Scientific Paradigms Assignment 2
Scientific Paradigms
Write a 195-word message in which you discuss:
1-Why are both paradigms important to the development of nursing science?
2-How do the authors justify having an alternative hierarchy of evidence for nursing, as contrasted with medicine (pp. 24–26, Types of Evidence and Evidence Hierarchies, Ch. 2, Nursing Research)?
Read instructions: ( used attached documents to write the word message discussion. Stay on topic given on the 2 questions above. all information needed is been attached. thank you. )
The Evidence-Based Practice Movement
The Cochrane Collaboration was an early contributor to the EBP movement. The collaboration was founded in the United Kingdom based on the work of British epidemiologist Archie Cochrane. Cochrane published an influential book in the 1970s that drew attention to the dearth of solid evidence about the effects of health care. He called for efforts to make research summaries of clinical trials available to health care providers. This eventually led to the development of the Cochrane Center in Oxford in 1993, and an international partnership called the Cochrane Collaboration, with centers established in locations throughout the world. Its aim is to help providers make good decisions about health care by preparing and disseminating systematic reviews of the effects of health care interventions.
At about the same time, a group from McMaster Medical School in Canada (including Dr. David Sackett) developed a clinical learning strategy they called evidence-based medicine. The evidence-based medicine movement has shifted to a broader conception of using best evidence by all health care practitioners (not just physicians) in a multidisciplinary team. EBP is considered a major shift for health care education and practice. In the EBP environment, a skillful clinician can no longer rely on a repository of memorized information but rather must be adept in accessing, evaluating, and using new evidence.
The EBP movement has advocates and critics. Supporters argue that EBP is a rational approach to providing the best possible care with the most cost-effective use of resources. Advocates also note that EBP provides a framework for self-directed lifelong learning that is essential in an era of rapid clinical advances and the information explosion. Critics worry that the advantages of EBP are exaggerated and that individual clinical judgments and patient inputs are being devalued. They are also concerned that insufficient attention is being paid to the role of qualitative research. Although there is a need for close scrutiny of how the EBP journey unfolds, an EBP path is the one that health care professions will almost surely follow in the years ahead.
TIP: A debate has emerged concerning whether the term “evidence-based practice” should be replaced with evidence-informed practice (EIP). Those who advocate for a different term have argued that the word “based” suggests a stance in which patient values and preferences are not sufficiently considered in EBP clinical decisions (e.g., Glasziou, 2005). Yet, as noted by Melnyk (2014), all current models of EBP incorporate clinicians’ expertise and patients’ preferences. She argued that “changing terms now … will only create confusion at a critical time where progress is being made in accelerating EBP” (p. 348). We concur and we use EBP throughout this book.
Knowledge Translation
Research utilization and EBP involve activities that can be undertaken at the level of individual nurses or at a higher organizational level (e.g., by nurse administrators), as we describe later in this chapter. In the early part of this century, a related movement emerged that mainly concerns system-level efforts to bridge the gap between knowledge generation and use. Knowledge translation (KT) is a term that is often associated with efforts to enhance systematic change in clinical practice.
It appears that the term was coined by the Canadian Institutes of Health Research (CIHR) in 2000. CIHR defined KT as “the exchange, synthesis, and ethically-sound application of knowledge—within a complex system of interactions among researchers and users—to accelerate the capture of the benefits of research for Canadians through improved health, more effective services and products, and a strengthened health care system” (CIHR, 2004, p. 4).
Several other definitions of KT have been proposed. For example, the World Health Organization (WHO) (2005) adapted the CIHR’s definition and defined KT as “the synthesis, exchange and application of knowledge by relevant stakeholders to accelerate the benefits of global and local innovation in strengthening health systems and improving people’s health.” Institutional projects aimed at KT often use methods and models that are similar to institutional EBP projects.
TIP: Translation science (or implementation science) has emerged as a discipline devoted to developing methods to promote knowledge translation. In nursing, the need for translational research was an important impetus for the development of the Doctor of Nursing Practice degree. Several journals have emerged that are devoted to this field (e.g., the journal Implementation Science).
EVIDENCE-BASED PRACTICE IN NURSING
Before describing procedures relating to EBP in nursing, we briefly discuss some important issues, including the nature of “evidence” and challenges to pursuing EBP, and resources available to address some of those challenges.
Types of Evidence and Evidence Hierarchies
There is no consensus about the definition of evidence nor about what constitutes usable evidence for EBP, but most commentators agree that findings from rigorous research are paramount. Debate continues, however, about what constitutes rigorous research and what qualifies as best evidence.
