Nursing
Differences between Quantitative and Qualitative Research
Quantitative and qualitative researches differ in their approach to the nature of phenomenon they study. Quantitative research is based on the measurement of quantity or amount and is applicable to phenomena that can be expressed in terms of quantity. On the other hand, qualitative research is concerned with qualitative phenomena, and is concerned about discovering the underlying motives and desires of the subjects (Kothari, 2004, p.3). Qualitative research studies smaller groups that are not randomly selected, while quantitative research studies larger and randomly selected groups. Qualitative research is holistic, looking at the big picture, while quantitative research studies specific variables. Qualitative research depends upon data in the form of words, images or objects gleaned from open-ended responses, interviews, participant observation, field notes or observations. The data is analyzed to identify patterns and themes with a modicum of subjectivity. On the other hand, quantitative research depends upon numbers and statistical data based on precise measurements using structures and validated data collection instruments. Objectivity is critical in quantitative research, as the aim is to determine statistical relationships between objective data. Qualitative research is exploratory, with the researcher generating a new hypothesis from the data collected, while quantitative research is confirmatory or top-down, with the researcher testing a hypothesis and theory from the given data. Qualitative research yields specialized findings that are not generalizable, while quantitative research yields generalizable findings that can be applied to other populations (Xavier University, n.d.).
Strengths and Weaknesses
Strengths of Qualitative Research
Qualitative research is useful in describing complex phenomena.
Qualitative research can conduct cross-case comparison and analysis.
Qualitative research is uniquely suited to describe in rich detail phenomena as they are situated an embedded in local contexts (South Alabama University, n.d.a).
Weaknesses of Qualitative Research
Qualitative research cannot be made to yield quantitative predictions.
The results of qualitative research are not generalizable.
It is likely that the results of qualitative research would be influenced by the researcher’s bias (South Alabama University, n.d.a).
Strengths of Quantitative Research
Quantitative research is generalizable to the broader population when the data is based on random samples and has sufficient size.
Quantitative research allows the researcher to study the influence of one variable at the exclusion of others.
Quantitative research draws relatively higher credibility with administrators and funding agencies due to the precise results it yields (South Alabama University, n.d.b).
Weaknesses of Quantitative Research
The research theories that are used in quantitative research may not reflect the understandings of the local constituencies.
The knowledge produced may be too abstract for direct application to specific situations (South Alabama University, n.d.b).
Critique of Quantitative Study
The aim of the research was to examine the pain situation, the use of oral analgesics and non-pharmacological strategies for pain relief and the psychological well-being of older patients living in nursing homes. Further, the study explored were the relationship between pain and psychological well-being (Tse, Leung & Ho, 2011).
Research Questions
What were the pain sites and pain intensity, and when did pain occur?
Did they take oral analgesics and/or use non-pharmacological strategies for pain relief?
What differences were there in the psychological well-being factors, including happiness, loneliness, life satisfaction and depression, among the pain and no-pain groups?
Dependent variables- psychological wellbeing factors.
Independent variable- pain and absence of pain.
Was there a relationship among psychological well-being and the presence of pain?
Dependent variable- psychological wellbeing.
Independent variable- pain.
Research Design
The research was a quantitative cross-sectional study. Residents of six privately owned nursing homes whose residents received government subsidies were invited for the study. The participants approached were based on the inclusion criteria of ability to communicate and ability to orient to time and place.
Internal Validity. The relationship between psychological well being and the presence of pain could have been influenced by the fact that all participants were living in nursing homes. The fact that people staying in nursing homes may as a whole feel more depressed may have influenced the results.
External Validity. The external validity of the study is limited by the fact that the sample was not representative of the broader population. Only members of selected nursing homes were taken. This inhibits the generalizability of the study.
Sampling Methods
The participants were selected on the basis of convenience sampling. Participants from six nursing homes were invited for the study based on the ability to communicate in Cantonese and the ability to orient in time and place. Participants with mental disorders were excluded.
The sample was not representative of the population, as it was restricted to members of nursing homes. Therefore, the results could not be generalized to community dwelling older adults as a whole.
Results
The study found that a majority of older patients in nursing homes suffered from moderate pain, and their psychological well being was significantly lower than that of their counterparts without pain.
