Nursing research gained momentum within the last half of the 20th century. Currently, there is too much emphasis on evidence-based practice; hence, nursing research is imperative. Research can either be quantitative or qualitative, but critics of qualitative research associate it with epistemological issues. This paper aims at reviewing one part of a research article that has adopted a qualitative research approach. The focus of this paper is to review the article in relation to various defining parameters of qualitative research such as planning, methodology, analysis and utilization.
There may be different definitions of the word research, but in all these definitions, the generalized definition entails essential components that define the research process. The research process is defined as a scientific and systematic inquiry into issues with the aim of discovering new knowledge, evidence or facts. Reference to the definition of the word research, research begins with a question that arises from an existing or emerging problem: the problem statement. The research problem is the basis for any research study and should be clearly stated (Caldwell, Henshaw & Taylor, 2010). In the article under review, the development of advanced practice nurses (APNs) roles and associated antecedents have been looked into by some studies in Hong Kong, but the available evidence is insufficient. In addition, it is not up-to-date given the transformations in place such as the transition of nurse education from three-year hospital apprenticeships to university degree programs that run for four years (Christiansen, Vernon, Jinks, 2012, p. 1174). This problem statement is relevant to the nursing practice in the search for a solution that will ensure efficiency and efficacy prevails during out-of-hours care when doctors are not accessible due to a reduction in their working hours. There are major challenges for APNs as some doctors are not comfortable with the APNs exercising advanced skills despite the noted benefits of their care (Christiansen, Vernon & Jinks, 2012).
The article under review aims at exploring the “benefits and challenges associated with the role of APNs and nurse-led out-of-hours care in Hong Kong” (Christiansen, Vernon & Jinks, 2012, p. 1173). The study adopts an inductive reasoning approach because it is based on pre-determined principles or theories. It is important to note that this is one section of a larger mixed-method study. However, for the purposes of this article by Christiansen, Vernon & Jinks (2012), the review will focus on the qualitative bit, which aims at supplementing the quantitative data presented in another research article. This qualitative study on APN’s roles is not focusing on a new discovery that has never been observed or witnessed, but its reality is based on human perceptions. This kind of reasoning is a component of the constructivist paradigm, which aims to generate its own hypothesis generated as per the themes described in the findings.
According to the constructivist researcher, “reality is not a fixed entity; rather, it is a construction of the people participating in the research” (Polit & Beck, 2014, p. 8). In addition, the constructivist inquirer understands the existence of multiple interpretations of a particular phenomenon based on people’s opinions; hence, the constructivist paradigm is associated with no ultimate truth, and no construction can be falsified. This paradigm emphasizes the interaction between the researcher and the participants in the search for new knowledge. The study under review aims at determining the attitudes of the nurses with regard to the APN; thus, this study investigates a subjective reality entailed within the constructivist paradigm, as opposed to the objective positivist.
According to Nolan & Behi (1995), research methodology distinguishes research from other approaches of seeking answers. Based on the nature of the paradigm represented by the article under review, it follows that this study has used a qualitative research approach, which according to Nolan & Behi (1995) aims to study items as they appear in their natural settings. Therefore, the study tries to understand concepts by gathering people’s opinions in their own environment. Christiansen, Vernon & Jinks (2012) investigate the roles of APNs in the natural hospital setting without altering any parameter. According to this qualitative paradigm, the reality is neither fixed nor external, but instead, variation occurs in relation to time and place. Human behavior is one such element that varies since universal laws cannot be applied. Tools used for collecting qualitative data include questionnaires, interviews and observations. This qualitative research approach makes use of two research questions, but there seems that one goal of the research was not investigated. The study aimed at investigating factors that facilitate or hinder the development of APNs’ roles; while there is a research question for the challenges of APNs’ role development, there is no research question to address the factors that foster the development of APNs’ roles.
In qualitative research, as opposed to quantitative research, researchers define concepts of interest as end products to reflect the participants’ views and opinions (Caldwell, Henshaw & Taylor, 2010). There is no manipulation of information obtained through statistics. In the study under review, open-ended questions were used, and self-administered questionnaires were administered to the participants. Every research study should ensure that ethical principles are observed (Loiselle, Profetto-Mc-Grath, Polit, & Beck, 2010). In the study under review, participants filled the questionnaires voluntarily and independently while their identities remained unknown. In accordance with Gilgun (2014), research expertise is important to enabling researchers to interpret and organize concepts. Research expertise is a component of the four cornerstones of qualitative research, which are “research findings, theory and methodologies; sociocultural dynamics of research informants; persons of researchers; and research expertise” (p. 437). Reference to the four cornerstones, research findings, theories and methodologies are a basis for evidence-based practice.