At the outset of the EBP movement, there was a strong bias toward reliance on information from studies called randomized controlled trials (RCTs). This bias stemmed from the fact that the Cochrane Collaboration initially focused on the effectiveness of therapies rather on other types of health care questions. RCTs are, in fact, very well suited for drawing conclusions about the effects of health care interventions ( Chapter 9 ). The bias in ranking sources of evidence in terms of questions about effective treatments led to some resistance to EBP by nurses who felt that evidence from qualitative and non-RCT studies would be ignored.
Positions about the contribution of various types of evidence are less rigid than previously. Nevertheless, many published evidence hierarchies rank evidence sources according to the strength of the evidence they provide, and in most cases, RCTs are near the top of these hierarchies. We offer a modified evidence hierarchy that looks similar to others, but ours illustrates that the ranking of evidence-producing strategies depends on the type of question being asked.
Figure 2.1 shows that systematic reviews are at the pinnacle of the hierarchy (Level I), regardless of the type of question, because the strongest evidence comes from careful syntheses of multiple studies. The next highest level (Level II) depends on the nature of inquiry. For Therapy questions regarding the efficacy of an intervention (What works best for improving health outcomes?), individual RCTs constitute Level II evidence (systematic reviews of multiple RCTs are Level I). Going down the “rungs” of the evidence hierarchy for Therapy questions results in less reliable evidence—for example, Level III evidence comes from a type of study called quasi-experimental. In-depth qualitative studies are near the bottom, in terms of evidence regarding intervention effectiveness. (Terms in Figure 2.1 will be discussed in later chapters.)
Evidence hierarchy: levels of evidence.
For a Prognosis question, by contrast, Level II evidence comes from a single prospective cohort study, and Level III is from a type of study called case control (Level I evidence is from a systematic review of cohort studies). Thus, contrary to what is often implied in discussions of evidence hierarchies, there really are multiple hierarchies. If one is interested in best evidence for questions about Meaning, an RCT would be a poor source of evidence, for example. We have tried to portray the notion of multiple hierarchies in Figure 2.1 , with information on the right indicating the type of individual study that would offer the best evidence (Level II) for different questions. In all cases, appropriate systematic reviews are at the pinnacle. Information about different hierarchies for different types of cause-probing questions is addressed in Chapter 9 .
Of course, within any level in an evidence hierarchy, evidence quality can vary considerably. For example, an individual RCT could be well designed, yielding strong Level II evidence for Therapy questions, or it could be so flawed that the evidence would be weak.
Thus, in nursing, best evidence refers to research findings that are methodologically appropriate, rigorous, and clinically relevant for answering persistent questions—questions not only about the efficacy, safety, and cost-effectiveness of nursing interventions but also about the reliability of nursing assessment tests, the causes and consequences of health problems, and the meaning and nature of patients’ experiences. Confidence in the evidence is enhanced when the research methods are compelling, when there have been multiple confirmatory studies, and when the evidence has been carefully evaluated and synthesized.
Of course, there continue to be clinical practice questions for which there is relatively little research evidence. In such situations, nursing practice must rely on other sources—for example, pathophysiologic data, chart review, quality improvement data, and clinical expertise. As Sackett and colleagues (2000) have noted, one benefit of the EBP movement is that a new research agenda can emerge when clinical questions arise for which there is no satisfactory evidence.
Evidence-Based Practice Challenges
Nurses have completed many studies about the use of research in practice, including research on barriers to EBP. Studies on EBP barriers, conducted in several countries, have yielded similar results about constraints on clinical nurses. Most barriers fall into one of three categories: (1) quality and nature of the research, (2) characteristics of nurses, and (3) organizational factors.
With regard to the research, one problem is the limited availability of high-quality research evidence for some practice areas. There remains an ongoing need for research that directly addresses pressing clinical problems, for replication of studies in a range of settings, and for greater collaboration between researchers and clinicians. Another issue is that nurse researchers need to improve their ability to communicate evidence, and the clinical implications of evidence, to practicing nurses.
Nurses’ attitudes and education are also potential barriers to EBP. Studies have found that some nurses do not value or know much about research, and others simply resist change. Fortunately, many nurses do value research and want to be involved in research-related activities. Nevertheless, many nurses do not know how to access research evidence and do not possess the skills to critically evaluate research findings—and even those who do may not know how to effectively incorporate research evidence into clinical decision making. Among nurses in non-English-speaking countries, another impediment is that most research evidence is reported in English.