Pain was found to be constant in 41% of the participants, and was likely to hinder the activities of daily living in older people, decreasing their desire to participate in exercise and social events.
The study found a statistically significant positive correlation in happiness and life satisfaction for the pain and no-pain groups. Further, statistically significant positive correlation was found in loneliness and depression in both groups. Similarly, a statistically significant negative correlation was found in loneliness, depression, happiness and life satisfaction in both groups, with the correlation being stronger in the pain group.
Implications for Practice
The study identifies pain management as being crucial for psychological well being of patients in nursing homes. This is a logical fallout of the results of the study. The implications thus make sense and would indicate future action that could be instituted in nursing homes in the form of palliative care.
Strengths of the Study
The study received 100% responses from selected participants. All participants were of sound mental faculty and could communicate. Therefore, the results of the study were strong for the sample studied, and implications could be applied to nursing homes.
The findings of the study were consistent with existing literature on the subject. For instance, the study found that 50% of the older population did not take oral medication for pain relief, and this finding was consistent with existing literature. The fact that the results of the study mirrored existing literature would indicate that the study was a progression on existing knowledge, and had validity as far as applicability to nursing homes was concerned.
Weaknesses of the Study
The study was based on convenience sampling. Hence, the results are not generalizable to the broader population of older adults. The results cannot be adduced to adults living in communities outside nursing homes.
The participants of the study were mostly recipients of government subsidy. This indicates a homogenous socio economic background of the participants. Therefore, even from the economic viewpoint, the results of the study cannot be generalized to all strata of society.
Critique of Qualitative Study
Research Question/ Purpose
The aim of the study was to describe the perspectives of patients/ family members and nurses about the usefulness, relevance and feasibility of non-pharmacological interventions for main management in the Intensive Care Unit (ICU).
Significance. The study was significant because it sought to identify methods to alleviate pain, a major stressor for patients in the intensive care units.
Sampling Method
The study used a convenience sample, consisting of patients, family members and ICU nurses. To be eligible, patients had to be 18 years or older with prior experience in hospitalization in the ICU in the past 2 years. Patients’ relatives were chosen as they were considered an extension of the patient. Nurses were chosen with minimum 2 years experience in working in the ICU. All participants had to speak either English or French.
Appropriateness of the Sample. The sample was appropriate as it could provide information about pain management in the ICU, being associated with the ICU as patients, family members and nurses. The fact that participants were chosen with their ability to communicate in desired languages indicates that the responses of the participants would have been authentic and appropriate.
Data Collection
Data Collection Methods. Data was collected from Focus Groups formed out of the participants. Eight Focus Groups were separately conducted- two with patients/ family members and six with nurses. All Focus Groups lasted 45 minutes or more, and were conducted in non threatening environments. The facilitators were respectful of diversity of opinions.
Data Interpretation Methods. The audiotapes of all Focus Groups were transcribed and reviewed. The categories of non-pharmacological interventions were used as a guide to develop a categorization scheme. The researchers looked for a recurrence of interventions being mentioned in the Focus Groups to identify those interventions that had the maximum acceptability. Those non-pharmacological interventions most discussed were further classified for usefulness to participants, relevance for pain mitigation and feasibility for execution.
Discussions and Conclusions
Main Findings. The study compiled 33 non-pharmacological interventions as useful, relevant and feasible for pain management in the ICU. Music therapy, distraction, simple massage and family presence facilitation were discussed in a majority of the Focus Groups. Patients/ family members and ICU nurses shared similar perspectives in most of the interventions to enhance comfort or reduce pain in critical care. Nurses also gave importance to preparatory sensory information and teaching procedure/ treatment and disease process.
Implications. The study provides nurses with a range of non-pharmacological interventions that they find helpful n their practice, besides providing them with knowledge about interventions the patents found useful. The nurses also developed a new perspective on the patients they were treating. The study could serve as a step towards developing a nursing intervention protocol for pain management in the ICU. The implications as identified by the study make sense as they flow out of the findings.
Trustworthiness of Data
Credibility. The data was credible, as the participants were with adequate experience as patients and nurses, and were qualified to provide information about non-pharmacological interventions.
