NURS 8201 Using Qualitative Research to Inform Evidence-Based Practice
NURS 8201 Using Qualitative Research to Inform Evidence-Based Practice
NURS 8201 Using Qualitative Research to Inform Evidence-Based Practice
Qualitative research is an erudite approach applied to elaborate on life experiences, traditions, and ways of life in the eyes of the participants included in the study. Qualitative researchers gain insights without measuring concepts or analyzing statistical relationships as they improve our comprehension of a phenomenon from the viewpoint of the people experiencing it (Gray, Grove, & Sutherland, 2017). This research topic aims to discover chronic pain and the encounters of patients with musculoskeletal disorders and their interpretation of quality of life. The methodology best suited for this qualitative research study is the phenomenology method. This methodology for this type of method is to depict experiences from the client’s viewpoint and lived experience.
An ethical issue that can arise in conducting this study is protecting the identity and privacy of the participants involved in the study. With this as a posing issue, it is imperative voluntarily for the participants to sign a protocol of informed consensus on the agreement to the further evaluation and potential publication of the results of the study ( Savvakis & Kolokouras, 2019)
A noted strength of the phenomenology method is its foundational approach in listening and evaluating all modes of communication to attain a more thorough understanding of experiences. A weakness of the phenomenology method is the difficulty in adequately analyzing and interpreting the research results and findings.
Another qualitative method applied to this research topic is grounded theory research. Grounded theory research is an inductive research technique with this method’s name. The findings are grounded in the concrete world experienced by participants and grounded in the actual data (Gray, Grove, & Sutherland, 2017). In terms of this research study, the symbolic interaction and perception seen in grounded theory research regarding a patient’s experience with chronic pain from a musculoskeletal disorder and the quality of life can be explored.
References
Gray, J.R., Grove, S.K., & Sutherland, S. (2017). Burn’s and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (8th ed.), St. Louis, MO: Saunders Elsevier
Savvakis, M. & Kolokouras, N. (2019). Quality of Life and Chronic Pain: Coping Practices and Experiences of Patients with Musculoskeletal Diseases. International Journal of Caring Sciences. 12(3). 1423-1429.
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The topic of interest that I would want to explore using the qualitative approach involves the following research question: Between Patient Health Questionnaire (PHQ-9) and the Beck Depression Inventory (BDI), which is more effective in identifying depression? Just as Gray and Grove (2020) posit, there is a need to unearth up-to-date evidence from previous studies to answer any research question to inform and improve nursing practice. Based on the type of data aimed to be collected from the study participants, the qualitative research design, specifically a case study, is the best suited approach. A case study, which is a thorough examination of people or groups of people, helps collect specific qualitative information to research experiences, perspectives, and meanings (Korstjens & Moser, 2017). Since it is possible to examine depression in terms of the experiences of the affected people and their caregivers, a case study involving patients with or suspected of depression is the most suitable qualitative design for a researcher to compare the effectiveness of PHQ-9 and BDI in identifying this mental condition. Many scholars rely on qualitative research to assess the validity and reliability of PHQ-9 and BDI in nursing practice (Ford et al., 2020; García-Batista et al., 2018). Therefore, the case study qualitative design will allow collecting first-hand data, which is crucial in comparing the effectiveness of these two diagnostic tools in identifying people with depression.
Depression is a highly sensitive research topic and hence, it is important to tackle potential ethical issues. One of the potential challenges with this kind of research is withdrawal by some participants before the study is over. According to Cypress (2019), study participants may opt to get out of a study due to such factors as feeling uncomfortable providing some information they consider confidential to a researcher. Since the topic is sensitive, it will be ethically challenging to frame some questions without infringing upon the privacy of the respondents. According to Serrander et al., (2020), it is possible to overcome the ethical challenges surrounding privacy when investigating people with depression by educating the participants about the study, having them sign informed consent, and most importantly, guaranteeing them of the safety and confidentiality of the information they provide. Moreover, since the case study will involve participants with or suspected of depression, it is important to earn their trust and confidence to avoid issues such as refusal to cooperate or aggressive behavior.