Finally, many of the challenges to using research in practice are organizational. “Unit culture” can undermine research use, and administrative and other organizational barriers also play a major role. Although many organizations support the idea of EBP in theory, they do not always provide the necessary supports in terms of staff release time and availability of resources. Nurses’ time constraints are a crucial deterrent to the use of evidence at the bedside. Strong leadership in health care organizations is essential to making evidence-based practice happen.
RESOURCES FOR EVIDENCE-BASED PRACTICE IN NURSING
The translation of research evidence into nursing practice is an ongoing challenge, but resources to support EBP are increasingly available. We urge you to explore other ideas with your health information librarian because the list of resources is growing as we write.
Preappraised Evidence
Research evidence comes in various forms, the most basic of which is in individual studies. Primary studies published in professional journals are not preappraised for quality or use in practice. Chapter 5 discusses how to access primary studies for a literature review.
Preprocessed (preappraised) evidence is evidence that has been selected from primary studies and evaluated for use by clinicians. DiCenso and colleagues (2005) have described a hierarchy of preprocessed evidence. On the first rung above primary studies are synopses of single studies, followed by systematic reviews, and then synopses of systematic reviews. Clinical practice guidelines are at the top of the hierarchy. At each successive step in the hierarchy, the ease in applying the evidence to clinical practice increases. We describe several types of preappraised evidence sources in this section.
PARADIGMS AND METHODS FOR NURSING RESEARCH
A paradigm is a worldview, a general perspective on the complexities of the world. Paradigms for human inquiry are often characterized in terms of the ways in which they respond to basic philosophical questions, such as, What is the nature of reality? (ontologic) and What is the relationship between the inquirer and those being studied? (epistemologic).
Disciplined inquiry in nursing has been conducted mainly within two broad paradigms, positivism and constructivism. This section describes these two paradigms and outlines the research methods associated with them. In later chapters, we describe the transformative paradigm that involves critical theory research ( Chapter 21 ), and a pragmatism paradigm that involves mixed methods research ( Chapter 26 ).
The Positivist Paradigm
The paradigm that dominated nursing research for decades is known as positivism (also called logical positivism ). Positivism is rooted in 19th century thought, guided by such philosophers as Mill, Newton, and Locke. Positivism reflects a broader cultural phenomenon that, in the humanities, is referred to as modernism, which emphasizes the rational and the scientific.
As shown in Table 1.2 , a fundamental assumption of positivists is that there is a reality out there that can be studied and known (an assumption is a basic principle that is believed to be true without proof or verification). Adherents of positivism assume that nature is basically ordered and regular and that reality exists independent of human observation. In other words, the world is assumed not to be merely a creation of the human mind. The related assumption of determinism refers to the positivists’ belief that phenomena are not haphazard but rather have antecedent causes. If a person has a cerebrovascular accident, the researcher in a positivist tradition assumes that there must be one or more reasons that can be potentially identified. Within the positivist paradigm, much research activity is directed at understanding the underlying causes of phenomena.
TABLE 1.2: Major Assumptions of the Positivist and Constructivist Paradigms
| TYPE OF QUESTION | POSITIVIST PARADIGM ASSUMPTION | CONSTRUCTIVIST PARADIGM ASSUMPTION |
| Ontologic: What is the nature of reality? | Reality exists; there is a real world driven by real natural causes and subsequent effects | Reality is multiple and subjective, mentally constructed by individuals; simultaneous shaping, not cause and effect |
| Epistemologic: How is the inquirer related to those being researched? | The inquirer is independent from those being researched; findings are not influenced by the researcher | The inquirer interacts with those being researched; findings are the creation of the interactive process |
| Axiologic: What is the role of values in the inquiry? | Values and biases are to be held in check; objectivity is sought | Subjectivity and values are inevitable and desirable |
| Methodologic: How is evidence best obtained? | Deductive processes → hypothesis testing | Inductive processes → hypothesis generation |
| Emphasis on discrete, specific concepts | Emphasis on entirety of some phenomenon, holistic | |
| Focus on the objective and quantifiable | Focus on the subjective and nonquantifiable | |
| Corroboration of researchers’ predictions | Emerging insight grounded in participants’ experiences | |
| Outsider knowledge—researcher is external, separate | Insider knowledge—researcher is internal, part of process | |
| Fixed, prespecified design | Flexible, emergent design | |
| Controls over context | Context-bound, contextualized | |
| Large, representative samples | Small, information-rich samples | |
| Measured (quantitative) information | Narrative (unstructured) information | |
| Statistical analysis | Qualitative analysis | |
| Seeks generalizations | Seeks in-depth understanding |
Positivists value objectivity and attempt to hold personal beliefs and biases in check to avoid contaminating the phenomena under study. The positivists’ scientific approach involves using orderly, disciplined procedures with tight controls of the research situation to test hunches about the phenomena being studied.
