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AUGUST 1997, VOL 66, NO 2 RESEARCH CORNER Qua/itativeand quantitative approaches to nursing research Editor‘s note: This column in the Journal high- lights research issues relaM to priopr~ve nursing practice. The authoa AORNs codi- rectors of prioprrote remrch, provideprac- tical advice for mding, conducting, and using research in prioprative nursing practice. n important step in any nursing research study is determining A how to study the research ques- tion. As explained in last month’s “Research Corner,” research ques- tions are the linchpins of all research.’ They drive the research methods, subject selections, and data analyses in nurse researchers’ quests to develop knowledge that hopefully will improve patient out- comes. When research questions are well articulated, nurse researchers can select the best methods to acquire the data needed to answer the research questions. RESEARCH METHODS grouped broadly into two cate- gories: qualitative and quantitative approaches (Table 1). Some studies combine both approaches. Qualita- tive nursing research studies employ methods such as ethnogra- phy or grounded theory and often involve in-depth data collection from small numbers of subjects through open-ended interviews or surveys. In contrast, quantitative studies (eg, experiments, quasi- experiments)are characterized by larger sample sizes, numeric data, and statistical analyses? The approach selected depends on the research question. If a nurse researcher is interested in identify- ing and describing a phenomenon Nursing research methods are of interest (eg, caring behaviors in perioperative nursing), a qualitative approach is appropriate. A nurse researcher who wants to measure physiologic parameters (eg, core body temperatures, blood pressures) would need to use a quantitative research approach. Neither research approach is superior to, more reli- able than, or more valid than the other. Each has a distinct purpose and uses various methods to answer research questions. Both approach- es and their associated methods require scientific rigor and the pur- suit of excellence throughout the research process. In any research endeavor, nurse researchers must be detail oriented and accurate to ensure the scientific integrity of the entire process. Qualitativemethods. Qualitative research focuses on uncovering and understandingthe meaning of lived experiences. Although there are several methods used in qualitative research, the four most common are grounded theory, phenomenology, ethnography, and historiography. Each of these methods is based on a unique philosophic perspective and theoretic framework that determines the overall approach and specific procedures for data collection and analysis. Sample sizes in qualitative research generally are small, and the researcher has extensive contact with each subject while conducting ongoing observations or in-depth interviews. The unit of analysis in qualitative research is subjects’ words or behaviors, and the entire research process is viewed as being subjective rather than objective. Grounded theoty. The grounded theory research method emerged from the discipline of sociology and is based on symbolic interaction theory. Nurse researchers who use the grounded theory method observe, collect, and organize data through interviews, observations, or record examinations.They then code and create categories of tran- scribed interviews, analyze the data, and develop theories that describe the phenomena being studied? Phenomendogy. The phenome- nology research method focuses on describing subjects’ lived experi- ences as they interact with their environments. With this method, nurse researchers collect data through observations,interviews, and videotaping. They identify focal meanings or themes by describing, analyzing, and validating subjects’ words. From these processes, researchers develop rich, detailed descriptions of subjects’lived expe- riences and their meanings? Ethnography. Ethnographic researchers immerse themselves in specific cultures where they may assume participant/observer roles to collect data. These researchers use literature reviews as the foun- dations for their interviews or observations. They analyze the data by using content analysis and pattern identification as they ex- plore the meaning of words, behav- iors, events, and object^.^ Historogruphy. Historic research is a systematic process in which his- toric data provide the primary source of information to answer research questions. Researchers 323 AORN JOURNAL

Qualitative and quantitative approaches to nursing research

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Page 1: Qualitative and quantitative approaches to nursing research

AUGUST 1997, VOL 66, NO 2 R E S E A R C H C O R N E R

Qua/itative and quantitative approaches to nursing research

Editor‘s note: This column in the Journal high- lights research issues relaM to p r i o p r ~ v e nursing practice. The authoa AORNs codi- rectors of prioprrote remrch, provide prac- tical advice for mding, conducting, and using research in prioprative nursing practice.

n important step in any nursing research study is determining A how to study the research ques-

tion. As explained in last month’s “Research Corner,” research ques- tions are the linchpins of all research.’ They drive the research methods, subject selections, and data analyses in nurse researchers’ quests to develop knowledge that hopefully will improve patient out- comes. When research questions are well articulated, nurse researchers can select the best methods to acquire the data needed to answer the research questions.

RESEARCH METHODS

grouped broadly into two cate- gories: qualitative and quantitative approaches (Table 1). Some studies combine both approaches. Qualita- tive nursing research studies employ methods such as ethnogra- phy or grounded theory and often involve in-depth data collection from small numbers of subjects through open-ended interviews or surveys. In contrast, quantitative studies (eg, experiments, quasi- experiments) are characterized by larger sample sizes, numeric data, and statistical analyses?

