Positivism and Qualitative Nursing Research

Article excerpt

Despite the hostility to positivism shown by qualitative methodologists in nursing, as in other disciplines, the epistemological and ontological instincts of qualitative researchers seem to coincide with those of the positivists, especially Bayesian positivists. This article suggests that positivists and qualitative researchers alike are pro-observation, proinduction, pro-plausibility and pro-subjectivity. They are also anti-cause, anti-realist, anti-explanation, anti-correspondence, anti-truth. In only one respect is there a significant difference between positivist and qualitative methodologists: most positivists have believed that, methodologically, the natural sciences and the social sciences are the same; most qualitative researchers are adamant that they are not. However, if positivism fails as a philosophy of the natural sciences (which it probably does), it might well succeed as a philosophy of the social sciences, just because there is a methodological watershed between the two. Reflex antagonism to positivism might therefore be a major obstacle to understanding the real reasons why qualitative research and the natural sciences are methodologically divergent; and less hostility on the part of qualitative nurse researchers might bring certain advantages in its wake.

The central claim of this article is that most qualitative research (in nursing, as in many other disciplines) is classically positivist. This statement will no doubt be greeted with scepticism, since qualitative researchers (especially in nursing) are fervently opposed to positivism and would strenuously resist the idea that their work might be described in this way. But positivism is not a sin. Unlike other authors, I do not use the term pejoratively; and, when I see a positivist coming, I experience no urge to hang out the garlic, or mutter a protective incantation. I think, in fact, that social scientists in nursing (and in other disciplines) ought to be positivists, and that they would find life a lot easier if they could rid their work of certain non-positivist (oranti-positivist) methodological tendencies. So, if most qualitative researchers are already positivists, that is a good thing. The only problem is that they are usually unaware of this fact. The main aim of this article, therefore, is to convince them that they really are positivists and persuade them that they should strive to be better positivists. I do not expect this to be easy going, however.

In using the term "qualitative research," I follow current practice. Research methods textbooks are still being published with titles such as Handbook of Qualitative Research (Denzin & Lincoln, 2000), Doing Qualitative Research (Silverman, 2000), and The Quality of Qualitative Research (Scale, 1999); and the most recent general texts on social research still recognize a workable distinction between qualitative and quantitative methods (for example: Blaikie, 2000; Bryman, 2001; de Vaus, 2001). Certainly, many of these authors reject the view that the terms "qualitative research" and "quantitative research" denote two distinct paradigms; but they accept that it is possible, and necessary, to distinguish between quantitative and qualitative techniques (Avis, 1998; Bryman, 2001; Hammersley, 1992; Paley, 2000).

There are, of course, several different "traditions" (as Gubrium & Holstein, 1997, call them) in qualitative research, each of them putting qualitative methods to work in a characteristic way and in the context of a particular philosophy. The similarities between these traditions, however, are still sufficient to warrant lists of common features (Bryman, 2001), common preoccupations (Blaikie, 2000) or common preferences (Hammersley, 1992). So I feel justified in referring to "qualitative research," tout court, without much reference to the disparity. And I would offer, in further defence, the following observation: if there is one thing which tends to unite the qualitative traditions, one thing to which almost all of them are explicitly and forcefully opposed, it is undoubtedly the philosophy of positivism. …