherfew (if any) studies have been done on the topic,or those that have been done have failed to rep-resent the groups point of view.Since the authors purpose is to represent ac-curately and fully the perspective of a particulargroup, the author should specify, in describingthe sample, the characteristics of the populationof which the subjects are representative. Themeasures subsection should be similar in contentto that described in the preceding section of thispaper. The development and pretesting of inter-


5/8

QUALITATIVE RESEARCH I KNAFL AND HOWARD 21

view guides andfor th e planning for and the ac-tual development of the researchers role vis-a-vis the subjects should be presented.In the procedure subsection, the author shoulddescribe carefully and succinctly how the datacollection and analysis techniques were carriedout to insure that the reader will understand howthe approach fulfilled the original research pur-pose. Varying approaches to reporting the re-search procedure are suggested in textbooks onqualitative methods. Bogdan and Taylor (1975)listed seven procedure topics: method, time andlength of study, nature and number of settingsand subjects, how the subject became a subject,the researchers frame of mind, researcher-sub-ject relationship, and checks on the data (p. 143).Lofland (1971) listed five topics: inception andsocial relations, personal feelings, materials col-lection, analysis, and retrospect (p. 131). Thedifference between the two sets of guidelineshighlights the lack of consensus among qualita-tive researchers regarding how their work shouldbe reported.Although differing in content, guidelines areuseful to the extent that they provide the writerwith an organizing framework for presenting thestudy design. The main problem with such guide-lines is a practical one having to do with spaceconstraints confronting any author who writes forpublication in a journal. Lofland (1971), for ex-ample, listed 39 questions or topics to be ad-dressed under five broad headings.We suggest the following as minimal require-ments for what should be reported in the proce-dure subsection of a qualitative report:

combined. In general, the results section shouldcomprise a synthesis of the subjects viewpoints,either in general or with regard to the specifictopic studied. The presentation must be selectiveas the investigator inevitably has more data thanreasonably can be present in one report.The specific organizing framework for pre-senting the analysis of data will vary consider-ably from study to study. For example, Ipema(1979) studied the experience of and recoveryfrom rape by interviewing 11 rape victims on twoseparate occasions. From transcripts of the taperecorded interviews, three major content cate-gories were identified: the victims report of rape,rape sequelae, and disruptions of the social sys-tem. In the results section, Ipema chose to presentthe category of rape sequelae more fully thanthe other two categories, using both direct quotesfrom interviews and repetition of subjects sim-ilar responses to convey the rape victims com-mon experiences.Hampe (1975), on the other hand, used liter-ature on needs of the grieving person to identifymajor topics for two interview schedules. Datafrom two tape recorded interviews with 27 spousesof terminally ill patients were then presented inthe results section to demonstrate the meaning ofeach category of need to the subjects. The pur-pose of sensitization is found in the authors fol-lowing statement introducing verbatim excerptsof data presented with some of the category de-scriptions: Because the impact of the words ofthe spouses was so strong and at times heartrend-ing, the significance of the study can be mostclearly exemplified when the spouses commentsspeak for themselves (p. 116).The final discussion section in a descriptivereport should focus on implications for practiceand future research. Specific implications areidentified and discussed with reference to the or-ganizing framework and major themes presentedin the results section of the paper. If the authorhas fulfilled the purpose stated at the outset, thenthe reader is sensitized to the perspective of thegroup being studied. In the final section, thenursing implications of the perspectives de-scribed are presented. The author also may sug-gest avenues for additional research and prom-

1. Preparation for data collection, includinggaining access to study sites and subjectsand training of project staff.2. Length of time spent collecting data, howdata were recorded, and the amount of datacollected.3 . Steps taken to organize, categorize, orsummarize the data prior to final analysis.4. Management of threats to the validity andreliability of the data.

5 . Process by which conclusions were derivedfrom the data.Depending on space limitations and the nature ofthe study being reported, the author may decide :sing approaches for such research.to devote comparatively more or less attention toany of the preceding topics or to add topics par- Conceptualizat ionticularly relevant to a study.More so than in reports of experimental andsurvey research, in the results section of a qual-itative article, data reporting and discussion are

Several nurse authors support an inductive ap-proach to theory development in nursing practicethrough the collection and use of qualitative data(Jackson, 1975; Jacobsen, 1970; Quint, 1967;