The approach selected depends on the research question. If a nurse researcher is interested in identify- ing and describing a phenomenon

Nursing research methods are

of interest (eg, caring behaviors in perioperative nursing), a qualitative approach is appropriate. A nurse researcher who wants to measure physiologic parameters (eg, core body temperatures, blood pressures) would need to use a quantitative research approach. Neither research approach is superior to, more reli- able than, or more valid than the other. Each has a distinct purpose and uses various methods to answer research questions. Both approach- es and their associated methods require scientific rigor and the pur- suit of excellence throughout the research process. In any research endeavor, nurse researchers must be detail oriented and accurate to ensure the scientific integrity of the entire process.

Qualitative methods. Qualitative research focuses on uncovering and understanding the meaning of lived experiences. Although there are several methods used in qualitative research, the four most common are grounded theory, phenomenology, ethnography, and historiography. Each of these methods is based on a unique philosophic perspective and theoretic framework that determines the overall approach and specific procedures for data collection and analysis. Sample sizes in qualitative research generally are small, and the researcher has extensive contact with each subject while conducting ongoing observations or in-depth interviews. The unit of analysis in qualitative research is subjects’ words or behaviors, and the entire research process is viewed as being subjective rather than objective.

Grounded theoty. The grounded theory research method emerged from the discipline of sociology and is based on symbolic interaction theory. Nurse researchers who use the grounded theory method observe, collect, and organize data through interviews, observations, or record examinations. They then code and create categories of tran- scribed interviews, analyze the data, and develop theories that describe the phenomena being studied?

Phenomendogy. The phenome- nology research method focuses on describing subjects’ lived experi- ences as they interact with their environments. With this method, nurse researchers collect data through observations, interviews, and videotaping. They identify focal meanings or themes by describing, analyzing, and validating subjects’ words. From these processes, researchers develop rich, detailed descriptions of subjects’ lived expe- riences and their meanings?

Ethnography. Ethnographic researchers immerse themselves in specific cultures where they may assume participant/observer roles to collect data. These researchers use literature reviews as the foun- dations for their interviews or observations. They analyze the data by using content analysis and pattern identification as they ex- plore the meaning of words, behav- iors, events, and object^.^

Historogruphy. Historic research is a systematic process in which his- toric data provide the primary source of information to answer research questions. Researchers

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AUGUST 1997, VOL 66, NO 2

Table 1 EXAMPLES OF QUALITATIVE AND QUANTITATIVE NURSING RESEARCH

Study topic Research approach

Managing health problems among homeless Qualitative women with children in a transitional shelter' Postoperative pain in frail, elderly women2 Qualitative

Modes of thought, feeling, and action Qualitative in pediatric nurses' pain assessments of infants3 Treatment of patients with poliomyelitis by Qualitative Sister Elizabeth Kenny, an Australian nurse4 Assessing abuse in female survivors Quantitative of partners' suicides5 Employees' perceptions af stress Quantitative and the relationship to repetitive strain injury symptoms6 Coping with disfigurement and Quantitative dysfunction and length of hospitalization at?er head and neck cancer surgery' Effect of preparatory information before elective total hip replacement procedures on postoperative physical coping outcomesa A comparison of two pressure-relieving devices on prevention of heel pressure ulcersg

Quantitative

Quantitative

Study method

Grounded theory

Phenomenology Ethnography

Historiography

Exploratory

Descriptive

Correlational

Quasiexperimental

Experimental

NOTES

Journal of Nursing Scholarship 29 (Spring 1997) 33-37. 1 . D C Hatton, 'Managing health problems among homeless women with children in a transitional shelter," /MAG€:

2. M L Zalon, 'Pain in frail, elderly women alter surgery,' IMAGE; Joumol of Nursing Scholarship 29 (Spring 1997)

3. E Seymour et al, 'Modes of thought, feeling, and action in infant pain assessment by pediatric nurses," Journal of

4. S R Oppewal, 'Sister Elizabeth Kenny, an Australian nurse, and treatment of poliomyelitis victims,' IMAGE; Journal

5. R E Constantina, L B Suiton, J Rohay, 'Assessing abuse in female suicide survivors,' Holistic Nursing Practice 1 1

6. D Hess, 'Employee perceived stress: Relationship to the development of repetitive strain injury symptoms," AAOHN

7. M J Dropkin, 'Coping with disfigurementldysfunction and length of hospital stay alter head and neck cancer

8. J Gammon, C W Mulholland, 'Effect of preparatory information prior to elective total hip replacement on postopera-

9. A C Tymec, B Pieper, K Vollman, 'A comparison of two pressure relieving devices on prevention of heel pressure

21-26.

Pediatic Nursing 12 (February 1997) 32-50.

of Nursing Scholarship 29 (Spring 1997) 83-87.