References
Cypress, B. S. (2019). Qualitative research: Challenges and dilemmas. Dimensions of Critical Care Nursing, 38(5), 264-270. https://doi.org/10.1097/DCC.0000000000000374
Ford, J., Thomas, F., Byng, R., & McCabe, R. (2020). Use of the Patient Health Questionnaire (PHQ-9) in practice: Interactions between patients and physicians. Qualitative Health Research, 30(13), 2146-2159. https://doi.org/10.1177/1049732320924625
García-Batista, Z. E., Guerra-Peña, K., Cano-Vindel, A., Herrera-Martínez, S. X., & Medrano, L. A. (2018). Validity and reliability of the Beck Depression Inventory (BDI-II) in general and hospital population of Dominican Republic. PLoS ONE, 13(6), e0199750. https://dx.doi.org/10.1371/journal.pone.0199750
Gray, J. R., & Grove, S. K. (2020). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (9th ed.). Elsevier.
Korstjens, I., & Moser, A. (2017). Series: Practical guidance to qualitative research. Part 2: Context, research questions and designs. European Journal of General Practice, 23(1), 274-279. https://doi.org/10.1080/13814788.2017.1375090
Serrander, M., Bremander, A., Jarbin, H., & Larsson, I. (2021). Joy of living through exercise – a qualitative study of clinically referred adolescents’ experiences of moderate to vigorous exercise as treatment for depression. Nordic Journal of Psychiatry, 75(8), 1-8. https://doi.org/10.1080/08039488.2021.1909128
diseases affect the quality of life?”
Qualitative research provides hands-on outline of qualitative research design, methodologies, data and assessment. When quantitative analysis is focused primarily on numerical data, qualitative research define a situation based on the perspectives of the researcher hence it is a fundamental method of inquiry for understanding social phenomena via experience lens (Barrett & Twycross, 2018). Also, qualitative research address the voids and issues that numbers cannot reach. It provides solutions and responses to questions like: Is it possible to quantify or measure emotions in numbers? Therefore, qualitative research is the best method or tool that can be used in research of unquantifiable human experience aspects and hence it is widely used in various fields such as medicine and nursing.
Nonetheless, it might be challenging to define qualitative research. The method approaches a concept like a clinical problem from a point of unknowing and tries to understand its various facets. This makes it helpful in the event little is known about the phenomenon since the research method helps in defining key constructs and concepts (Johansson, 2019). In addition, qualitative research provides a foundation for future qualitative or quantitative research and it can also stand alone sufficiently without quantitative research in a study.
The protection of participants through adoption of appropriate ethical principles is vital in all research methods. For instance, ethical considerations in qualitative research have a particular resonance because of the in-depth nature of the process of study. The present ethical guidance for qualitative research provide often general guidelines instead of concentrating on how to apply it specifically when interviewing the vulnerable community (Arifin, 2018). Ethical considerations that are important in this particular research are respect to anonymity and confidentiality. Anonymity entails not knowing the research participants and an individual cannot be linked to their data whereas confidentiality means the research participants are known but any information about them is removed from the research report.
References
Arifin, S. R. M. (2018). Ethical considerations in qualitative study. International Journal of Care Scholars, 1(2), 30-33.
Barrett, D., & Twycross, A. (2018). Data collection in qualitative research. Evidence-based nursing, 21(3), 63-64.
Johansson, C. B. (2019). Introduction to qualitative research and grounded theory. International Body Psychotherapy Journal, 18(1), 94-99.
Using Qualitative Research to inform Evidence-Based Practice
What is the topic of your research? When statisticians come up with an interesting idea, this is frequently one of the first questions they ask. The findings of a study may only be relevant if they provide an accurate and unbiased answer to a specific question, and it has been suggested that finding the right primary study question could take up to one-third of the time spent in the entire process from the conception of an idea to the publication of the manuscript. Furthermore, coming up with a good research question can be time-consuming and challenging (Fandino, 2019). So formulating a good research question is a must.