Strict positivist thinking has been challenged, and few researchers adhere to the tenets of pure positivism. In the postpositivist paradigm , there is still a belief in reality and a desire to understand it, but postpositivists recognize the impossibility of total objectivity. They do, however, see objectivity as a goal and strive to be as neutral as possible. Postpositivists also appreciate the impediments to knowing reality with certainty and therefore seek probabilistic evidence—that is, learning what the true state of a phenomenon probably is, with a high degree of likelihood. This modified positivist position remains a dominant force in nursing research. For the sake of simplicity, we refer to it as positivism.
The Constructivist Paradigm
The constructivist paradigm (often called the naturalistic paradigm ) began as a countermovement to positivism with writers such as Weber and Kant. Just as positivism reflects the cultural phenomenon of modernism that burgeoned after the industrial revolution, naturalism is an outgrowth of the cultural transformation called postmodernism. Postmodern thinking emphasizes the value of deconstruction—taking apart old ideas and structures—and reconstruction—putting ideas and structures together in new ways. The constructivist paradigm represents a major alternative system for conducting disciplined research in nursing. Table 1.2 compares the major assumptions of the positivist and constructivist paradigms.
For the naturalistic inquirer, reality is not a fixed entity but rather is a construction of the individuals participating in the research; reality exists within a context, and many constructions are possible. Naturalists thus take the position of relativism: If there are multiple interpretations of reality that exist in people’s minds, then there is no process by which the ultimate truth or falsity of the constructions can be determined.
The constructivist paradigm assumes that knowledge is maximized when the distance between the inquirer and those under study is minimized. The voices and interpretations of study participants are crucial to understanding the phenomenon of interest, and subjective interactions are the primary way to access them. Findings from a constructivist inquiry are the product of the interaction between the inquirer and the participants.
Paradigms and Methods: Quantitative and Qualitative Research
Research methods are the techniques researchers use to structure a study and to gather and analyze information relevant to the research question. The two alternative paradigms correspond to different methods for developing evidence. A key methodologic distinction is between quantitative research , which is most closely allied with positivism, and qualitative research , which is associated with constructivist inquiry—although positivists sometimes undertake qualitative studies, and constructivist researchers sometimes collect quantitative information. This section provides an overview of the methods associated with the two paradigms.
The Scientific Method and Quantitative Research
The traditional, positivist scientific method refers to a set of orderly, disciplined procedures used to acquire information. Quantitative researchers use deductive reasoning to generate predictions that are tested in the real world. They typically move in a systematic fashion from the definition of a problem and the selection of concepts on which to focus to the solution of the problem. By systematic, we mean that the investigator progresses logically through a series of steps, according to a specified plan of action.
Quantitative researchers use various control strategies. Control involves imposing conditions on the research situation so that biases are minimized and precision and validity are maximized. Control mechanisms are discussed at length in this book.
Quantitative researchers gather empirical evidence —evidence that is rooted in objective reality and gathered through the senses. Empirical evidence, then, consists of observations gathered through sight, hearing, taste, touch, or smell. Observations of the presence or absence of skin inflammation, patients’ anxiety level, or infant birth weight are all examples of empirical observations. The requirement to use empirical evidence means that findings are grounded in reality rather than in researchers’ personal beliefs.
Evidence for a study in the positivist paradigm is gathered according to an established plan, using structured methods to collect needed information. Usually (but not always) the information gathered is quantitative —that is, numeric information that is obtained from a formal measurement and is analyzed statistically.
A traditional scientific study strives to go beyond the specifics of a research situation. For example, quantitative researchers are typically not as interested in understanding why a particular person has a stroke as in understanding what factors influence its occurrence in people generally. The degree to which research findings can be generalized to individuals other than those who participated in the study is called the study’s generalizability .
The scientific method has enjoyed considerable stature as a method of inquiry and has been used productively by nurse researchers studying a range of nursing problems. This is not to say, however, that this approach can solve all nursing problems. One important limitation—common to both quantitative and qualitative research—is that research cannot be used to answer moral or ethical questions. Many persistent, intriguing questions about human beings fall into this area—questions such as whether euthanasia should be practiced or abortion should be legal.