Transferability. The data was collated from a particular subset of patients- those who were in the ICU for organ transplant. Therefore, their viewpoint might not be transferable to the entire patient population in the ICUs. Hence, the study is limited in transferability.
Dependability/ Auditability. The study is dependable and auditable as all audiotapes of the focus groups were transcribed and recorded. The interpretation of findings and recording of results is clearly tabulated, further enhancing the dependability of the study.
Confirmability. The study was based on responses of Focus Groups. The data from the respondents was collated to form the results and recommendations. Therefore, there is little chance of inherent researcher bias. Hence, the study could be said to be bias-free and confirmable.
Web Module/ Discussion Board
Concepts/ Constructs.
Music therapy was operationalized as music without lyrics and sustained melody such as classical or instrumental music (Gélinas, Arbour, Mirchaud, Robar & Côté, 2012, p. 308).
Non-pharmacological interventions were defined as therapies that do not involve taking medicines or any other active substances. Some researchers have divided non-pharmacological interventions into five categories: cognitive-behavioral, physical, emotional support, helping with activities of daily living and creating a comfortable environment (Gélinas, Arbour, Mirchaud, Robar & Côté, 2012, p. 308).
Definitions. Existing literature is used as a basis to provide the operational definitions and constructs. Boldt et al are referred to while defining non-pharmacological interventions. Gaston and Knox et al. are referred to while defining music therapy.
Relationships. The concept that non-pharmacological interventions can mitigate pain is supported by literature. The researchers refer to two studies by Chan (2007) and Chan et al. (2006), which show a significant decrease in pain observed in patients who listened to 45 minutes of classical music during an operation. They also refer to a study by Voss et al (2004), which showed pain scores decreasing in post operative cardiac surgery due to music intervention. Similarly, Demir and Khurshid’s study (2010) is referred to while describing the efficacy of ice therapy.
Variables. The variables being studied are non-pharmacological interventions and prevalence of pain amongst patients. The need for non-pharmacological interventions is supported by theory, insofar as Dunwoody et al claim that unrelieved acute pain has the potential to produce long lasting physical, psychological and emotional distress and may negatively affect clinical outcomes (Gélinas, Arbour, Mirchaud, Robar & Côté, 2012, p. 307).
Aim. The aim of the study was to describe the perspectives of patients/ family members and nurses about the usefulness, relevance and feasibility of non-pharmacological interventions for main management in the Intensive Care Unit (ICU).
The aim fits the theoretical framework that prevalence of pain would negatively affect clinical outcomes. Based on the framework, the phenomena of non-pharmacological interventions mitigating pain and being effective for recuperation is explained.
Methodologies. The study is done in the form of Focus Groups. The design fits into the theory of the usefulness of non-pharmacological interventions, as it is the domain knowledge of patients, family members and nurses that could correctly provide information about such interventions.
Findings. The findings of the study yield 33 non-pharmacological interventions for pain mitigation in ICU. The findings are aligned to the framework of such interventions being suitable for mitigating pain. Previous literature on the subject indicates the possibility of interventions by way of music therapy and ice therapy, and thus the findings of the study flow out of previous literature on the subject.
References
Gélinas, C., Arbour, C., Mirchaud, C., Robar, L., & Côté, J. (2012). Nursing in Critical Care [British Association of Critical Care Nurses]: 307-318.
Kothari, C.R. (2004). Research methodology: methods and techniques. New Delhi: New Age Publishers.
South Alabama University. (n.d.a.). Strengths and weaknesses of qualitative research. Retrieved February 7, 2016, from http://www.southalabama.edu/coe/bset/johnson/oh_master/Ch14/Tab14-02.pdf
South Alabama University. (n.d.b.). Strengths and weaknesses of quantitative research. Retrieved February 7, 2016, from http://www.southalabama.edu/coe/bset/johnson/oh_master/Ch14/Tab14-01.pdf
Tse, M., Leung, R., & Ho, S. (2011). Pain and psychological well-being of older persons living in nursing homes: an exploratory study in planning patient-centered intervention. Journal of Advanced Nursing: 312-321.
Xavier University. (n.d.). Qualitative versus quantitative research. Retrieved February 7, 2016, from http://www.xavier.edu/library/students/documents/qualitative_quantitative.pdf