My research question: what is the effect of mandatory overtime on nurses’ performance and health?
Why a qualitative research design is best suited to support this research question
The focus of qualitative research is multimethod, with an interpretive, naturalistic approach to its subject matter. This means that qualitative researchers investigate phenomena in their natural contexts, attempting to make sense of or interpret phenomena in terms of the meanings that people assign to them. The study and collection of a variety of empirical materials case study, personal experience, life story, interview, observational, historical, interactional, and visual texts that describe routine and difficult moments and meanings in individuals’ lives constitute qualitative research (Aspers & Corte, 2019). To answer my research question, a qualitative study is more appropriate because the research study answers the above question by doing a face-to-face interview, asking nurses’ personal experience, observation, and nurses’ interactions. In a qualitative study, the researcher seeks to describe an experience or a phenomenon, so the questions are typically more global in scope (Gray & Grove, 2020). So working long hours and associated nurses’ health issues (burnout and fatigue) and medical error is now a global issue in our healthcare environment.
Describe potential ethical considerations
Ethical consideration: Employees who work long hours or shift work have a higher risk of illness and injury. Fatigue-related errors made by employees working in these demanding schedules can have serious and negative consequences for public safety.
References
Aspers, P., & Corte, U. (2019). What is Qualitative in Qualitative Research. Qualitative Sociology, 42(2), 139–160. https://doi.org/10.1007/s11133-019-9413-7
Fandino W. (2019). Formulating a good research question: Pearls and pitfalls. Indian journal of anaesthesia, 63(8), 611–616. https://doi.org/10.4103/ija.IJA_198_19
Gray, J. R., & Grove, S.K. (2020). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (9th ed.). Elsevier.
Most of all, I appreciate your idea that qualitative research design will allow you to investigate the impact of mandatory overtime on nurses’ subjective experiences in natural context. In such a way, one can find an opportunity to observe their genuine feelings, emotional and physical state as it occurs on a regular basis, as part of daily working experiences (Teherani et al., 2015). In laboratory, it would be impossible to investigate such subjective personal matters as human feelings, behaviors, or emotions in response to certain stimuli, which are inherent in a particular real world context, such as clinical practice settings. By and large, personal views, attitudes, and phenomenological experiences of people can only be perceived by applying qualitative methods, from interviews to observations. Even though maximum objectivity can be ensured by quantitative designs, which heavily rely on statistical analyses, there are situations and questions that can only rely on a researcher’s personal interpretation of the collected data, which reflect people’s states of mind and soul (Grove et al., 2013). That is exactly the case with the current research question, which aims to explore nurses’ risk for burnout and exhaustion resulting from overtime.
Also, as you have enumerated, there is a whole range of qualitative methods and instruments, so a researcher can achieve the goals and objectives of a study by selecting the most suitable, informative tools. For the research question about the nurses’ experiences in response to overtime, obviously, in-depth interviews will be appropriate, you are right. Unstructured interviews will allow participants freedom of expression, so that they can provide valuable insights into the problem and give detail that could not even be anticipated (Britten, 1995). In such a way, in-depth interviews can give a rich material for interpretation and analysis, adding also information from the body language, non-verbal means of expression.
References
Britten, N. (1995). Qualitative Interviews in Medical Research. BMJ (Clinical research ed.). 311. 251-3. 10.1136/bmj.311.6999.251.