The traditional research approach also must contend with problems of measurement. To study a phenomenon, quantitative researchers attempt to measure it by attaching numeric values that express quantity. For example, if the phenomenon of interest is patient stress, researchers would want to assess if patients’ stress is high or low, or higher under certain conditions or for some people. Physiologic phenomena such as blood pressure and temperature can be measured with great accuracy and precision, but the same cannot be said of most psychological phenomena, such as stress or resilience.
Another issue is that nursing research focuses on humans, who are inherently complex and diverse. Traditional quantitative methods typically concentrate on a relatively small portion of the human experience (e.g., weight gain, depression) in a single study. Complexities tend to be controlled and, if possible, eliminated, rather than studied directly, and this narrowness of focus can sometimes obscure insights. Finally, quantitative research within the positivist paradigm has been accused of an inflexibility of vision that does not capture the full breadth of human experience.
Constructivist Methods and Qualitative Research
Researchers in constructivist traditions emphasize the inherent complexity of humans, their ability to shape and create their own experiences, and the idea that truth is a composite of realities. Consequently, constructivist studies are heavily focused on understanding the human experience as it is lived, usually through the careful collection and analysis of qualitative materials that are narrative and subjective.
Researchers who reject the traditional scientific method believe that it is overly reductionist—that is, it reduces human experience to the few concepts under investigation, and those concepts are defined in advance by the researcher rather than emerging from the experiences of those under study. Constructivist researchers tend to emphasize the dynamic, holistic, and individual aspects of human life and attempt to capture those aspects in their entirety, within the context of those who are experiencing them.
Flexible, evolving procedures are used to capitalize on findings that emerge in the course of the study. Constructivist inquiry usually takes place in the field (i.e., in naturalistic settings), often over an extended time period. In constructivist research, the collection of information and its analysis typically progress concurrently; as researchers sift through information, insights are gained, new questions emerge, and further evidence is sought to amplify or confirm the insights. Through an inductive process, researchers integrate information to develop a theory or description that helps illuminate the phenomenon under observation.
Constructivist studies yield rich, in-depth information that can elucidate varied dimensions of a complicated phenomenon. Findings from in-depth qualitative research are typically grounded in the real-life experiences of people with first-hand knowledge of a phenomenon. Nevertheless, the approach has several limitations. Human beings are used directly as the instrument through which information is gathered, and humans are extremely intelligent and sensitive—but fallible—tools. The subjectivity that enriches the analytic insights of skillful researchers can yield trivial and obvious “findings” among less competent ones.
Another potential limitation involves the subjectivity of constructivist inquiry, which sometimes raises concerns about the idiosyncratic nature of the conclusions. Would two constructivist researchers studying the same phenomenon in similar settings arrive at similar conclusions? The situation is further complicated by the fact that most constructivist studies involve a small group of participants. Thus, the generalizability of findings from constructivist inquiries is an issue of potential concern.
Multiple Paradigms and Nursing Research
Paradigms should be viewed as lenses that help to sharpen our focus on a phenomenon, not as blinders that limit intellectual curiosity. The emergence of alternative paradigms for studying nursing problems is, in our view, a healthy and desirable path that can maximize the breadth of evidence for practice. Although researchers’ worldview may be paradigmatic, knowledge itself is not. Nursing knowledge would be thin if there were not a rich array of methods available within the two paradigms—methods that are often complementary in their strengths and limitations. We believe that intellectual pluralism is advantageous.
We have emphasized differences between the two paradigms and associated methods so that distinctions would be easy to understand—although for many of the issues included in Table 1.2 , differences are more on a continuum than they are a dichotomy. Subsequent chapters of this book elaborate further on differences in terminology, methods, and research products. It is equally important, however, to note that the two main paradigms have many features in common, only some of which are mentioned here:
· Ultimate goals. The ultimate aim of disciplined research, regardless of the underlying paradigm, is to gain understanding about phenomena. Both quantitative and qualitative researchers seek to capture the truth with regard to an aspect of the world in which they are interested, and both groups can make meaningful—and mutually beneficial—contributions to evidence for nursing practice.
· External evidence. Although the word empiricism has come to be allied with the classic scientific method, researchers in both traditions gather and analyze evidence empirically, that is, through their senses. Neither qualitative nor quantitative researchers are armchair analysts, depending on their own beliefs and worldviews to generate knowledge.