(January 1997) 60-68

Journal45 (March 1997) 1 15-1 23.

surgety,' ORL Head and Neck Nursing 15 (Winter 1997) 22-26.

tive physical coping outcomes,' lntemdionul Journal of Nursing Sludies 33 (December 1996) 589-604.

ulcers,' Advunces in Wound Care 10 (Januaryhbtuary 1997) 39-44.

who use this method also identlfy, analyze, and critique for reliability and validity primary and secondary data sources (eg, letters, diaries, reports). After the data collection process is complete, these researchers synthesize the data and draw final conclusions. Historic

research helps nurses understand the past, and it offers perspectives on the evolving nature of nursing practice.6 AORN's perioperative nursing history project is an exam- ple of this type of research?

Quantitative research. Quanti- tative research methods are based

on the premise that researchers are objective and that variables can be measured precisely. Quan- titative research explores the rela- tionships between variables and tests hypotheses. The framework for quantitative research is derived from nonexperimental,

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AUGUST 1997, VOL 66, NO 2

experimental, and quasiexperi- mental designs.

Nonexperimental research designs. Nonexperimental research designs include exploratory, descriptive, and correlational stud- ies. Nurse researchers who use non- experimental methods typically select surveys or questionnaires to obtain data about phenomena or to explore the strength of relationships between variables. Nonexperimen- tal designs help answer research questions in which variables can be quantified and data analyzed with descriptive and inferential statistics.

Experimental research designs. Researchers use experimental research designs to explore cause- and-effect relationships. The goal of many experimental research studies is prediction and control of vari- ables. To be classified as a true experiment, a research method must meet the following three criteria:

the researcher has control of a study intervention and is able to manipulate it so that some sub- jects receive the intervention and other subjects do not;

m there are at least two groups of subjects (ie, an experimental group that receives the interven- tion, a control group that does not); and

m subjects who participate in the study are selected randomly and assigned to either the control or experimental group.8 Quasiexperimental research

designs. Researchers use quasiex- perimental designs to study rela- tionships or to look for cause-and- effect outcomes. A study is consid- ered to be quasiexperimental if it

does not meet one or two of the three criteria for an experiment? When studying human behavior, researchers may find it difficult to manipulate or control variables suf- ficiently to meet the criteria of an experiment. This difficulty helps explain why there are more pub- lished quasiexperimental studies than true experimental studies in the nursing literature.

SELECTING THE CORRECT APPROACH

Nurse researchers and educators have had heated debates about which research approach (ie, quali- tative, quantitative) is superior. We believe that research questions drive the approach (ie, it should be clear from the questions which approach- es are appropriate). For example, very little is known about the long- term effects of surgery on patients. If a person undergoes a major surgi- cal procedure (eg, coronary artery bypass graft surgery), what are the effects of this surgery months and years later? To answer this question would require several in-depth interviews with the person over an extended period of time, which indicates the need for a qualitative research approach. In contrast, if a nurse researcher wanted to compare different methods of rewarming patients in the immediate postopera- tive period, the major variable of interest (ie, patients’ core body tem- peratures) is quantifiable, which indicates that a quantitative approach would be appropriate.

The ability to develop and implement a research study requires education, experience, and skill.

NOTES

tion?’ (Research Comer) AORN Journal 66 (July 1997) 1. K B Gaberson, “What’s the answer? What’s the ques-

148-151. 2. P R Liehr, M T Marcus, “Qualitative approaches to

research,” in Nursing Research: Methods, Critical Appraisat, and Utilization, third ed, G LoBiondo-Wood, J Haber, eds (St Louis: Mosby-Year Book, Inc, 1994) 255.

3. Ibid, 264-268. 4. Ibid, 262-264.

Many nurse researchers become proficient in the use of particular research methods. This process is similar to developing specialty practice areas in nursing. Expert nurse researchers know the limits of their expertise and seek additional education or consultation to study questions that require methods with which they are less familiar.

Nurses in clinical practice set- tings are in excellent positions to help researchers identify clinical practice problems and related research questions. Clinically based nurses also may help collect research data through interviews, observations, administration of questionnaires, and recording of information. Appreciating the dif- ferences between qualitative and quantitative research approaches can help clinically based nurses understand why researchers choose particular research methods.

Nurses who read research need to understand the contexts within which research questions are stud- ied. Understanding and valuing the importance of both qualitative and quantitative research methods in the development of nursing knowledge can enhance nurses’ comprehension of the entire research process and facilitate reading and using research in clinical practice settings.

SUZANNE C. BEYEA RN, CS, PHD

AORN CODIRECTOR OF PERIOPERATIVE RESEARCH

LESLIE H. NICOLL RN, MBA PHD

AORN CODIRECTOR OF PERIOPERATWE RESEARCH

5. Ibid, 268-270. 6. Ibid, 271-273. 7. B P Giordano, “We must know where penoperative

nursing has been to know where it is going,” (Editorial) AORN Journal 64 (August 1996) 178,180.

8. M Grey, “Experimental and quasiexperimental designs,” in Nursing Research: Methods, Critical Appraisal, and Utilization, third ed, G LoBiondo-Wood, J Haber, eds (St Louis: Mosby-Year Book, Inc, 1994) 214-220.

9. Ibid, 221.

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