Researchers collect information in the form of data. In qualitative methodologies, narrative descriptions are the form of primary data collected, and these have been obtained by filling in the questionnaires. As opposed to quantitative research that take the form of a linear model, qualitative studies assume the shape of a circle. In accordance with the article under review, the qualitative research process begins with the planning of the study where the problem is identified, a literature review is conducted, an overall approach of conducting the study is developed, research site(s) selected and ethical considerations reviewed. This is followed by data collection strategies that envisage the type of data to be collected, the participants to engage in the study and the creation of rapport. Subsequently, collected data is analyzed and evaluated based on data collection strategies and saturation. If modifications are deemed necessary then, this forms a basis for subsequent research. In conclusion, dissemination of findings, while highlighting the relevant recommendations, is very important (Polit & Beck, 2014).
Data analysis in qualitative research entails classification and indexing of data. Data is reduced to smaller and manageable units to aid in review and analysis. Most often, according to Loiselle, Profetto-Mc-Grath, Polit, & Beck (2010), a color scheme is developed and used to code data into clusters of concepts. There is no alternative straightforward way of doing it. Christiansen, Vernon & Jinks’ (2012) article used this data analysis approach in what has been referred to as thematic content analysis. Initially, the motifs were grouped and regrouped to develop smaller units or thematic concepts. This gave rise to six themes, 26 subthemes and 286 motifs from individual respondents (p. 1176). There has been much criticism as to the nature of qualitative research associated with the trustworthiness of information since most of the critics look at it from a quantitative researcher’s approach. In this study by Christiansen, Vernon & Jinks (2012), the validity and reliability of open-ended questions were determined qualitatively in relation to the usability and acceptability of the questionnaire. Cutcliffe & McKenna (1999) argue that there is the need to develop approaches that are suited for qualitative research methodology when investigating the credibility of qualitative research. In nursing, research helps to guide practice in the delivery of health care since nurses are required to base their practice on evidence (Polit & Beck, 2014, p. 2).
According to Gilgun (2014), outcomes of qualitative research are very important to EBP because they help involved stakeholders to understand consumer experiences, factors that are associated with effectiveness and efficiency, and implementation of interventions. After gaining results of a particular medicine from clinical trials, qualitative research is important to help understand consumer experiences by informing about the most appropriate interventions; thereby increasing efficacy in the delivery of health care. In the same way, the article under review informs about APNs in relation to roles and derived benefits.
Qualitative research in nursing is just as important as quantitative research, but it is important to understand the differences. The research study under review makes use of a qualitative paradigm to understand the roles of APNs in relation to benefits, challenges and facilitating factors. The research questions address these goals apart from the goal of facilitating factors. The themes developed from the translations are the ultimate outcomes that cannot undergo further analysis.
References
Caldwell, K., Henshaw, L., & Taylor, G. (2010). Developing a framework for critiquing health research: An early evaluation. Nurse Education Today, 31(2011), e1-e7. Web.
Christiansen, A., Vernon, V., & Jinks, A. Perceptions of the benefits ad challenges of the role of advanced practice nurses in nurse-led out-of-hours care in Hong Kong: a questionnaire study. Journal of Clinical Nursing, 22, 1173–1181, Web.
Cutcliffe, J. R., & McKenna, H. P. (1999). Establishing the credibility of qualitative research findings: the plot thickens. Journal of Advanced Nursing, 30(2), 374- 380.
Gilgun, J. F. (2006). The four cornerstones of qualitative research. Qualitative Health Research, 16(3), 436-443. Web.
Loiselle, C. G., Profetto-Mc-Grath, J., Polit, D. F., & Beck, C. T. (2010). Canadian Essentials of Nursing Research. 3rd ed. Philadelphia: Lippincott Williams & Wilkins.
Nolan, M., & Behi, R. (1995). What is research? Some definitions and dilemmas. British Journal of Nursing, 4(2), 111–115.
Polit, D. F., & Beck, C. T. (2014). Essentials of Nursing Research: Appraising Evidence for Nursing Practice. 8th ed. Philadelphia: Lippincott Williams & Wilkins.