6/8

22 RESEARCH IN NURSING AND HEALTHWilson, 1977). A s Jacobsen (1970) noted,Nursing is in need of substantive theories ap-plicable in a variety of nursing situations. It ispossible to develop such theories directly fromthe qualitative data of everyday nursing con-texts (p. 13).Investigators reporting such studies should in-troduce the reader to the conceptual or theoreticalsignificance of the subject matter. For example,Wilson (1977) placed her study of an experimen-tal treatment community within the context ofhistorical social rejection of the insane. The con-ceptual significance of her study, implied in theintroductory information, explained how a non-traditional psychiatric treatment center survivesin the midst of a potentially rejecting public. Whenthe purpose is to develop theory, it is importantto alert the reader from the outset that the reportis aimed at conceptualization. The study ap-proach may be introduced as an extension of ex-isting descriptive research, with an emphasis onidentifying conceptual links among categories ofdata rather than simply describing the data tocommunicate thc subjects point of view. Thisbeing the case, it is necessary to review othertheories pertinent to the subject matter and todiscuss the rationale for additional theorizing.Studies often are described explicitly in termsof prhciples of grounded theory (Glaser& Strauss,1967). Integral to this theory-discovering ap-proach is theoretical sampling. The techniqueprecludes specifying ones entire sampling de-sign prior to data collection. Sampling decisionsare dependent on analysis of the incoming dataand the developing theory. The author shouldpresent major sampling decisions made duringthe course of data collection. These usually entailchanges in the settings or subjects being studiedor in the timing of observations. Further, the au-thor should state how changes were justified interms of the developing theory. For example, aresearcher who is conceptualizing the relation-ship between staff nurses and patients relativesbased on observations made on adult acute careunits may choose to refine and further expand thedeveloping theory by collecting data on pediatricunits or on units where a different mode of nurs-ing care is practiced. Such changes and the ra-tionales underlying them should be summarizedin the sampling subsection. Because this is a non-conventional sampling approach, it is advisableto cite articles or texts which address the appro-priateness and use of theoretical sampling for thepurpose of theory development (Glaser & Strauss,1967; Wilson, 1977).

As stated previously, the measures subsectionshould describe the development and nature ofdata collection instruments. When the authorspurpose is conceptualization, changes in the in-struments during the course of data collectionshould be noted and justified in terms of theirtheoretical relevance. As in the sampling subsec-tion, the author needs to make explicit the fitbetween ongoing methodological decisions andthe developing theory.In a conceptualization study, as with previ-ously discussed descriptive studies, the proce-dure subsection should contain what specific datacollection techniques were used, the time spanover which data was collected, the quantity ofdata collected, steps taken to organizeand processthe data, and limitations of the data. The authorshould demonstrate that specific data collectionand processing steps served the overall theoreti-

Research by Kueffner (1976) illustrates thispoint. In initiating a study of hospitalized chil-dren on isolation technique, the investigator se-lected a sample of children with severe burns,because they are inevitably isolated, generallyfor extended periods (p. 183). However, theauthor commented on how the original theoreti-cal notion was altered by her observations as datagathering progressed. Within the research de-sign, it became increasingly difficult to identifybehaviors relating solely to the isolation experi-ence. It was the burn with its all-encompassingpain that dominated the situation (p. 185). Theauthor later incorporated this alteration in con-ceptualization with the original concept of iso-lation and a new category of data, loss, in herformulation of a theoretical model of the passagethrough hospitalization of a severely burned schoolage child. In describing her model, Kueffnerstated, The pain, sense of aloneness, and feel-ings of loss experienced during hospitalizationand stemming from the bum and the state of iso-lation, exert the dominant influence on behavior

In the results section, the authors conceptualrendering of the data is presented. Specific con-cepts or categories of data are discussed in termsof their place within and contribution to the au-thors overall conceptualization of the phenom-enon under study. Lofland (1971) said thatpenetrating and useful qualitative analysis hasthe feature of striking a balance between abstractand general concepts on the one hand and de-scription and quotations from a settings partici-pants on the other @, 128). This balance is

cal purpose.

(P. IN).


7/8

QUALITATIVE RESEARCH / KNAFL AND HOWARD 23achieved test by interweaving theory and exam-ples of the data from which the theory was de-rived.Presenting and discussing specific results in thecontext of their theoretical relevance demon-strates how conceptual formulations are groundedin the data. T he author should indicate the natureand scope of the data underlying conclusions andhighlight the report with representative quotes fromthe data. Lofland (1974) suggested that approx-imately 60%of the report be devoted to concep-tualization and 40% to presentation of data. Whilethese percentages are likely to vary across arti-cles, it is reasonable to expect that a groundedtheory report should have proportionately moretheory than description.Lofland (1974) described the blending of re-sults, frame (conceptualization), and discus-sion:

Frame and qualitative materials coexist as onewhole, each depending upon the other for theinterest a reader has in the frame or in thequalitative material . . . The frame taken sep-arately is dull because the reader has little con-ception of the concrete empirical reality to whichthe frame might refer. The data alone aredull because the reader has no notion of whatsort of social structure or process m ight be in-volved. But interpenetrated through minute andcontinual alternation between data and frame-elements, the whole is more than the part. (pp.108-109)As in virtually all reports of nursing research,the author should conclude the final discussionsection with statements of the implications for

nursing practice and further research and theorydevelopment needed in the area. Such implica-tions and recommendations should be linked ex-plicitly to the authors conceptual formulations.Recognizing the fact that nursing as a scientificdiscipline has a relatively short history of pub-lished research endeavors, we felt that clarifyingthe purposes of qualitative research would benefitinvestigators who need to know and understanda variety of research methodologies. We partic-ularly wanted to suggest guidelines for reportingqualitative, studies, because we believe, as doothers (Glaser & Strauss, 1966; Klenow, 1981;Quint, 1967), that existing misunderstandings re-late to the lack of standardization in reporting thistype of research.The data collection techniques associated withqualitative studies serve a variety of research pur-

poses. These varying purposes are, in turn, re-flected in research reports with differing em-phases and structures. This is especially true withregard to sensitization and conceptualization.Descriptive reports too often are criticized for notgoing beyond description; grounded theories arecriticized fo r not presenting detailed descriptionsof settings and subjects. Such criticisms are un-justified when viewed in terms of study purpose.They reflect misunderstanding on the part of thereader, inadequate reporting on the part of theresearcher, or both. W ith these guidelines we havesought to reduce both misunderstanding and poorreporting. We ask readers of qualitative researchto evaluate that work in the context of overallstudy purpose. We ask writers to state their pur-pose explicitly so that the reader can formulaterealistic expectations.A s we have shown, varying reports of quali-tative research can be adapted to a standard jour-nal format. However, one might expect reportsof qualitative studies to continue to emphasizedifferent aspects of the research or indicate thatthe research was carried out in differing ways.This is as it should be since qualitative studiesserve a variety of research purposes, which re-quire varying research designs and result in sev-eral styles of research reporting.

\RFRNCSBecker, H. S. Sociologim/work.Chicago: Aldine, 1970.Bogdan, R., & Taylor, S. Introduction to qualitative

research methods: A phenomenological apprwch tothe social sciences. New York: Wiley, 1975.

Cook, T. D., & Reichordt, C. S.Qualitative and quan-titative methods in evaluotion research. Beverly Hills:Sage, 1979.

Glaser, B., & Strauss, A . The purpose and credibilityof qualitative research. Nursing Research, 1966,

Glaser, B., & Strauss, A. The discovery of groundedtheory: Strategies for quolitotive research. Chicago:Aldine, 1967.

Hampe, S. 0. Needs of the grieving spouses in ahospital setting. Nursing Reseorch, 1975, 24,

Ipema, D. K. Rape: The process of recovery. NursingResearch, 1979, 28, 272-275.J ackson, 8. S. An experience in participant obser-vation. Nursing Outlook, 1975, 23, 552-555.

J acobsen, M. Qualitotive data as a potential sourceof theory in nursing. Image, 1979, 4 , 19-14.Klenow, D. J . Qualitative methodology: A neglected

resource in nursing research. Research in Nursingand HeoIth, 1981, 4, 281-282.

15, 56-61.

113-1 20.


8/8

24 RESEARCH IN NURSING AND HEALTHKramer, M. Role models, role conceptions, and role

deprivation. Nursing Reseorch, 1968, 77, 1 15-1 20.Kramer, M. Collegiate graduate nurses in medical

center hospitals. Nursing Research, 1969, 18,

Kueffner, M. Passage through hospitalization of se-verely burned, isolated school-age children. Com-municating Nursing Research, 1976, 7 1 81-1 97.

Lofland, J . Analyzing social settings: A guide to qual-itative observation and analysis. Belmont, CA:Wadsworth, 1971.

Lofland, J . Styles of reporting qualitative field re-search. The American Sociologist, 1974,9, 101-1 1 1 .

Lofland, J . Doing social life: The qualitative study ofhuman interaction in natural settings. New York:Wiley, 1976.

Mishel, M. H. The measurement of uncertainty inillness. Nursing Research, 1981, 30, 258-263.

196-220.

Publication manual of the American Psychological As-sociation (3rd ed.). Washington, D.C.: AmericanPsychological Association, 1983.

Quint, J . C. The case for theories generated fromempirical data. Nursing Research, 1967, 16,

Ragucci, A. T. The ethnographic approach and nurs-ing research. Nursing Research, 1972,21, 485-490.

Schatzman, L. & Strauss, A. Field research: Strategiesfor natuml sociology. Englewood Cliffs, NJ : Pren-tice Hall, 1973.

Stern, P. N.Stepfather families: Integration aroundchild discipline. Issues in Mental Health Nursing,

Wilson, H. A. Limiting intrusio4ocial control ofoutsiders in a healing community. Nursing Re-search, 1977,26, 103-1 1 1.

109-1 14.

1978, I , 50-56.

Documents

Qual Report