Teherani, A., Martimianakis, T., Stenfors-Hayes, T., Wadhwa, A., & Varpio, L. (2015). Choosing a qualitative research approach. The Journal of Graduate Medical Education, 7(4), 669-670. doi: 10.4300/JGME-D-15-00414.1
I enjoyed reading your post. This is an interesting topic for research. The presence of well-rested and healthy nurses is very critical to the provision of emphatic patient care, vigilant monitoring, and vigorous advocacy. Nurses typically worked overtime due to pressure to conform, high workload, and enhance self-development. Involuntary overtime work demonstrated a detrimental effect on mental health and work engagement at both the ward and individual level, whereas voluntary overtime work exerted a beneficial effect on well-being (Watanabe, & Yamauchi, 2018). The nurses have shown to experience a lot of physical and psychological demands during their day-to-day operations. The pressure within the organization to downsize has caused the nurses to have to work overtime. Mandatory overtime for the nurses has increased the physical and psychological strain on the nurses increasing the level of risk on their health. The lack of policies on the maximum hours a day a nurse is supposed to work has resulted in detrimental physical and psychological effects on the health of the nurses. Nurses who must work for long hours are prone to making errors during the treatment of patients and therefore, this also exposes the patients to risks as well. In fact, many nurses admit that working for long hours, especially overnight can be very challenging and difficult. The problem is that the nurses are required to work mandatory overtime or face the risk of dismissal. Working overtime has also shown to cause family problems for many nurses as they have very little time left for their families. This increases frustration and the tendency to make errors at the work. Mandatory overtime is detrimental to the health and performance of the nurses. Individual nurses have a responsibility of bringing out the fact that mandatory overtime is physically and mentally detrimental to them. The nursing association has a responsibility of fighting for the safety of the nurses, and this should be on top of their list. Finally, the government legislators have a responsibility of enacting a policy that will free the nurses from mandatory overtime (Wheatley, 2017).
References:
Watanabe, M., & Yamauchi, K. (2018). The effect of quality of overtime work on nurses’ mental health and work engagement. Journal of Nursing Management, 26(6), 679–688. https://doi.org/10.1111/jonm.12595
Wheatley, C. (2017). Nursing overtime: Should it be regulated? Nursing Economics, 35(4), 213-217. Web.
I concur with your thoughts on adopting qualitative research to inform evidence-based research. Qualitative research defines an inquiry method whereby the researcher who acts as a data collection instrument attempts to respond to questions about why and how a particular phenomenon happens. Also, questions about what can also be answered by qualitative research. The most significant assumption underlying this research design is reality is an aspect that is socially constructed on individual basis (Sawatsky, Ratelle & Beckman, 2019). There are different qualitative research methods that can be used in a study depending with the nature of the phenomenon in question. For instance in nursing practice, qualitative methods that can used include qualitative description, grounded theory and phenomenology. Each qualitative research method constitute its own purposes and assumptions and a suitable method is selected on the research question. For instance, in a research whereby the question entails the researcher examining the process involved in the phenomenon occurrence would possibly use grounded theory in research to address the question (Sale & Thielke, 2018). On the other hand, the researcher would use phenomenology if he is interested in finding out the meaning of the phenomenon. Irrespective of the research method adopted, participants are enrolled purposefully based on their knowledge on the research phenomenon.
Data is usually collected through one or combination of the following methods: photograph or document review, interviews, observations or questionnaires. The collected data is then examined inductively through rigorous specific techniques and then organized in ways that provide answers to the research question. The main role of qualitative research is not just on accumulation of information but the progression of comprehensive understanding of the phenomenon of concern like the effect of mandatory overtime on nurses’ performance and health. Research ethics entails protecting the dignity of research participants and publication of research information (Aspers & Corte, 2019). In addition to the mentioned potential ethical consideration, informed consent is another potential research ethic. The process of obtaining consent in qualitative research entails consent be given voluntarily, participants have to understand the phenomenon in research and subjects needs to be informed adequately on the research, understand the information and have an authority to choose to participate or not.
References
Sawatsky, A. P., Ratelle, J. T., & Beckman, T. J. (2019). Qualitative research methods in medical education. Anesthesiology, 131(1), 14-22.
Sale, J. E., & Thielke, S. (2018). Qualitative research is a fundamental scientific process. Journal of clinical epidemiology, 102, 129-133.
Aspers, P., & Corte, U. (2019). What is Qualitative in Qualitative Research. Qualitative Sociology, 42(2), 139–160. https://doi.org/10.1007/s11133-019-9413-7