Magazine article American Nurse Today

Understanding Qualitative Research

Magazine article American Nurse Today

Understanding Qualitative Research

Article excerpt

Research can be conducted using either quantitative or qualitative methods. The distinction is crucial. Perhaps because of today's emphasis on numerical data in health care, most nursing research is quantitative. Although quantitative studies yield valuable information that contributes to practice change, their predominance sometimes can obscure the valuable contribution qualitative research can make in generating new knowledge and ultimately influencing the practice of nursing and other health professions.

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In recent years, many healthcare organizations have shifted their focus 10 a patient-centered model in which patients are involved in decision-making and their preferences are honored. This model has been reinforced by regulators who focus on the patient experience and achieving favorable patient outcomes; in some cases, these outcomes are tied to reimbursement. The only way to obtain information about patients' (and families') perspectives is to ask them, to listen and learn from them, and to incorporate their responses into the delivery of care. Qualitative research does just that.

Observation and interview

Qualitative researchers use the research process to conduct a systematic investigation into patient and family perspectives and make recommendations based on their responses that can advance the patient-centered model. Essentially, the goal of qualitative research is to understand a particular phenomenon from the viewpoint of those who've experienced it. In other words, the researcher is open to learning from people with firsthand experience of an event, a situation, or a set of circumstances.

Observation and interview are the main methods used to obtain such data (although sometimes artwork, journals, photos, and documents are used to further elicit understanding). The researcher analyzes the data, searching for patterns, regularities, and commonalties shared by most or all participants. The result is a number of themes, or dimensions, of the phenomenon that together yield deeper insight into that phenomenon and participants' experience of it.

An aid to treatment planning and approach to care

Findings from qualitative studies can guide healthcare providers in planning treatment and approaches to patient care that meet patients' needs. For example, many patients with end-stage heart failure (HF) or chronic obstructive pulmonary disease (COPD) die in hospitals during an acute event without expressing their choices or preparing for the end of life. Lowey et al. (2013) undertook a qualitative study to understand the experiences and goals of home healthcare patients with end-stage HF or COPD. They conducted 40 interviews with 20 participants who had either advanced HF or COPD and were treated in one of two home healthcare agencies. Interview findings indicated participants identified severe shortness of breath as engulfing "everything in life" and limiting their daily activities---yet they didn't associate these symptoms with being near the end of their lives. The patients didn't want to report these symptoms because they didn't want to be hospitalized. Their goals for care were shaped by previous experiences of recovering from exacerbations. They were sure that if their illness were life-threatening, their healthcare provider would communicate this to them clearly. Furthermore, while they knew their illness wouldn't improve, they hoped it would remain stable--and maintained that hope while living with worsening symptoms.

Based on these results, the researchers made the following recommendations to clinicians:

* Improve communication with patients about their prognosis so they can make appropriate, informed decisions about their care.

* Examine their transition-of-care practices.

* Place such patients with a homecare team that provides palliative care for beller symptom management.

The researchers also urged healthcare professionals to expedite implementation of these recommendations to ease patient suffering. …

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