· Reliance on human cooperation. Because evidence for nursing research comes primarily from humans, human cooperation is essential. To understand people’s characteristics and experiences, researchers must persuade them to participate in the investigation and to speak and act candidly.
· Ethical constraints. Research with human beings is guided by ethical principles that sometimes interfere with research goals. As we discuss in Chapter 7 , ethical dilemmas often confront researchers, regardless of paradigms or methods.
· Fallibility of disciplined research. Virtually all studies have some limitations. Every research question can be addressed in many ways, and inevitably, there are trade-offs. The fallibility of any single study makes it important to understand and critique researchers’ methodologic decisions when evaluating evidence quality.
Thus, despite philosophic and methodologic differences, researchers using traditional scientific methods or constructivist methods share overall goals and face many similar challenges. The selection of an appropriate method depends on researchers’ personal philosophy and also on the research question. If a researcher asks, “What are the effects of cryotherapy on nausea and oral mucositis in patients undergoing chemotherapy?” the researcher needs to examine the effects through the careful measurement of patient outcomes. On the other hand, if a researcher asks, “What is the process by which parents learn to cope with the death of a child?” the researcher would be hard pressed to quantify such a process. Personal worldviews of researchers help to shape their questions.
In reading about the alternative paradigms for nursing research, you likely were more attracted to one of the two paradigms. It is important, however, to learn about both approaches to disciplined inquiry and to recognize their respective strengths and limitations. In this textbook, we describe methods associated with both qualitative and quantitative research in an effort to assist you in becoming methodologically bilingual. This is especially important because large numbers of nurse researchers are now undertaking mixed methods research that involves gathering and analyzing both qualitative and quantitative data ( Chapters 26 – 28 ).
THE PURPOSES OF NURSING RESEARCH
The general purpose of nursing research is to answer questions or solve problems of relevance to nursing. Specific purposes can be classified in various ways. We describe three such classifications—not because it is important for you to categorize a study as having one purpose or the other but rather because this will help us to illustrate the broad range of questions that have intrigued nurses and to further show differences between qualitative and quantitative inquiry.
Applied and Basic Research
Sometimes a distinction is made between basic and applied research. As traditionally defined, basic research is undertaken to enhance the base of knowledge or to formulate or refine a theory. For example, a researcher may perform an in-depth study to better understand normal grieving processes, without having explicit nursing applications in mind. Some types of basic research are called bench research, which is usually performed in a laboratory and focuses on the molecular and cellular mechanisms that underlie disease.
Example of Basic Nursing Research: Kishi and a multidisciplinary team of researchers (2015) studied the effect of hypo-osmotic shock of epidermal cells on skin inflammation in a rat model, in an effort to understand the physiologic mechanism underlying aquagenic pruritus (disrupted skin barrier function) in the elderly.
Applied research seeks solutions to existing problems and tends to be of greater immediate utility for EBP. Basic research is appropriate for discovering general principles of human behavior and biophysiologic processes; applied research is designed to indicate how these principles can be used to solve problems in nursing practice. In nursing, the findings from applied research may pose questions for basic research, and the results of basic research often suggest clinical applications.
Example of Applied Nursing Research: S. Martin and colleagues (2014) studied whether positive therapeutic suggestions given via headphones to children emerging from anesthesia after a tonsillectomy would help to lower the children’s pain.
Research to Achieve Varying Levels of Explanation
Another way to classify research purposes concerns the extent to which studies provide explanatory information. Although specific study goals can range along an explanatory continuum, a fundamental distinction (relevant especially in quantitative research) is between studies whose primary intent is to describe phenomena, and those that are cause-probing —that is, designed to illuminate the underlying causes of phenomena.
Within a descriptive/explanatory framework, the specific purposes of nursing research include identification, description, exploration, prediction/control, and explanation. For each purpose, various types of question are addressed—some more amenable to qualitative than to quantitative inquiry and vice versa.
Identification and Description
Qualitative researchers sometimes study phenomena about which little is known. In some cases, so little is known that the phenomenon has yet to be clearly identified or named or has been inadequately defined. The in-depth, probing nature of qualitative research is well suited to the task of answering such questions as, “What is this phenomenon?” and “What is its name?” ( Table 1.3 ). In quantitative research, by contrast, researchers begin with a phenomenon that has been previously studied or defined—sometimes in a qualitative study. Thus, in quantitative research, identification typically precedes the inquiry.
